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

Jürgen M Bauer 1, Sjors Verlaan 2, Ivan Bautmans 3, Kirsten Brandt 4, Lorenzo M Donini 5, Marcello Maggio 6, Marion E T McMurdo 7, Tony Mets 3, Chris Seal 4, Sander L Wijers 8, Gian Paolo Ceda 6, Giuseppe De Vito 9, Gilbert Donders 10, Michael Drey 11, Carolyn Greig 12, Ulf Holmbäck 13, Marco Narici 14, Jamie McPhee 15, Eleonora Poggiogalle 5, Dermot Power 16, Aldo Scafoglieri 3, Ralf Schultz 17, Cornel C Sieber 18, Tommy Cederholm 13

Abstract

Background: Age-related losses of muscle mass, strength, and function (sarcopenia) pose significant threats to physical performance, independence, and quality of life. Nutritional supplementation could positively influence aspects of sarcopenia and thereby prevent mobility disability.

Objective: To test the hypothesis that a specific oral nutritional supplement can result in improvements in measures of sarcopenia.

Design: A multicenter, randomized, controlled, double-blind, 2 parallel-group trial among 380 sarcopenic primarily independent-living older adults with Short Physical Performance Battery (SPPB; 0-12) scores between 4 and 9, and a low skeletal muscle mass index. The active group (n = 184) received a vitamin D and leucine-enriched whey protein nutritional supplement to consume twice daily for 13 weeks. The control group (n = 196) received an iso-caloric control product to consume twice daily for 13 weeks. 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.

Results: Handgrip strength and SPPB improved in both groups without significant between-group differences. The active group improved more in the chair-stand test compared with the control group, between-group effect (95% confidence interval): -1.01 seconds (-1.77 to -0.19), P = .018. The active group gained more appendicular muscle mass than the control group, between-group effect: 0.17 kg (0.004-0.338), P = .045.

Conclusions: This 13-week intervention of a vitamin D and leucine-enriched whey protein oral nutritional supplement resulted in improvements in muscle mass and lower-extremity function among sarcopenic older adults. This study shows proof-of-principle that specific nutritional supplementation alone might benefit geriatric patients, especially relevant for those who are unable to exercise. 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.