Whey Protein, Leucine- and Vitamin-D-Enriched Oral Nutritional Supplementation for the Treatment of Sarcopenia
Abstract
:1. Introduction
2. Pathophysiology of the Aging Muscle and Rationale for Nutritional Therapy
3. Nutrikinetic and Nutridynamic Studies
4. Efficacy Trials
4.1. MT-ONS in the Community Setting
4.2. MT-ONS in Rehabilitation Units and Care Homes
4.3. MT-ONS in Sarcopenic Obesity
5. Discussion and Conclusion
Supplementary Materials
Author Contributions
Funding
Informed Consent Statement
Conflicts of Interest
References
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Author, Year [Ref] | Study Aim | Study Design | Participants | Experimental Intervention (Dosages) | Control Intervention (None or Description) | Combined Physical Activity Intervention (None or Description) | Findings | Other Findings |
---|---|---|---|---|---|---|---|---|
Pennings, 2011 [38] | To compare protein digestion and absorption kinetics and post-prandial muscle protein accretion after ingestion of different protein sources | Randomized, parallel-group trial | Healthy older men (n = 48; age, 74 ± 1 years) | Single bolus of whey protein (20 g) | Single bolus of casein (20 g) or casein hydrolisate (20 g) | None (avoidance any sort of exhaustive physical activity for 3 days before the experiment) |
| Strong positive correlation (r = 0.66; p < 0.01) between peak plasma leucine concentration and post-prandial FSR |
Luiking, 2014 [39] | To evaluate muscle protein synthesis after ingestion of two different oral nutritional supplements (ONS) and to study the combined effect with resistance exercise, using a unilateral resistance exercise protocol. | Randomized, parallel-group, double-blind trial | Healthy older adults (n = 19; males, 47%; age, 69 ± 6 years) | Single bolus of whey protein (20 g) leucine-enriched (3 g) supplement | Conventional iso-caloric diary product (single bolus containing 6 g of proteins) | Unilateral resistance exercise protocol | FSR: higher after whey protein + leucine vs. control (p = 0.049) | None |
Luiking, 2016 [40] | To evaluate the impact of ONS with distinct protein source and energy density on serum amino acids (AAs) profile | Randomized, cross-over, single-blind trial | Healthy adults (n = 12; males, 42%; age, 67 ± 2 years) | Single bolus of low-calorie (150 kcal) and high-calorie (300 kcal) whey-protein-based (20 g) ONS | Single bolus of low-calorie (150 kcal) and high-calorie (300 kcal) casein-based (20 g) ONS | None |
| In vitro digestion modelling for 90 min resulted in higher levels of free total AAs, essential AAs and leucine for low-calorie whey protein ONS vs. low-calorie casein ONS, for low-calorie whey protein ONS vs. high-calorie whey protein ONS, and for low-calorie casein ONS vs. high-calorie casein ONS. High-calorie ONS resulted in higher serum insulin concentration vs. low-calorie ONS (p < 0.001) |
Kramer, 2015 [41] | To determine the impact of the macronutrient composition of ONS on the post-prandial muscle protein synthesis (MPS) rates | Randomized, parallel-group, double-blind trial | Non sarcopenic older men (n = 45; age, 69 ± 1 years) | Single bolus of two different isonitrogenous whey protein (20 g) leucine-enriched ONS containing (150 kcal) or not containing carbohydrate and fat | Protein-free isocaloric mixture (150 kcal) containing carbohydrate and fat | None |
| Insulin levels: greater post-prandial rise after protein-leucine ONS containing calories, but not significantly superior to ONS containing protein-leucine only |
Kramer, 2017 [42] | To assess basal and post-prandial muscle protein FSR in healthy and sarcopenic subjects | Comparative study of two different patients populations | Healthy adults (n = 15; age, 69 ± 1 years) and sarcopenic older men (n = 15; age, 81 ± 1 years) | Single bolus of a low-calorie (150 kcal) whey protein (20 g) leucine-enriched ONS | None | None |
| None |
Author, Year | Random Sequence Generation (Selection Bias) | Allocation Concealment (Selection Bias) | Blinding of Participants and Personnel (Performance Bias) | Blinding of Outcome Assessment (Detection Bias) | Incomplete Outcome Data (Attrition Bias) | Selective Reporting (Reporting Bias) | Other Bias |
---|---|---|---|---|---|---|---|
PROVIDE study Bauer, 2015 [44] Verlaan, 2018 [45] Liberman, 2019 [46] | | | | | | | |
Verreijen, 2015 [47] | | | | | | | Single-center |
Rondanelli, 2016 [48] | | | | | | | Single-center |
Chanet, 2017 [43] | | | | | | | |
Dimori, 2018 [49] | | | | | | | Single-center |
PRO-LEADER study Barichella, 2019 [48] | | | | | | | |
IRIS study Rondanelli, 2020 [50] | | | | | | | Single-center |
Author, Year [Ref] | Study Design | Setting | Study Duration | Muscle-Targeted Intervention (Dosages) | Control Intervention (None or Description) | Combined Physical Activity Intervention (None or Description) | Muscle Mass | Physical Performance Endpoints | Physical Function Endpoints | Other Endpoints |
---|---|---|---|---|---|---|---|---|---|---|
Bauer, 2015 [46] PROVIDE study (first analysis) | RCT, multi-centre | Community | 13 weeks | Twice daily (21 g whey protein, 3 g leucine and 800 IU vitamin D each serving) for 13 weeks | Isocaloric matched placebo | None | Appendicular muscle mass (Between-group difference of 0.17 kg; p = 0.045) | Handgrip strength (No between- group differences) | SPPB (No between- group differences) Chair stand test (Delta = −1.01 s, p = 0.018); gait speed; balance score | None |
