ABSTRACT
BACKGROUND: Spastic cerebral palsy (CP) is characterized by muscle weakness owing, in part, to a blunted muscle protein synthetic response. This might be normalized by long-term leucine supplementation. OBJECTIVES: The study assessed the effects of 10 wk leucine supplementation in adolescents and adults with CP. METHODS: The study was a single-center randomized controlled trial. Twenty-four participants were randomly assigned to a control group (n = 12) or a leucine group (n = 12). l-Leucine (192 mg/kg body mass) was dissolved in water and administered daily for 10 wk. The primary outcome measures of elbow flexor muscle strength and muscle volume (measured by 3D ultrasound technique) and inflammation [C-reactive protein (CRP) concentration] were assessed before and after the 10 wk, alongside the secondary outcomes of body composition (measured by CP-specific skinfold assessment), metabolic rate (measured by indirect calorimetry), and wellbeing (measured by a self-reported daily questionnaire). Data were compared via a series of 2-factor mixed ANOVAs. RESULTS: Twenty-one participants completed the intervention (control group: n = 11, mean ± SD age: 18.3 ± 2.8 y, body mass: 48.8 ± 11.9 kg, 45% male; leucine group: n = 10, age: 18.6 ± 1.7 y, body mass: 58.3 ± 20.2 kg, 70% male). After 10 wk, there was a 25.4% increase in strength (P = 0.019) and a 3.6% increase in muscle volume (P = 0.001) in the leucine group, with no changes in the control group. This was accompanied by a 59.1% reduction in CRP (P = 0.045) and improved perceptions of wellbeing (P = 0.006) in the leucine group. No changes in metabolism or body composition were observed in either group (P > 0.05). CONCLUSIONS: Improvements in muscle strength and volume with leucine supplementation might provide important functional changes for adults and adolescents with CP and could be partly explained by reduced inflammation. The improved wellbeing highlights its capacity to improve the quality of daily living. This trial was registered at clinicaltrials.gov as NCT03668548.
Subject(s)
Cerebral Palsy/diet therapy , Inflammation/drug therapy , Leucine/administration & dosage , Muscle Strength/drug effects , Muscle, Skeletal/drug effects , Adolescent , Body Composition/drug effects , Dietary Supplements , Energy Metabolism/drug effects , Female , Humans , Male , Young AdultSubject(s)
Hospice Care , Adolescent , Adolescent Health Services , Child , Child Health Services , Child, Preschool , England , Female , Humans , Infant , Infant, Newborn , Male , Young AdultABSTRACT
BACKGROUND: Body Mass Index (BMI) does not distinguish between fat-free mass and fat mass, yet this distinction is important as a clinical tool, especially in the military and occupations for which physical fitness is important. AIM: This study assessed the level of agreement between BMI, sum of skin-folds and waist circumference in UK Army personnel. SUBJECTS AND METHODS: Three hundred and eighty-six males were selected to study the level of agreement between BMI, waist circumference, waist circumference/height and sum of skin-folds at four sites. As the units of measurement differ, this study generated standardized distributions with skewness of zero. RESULTS: The limits of agreement between BMI and waist circumference were fairly wide (between boundaries 1.75 z-score) and wide between BMI and sum of skin-folds (2.57 z-score) and waist circumference and skin-folds (2.37 z-score). The standard deviations of the differences of BMI and waist circumference decreased with increasing means of these two measures. The kappa statistic for BMI and waist circumference was 0.7 and â¼0.5 if compared against sum of skin-folds. CONCLUSION: The level of agreement between BMI and waist circumference is acceptable regardless of method to assess obesity, but would be poor for assessing thinness. The level of agreement with sum of skin-folds was mediocre.
