RESEARCH - Exercise treatment to counteract protein wasting of chronic diseases

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Curr Opin Clin Nutr Metab Care. 2003 Jan;6(1):87-93.

Exercise treatment to counteract protein wasting of chronic diseases.

Zinna EM, Yarasheski KE.

Division of Metabolism, Endocrinology and Diabetes, Department of Internal

Medicine, Washington University School of Medicine, 660 South Euclid Avenue,

St. Louis, MO 63110, USA.

PURPOSE OF REVIEW: The objective is to summarize the findings from recent

(June 2001-2002) studies that have examined the potential benefits of

exercise training for the treatment of wasting associated with sarcopenia,

cancer, chronic renal insufficiency, rheumatoid arthritis, osteoarthritis

and HIV. In many clinical conditions, protein wasting and unintentional

weight loss are predictors of morbidity and mortality. The pathogenesis of

protein wasting in these conditions can be different, but the fundamental

mechanism is an imbalance between muscle protein synthetic and proteolytic

processes. The muscle proteins most affected and the precise alterations in

their synthetic and proteolytic rates that occur in each cachectic condition

are still under investigation. RECENT FINDINGS: Regular exercise, or

sometimes just a modest increase in physical activity, can mitigate muscle

protein wasting. Aerobic exercise training primarily alters mitochondrial

and cytosolic proteins (enzyme activities), while progressive resistance

exercise training predominantly increases contractile protein mass. Previous

studies indicate that resistance exercise acutely increases the muscle

protein synthetic rate more than muscle proteolysis such that the muscle

amino acid balance is increased for up to 2 days after exercise. Progressive

resistance exercise training increases muscle protein synthesis and muscle

mass, but attenuates the increment in proteolysis that results from a single

bout of resistance exercise. The cellular mechanisms that produce these

adaptations are not entirely clear.

SUMMARY: In general, patients with wasting conditions who can and will

comply with a proper exercise program gain muscle protein mass, strength and

endurance, and, in some cases, are more capable of performing the activities

of daily living.

PMID: 12496685

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=12496685

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