Verreijen, 2015 [53] | RCT, single-centre | Community | 13 weeks | 10 times/week (21 g whey protein, 3 g leucine and 800 IU of vitamin D each serving) for 13 weeks | Isocaloric matched placebo | Resistance training 3X/week for 13 weeks in both groups | Appendicular muscle mass (+0.4 kg vs. −0.5 kg; p = 0.03) | Handgrip strength (No between-group differences) | 400 m walking test; 4 m gait speed test; chair stand test | Body composition |
Rondanelli 2016 [54] | RCT, single-centre | Rehabilitation center | 12 weeks | Once daily (22 g whey protein, 4 g leucine and 100 IU of vitamin D each serving) | Isocaloric matched placebo | Controlled physical activity program (20 min exercise session/day, 5 times/week) | Fat free mass (1.7 kg gain; p <0.001); relative skeletal muscle mass (p = 0.009) | Handgrip strength (improved with test product; p = 0.001) | Activities of daily living | Body composition; IGF-1 and PCR; HR-QoL; global nutritional status |
Chanet, 2017 [43] | RCT, single-centre | Community | 6 weeks | Once daily before breakfast (21 g whey protein, 3 g leucine and 800 IU of vitamin D each serving) for 6 weeks | Non caloric flavored watery placebo | None | Mixed muscle protein synthesis rate(FSR) (higher in the test group; p = 0.001); appendicular lean mass (higher in the test group; p = 0.035) | Handgrip strength (No between- group differences) | SPPB (no between-group differences) | Body composition; blood glucose, insulin, EAA and leucine |
Verlaan, 2018 [55] PROVIDE study (secondary analysis) | RCT, multi-centre; post hoc analysis | Community | 13 weeks | Twice daily (21 g whey protein, 3 g leucine and 800 IU vitamin D each serving) for 13 weeks | Isocaloric matched placebo | None | Appendicular muscle mass (higher baseline concentrations of 25(OH)D are associated with greater gain in AMM) | None | Chair stand test (no effect of baseline concentrations of 25(OH)D) | None |
Dimori, 2018 [56] | Observational study: cross-sectional survey (Phase 1) + single-arm intervention trial (Phase 2) | Care home | 6 months on + 3 months off + 3 months on | Twice daily (21 g whey protein, 3 g leucine and 800 IU vitamin D each serving) when administered | None | Patients with Tinetti score >9: 40 min physical therapy session, 3 times/week for 12 months | Skeletal muscle mass | Handgrip strength | SPPB (patients with Tinetti score > 9); gait speed (4 m walking test) | Body composition; sarcopenia prevalence (Phase 1 of the study) |
Liberman, 2019 [48] PROVIDE study (Tertiary analysis) | RCT, multi-centre | Community | 13 weeks | Twice daily (21 g whey protein, 3 g leucine and 800 IU vitamin D each serving) for 13 weeks | Isocaloric matched placebo | None | IL-8 (higher decrease with the test product; p = 0.03); IL-1RA and IL-6 (no significant between-group differences); sTNFR1; CRP; pre-albumin | |||
Barichella, 2019 [47] PRO-LEADER study | RCT, pragmatic, bicentric, assessor-blind | Rehabilitation centre for patients with Parkinson’s disease | 30 days | Twice daily (21 g whey protein, 3 g leucine and 800 IU vitamin D each serving) for 30 days | Usual care | Multidisciplinary Intensive Rehabilitation Program (MIRT) | Skeletal muscle mass (increased vs. usual care; p = 0.029) and skeletal muscle index | Handgrip strength | 6 min walking test (+18.1 m vs. usual care; p = 0.039); 4 m walking speed, timed up and go, Berg balance scale (all improved vs. usual care) | |
Rondanelli, 2020 [49] IRIS study | RCT, single-centre | Rehabilitation centre | Until discharge (at least 4 weeks and up to 8 weeks) | Twice daily (21 g whey protein, 3 g LEU and 800 IU vit. D each serving) for 4-8 weeks | Isocaloric control formula | Controlled physical activity program (20 min exercise session/day, 5 times/week) | Muscle mass (increased vs. control; p <0.03) | Handgrip strength (increased vs. control; p <0.03) | Change in4 m gait speed/month (+0.063 m/sec/month with active vs. control; p <0.001); chair stand test; timed up and go test; SPPB (all improved vs. control; p <0.001) | Cognitive function tests (both improved vs. control; p <0.001); rehabilitation intensity profile (improved vs. control; p = 0.003); probability of being discharged at home (higher vs. control; p = 0.002); overall economic benefit (duration of rehabilitation and length of hospital stay, both improved vs. control; p <0.001) |
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Cereda, E.; Pisati, R.; Rondanelli, M.; Caccialanza, R. Whey Protein, Leucine- and Vitamin-D-Enriched Oral Nutritional Supplementation for the Treatment of Sarcopenia. Nutrients 2022, 14, 1524. https://doi.org/10.3390/nu14071524
Cereda E, Pisati R, Rondanelli M, Caccialanza R. Whey Protein, Leucine- and Vitamin-D-Enriched Oral Nutritional Supplementation for the Treatment of Sarcopenia. Nutrients. 2022; 14(7):1524. https://doi.org/10.3390/nu14071524
Chicago/Turabian StyleCereda, Emanuele, Roberto Pisati, Mariangela Rondanelli, and Riccardo Caccialanza. 2022. "Whey Protein, Leucine- and Vitamin-D-Enriched Oral Nutritional Supplementation for the Treatment of Sarcopenia" Nutrients 14, no. 7: 1524. https://doi.org/10.3390/nu14071524