The relationships among nutrition, body composition, muscle strength and physical performance in patients with acromegaly.

OBJECTIVE

To investigate the impact of dietary intake profile on body composition, physical performance, and muscle strength in patients with acromegaly.

SUBJECTS AND

METHODS

Observational, cross-sectional study involving patients with acromegaly compared with age and sex-matched controls. Body composition, including total lean mass (TLM) and appendicular lean mass (ALM), was assessed using dual-energy X-ray absorptiometry (DXA). All participants completed a Food Frequency Questionnaire (FFQ) and underwent strength and performance testing.

RESULTS

A total of 82 patients were included, 41 in the acromegaly group (AG) and 41 in the control group (CG). The AG comprised 23 women and 18 men, mean age 55.9 ± 11.8 years and mean BMI 31.1 ± 5.2 kg/m2. Muscle mass was increased in the AG, but strength and physical performance were worse compared to CG. AG exhibited a higher intake of carbohydrates, trans fats, and certain micronutrients, as omega-3, vitamin B9, and beta-carotene, compared to the CG. Niacin (R = -0.316, p = 0.004) and vitamin B6 (R = -0.320, p = 0.042) were associated with performance on the sit to stand test. Beta-carotene (R=-0.429, p=0.005), vitamin E (R = -0.321, p=0.041), and flavone (R = -0.313, p = 0.046) were associated with better time to get up and go (TUG) test performance, whereas caffeine intake (R = 0.344, p = 0.028) was associated with worse time. Additionally, niacin (R = 0.341, p = 0.029) and selenium (R = 0.317, p = 0.046) had a positive impact on the short physical performance battery (SPPB) test. Hand grip strength was positively correlated with monounsaturated fats (R = 0.387, p = 0.012) and selenium (R = 0.316, p = 0.044). Selenium, zinc, omega-6 fatty acids, calcium, and iron, were all positively associated with TLM, while caffeine and isoflavones showed a negative association.

CONCLUSION

Patients with acromegaly exhibited increased muscle mass, but their functional capacity were compromised, potentially due to alterations in muscle composition. The intake of nutrients such as selenium, β-carotene, flavonoids, vitamin E and niacin, may improve physical performance and muscle strength.