The goal of this clinical trial is to learn if the AMBROSIA Bar helps prevent undernutrition and muscle loss in older adults with heart failure or atrial fibrillation. The main questions it aims to answer are: Does the AMBROSIA Bar help improve muscle mass and physical performance in older adults with heart conditions? What effects does the AMBROSIA Bar have on body composition, quality of life, inflammation, nutrition status, and gut microbiota? Researchers will compare people who assume the AMBROSIA Bar in addition to nutritional counseling to those who only receive nutritional counseling. Participants will: * Receive nutritional counseling and consume one AMBROSIA Bar per day for 6 months (intervention group) or receive nutritional counseling only (control group). * Receive clinical assessment at the moment of enrolment, after 3 months, and after 6 months * Give samples (blood, saliva, urine, and stool) and complete questionnaires to check their nutrition, cognitive, and physical health
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
60
The experimental intervention involves the "AMBROSIA" bar alongside healthy dietary counseling. The "AMBROSIA" bar is a novel chocolate bar designed for older Heart Failure (HF) and Atrial Fibrillation (AF) patients to prevent undernutrition. Its distinguishing features are: * Unique Composition: It contains a unique and specific blend of probiotic strains and a cocktail of micro/macronutrients. * Patented Probiotic Efficacy: The SYNBIO® blend is patented (RM2004A000166, EP1743042) for its exceptional intestinal mucosal adhesion, ensuring effective colonization and persistence. * Optimal Delivery Matrix: The chocolate bar serves as a palatable and effective vehicle for probiotic delivery, confirmed to maintain probiotic viability. * Targeted Nutritional Strategy: The bar aims to modulate gut microbiota and address undernutrition, inflammation, and cachexia in the target.
Azienda Ospedaliera Universitaria Careggi
Florence, Italy
RECRUITINGChange from Baseline in the Skeletal Muscle Mass at 6 months
A change in skeletal muscle mass from baseline versus the control group as assessed by Bioelectrical Impedence Analysis, change in physical performance as evaluated with SHORT PHYSICAL PERFORMANCE BATTERY test, a measure of frailty).
Time frame: From enrollment to the end of treatment at 6 months.
Changes to anthropometry
Weight (kg) and height (m) will be measured and used to calculate Body Mass Index (BMI, kg/m²). Each parameter will be analyzed separately.
Time frame: From enrollment to the end of treatment at 6 months.
Changes to body composition
Change in body composition assessed by Bioelectrical Impedance Analysis (BIA): Fat Mass (FM, kg), Fat Free Mass (FFM, kg), and Body Cell Mass (BCM, kg). In addition, FFM will be combined with height (m) to calculate Fat-Free Mass Index (FFMI, kg/m²). Each parameter will be reported and analyzed separately.
Time frame: From enrollment to the end of treatment at 6 months.
Impacts on Quality of Life associated with Bowel Function:
Changes in quality of life assessed by Gastrointestinal Quality of Life Index (GIQLI). The GIQLI is a validated 36-item questionnaire measuring gastrointestinal-specific quality of life. Scores range from 0 to 144. Higher scores indicate better quality of life..
Time frame: From enrollment to the end of treatment at 6 months.
Change in Geriatric Depression Scale (GDS-15) score
The GDS-15 is a self-report screening tool for depression in older adults. Scores range from 0 to 15; higher scores indicate more severe depressive symptoms.
Time frame: From enrollment to the end of treatment at 6 months.
Change in Mini-Mental State Examination (MMSE) score
The MMSE is a cognitive screening tool scored from 0 to 30. Higher scores indicate better cognitive function.
Time frame: From enrollment to the end of treatment at 6 months.
Change in handgrip strength
Measured using a hand dynamometer. Results expressed in kilograms (kg). Higher values indicate better muscle strength.
Time frame: From enrollment to the end of treatment at 6 months.
Change in Clinical Frailty Scale (CFS)
Assessed using the Clinical Frailty Scale, a 9-point scale (1 = very fit; 9 = terminally ill). Higher scores indicate worse frailty.
Time frame: From enrollment to the end of treatment at 6 months.
Impacts on the composition of the fecal microbiota
Evaluation of changes in the gut microbiota profile through 16s RNA targeted sequencing.
Time frame: From enrollment to the end of treatment at 6 months.
Changes to nutritional and inflammatory biomarkers in blood samples
Changes in circulating inflammatory markers, mainly plasma cytokine profiles, and blood markers of undernutrition, using the immunoassays based on Luminex xMAP (multi-analyte profiling) technology which enable simultaneous detection and quantification of multiple secreted proteins.
Time frame: From enrollment to the end of treatment at 6 months.
Changes to blood lipid profile
Modifications in the blood lipid profile, using gas chromatography techniques.
Time frame: From enrollment to the end of treatment at 6 months.
Modifications in metabolomic profiles in plasma, saliva, and stool samples.
Metabolite profiles of plasma, urine and faecal water in all samples will be generated through reverse phase (plasma) and hydrophilic interaction (urine, faecal water) chromatography, in order to define potential markers of undernutrition and responsiveness to nutritional intervention.
Time frame: From enrollment to the end of treatment at 6 months.
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