Sickle Cell Anemia
Conditions
Brief summary
Wasting is a common and significant problem in sickle cell anaemia (SCA) that correlates with poorer clinical outcome such as frequent painful crises, acute chest syndrome and sub normal resistance to infection. Thus, improvement of nutritional status in SCA holds the potential of ameliorating the course of the disease. Elevated haemolysis and its effects are associated with hypermetabolism and have resulted in higher rates of protein breakdown and synthesis, and energy expenditure. Offering more food has not optimized nutritional status and metabolic performance in free-living patients with SCA. Moreover, appetite might be suppressed. Supplementation with β-hydroxy-β-methylbutyrate (HMB), which is produced in the body from leucine, has been shown to have inhibitory effect on protein breakdown and to promote lean tissue synthesis in humans with sarcopenia. Also, HMB has been implicated as an ergogenic tool to promote exercise performance and skeletal muscle hypertrophy. Therefore, the investigators hypothesize that in individuals with SCA, an intervention of resistance exercise with HMB supplement will have a greater enhancing effect on muscle mass and strength compared to receiving resistance exercise without HMB.
Detailed description
The investigators aim to measure muscle strength, body composition and whole body protein oxidation in two groups of adults with SCA within one week before and after 9 weeks of intervention in a randomized, double blinded study. One group (n =12 ) will receive an intervention of resistance exercise and HMB supplement, and the other group (n=12) will receive resistance exercise and a placebo (maltodextrin). Participants will be assigned a study code and all information and samples will be stored under the assigned code.
Interventions
BEHAVIORALResistance exercise
effect of exercise and an anabolic agent on body composition, muscle strength, phenylalanine and protein oxidation.
DIETARY_SUPPLEMENTβ-hydroxy-β-methylbutyrate
DIETARY_SUPPLEMENTplacebo
Sponsors
The University of The West Indies
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
19 Years to 35 Years
Healthy volunteers
No
Inclusion criteria
* BMI \< 18.5 kg/m2
Exclusion criteria
* BMI \> 19 kg/m2
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Body composition assessment using Dual-energy X-ray absorptiometry | 3 months | Change between baseline and after 3 months of intervention |
| Body composition assessment using deuterium dilution method | 3 months | Change between baseline and after 3 months of intervention |
| muscle strength assessment using the 1-repetition maximum method for the lower body (leg extension and or seated leg press) and upper body (bench press, bicep preacher curl) | 3 months | Change between baseline and after 3 months of intervention |
| Body composition assessment using bioelectrical impedance | 3 months | Change between baseline and after 3 months of intervention |
| Protein oxidation using established stable isotope tracer method with oral doses of isotopically labelled sodium bicarbonate and phenylalanine | 3 months | Change between baseline and after 3 months of intervention |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Resting metabolic rate using indirect calorimetry before and after intervention | 30 min | Change between baseline and after 3 months of intervention |
| Dietary intake using three 24 h dietary recall before and after intervention | 30 min | Change between baseline and after 3 months of intervention |
Other
| Measure | Time frame | Description |
|---|---|---|
| Number of participants with intervention-related abnormal laboratory values as assessed by blood haematology (anaemia profile,white blood cells count, platelet count) | 3 months | Three measurements at baseline, mid point of intervention and at end of intervention |
| Number of participants with intervention-related adverse health effect as assessed by completing a health-related questionnaire | weekly for 3 months | Assessment at baseline and at the end of each week during the intervention |
| Number of participants with intervention-related adverse effect on emotional profile according to the Circumplex Test of emotion questionnaire | weekly for 3 months | Assessment at baseline and at the end of each week during the intervention |
| Number of participants with intervention-related abnormal laboratory values as assessed by blood chemistry (liver function and lipid profile) | 3 months | Three measurements at baseline, mid point of intervention and at end of intervention |
Outcome results
None listed