Abstract
Alterations in musculoskeletal health with advanced age contribute to sarcopenia and decline in bone mineral density (BMD) and bone strength. This decline may be modifiable via dietary supplementation. To test the hypothesis that a specific oral nutritional supplement can result in improvements in measures of bone health. Participants (n 380) were participants of the PROVIDE study, a 13-week, multicenter, randomized, controlled, double-blind, 2 parallel-group study among non-malnourished older participants (≥ 65 years) with sarcopenia [determined by Short Physical Performance Battery (SPPB; 0-12) scores between 4 and 9, and a low skeletal muscle mass index (SMI; skeletal muscle mass/BW × 100) ≤ 37% in men and ≤ 28% in women using bioelectric impedance analysis] Supplementation of a vitamin D, calcium and leucine-enriched whey protein drink that comprises a full range of micronutrients (active; 2/day) was compared with an iso-caloric control. Serum 25-hydroxyvitamin D [25(OH)D], parathyroid hormone (PTH), biochemical markers of bone formation (osteocalcin; OC, procollagen type 1 amino-terminal propeptide; P1NP) and resorption (carboxy-terminal collagen crosslinks; CTX), insulin like growth factor 1 (IGF-1) and total-body BMD were analysed pre- and post-intervention. Serum 25(OH)D concentrations increased from 51.1 ± 22.9 nmol/L (mean ± SD) to 78.9 ± 21.1 nmol/L in the active group (p < 0.001 vs. control). Serum PTH showed a significant treatment difference (p < 0.001) with a decline in the active group, and increase in the control group. Serum IGF-1 increased in the active group (p < 0.001 vs. control). Serum CTX showed a greater decline in the active group (p = 0.001 vs. control). There were no significant differences in serum OC or P1NP between groups during the intervention. Total body BMD showed a small (0.02 g/cm2; ~ 2%) but significant increase in the active group after supplementation (p = 0.033 vs. control). Consuming a vitamin D, calcium and leucine-enriched whey protein supplement for 13 weeks improved 25(OH)D, suppressed PTH and had small but positive effects on BMD, indicative of improved bone health, in sarcopenic non-malnourished older adults.
Highlights
Loss of muscle mass and function, and decline in bone mineral density (BMD) and bone strength lead to alterations in musculoskeletal health with advanced age [1]
In a previous publication [14], we described the intervention effects of a targeted nutritional supplement containing whey protein enriched with leucine, vitamin D, calcium and a full range of micronutrients on macronutrient intake and muscle mass and lower-extremity function in older sarcopenic adults
Concentrations of the bone resorption marker CTX declined in both treatment groups the decline was more pronounced in the active group
Summary
Loss of muscle mass and function (i.e. sarcopenia), and decline in bone mineral density (BMD) and bone strength (i.e. osteopenia and osteoporosis) lead to alterations in musculoskeletal health with advanced age [1] Both disorders increase the risk of fractures, loss of independence, and. Dietary essential amino acid supplementation in rats on a low-protein diet increased bone strength through significant (2–4%) increases in lumbar spine and tibia BMD, trabecular architecture, and cortical thickness, likely mediated via an increase of IGF-1 [11] This is reflected by the dietary recommendation for prevention of age-related deterioration of musculoskeletal health in postmenopausal women by The European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO). We report the efficacy of this supplement for improving serum 25(OH)D and reducing parathyroid hormone (PTH) as well as altering biochemical markers of bone formation (Osteocalcin; OC, Procollagen type 1 amino-terminal propeptide; P1NP), resorption (carboxy-terminal collagen crosslinks; CTX), serum IGF-1 and total body BMD
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