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A vitamin D, calcium and leucine-enriched whey protein nutritional supplement improves measures of bone health in sarcopenic non-malnourished older adults – the PROVIDE study.

Lookup NU author(s): Professor Thomas Hill, Dr Kirsten Brandt, Emeritus Professor Chris Seal, Dr Terry Aspray

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


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.


Publication metadata

Author(s): Hill TR, Verlaan S, Biesheuvel E, Eastell R, Bauer JM, Bautmans I, Brandt K, Donini LM, Maggio M, Mets T, Seal CJ, Wijers SLJ, Sieber C, Cederholm T, Aspray T

Publication type: Article

Publication status: Published

Journal: Calcified Tissue International

Year: 2019

Pages: ePub ahead of Print

Online publication date: 23/07/2019

Acceptance date: 01/01/2019

Date deposited: 26/07/2019

ISSN (print): 0171-967X

ISSN (electronic): 1432-0827

Publisher: Springer US

URL: https://doi.org/10.1007/s00223-019-00581-6

DOI: 10.1007/s00223-019-00581-6


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