Exercise and exogenous ketosis to counteract muscle wasting during catabolic stress

Skeletal muscle wasting, i.e. the decline of skeletal muscle mass, can occur in various circumstances including: i) long periods of inactivity, e.g. immobilization, ii) denervation, e.g. spinal cord injury, iii) caloric restriction or fasting, iv) during aging, i.e. age-related sarcopenia and v) in many diseases, called cachexia. This reduction of skeletal muscle mass can induce various negative consequences including fatigue, muscle weakness and decreased functional capacity, eventually impairing quality of life. Moreover, in several diseases, muscle atrophy is associated with poor prognosis and can increase morbidity and mortality. Consequently, developing efficient strategies to prevent and/or treat skeletal muscle wasting is extremely important and may have major therapeutic benefits for multiple clinical conditions. Based on this background, the general aim of this PhD manuscript was to investigate different treatment strategies to counteract skeletal muscle wasting. Because of their important clinical relevance, both cancer cachexia and caloric restriction were investigated, each with its own specific treatment strategy, i.e. exercise in cancer cachexia and ketone body with/without protein supplementation during caloric restriction.status: publishe