LB102 - INFLAMMATION PREDICTS CHANGE IN ENERGY EXPENDITURE IN PATIENTS WITH CANCER ON A HIGH-PROTEIN DIET: INSIGHTS FROM THE PRIME TRIAL

LB102

INFLAMMATION PREDICTS CHANGE IN ENERGY EXPENDITURE IN PATIENTS WITH CANCER ON A HIGH-PROTEIN DIET: INSIGHTS FROM THE PRIME TRIAL

B. R. Da Silva^1,*, K. L. Ford¹, B. C. Santos¹, N. E. Deutz², M. P. Engelen², M. Siervo³, M. B. Sawyer⁴, C. M. Prado¹

¹Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada, ²Center for Translational Research in Aging and Longevity, Texas A&M University, College Station, United States, ³School of Population Health , Curtin University, Perth, Australia, ⁴Department of Oncology, University of Alberta, Edmonton, Canada

Rationale: High-protein diets are recommended to counter muscle loss in cancer. However, not all patients respond equally and this may be mediated by inflammation. Inflammatory processes may impair anabolic responses, yet their role in energy metabolism remains underexplored. We investigated whether interleukin-6 (IL-6), predicts changes in total energy expenditure (TEE) and muscle mass during a high-protein dietary intervention in patients with stage II–IV colorectal cancer (CRC).

Methods: This secondary analysis included 15 patients from the Protein Recommendations to Increase Muscle (PRIMe) trial implementing a high-protein diet (target: 2.0 vs 1.0 g/kg/day) for 12 weeks. TEE was measured using whole-room indirect calorimetry, and appendicular lean soft tissue (ALST) as a surrogate for muscle using DXA. Multiple linear regression models assessed associations between IL-6 at follow-up, TEE and ALST changes, and were adjusted for age, sex, baseline ALST, and protein intake.

Results: In these patients (55±9 y; BMI: 28.2±6.1 kg/m²; 81.3% males; 31.3% stage IV), IL-6  predicted TEE change (R² = 0.64, p = 0.004, standardized β = -0.52), independent of ALST and protein intake. IL-6 and ALST change were associated (R² = 0.30, p = 0.033). When IL-6 and ALST were included in the model, IL-6 remained the dominant predictor of TEE change, suggesting the dual role of inflammation in regulating TEE and muscle mass.

Conclusion: Inflammation significantly influenced responses to a high-protein diet, attenuating changes in TEE and ALST. These findings support the hypothesis that elevated IL-6 may interfere with anabolic and metabolic effects of protein intake. Interventions targeting inflammation may enhance the efficacy of nutritional strategies in cancer care.

Disclosure of Interest: B. Da Silva: None declared, K. Ford Other: honoraria from Abbott Nutrition, B. Santos: None declared, N. Deutz Other: honoraria from Abbott Nutrition, M. Engelen: None declared, M. Siervo: None declared, M. Sawyer Speakers Bureau of: Viatris, Other: Viatris - Advisory board , C. Prado Consultant for: Abbott Nutrition, Nutricia, Novo Nordisk, Other: Speaker engagement: Abbott Nutrition, Nutricia, Nestle Health Science, Novo Nordisk