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
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
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DOI：
10.1016/j.jamda.2015.05.021
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发表时间：
2015-09-01
影响因子：
7.6
通讯作者：
Cederholm, Tommy
中科院分区：
文献类型：
--
作者：
Bauer, Juergen M.;Verlaan, Sjors;Cederholm, Tommy
背景资料：肌肉质量、力量和功能的减少（肌肉减少症）对身体表现、独立性和生活质量构成重大威胁。营养补充剂可以积极影响肌肉减少症的各个方面，从而预防行动能力障碍。目的：为了验证一个假设，即一个特定的口服营养补充剂可以导致改善措施的肌肉减少症。设计：一个多中心，随机，对照，双盲，2个平行组的试验中，380肌肉减少症主要是独立生活的老年人与短期身体表现电池（SPPB; 0-12）评分在4和9之间，并且骨骼肌质量指数低。活动组（n = 184）接受维生素D和富含亮氨酸的乳清蛋白营养补充剂，每天服用两次，持续13周。对照组（n = 196）接受等热量控制产品，每天两次，持续13周。在基线、第7周和第13周测量握力和SPPB评分的主要结果，以及椅子站立试验、步态速度、平衡评分和肱二头肌质量（DXA）的次要结果。与对照组相比，活动组在椅子站立测试中的改善更多，组间效应（95%置信区间）：-1.01秒（-1.77至-0.19），P = 0.018。活动组比对照组获得更多的四肢肌肉质量，组间效应：0.17 kg（0.004-0.338），P = 0.045。结论：维生素D和富含亮氨酸的乳清蛋白口服营养补充剂的13周干预导致肌肉减少老年人的肌肉质量和下肢功能改善。这项研究表明，单独的特定营养补充剂可能对老年患者有益，特别是对那些无法锻炼的患者。这些结果值得进一步调查特定营养补充剂作为多模式方法的一部分的作用，以防止有残疾风险的老年人的不良后果。(C)2015年AMDA -急性后和长期护理医学协会。这是一个在CC BY-NC-ND许可证下的开放获取文章（http：//creativecommons.org/licenses/by-nc-nd/4.0/）。
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. (C) 2015 AMDA - The Society for Post-Acute and Long-Term Care Medicine. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).