|Englund, Davis - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|Kirn, Dylan - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|Koochek, Afsaneh - Uppsala University|
|Zhu, Hao - Hebrew Senior Life|
|Travison, Thomas - Hebrew Senior Life|
|Reid, Kieran - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|Von Berens, Asa - Uppsala University|
|Melin, Michael - Karolinska Institute|
|Cederholm, Tommy - Uppsala University|
|Gustafsson, Thomas - Karolinska Institute|
|Fielding, Roger - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
Submitted to: Journal of Gerontology Biological Science
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 6/28/2017
Publication Date: 12/12/2017
Citation: Englund, D.A., Kirn, D., Koochek, A., Zhu, H., Travison, T.G., Reid, K.F., Von Berens, A., Melin, M., Cederholm, T., Gustafsson, T., Fielding, R.A. 2017. Nutritional supplementation with physical activity improves muscle composition in mobility-limited older adults, The VIVE2 Study: a randomized, double-blind, placebo-controlled trial. Journal of Gerontology Biological Science. 73(1):95-101. https://doi.org/10.1093/gerona/glx141.
DOI: https://doi.org/10.1093/gerona/glx141 Interpretive Summary: The long-term effects of nutritional supplementation in combination with physical activity in older adults, particularly in older adults with limited mobility, remains unclear. Tufts researchers at the Jean Mayer USDA Human Nutrition Research Center on Aging in Boston, MA examined total-body composition, thigh muscle composition, and muscle strength in older adults with limited mobility and vitamin D insufficiency in response to a 6-month physical activity program. One group of participants consumed a daily nutritional supplement or a placebo during the 6-month program. Both groups experienced decreases in total body fat mass and increases in thigh muscle size. Participants receiving the nutritional supplement experienced greater declines in fat accumulation between muscles in the thigh than those receiving placebo. Participants receiving the nutritional supplement experienced a greater increase in normal density muscle size than those receiving placebo. These results highlight the synergistic effects of exercise and nutritional supplementation on fat accumulation and skeletal muscle composition in older adults with limited mobility.
Technical Abstract: BACKGROUND: Nutritional supplementation and physical activity have been shown to positively influence muscle mass and strength in older adults. The efficacy of long-term nutritional supplementation in combination with physical activity in older adults remains unclear. METHODS: Mobility-limited (short physical performance battery [SPPB] </= 9) and vitamin D insufficient (serum 25(OH) D 9-24 ng/mL) older adults were recruited for this study. All subjects participated in a physical activity program. Subjects were randomized to consume a daily nutritional supplement (150 kcal, 20 g whey protein, 800 IU vitamin D, 119 mL beverage) or placebo (30 kcal, nonnutritive, 119 mL). In a prespecified secondary analysis, we examined total-body composition (dual energy X-ray absorptiometry), thigh composition (computed tomography), and muscle strength, power, and quality before and after the 6-month intervention. RESULTS: One hundred and forty-nine subjects were randomized into the study [mean (standard deviation, SD) age 78.5 (5.4) years; 46.3% female; mean (SD) short physical performance battery 7.9 (1.2); mean (SD) vitamin D 18.7 (6.4) ng/mL]. After the intervention period both groups demonstrated improvements in muscle strength, body composition, and thigh composition. Nutritional supplementation lead to further losses of intermuscular fat (p = .049) and increased normal muscle density (p = .018). CONCLUSIONS: Six months of physical activity resulted in improvements in body composition, subcutaneous fat, intermuscular fat, and strength measures. The addition of nutritional supplementation resulted in further declines in intermuscular fat and improved muscle density compared to placebo. These results suggest nutritional supplementation provides additional benefits to mobility-limited older adults undergoing exercise training.