The prolonged immobilisation associated with COVID-19 infection and the restrictions imposed by the pandemic have determined major changes in physical activity and eating habits, with a negative impact on physical performance.
Resistance exercise is typically thought to be the strongest protection against sarcopenia (age related progressive loss of muscle mass). Plus protein intake of 1.0–1.3 g/kg/day helps maintain muscle mass and function. Also, supplementation with probiotics is recommended to facilitate the absorption of essential amino acids.
The current study was therefore conducted to monitor non-pharmacological interventions - diet therapy and probiotics - alongside exercise, in managing sarcopenia for patients with recent SARS-CoV-2 history (14 days).
The probiotic supplement contained 6 bacterial strains (Enterococcus faecium, Lactobacillus acidophilus, Lactobacillus brevis, Lactococcus lactis, Bifidobacterium bifidum, and Bifidobacterium lactis), at least 10 bn organisms per portion = 4 g (from AllergoSan Institute, Austria).
After two months of hyper protein diet with probiotics, a significant improvement of skeletal muscle index (SMI) was observed. Moreover, after the therapeutic intervention, the average value of two metabolic parameters Alb (low levels of which indicate kidney disease, liver disease, inflammation or infections) and Hb (a well-known biomarker for anemia and nutritional status) in the group with diet therapy and probiotics increased significantly, indicating an improvement in the general condition of the patients.
The authors conclude: "Diet therapy, consisting of increased protein intake and specific probiotics in muscle anabolism, along with adequate physical training, has demonstrated its role in improving SMI... Significant differences were reported in the improvement of the sarcopenic index values in patients who were recommended an additional intake of proteins and probiotics.
"More studies to confirm these results and elucidate the mechanism through which some probiotics can influence sarcopenia are necessary. Understanding how specific dietary interventions associated with probiotics can prevent muscle loss can help improve the clinical and therapeutic management of infected patients in order to reduce the health consequences of COVID-19."
The study
A prospective study was performed on 200 patients (aged 67.43 ± 7.94 years), with A SPPB score of less than 9 (the Short Physical Performance Battery Protocol and Score Sheet Questionnaire considers ability to rise from a chair, balance, and walking speed).
The recruited patients had a positive COVID-19 test in the 14 days prior.
Participants were randomly divided into: Group K—DP with dietary therapy (protein 1.2–1.5 g/kg) and probiotics for two months; and Group K—non-DP (107 patients) without diet therapy and probiotics.
All patients were included in a specific physical training program (40 min), three sessions per week. Skeletal muscle index (SMI), serum albumin, and hemoglobin were determined.
Those receiving probiotics were given a 4g sachet dissolved in 125 mL of water to consumer in the morning on an empty stomach or in the evening before going to bed.
After two months, a significant difference between initial and final SMI values was determined for the treatment group.
In Group K—DP, at end of study, there were more patients with normal SMI (n = 32 → N = 70) values and fewer sarcopenia patients.
The initial serum albumin showed values in the two groups were not statistically significantly different but the hemoglobin level improved significantly in the treatment group.
The authors note limitations of this study include that protein intake could not be tracked with great accuracy because the recommendation of protein supplementation was not strictly supervised and the adherence to the physical training program was not monitored. Furthermore, the incidence of diabetes was not evaluated.
Source: Nutrients
https://doi.org/10.3390/nu14214701 (registering DOI)
"The Contribution of Diet Therapy and Probiotics in the Treatment of Sarcopenia Induced by Prolonged Immobilization Caused by the COVID-19 Pandemic"
Nistor-Cseppento, C.D.; Moga, T.D.; Bungau, A.F.; Tit, D.M.; Negrut, N.; Pasca, B.; Bochis, C.F.; Ghitea, T.C.; Jurcau, A.; Purza, A.L.; Uivarosan, D.