Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial

J.M. Bauer, S. Verlaan, I. Bautmans, K. Brandt, L.M. Donini, M. Maggio, M.E.T. McMurdo, T. Mets , C. Seal, S.L. Wijers, G.P. Ceda, G. De Vito, G. Donders, M. Drey, C. Greig, U. Holmbäck, M. Narici, J. McPhee, E. Poggiogalle, D. Power, A. Scafoglieri, R. Schultz, C.C. Sieber, T. Cederholm

J Am Med Dir Assoc.2015;16:740-747

Sarcopenia is characterized by an age-related loss of  muscle mass, strength, and function and poses significant threats to physical performance, independence, and quality of life.

This study aimed to test the hypothesis that a specific targeted oral nutritional supplement provided in a timely bolus amount, could result in improvements in measures of sarcopenia, in non-malnourished sarcopenic older adults at high risk for disability.

The authors conducted a 13-week, multicenter, randomized, controlled, double-blind, 2 parallel-group trial, on 380 sarcopenic, primarily independent-living older adults with Short Physical Performance Battery scores between 4 and 9 and a low skeletal muscle mass index.

The active group (n=184) received the active product, to consume twice daily, containing, 20 g whey protein, 3 g total leucine, 9 g carbohydrates, 3 g fat, 800 IU vitamin D, and a mixture of vitamins, minerals, and fibers per serving.

The control group (n= 196) received an iso-caloric control product did not contain any protein or micronutrients  to consume twice daily.

Primary outcomes of handgrip strength and SPPB score, and secondary outcomes of chair-stand test, gait speed, balance score, and appendicular muscle mass (by DXA) were measured at baseline, week 7, and week 13 of the intervention.

Handgrip strength and SPPB improved in both groups without significant between-group differences. The active group improved more in the chair-stand test ( -1.01 seconds, p = .018) and gained more appendicular muscle mass (0.17 kg, P = .045) compared with the control group.

Comment: These findings suggest that using nutritional supplementation alone might result in an increased muscle mass among sarcopenic older adults characterized by both low muscle mass and function. Although exercise should be considered as the standard treatment for increasing muscle strength and improving physical performance among adults with sarcopenia this study shows proof-of-principle that specific nutritional supplementation alone might benefit geriatric patients, which is especially relevant for those who are unable to exercise.

However these results warrant further investigations into the role of a specific nutritional supplement as part of a multimodal approach to prevent adverse outcomes among older adults at risk for disability.