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. 2024 May 11;16(10):1448.
doi: 10.3390/nu16101448.

Adding Branched-Chain Amino Acids and Vitamin D to Whey Protein Is More Effective than Protein Alone in Preserving Fat Free Mass and Muscle Strength in the First Month after Sleeve Gastrectomy

Luigi Schiavo  1   2 , Biagio Santella  1   2 , Barbara Paolini  3 , Farnaz Rahimi  4 , Emmanuele Giglio  5 , Barbara Martinelli  3 , Stefano Boschetti  4 , Lilia Bertolani  5 , Katia Gennai  3 , Simone Arolfo  6 , Maria Paola Bertani  5 , Vincenzo Pilone  7
Affiliations

Adding Branched-Chain Amino Acids and Vitamin D to Whey Protein Is More Effective than Protein Alone in Preserving Fat Free Mass and Muscle Strength in the First Month after Sleeve Gastrectomy

Luigi Schiavo et al. Nutrients. .

Abstract

Objectives: Sleeve gastrectomy (SG) is one of the most commonly performed weight loss (WL) bariatric procedures. The main goal of WL is reducing total body weight (TBW) and fat mass (FM). However, TBW loss is systematically accompanied by a decline in fat-free mass (FFM), predominantly in the first post-surgical month, despite protein supplementation. Branched-chain amino acids (BCAAs) and vitamin D seem to attenuate loss of FFM and, thus, reduce the decline in muscle strength (MS). However, data on the role of an integrated supplementation with whey protein plus BCAAs plus vitamin D (P+BCAAs+Vit.D) vs. protein alone on total weight loss (TWL), fat mass (FM), fat-free mass (FFM), and (MS) in the first month after SG are lacking. Therefore, the present study aims to evaluate the impact of P+BCAAs+Vit.D vs. protein alone supplementation on TWL, FM, FFM, and MS in the first month after SG.

Materials and methods: Before SG and at 1 month afterward, we prospectively measured and compared TBW, FM, FFM, and MS in 57 patients who received either a supplementation with P+BCAAs+Vit.D (n = 31) or protein alone (n = 26). The impact of P+BCAAs+Vit.D and protein alone supplementation on clinical status was also evaluated.

Results: Despite non-significant variation in TBW, FM decreased more significantly (18.5% vs. 13.2%, p = 0.023) with the P+BCAA+Vit.D supplementation compared to protein alone. Furthermore, the P+BCAA+Vit.D group showed a significantly lower decrease in FFM (4.1% vs. 11.4%, p < 0.001) and MS (3.8% vs. 18.5%, p < 0.001) compared to the protein alone group. No significant alterations in clinical status were seen in either group.

Conclusion: P+BCAA+Vit.D supplementation is more effective than protein alone in determining FM loss and is associated with a lower decrease in FFM and MS, without interfering with clinical status in patients 1 month after SG.

Keywords: body composition; branched-chain amino acids; muscle strengh; protein supplementation; sleeve gastrectomy; vitamin D.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1
Flow chart comparing a 4-weeks post-operative supplementation with whey protein, 40 g; vitamin D, 2000 UI; L-leucine, 40 mg; L-isoleucine, 20 mg; L-valine, 20 mg [P+BCAA+Vit.D group] vs. protein alone group. TBW = total body weight; FM = fat mass; FFM = fat-free mass; MS = muscle strength.
See this image and copyright information in PMC

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