Ernährungstherapie bei Kachexie und Sarkopenie

Zusammenfassung

Im Gegensatz zur Erforschung der Behandlungsmöglichkeiten bei einer Kachexie ist das wissenschaftliche Interesse an der Entstehung und Behandlung einer Sarkopenie relativ jung. Neben Sport und einer medikamentösen Behandlung sind verschiedene ernährungstherapeutische Interventionen Schwerpunkt der Forschung auf dem Gebiet der Prävention und Therapie von Kachexie und Sarkopenie. Ziel dieser Übersichtsarbeit ist es, einen Einblick in die aktuelle Forschung in der Ernährungstherapie von Kachexie und Sarkopenie zu geben. In der ernährungstherapeutischen Prävention und Therapie der Kachexie stehen die Faktoren Energie- und Proteinbedarf bzw. Maßnahmen, diese zu decken, sowie die Supplementierung von n-3-Fettsäuren und L-Carnitin zur Diskussion. Im Bereich der Sarkopenie liegt der Schwerpunkt der Forschung auf einer Supplementierung von Proteinen und Aminosäuren, Antioxidanzien und n-3-Fettsäuren, Vitamin D und dem Effekt einer Kalorienrestriktion. Die aktuelle Studienlage zum Effekt verschiedener Nährstoffe, besonders in Bezug auf die Supplementierung von n-3-Fettsäuren, ist vielversprechend. Um eine allgemeingültige Empfehlung zur Supplementierung geben zu können, werden jedoch mehr hochwertige Langzeitstudien benötigt. Bis dahin sollte der Betreuungsschwerpunkt auf der Prävention bzw. einer frühzeitigen Diagnosestellung einer Kachexie/Sarkopenie liegen. Hierfür stellt die Verlaufskontrolle des Ernährungszustands eine wichtige Basis dar und ermöglicht eine frühzeitige Intervention. Behebbare Hemmnisse in der Nahrungsaufnahme sollten festgestellt und behandelt werden, sodass eine ausreichende Zufuhr an Makro- und Mikronährstoffen, mit einer besonderen Aufmerksamkeit auf die bedarfsdeckende Proteinzufuhr, sichergestellt werden kann.

Abstract

Compared to research in treatments for cachexia, the interest in the development and treatment of sarcopenia is relatively new. Besides exercise and medical treatment, research in the field of prevention and therapy of cachexia and sarcopenia focuses on different nutritional interventions. The aim of this review is to give insight into recent research in the field of nutritional therapy for cachexia and sarcopenia. Energy and protein requirements and interventions to meet these requirements, as well as the supplementation of omega-3 fatty acids and L-carnitine are currently being discussed for prevention and therapy of cachexia. For sarcopenia, the supplementation of proteins and amino acids, antioxidants and omega-3 fatty acids, vitamin D, and the positive effect of a caloric restriction are under investigation. Recent results on the effect of different nutrients, especially about the supplementation with omega-3-fatty acids, are promising. To be able to make general recommendations for supplementation further high-quality long-term studies are necessary. In the meantime, emphasis should be placed on prevention and early diagnosis of cachexia and sarcopenia. Monitoring the nutritional status is an important factor to enable an early intervention in the care of persons at risk of or with cachexia/sarcopenia. Barriers in nutritional intake should be diagnosed and treated to enable a sufficient intake of macro- and micronutrients, with particular attention to a sufficient protein intake.

Schlüsselwörter

Sarkopenie - Kachexie - Proteine - Antioxidanzien - n-3-Fettsäuren

Keywords

Sarcopenia - cachexia - proteins - antioxidants - omega-3-fatty acids

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