Impact of protein and alkali supplementation on skeletal muscle in older adults

补充蛋白质和碱对老年人骨骼肌的影响

• 批准号: 10362750
• 负责人: Lisa Ceglia
• 金额: $ 34.44万
• 依托单位: TUFTS UNIVERSITY BOSTON
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2025-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10362750
• 关键词: Acidosis; Acids; Adult; Aging; Alkalies; Amino Acids; Area; Bicarbonates; Body Weight decreased; Catabolism; Consumption; Data; Development; Diet; Dietary Intervention; Dietary Proteins; Dose; Double-Blind Method; Elderly; Enrollment; Equilibrium; Excretory function; Exercise; Extensor; Food; Health; Impairment; Individual; Intake; Intervention; Intervention Studies; Isotonic Exercise; Kidney; Knee; Lead; Leg; Link; Lower Extremity; Measures; Metabolic acidosis; Muscle; Muscular Atrophy; Musculoskeletal; Nitrogen; Outcome; Participant; Performance; Physical Function; Physical Performance; Pilot Projects; Placebo Control; Placebos; Population; Postmenopause; Process; Protein-Restricted Diet; Proteins; Randomized; Recommended Daily Allowances; Renal function; Reporting; Research; Research Design; Roentgen Rays; Skeletal Muscle; Societies; Sodium Chloride; Stimulus; Sulfur; Supplementation; Testing; Therapeutic; Thinness; Translating; Whey Protein; Woman; age related; base; dietary; epidemiology study; feeding; fruits and vegetables; functional decline; human old age (65+); improved; indexing; innovation; lean body mass; men; metabolic abnormality assessment; muscle form; older men; physically handicapped; potassium bicarbonate; primary outcome; protein intake; secondary outcome; sedentary; skeletal muscle wasting; urinary

PROJECT SUMMARY Skeletal muscle loss and impairment – prominent features of the aging process – lead to physical disability. There is plausible evidence that altering components of the diet, mainly protein intake and acid/base balance, may improve indices of muscle health in older adults and thus translate to a reduction in physical disability. A growing number of studies suggest that increasing protein intake using a whey protein supplement may benefit muscle health in older adults. However, a main concern is that high protein results in a large dietary acid load from the breakdown of protein to acidogenic byproducts, which could in turn promote muscle degradation particularly in older adults with age-related declines in renal excretion of acid. Thus, our hypothesis is that the balance between the amount of protein in the diet (anabolic component) and the net acid load of the diet (catabolic component) in part determines whether the diet as a whole has a net anabolic or catabolic effect on muscle. Preliminary data from our group have suggested that a daily potassium bicarbonate (KHCO3) supplement improved lower extremity muscle power in postmenopausal women. Based on our preliminary data, we plan to conduct a randomized, double-blind, placebo-controlled, 2x2 factorial study in which sedentary men and women age 65 and older on baseline lower protein diets will be enrolled. Participants will assigned to one of four groups: either a whey protein supplement (to raise protein intake to 1.5 g/kg/d) with or without KHCO3 81 mmol/d or an isocaloric placebo supplement with or without KHCO3 81 mmol/d for 24 wks. The primary outcome is lower extremity muscle power. Secondary outcomes are lower extremity muscle endurance, physical performance, lean mass, and 24-hr urinary nitrogen excretion. Twenty-four-week changes in these outcomes will be compared in the 4 groups. Our central hypothesis is that higher protein intake plus a neutralizing alkaline salt will have additive effects on muscle performance and mass in older adults to either intervention alone. If successful, this research could result in a paradigm shift in dietary advice to older adults to reduce physical disability. As 1 in 5 US adults will be over age 65 by year 2040, a safe dietary intervention that reduces age-related musculoskeletal decline will be an important preventative health step for our aging society.

项目摘要 骨骼肌的损失和损伤-衰老过程的突出特征-导致身体残疾。 有合理的证据表明，改变饮食成分，主要是蛋白质摄入量和酸/碱平衡， 可以改善老年人的肌肉健康指数，从而减少身体残疾。一 越来越多的研究表明，使用乳清蛋白补充剂增加蛋白质摄入量可能有益于 老年人的肌肉健康然而，一个主要的问题是，高蛋白导致大量的饮食酸负荷 从蛋白质分解为产酸副产物，这反过来又会促进肌肉降解， 特别是在与年龄相关的肾酸排泄下降的老年人中。因此，我们的假设是 饮食中蛋白质（合成代谢成分）和饮食净酸负荷之间的平衡 （分解代谢成分）在一定程度上决定了饮食作为一个整体是否具有净合成代谢或分解代谢作用 肌肉.我们小组的初步数据表明，每日碳酸氢钾（KHCO 3） 补充改善绝经后妇女下肢肌肉力量。根据我们的初步数据， 我们计划进行一项随机、双盲、安慰剂对照、2 × 2析因研究， 以及65岁及以上基线低蛋白饮食的女性。参与者将被分配到一个 四组：乳清蛋白补充剂（将蛋白质摄入量提高到1.5 g/kg/d），含或不含KHCO 3 81 mmol/d或等热量安慰剂补充剂，含或不含KHCO 3 81 mmol/d，持续24周。 结果是下肢肌肉力量。次要结局是下肢肌肉耐力， 体能、瘦体重和24小时尿氮排泄。24周的变化 将在4组中比较结果。我们的中心假设是，较高的蛋白质摄入量加上 中和碱性盐将对老年人的肌肉性能和质量产生累加效应， 单独干预。如果成功，这项研究可能会导致老年人饮食建议的范式转变 减少身体残疾。到2040年，五分之一的美国成年人将超过65岁，这是一种安全的饮食干预措施。 减少与年龄相关的肌肉骨骼衰退将是我们衰老的重要预防性健康步骤 社会