Nutritional impact of leucine-enriched supplements: Evaluating protein type through artificial intelligence (AI)-augmented muscle ultrasonography in hypercaloric, hyperproteic support.

INTRODUCTION

Malnutrition adversely affects physical function and body composition in patients with chronic diseases. Leucine supplementation has shown benefits in improving body composition and clinical outcomes. This study aimed to evaluate the effects of a leucine-enriched oral nutritional supplement (ONS) on the nutritional status of patients at risk of malnutrition.

METHODS

This prospective observational study followed two cohorts of malnourished patients receiving personalized nutritional interventions over 3 months. One group received a leucine-enriched oral supplement (20 % protein, 100 % whey, 3 g leucine), while other received a standard supplement (hypercaloric and normo-hyperproteic) with mixed protein sources. Nutritional status was assessed at baseline and after 3 months using anthropometry, bioelectrical impedance analysis, AI assisted muscle ultrasound, and handgrip strength.

RESULTS

A total of 142 patients were included (76 Leucine-ONS, 66 Standard-ONS), mostly women (65.5 %), mean age 62.00 (18.66) years. Malnutrition was present in 90.1 % and 34.5 % had sarcopenia. Cancer was the most common condition (30.3 %). The Leucine-ONS group showed greater improvements in phase angle (+2.08 % vs. -1.57 %; p = 0.02) and rectus femoris thickness (+1.72 % vs. -5.89 %; p = 0.03). Multivariate analysis confirmed associations between Leucine-ONS and improved phase angle (OR = 2.41; 95%CI: 1.18-4.92; p = 0.02) and reduced intramuscular fat (OR = 2.24; 95%CI: 1.13-4.46; p = 0.02).

CONCLUSIONS

Leucine-enriched-ONS significantly improved phase angle and muscle thickness compared to standard ONS, supporting its role in enhancing body composition in malnourished patients. These results must be interpreted in the context of the observational design of the study, the heterogeneity of comparison groups and the short duration of intervention. Further randomized controlled trials are needed to confirm these results and assess long-term clinical and functional outcomes.