The importance of protein sources to support muscle anabolism in cancer: An expert group opinion

Ford, Katherine L.; Arends, Jann; Atherton, Philip J.; Engelen, Mariëlle P.K.J.; Gonçalves, Thiago J.M.; Laviano, Alessandro; Lobo, Dileep N.; Phillips, Stuart M.; Ravasco, Paula; Deutz, Nicolaas EP.; Prado, Carla M.

Abstract

This opinion paper presents a short review of the potential impact of protein on muscle anabolism in cancer, which is associated with better patient outcomes. Protein source is a topic of interest for patients and clinicians, partly due to recent emphasis on the supposed non-beneficial effect of proteins; therefore, misconceptions involving animal-based (e.g., meat, fish, dairy) and plant-based (e.g., legumes) proteins in cancer are acknowledged and addressed. Although the optimal dietary amino acid composition to support muscle health in cancer is yet to be established, animal-based proteins have a composition that offers superior anabolic potential, compared to plant-derived proteins. Thus, animal-based foods should represent the majority (i.e., ≥65%) of protein intake during active cancer treatment. A diet rich in plant-derived proteins may support muscle anabolism in cancer, albeit requiring a larger quantity of protein to fulfill the optimal amino acid intake. We caution that translating dietary recommendations for cancer prevention to cancer treatment may be inadequate to support the pro-inflammatory and catabolic nature of the disease. We further caution against initiating an exclusively plant-based (i.e., vegan) diet upon a diagnosis of cancer, given the presence of elevated protein requirements and risk of inadequate protein intake to support muscle anabolism. Amino acid combination and the long-term sustainability of a dietary pattern void of animal-based foods requires careful and laborious management of protein intake for patients with cancer. Ultimately, a dietary amino acid composition that promotes muscle anabolism is optimally obtained through combination of animal- and plant-based protein sources.

Citation

Ford, K. L., Arends, J., Atherton, P. J., Engelen, M. P., Gonçalves, T. J., Laviano, A., …Prado, C. M. (2022). The importance of protein sources to support muscle anabolism in cancer: An expert group opinion. Clinical Nutrition, 41(1), 192-201. https://doi.org/10.1016/j.clnu.2021.11.032

• Journal Article Type: Article
• Acceptance Date: Nov 24, 2021
• Online Publication Date: Nov 29, 2021
• Publication Date: Jan 1, 2022
• Deposit Date: Dec 2, 2021
• Publicly Available Date: Dec 2, 2021
• Journal: Clinical Nutrition
• Print ISSN: 0261-5614
• Electronic ISSN: 1532-1983
• Publisher: Elsevier BV
• Peer Reviewed: Peer Reviewed
• Volume: 41
• Issue: 1
• Pages: 192-201
• DOI: https://doi.org/10.1016/j.clnu.2021.11.032
• Keywords: Critical Care and Intensive Care Medicine; Nutrition and Dietetics
• Public URL: https://nottingham-repository.worktribe.com/output/6846036
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S0261561421005422