|
mune titers for Cryptosporidium antibody
are most effective.51 Promune has 1:64,000 to 1:128,000 cryptosporidium-specific
antibody titers if reconstituted at a dilution of 0.45 g of whey
powder/mL.
Clinical trials using hyperimmune colostrum
with cryptosporidium antibodies have been made with small numbers
of patients, were uncontrolled, and had different dosages and
routes of administration (Moffat C. Personal Communication, on
file, Optim Nutrition, 1995). Most studies reported improvement
in symptoms; the most favorable results were achieved when the
colostrum was administered continuously via nasogastric tube,
in large volumes, and with a high titer count (greater than 1:120,000).50,51
Specially processed whey (Promune) was
also administered nasogastrically for 10 days to 6 patients with
AIDS and chronic cryptosporidiosis (Kotler DP, Personal Communication,
on file, Optim Nutrition, 1996). The patients received 2.4 g
protein/kg body weight from the whey containing an anticrpytosporidial
titer count of 1:120,000 or more. No evidence of anticryptosporidial
activity was detected, but despite severe malabsorption, nitrogen
retention improved. More work is needed to determine the efficacy
of this product for its anticryptosporidial activity, but at
present it appears to be well tolerated and allows for improvement
in nitrogen retention, which could lead to increases in lean
body mass.
STUDIES OF WHEY PROTEIN IN PATIENTS
WITH CANCER
Several promising animal studies support
the notion that whey protein may inhibit growth of cancer cells.
Investigators at Vanderbilt evaluated the effect of whey protein
on tumorigenicity of prostate cancer (Steiner MS. Personal Communication,
on file, Optim Nutrition, 1995). The results suggested that
as doses of whey increased, tumor volume decreased, although
not significantly (11%). Whey protein has slight antineoplastic
effects on established tumors, but a significant influence on
clonogenicity of prostate cancer cells (tumor formation). Additionally,
in renal cell lines injected in mice, tumor growth was inhibited
in whey-treated animals but not in those in the control group
(Smith JA. Personal Communication, on file, Optim Nutrition,
1995).
In vitro assays showed that whey protein
caused GSH depletion and inhibition of proliferation in cancer
cells but not in normal cells. Thirty grams of whey protein
(Immunocal, Immunotech Research Corporation, Montreal) was consumed
by patients with metastatic cancer of the breast (5), the pancreas
(1), and the liver (1) for 6 months.52 Six of the seven patients
had lymphocyte GSH levels substantially
|
above normal at the beginning of the study,
indicating high tumor GSH levels. Two of them exhibited signs
of tumor regression and declines in GSH levels toward normal.
Two showed tumor stabilization but no change in GSH. Three
had higher GSH concentrations in the lymphocytes and evidence
of disease progression. These preliminary results indicate that
whey protein might deplete tumor cell GSH, slow disease progression,
and render the tumors more vulnerable to chemotherapy. The high
concentration of tumor GSH protects the cells from the chemotherapy.
HOW TO USE THE WHEY PROTEIN SUPPLEMENT
Protein supplementation is usually required
by hospitalized patients who are undergoing major surgery, have
sustained a major burn or trauma, or have chronic conditions
such as diabetes, cancer, or AIDS.53 When these patients go
home they still need extra protein until they have fully convalesced.
For patients with chronic conditions, a high-protein diet may
always be needed.
These patients require 1.5 g protein per
kg ideal body weight per day, in contrast to normal adults who
require 0.8 g/kg actual body weight.33,39 Typical hospital meals
and meals people eat at home offer about one half of the protein
and all of the energy needed. Thus, oral supplements rich in
protein are required. This is particularly true for patients
with HIV infection and cancer.39,54 Unfortunately, most formulas
have too high a kcal/N ratio to satisfy the protein needs without
overfeeding energy to the patients. Usually it is necessary to
add a protein supplement directly to these formulas.55 Table
3 presents an example of adding 13 grams of whey protein (10
grams protein) to a typical 1,800 kcal meal plan including supplements.
This would be a suitable diet for a male patient with AIDS who
normally weighs 65 kg but now weighs 60 kg.
If patients requiring a high protein diet
receive enteral nutrition by tube, the same circumstances usually
arise: the formulas satisfy the energy needs and are lacking
in protein. It is customary to add protein directly into the
formulas before they are administered.53,55 For example, a patient
requiring 1,800 kcal of a standard tube-feeding formula would
usually get only 70 to 80 g of protein and would need 20 to 30
g more. The protein deficit could be supplied by adding the
correct amount of whey protein to the tube-feeding formula and
shaking it well.
Thus, whey protein can serve as a protein
supplement for a patient consuming an oral diet or receiving
a tube-feeding formula. Promune, unlike many other protein sources,
can be consumed orally on its own without the need to add non-protein
kcal to improve
Next
|
Back