scholarly journals Nutritional Supplementation With Physical Activity Improves Muscle Composition in Mobility-Limited Older Adults, The VIVE2 Study: A Randomized, Double-Blind, Placebo-Controlled Trial

2017 ◽  
Vol 73 (1) ◽  
pp. 95-101 ◽  
Author(s):  
Davis A Englund ◽  
Dylan R Kirn ◽  
Afsaneh Koochek ◽  
Hao Zhu ◽  
Thomas G Travison ◽  
...  

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. ClinicalTrials.gov Identifier: NCT01542892

2010 ◽  
Vol 18 (1) ◽  
pp. 75-86 ◽  
Author(s):  
Simone Nicolai ◽  
Petra Benzinger ◽  
Dawn A. Skelton ◽  
Kamiar Aminian ◽  
Clemens Becker ◽  
...  

The purpose of the study was to investigate whether a 24-hr recording period is sufficient to describe physical activity (PA) of 1 week for intraindividual comparison in older adults. Furthermore, the authors analyzed whether physical performance can be used as a surrogate marker of PA. PA was captured on 7 consecutive days by a body-fixed sensor in 44 community-dwelling older adults (80.75 ± 4.05 yr). Mean times of walking and of “time on feet” of the group were 10.2 hr (± 3.5) and 35.1 hr (± 9.43), respectively. Intraindividual variabilities of walking and of time on feet were 31.9% ± 10.79% and 19.4% ± 8.76%, respectively. Accumulated time of variables of PA showed no differences between weekdays, with variabilities of 3.8% and 1.8% for walking and time on feet, respectively. Association between Short Physical Performance Battery and PA was limited (walkingr= .397, time on feetr= .41).


2015 ◽  
Vol 100 (2) ◽  
pp. 670-678 ◽  
Author(s):  
David Scott ◽  
Peter R. Ebeling ◽  
Kerrie M. Sanders ◽  
Dawn Aitken ◽  
Tania Winzenberg ◽  
...  

Abstract Context: High vitamin D and physical activity (PA) levels are independently associated with improved body composition and muscle function in older adults. Objective: The objective of this study was to investigate the interaction of 25-hydroxyvitamin D (25OHD) and PA status in maintenance of body composition and muscle function in older adults. Design and Setting: This was a 5-year prospective population-based study of Australian community-dwelling older adults. Participants: Participants in the study included 615 community-dwelling volunteers aged 50 years old or older [61.4 ± 6.9 (mean ± SD) y; 48% female] randomly selected from electoral rolls and categorized according to baseline serum 25OHD (≥ or <50 nmol/L) and PA (≥ or <10 000 pedometer determined steps/d) levels as follows: high 25OHD and high PA (VitD+PA+); high 25OHD and low PA (VitD+PA−); low 25OHD and high PA (VitD-PA+); and low 25OHD and low PA (VitD-PA−). A subset of 518 participants completed accelerometer assessments during follow-up. Main Outcome Measures: Changes in dual-energy X-ray absorptiometry-assessed body composition and lower-limb muscle function were measured. Results: VitD+PA+ had significantly smaller increases in body fat over 5 years compared with other groups (all P < .05). Higher baseline pedometer-determined PA resulted in declines in total body fat (β = −.23 kg per 100 steps/d, P = .001) over 5 years for participants with high 25OHD but not those with low 25OHD (P > .05). Among participants with accelerometer data, these associations were generally mediated by higher levels of moderate/vigorous PA. Conclusions: High vitamin D status appears to enhance PA-related declines in body fat during aging, but the mechanism may be greater amounts of outdoor moderate/vigorous PA rather than a direct effect of 25OHD.


Author(s):  
Irene Rodríguez-Gómez ◽  
Asier Mañas ◽  
José Losa-Reyna ◽  
Luis M. Alegre ◽  
Leocadio Rodríguez-Mañas ◽  
...  

