Abstract
Objectives
To test the long-term effects of whey-enriched protein supplementation on muscle and
physical performance.
Design
A 12-month randomized controlled double blind trial with a 43-month of post-trial
follow-up.
Setting
Porvoo, Finland.
Participants
A total of 218 older (>74 years of age) community-dwelling people with sarcopenia.
Intervention
(1) Control with no supplementation; (2) isocaloric placebo; and (3) 20 g × 2 whey-enriched
protein supplementation. All participants were given instructions on home-based exercise,
dietary protein, and vitamin D supplementation of 20 μg/d.
Measurements
Physical performance was assessed by short physical performance battery and continuous
summary physical performance scores. Hand grip strength and calf intracellular resistance
based skeletal muscle index were measured by bioimpedance spectroscopy. The measurements
were performed at 0, 6, and 12 months. The post-trial follow-up was performed by a
postal questionnaire and national census record data.
Results
The participants were older (75-96 years of age) and mostly women (68%). The test
supplements had no significant effects on physical performance; the 12-month changes
for short physical performance battery were −0.55, −.05, and 0.03 points in control,
isocaloric, and protein groups (P = .17), respectively. The changes in continuous summary physical performance scores
were similar between the intervention groups (P = .76). The hand grip strength decreased significantly in all intervention groups,
and the 12-month changes in calf intracellular resistance-based skeletal muscle index
were minor and there were no differences between the intervention groups. One-half
of the patients (56%) in both supplement groups reported mild gastrointestinal adverse
effects. Differences were found neither in the all-cause mortality nor physical functioning
in the post-trial follow-up.
Conclusions
The whey-enriched protein supplementation in combination with low intensity home-based
physical exercise did not attenuate the deterioration of muscle and physical performance
in community-dwelling older people with sarcopenia.
Keywords
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Article info
Publication history
Published online: November 13, 2019
Footnotes
This study is funded by University of Helsinki, by a special governmental subsidy for health sciences research and training to Helsinki University Central Hospital, by Yrjö Jahnsson Foundation and by Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse. The study is conducted in collaboration with the municipal healthcare and social services of Porvoo, Finland. All supplements are manufactured and provided free of charge by Valio Ltd, Helsinki, Finland.
MPB reports professional cooperation including lecturing fees from Valio Ltd, Nestle Health Science Ltd. and Nutricia Medical Ltd., Dr TES reports having various educational and consultative cooperation with several companies, including Nutricia, Abbott, Amgen, Merck, Pfizer, Novartis, and Novo-Nordisk; a minor amount of stock in Orion Pharma; and is a board member and former president of executive board of European Union Geriatric Medicine Society which has cooperation also with the nutrition industry. MHS, HK, HFS, SKJ, KHP, and RS have no competing interests.
Trial registration: ACTRN12612001253897
Identification
Copyright
© 2019 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
