The relationships among nutrition, body composition, muscle strength and physical performance in patients with acromegaly.

OBJECTIVE: To investigate the impact of dietary intake profile on body composition, physical performance, and muscle strength in patients with acromegaly. SUBJECTS AND METHODS: Observational, cross-sectional study involving patients with acromegaly compared with age and sex-matched controls. Body composition, including total lean mass (TLM) and appendicular lean mass (ALM), was assessed using dual-energy X-ray absorptiometry (DXA). All participants completed a Food Frequency Questionnaire (FFQ) and underwent strength and performance testing. RESULTS: A total of 82 patients were included, 41 in the acromegaly group (AG) and 41 in the control group (CG). The AG comprised 23 women and 18 men, mean age 55.9 ± 11.8 years and mean BMI 31.1 ± 5.2 kg/m2. Muscle mass was increased in the AG, but strength and physical performance were worse compared to CG. AG exhibited a higher intake of carbohydrates, trans fats, and certain micronutrients, as omega-3, vitamin B9, and beta-carotene, compared to the CG. Niacin (R = -0.316, p = 0.004) and vitamin B6 (R = -0.320, p = 0.042) were associated with performance on the sit to stand test. Beta-carotene (R=-0.429, p=0.005), vitamin E (R = -0.321, p=0.041), and flavone (R = -0.313, p = 0.046) were associated with better time to get up and go (TUG) test performance, whereas caffeine intake (R = 0.344, p = 0.028) was associated with worse time. Additionally, niacin (R = 0.341, p = 0.029) and selenium (R = 0.317, p = 0.046) had a positive impact on the short physical performance battery (SPPB) test. Hand grip strength was positively correlated with monounsaturated fats (R = 0.387, p = 0.012) and selenium (R = 0.316, p = 0.044). Selenium, zinc, omega-6 fatty acids, calcium, and iron, were all positively associated with TLM, while caffeine and isoflavones showed a negative association. CONCLUSION: Patients with acromegaly exhibited increased muscle mass, but their functional capacity were compromised, potentially due to alterations in muscle composition. The intake of nutrients such as selenium, β-carotene, flavonoids, vitamin E and niacin, may improve physical performance and muscle strength.