Abstract
Background
A previous comprehensive prehabilitation program, providing nutrition counseling with
whey protein supplementation, exercise, and psychological care, initiated 4 weeks
before colorectal surgery for cancer, improved functional capacity before surgery
and accelerated functional recovery. Those receiving standard of care deteriorated.
The specific role of nutritional prehabilitation alone on functional recovery is unknown.
Objective
This study was undertaken to estimate the impact of nutrition counseling with whey
protein on preoperative functional walking capacity and recovery in patients undergoing
colorectal resection for cancer.
Design
We conducted a double-blinded randomized controlled trial at a single university-affiliated
tertiary center located in Montreal, Quebec, Canada. Colon cancer patients (n=48)
awaiting elective surgery for nonmetastatic disease were randomized to receive either
individualized nutrition counseling with whey protein supplementation to meet protein
needs or individualized nutrition counseling with a nonnutritive placebo. Counseling
and supplementation began 4 weeks before surgery and continued for 4 weeks after surgery.
Main Outcome Measure
The primary outcome was change in functional walking capacity as measured with the
6-minute walk test. The distance was recorded at baseline, the day of surgery, and
4 weeks after surgery. A change of 20 m was considered clinically meaningful.
Results
The whey group experienced a mean improvement in functional walking capacity before
surgery of +20.8 m, with a standard deviation of 42.6 m, and the placebo group improved
by +1.2 (65.5) m (P=0.27). Four weeks after surgery, recovery rates were similar between groups (P=0.81).
Conclusion
Clinically meaningful improvements in functional walking capacity were achieved before
surgery with whey protein supplementation. These pilot results are encouraging and
justify larger-scale trials to define the specific role of nutrition prehabilitation
on functional recovery after surgery.
Keywords
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Biography
C. Gillis is a registered dietitian, Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada.
Biography
R. Awasthi is a kinesiologist, Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada.
Biography
F. Carli is an anesthesiologist, Department of Anesthesia, McGill University Health Centre, Montreal, Quebec, Canada.
Biography
S.-E. Loiselle is a professional dietitian, School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada.
Biography
L. Wykes is director and professor, School of Dietetics and Human Nutrition, McGill University, Montreal, Quebec, Canada.
Biography
J. F. Fiore, Jr, is a physiotherapist, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Biography
A. S. Liberman is a surgeon, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Biography
B. Stein is a surgeon, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Biography
P. Charlebois is a surgeon, Department of Surgery, McGill University Health Centre, Montreal, Quebec, Canada.
Article info
Publication history
Published online: July 21, 2015
Accepted:
June 3,
2015
Received:
August 28,
2014
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This research was funded by Canadian Foundation for Dietetic Research (CFDR).
ClinicalTrials.gov registration: NCT 01727570.
Identification
Copyright
© 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