The objectives were to clarify whether the relationship between physical performance and frailty was independently and jointly mediated by movement behaviors and body composition. We analyzed 871 older adults (476 women) from The Toledo Study for Healthy Aging. Skeletal muscle index (SMI) and fat index (FI) were determined using bone densitometry. Sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. The Frailty Trait Scale and The Short Physical Performance Battery (SPPB) were used to evaluate frailty and physical performance, respectively. Simple and multiple mediation analyses were carried out to determine the role of movement behaviors and body composition, adjusted for potential confounders. ST and MVPA acted independently as mediators in the relationship between SPPB and frailty (0.06% for ST and 16.89% for MVPA). FI also acted as an independent mediator in the same relationship (36.47%), while the mediation role of SMI was not significant. MVPA and FI both acted jointly as mediators in this previous relationship explaining 58.15% of the model. Our data support the fact that interventions should simultaneously encourage the promotion of MVPA and strategies to decrease the FI in order to prevent or treat frailty through physical performance improvement.


2018 ◽  
pp. 1-7
Author(s):  
N.W. BRAY ◽  
T.J. DOHERTY ◽  
M. MONTERO-ODASSO

Background: Vitamin D deficiency is ubiquitous in frailty but the effectiveness of vitamin D supplementation to improve outcomes in frail individuals is unclear. It has been postulated that higher than the current recommended doses (800 IU/day) may be needed to achieve a neuromuscular effect in frail individuals. Objectives: 1) determine if 4000 IU per day of vitamin D3 is safe for frail older adults; and 2) establish the efficacy of this dose to improve physical performance outcomes in this population. Design: Open-label, feasibility study. Setting: Community retirement centre. Participants: 40 older adults with frail or pre-frail characteristics. Intervention: 4000 IU of vitamin D3 and 1200 mcg of calcium carbonate daily for four months. Measurements: Physical performance (grip strength, gait speed and short physical performance battery score), cognitive health and vitamin D and iPTH serum levels before and after the intervention. Results: Frail individuals improved short physical performance battery score (1.19, p = 0.005), fast gait speed (4.65, p = 0.066) and vitamin D levels (7.81, p = 0.011). Only frail females made a significant improvement in grip strength (1.92, p = 0.003). Stratifying the sample by baseline vitamin D levels revealed that participants with vitamin D insufficiency (≤ 75 nmol/L) significantly improved short physical performance battery score (1.06, p = 0.04), fast gait speed (6.28, p = 0.004) and vitamin D levels (25.73, p = <0.0001). Pre-frail individuals, as well as those with sufficient vitamin D levels (> 75 nmol/L) made no significant improvement in any outcome. Conclusions: Vitamin D supplementation using 4000 IU/daily is safe and has a modest beneficial effect on physical performance for frail individuals and those with insufficient vitamin D levels. Participants with vitamin D insufficiency (≤ 75 nmol/L) showed greater benefits. Our feasibility study provides results to help calculate effect size for a future RCT.


2018 ◽  
Vol 7 ◽  
pp. 117957271876576 ◽  
Author(s):  
Josephine Gade ◽  
Rie Johanne Pedersen ◽  
Anne Marie Beck

Objectives: Loss of muscle mass and strength with aging, sarcopenia, burdens many older adults, making identification of strategies on how to counteract it very relevant—especially to health care providers working in rehabilitation. The aim of this systematic review was to determine the effect of protein or essential amino acid (EAA) supplementation during prolonged resistance exercise training (RT) in older adults. No known stimulants of muscle protein synthesis, or ingredients with an effect on muscle strength/physical function, were allowed with the supplementation, differentiating this systematic review from others. Data sources and methods: In January 2017, 4 electronic databases and reference lists were searched for randomized controlled trials investigating the effect of protein or EAA supplementation during RT in older adults (mean age >60 years) on outcomes of body composition, muscle strength, and physical performance. Study selection and data extraction were performed by 2 independent reviewers. Results Sixteen studies (1107 participants) fulfilled the eligibility criteria. Methodologic differences between the studies disallowed a meta-analysis. Of the 16 studies, 6 found significant effects on body composition (3 studies), muscle strength (3 studies), and physical performance (2 studies) measures. Conclusions The evidence is weak and inconsistent, as benefit of protein or EAA supplementation during RT in older adults is only shown in some studies. The findings indicate that frail/sarcopenic older adults might benefit more than healthy older adults. Further research is needed to allow an interpretation on the importance of study population and design. Trial registration: PROSPERO, Reg. no.: CRD42017063808. Registered April 14, 2017.


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