Effects of adequate dietary protein with whey protein, leucine, and vitamin D supplementation on sarcopenia in older adults: An open-label, parallel-group study.
Sarcopenia is defined as a syndrome characterized by declines in skeletal muscle mass and strength or an alteration in physical function. Although some studies showed nutritional supplementation alone might have health benefits for older sarcopenic patients, their results were inconsistent and remain controversial. The objective of this study was to evaluate if a diet with high protein supplementation (Supp) can lead to better improvement than additional protein intake via dietary counseling (Diet) in maintaining the muscle mass and strength among sarcopenic elders.
This was an open-label, parallel-group (Supp vs. Diet) trial. In total, 56 sarcopenic elders completed this study. All subjects were advised to achieve adequate protein intake (1.2-1.5 g/kg body weight/day). This amount of protein is recommended for the elderly and is thought to prevent or retard muscle loss due to aging. The diet group (n = 28) was recommended to consume an ordinary protein-rich diet via counselling whereas the Supp group (n = 28) received a vitamin D- and leucine-enriched whey protein supplement for 12 weeks. The appendicular muscle mass index (AMMI), handgrip strength, gait speed, and calorie and macronutrients intake were evaluated after 4 and 12 weeks of the diet intervention.
Total energy and protein intake increased in both groups. The Supp group had higher intake than the Diet group. The AMMI increased in both groups, and handgrip strength improved in the Diet group. However, no significant differences in AMMI or handgrip strength were found between the two groups. Compared to the Diet group, the Supp group had better improvement in gait speed after 12 weeks of the supplement intervention especially in subjects younger than 75 years.
The AMMI can be improved as long as sufficient protein is consumed (1.2-1.5 g/kg body weight/day) in sarcopenic elders. Nutritional supplement allows the sarcopenic elderly to more conveniently meet their protein requirements. Supplementation with whey protein and vitamin D can further improve gait speed in elderly sarcopenic subjects, especially in the "younger" age group.
ClinicalTrials.gov NCT03860194.
Lin CC
，Shih MH
，Chen CD
，Yeh SL
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The effects of dietary protein on physical performance and body composition in middle age and older people having type II diabetes mellitus: a randomized pilot study.
Protein supplementation has been proposed as an effective dietary strategy for maintaining or increasing skeletal muscle mass and improving physical performance in middle-aged and older adults. Diabetes mellitus exacerbates muscle mass loss, leading to many older adults with type 2 diabetes mellitus (T2DM) experiencing sarcopenia, and vice versa. Our objective was to assess the impact of increased dietary protein intake on muscle mass, strength, physical performance, and the progression of T2DM in middle-aged and older adults diagnosed with this condition.
A 12-week randomized, controlled, parallel pilot study was conducted with 26 patients diagnosed with T2DM and had either low muscle mass, or low muscle strength or poor physical performance (age > 55 years old), aiming to investigate the effects of a protein-rich diet in sarcopenic and metabolic markers. The control group received 0.8-1.0 g/kg/day, while the intervention group received 1.2-1.5 g/kg/day of protein respectively. Body composition, muscle mass/strength and biochemical parameters were measured before and after the intervention period.
Different kinetics of skeletal muscle index (SMI), appendicular lean mass (ALM), hand grip strength (HGS), gait speed (GS) and standing balance (SB) (p < 0.05) were observed between two groups. Specifically, the intervention group showed a significant improvement in HGS (p < 0.001) and physical performance (timed-up-and-go, p < 0.001; GS, p = 0.011; SB, p = 0.022), while the control group had its ALM (p = 0.014), SMI (p = 0.011) and HGS (p = 0.011) significantly reduced. The kinetics of metabolic markers indices was similar for both groups.
Current recommendation for protein intake (0.8-1 g/kg/day) is certainly not enough to ameliorate the muscle mass loss in middle age and older adults' individuals with T2DM. In contrast, protein intake of 1.2-1.5 g/kg/day seems to be a more appropriate recommendation to combat upcoming sarcopenia, nonetheless the progression of T2DM was not interrupted.
Argyropoulou D
，Nomikos T
，Terzis G
，Tataki S
，Geladas ND
，Paschalis V
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Provision of a daily high protein and high energy meal: Effects on the physical and psychological wellbeing of community-dwelling, malnourished older adults; a randomised crossover trial.
To determine whether daily provision of a high protein, high energy meal for 12-weeks to under-nourished older adults living independently in the community can improve physical, physiological, and psychological outcomes.
A randomised crossover trial.
Participant homes within a 15-mile radius to meal supplier; Dartmoor Community Kitchen Hub.
Fifty-six community dwelling older adults (82 ± 7 years, 70% female) were randomised (stratified for baseline mini nutritional assessment (MNA) score and cohabiting or living alone) to receive 12-weeks of meal provision followed by 12-weeks no intervention (meals first group, n = 28), or, 12-weeks without intervention followed by 12-weeks of meal provision intervention (meals second group, n = 28).
A daily high protein and high energy home-delivered meal for 12-weeks. Each meal contained >50% daily protein requirements (0.6 g kg-1 of the recommended 1.2 g kg-1.day-1, ∼42 g protein per meal) and >40% daily energy requirements (∼715 kcal).
Physical, physiological and psychological health (including MNA score, body composition, hand grip strength, self-esteem, and depression) were evaluated in participants' homes before and after each 12-week period (baseline, 12-weeks, and 24-weeks). The effect of meal provision was assessed by t-test then effects were combined using meta-analysis. Retention of any meal provision effect after cessation of meal delivery was quantified as change from the end of the meal intervention versus 12-weeks follow-up via paired t-test.
The meal intervention significantly increased MNA score with a medium effect size (MNA: pooled Cohen's D = 0.74, p < 0.001). Energy and protein intake increased significantly during the control period where participants were asked to maintain their habitual diet in the meals second group (energy intake: increase = 252 kcal [95% CI 36-487 kcal], t(22) = 2.408, p = 0.025, protein intake: increase = 0.20 g kg-1 [95% CI 0.04-0.357 g kg-1], t(22) = 2.629, p = 0.015), which confounded the principle of a randomised crossover design analysis. When the control effect in those in the meals second group was removed from the analysis, the effect of the meal provision was much greater (meal provision significantly improved energy and protein intakes (311 kcal D = 0.52 (95% CI 0.22 to 0.82), p < 0.001; 0.24 g kg-1D = 0.52 (0.19-0.81), p < 0.001, respectively), MNA score (2.6 points D = 1.14 (0.78-1.50), p < 0.001), and handgrip strength (1.5 kg D = 0.36 (0.06-0.66), p = 0.02), but did not change levels of depression or self-esteem). Twelve weeks after meal removal, the following % of the meal effect was retained: 68% for MNA score, 27% for negative mood score, 15% for daily energy intake, 6% for daily protein intake and 0% for handgrip strength.
Provision of high protein, high energy meals to community dwelling older adults for 12-weeks improved nutritional status and handgrip strength, indicative of reduced frailty risk. Benefits were not retained upon withdrawal of the intervention, suggesting a need for sustained interventions in this cohort to meet nutritional needs. Home-delivered meals offer a popular, and scalable intervention for community dwelling older adults to prevent malnutrition, promote health and sustain high quality independent living thus reducing the burden of ageing and frailty on health and social care systems.
Struszczak L
，Hickson M
，McClelland I
，Metcalf B
，Barreto M
，Torquati L
，Fulford J
，Allen R
，Hulme C
，O'Leary MF
，Bowtell JL
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ResearchGate
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