La récupération post-opératoire est plus rapide avec un programme whey + sport débuté l'avant l'opération
Prehabilitation with whey protein supplementation and perioperative functional exercise capacity in patients
undergoing colorectal resection for cancer: a pilot double-blinded randomized controlled trial
Chelsia Gilli Appl. Physiol. Nutr. Metab. 2015 Vol. 40, p511
A prehabilitation program consisting of nutritional counselling
with whey protein supplementation, exercise, and psychological
care initiated four weeks before colorectal surgery, improved func-
tional capacity before surgery and accelerated functional recovery.
Those receiving preoperative standard of care deteriorated. The
specific role of nutrition prehabilitation alone on functional recov-
ery needs to be determined. The objective of this investigation was
to estimate the extent to which nutritional counselling with whey
protein supplementation impacts pre- and postoperative func-
tional capacity in patients undergoing colorectal resection for can-
cer.
A double-blinded randomized controlled trial was conducted at
a single university-affiliated tertiary center located in Montréal,
Canada. Colon cancer patients (n=48) awaiting elective surgery for
non-metastatic disease were randomized to receive individualized
nutritional counselling with whey protein supplementation to
meet protein needs (1.2g/kg/d) or individualized nutritional coun-
selling with a non-nutritive placebo. Counselling and supplemen-
tation began four weeks before surgery and continued for four
weeks after surgery. The primary outcome was change in func-
tional walking capacity as measured using the validated six-minute
walk test (6MWT). Measurements were recorded at baseline, the
day of operation, and four weeks after surgery by a research assis-
tant blinded to group assignment. The reported minimal clinically
important difference for the 6MWT in the context of abdominal
surgery is 14 m. Statistical analyses were performed with STATA 12.
Functional walking capacity improved in the whey group before
surgery, by an average of +20.8 (SD 42.6) m, while the placebo group
improved by +1.2 (SD 65.5) m (p=0.27).
Four weeks after surgery, the whey group recovered baseline function (baseline: 423 + 132 m vs.
4 weeks: 425 + 146 m), while the placebo group had not yet returned
to baseline values (baseline: 440 + 89 m vs. 4 weeks: 424 + 89 m) (p =
0.83). Clinically meaningful improvements in functional walking
capacity were achieved with whey protein supplementation before
and after surgery. These pilot results are encouraging and justify
larger-scale trials to define the specific role of nutrition prehabili-
tation on functional recovery.
