Muscle-targeted nutritional support for rehabilitation in patients with parkinsonian syndrome

Neurology ◽  
2019 ◽  
Vol 93 (5) ◽  
pp. e485-e496 ◽  
Author(s):  
Michela Barichella ◽  
Emanuele Cereda ◽  
Giovanna Pinelli ◽  
Laura Iorio ◽  
Diana Caroli ◽  
...  
Keyword(s):  
Vitamin D ◽  
Whey Protein ◽  
Muscle Mass ◽  
Nutritional Support ◽  
Walking Speed ◽  
Handgrip Strength ◽  
Controlled Trial ◽  
Mean Difference ◽  
Secondary Endpoints ◽  
Intensive Rehabilitation

ObjectiveWe evaluated the efficacy of muscle-targeted nutritional support on the functional outcomes of multidisciplinary intensive rehabilitation treatment (MIRT) in patients with Parkinson disease (PD) or parkinsonism.MethodsWe conducted a pragmatic, bicentric, randomized (1:1), assessor-blind controlled trial (Protein, Leucine and Vitamin D Enhancing Rehabilitation [PRO-LEADER]; April 2017 to January 2018) in cognitively intact patients with PD or parkinsonism and undergoing a 30-day MIRT. Patients (n = 150) received a standard hospital diet with or without a whey protein–based nutritional supplement enriched with leucine and vitamin D twice daily. The primary efficacy endpoint was the increase in the distance walked during a 6-minute walking test (6MWT). Secondary endpoints were changes in 4-meter walking speed, Timed Up and Go test (TUG), Berg balance scale, handgrip strength, Self-assessment Parkinson's Disease Disability Scale, body weight, and skeletal muscle mass (SMM).ResultsNutritional support resulted in greater increase in the distance walked during 6MWT (mean 69.6 meters [95% confidence interval (CI) 60.7–78.6]) than no support (51.8 meters [95% CI 37.0–66.7]): center-adjusted mean difference, 18.1 meters (95% CI 0.9–35.3) (p = 0.039). Further adjustment for changes in dopaminergic therapy and SMM yielded consistent results: mean difference, 18.0 meters (95% CI 0.7–35.2) (p = 0.043). A meaningful effect was also found for the following secondary endpoints: 4-meter walking speed (p = 0.032), TUG (p = 0.046), SMM, and SMM index (p = 0.029). Six patients discontinued the nutritional therapy due to mild side effects.ConclusionThe consumption of a whey protein–based nutritional formula enriched with leucine and vitamin D with MIRT improved lower extremity function and preserved muscle mass in patients with PD or parkinsonism.Clinicaltrials.gov identifierNCT03124277.Classification of evidenceThis study provides Class I evidence that for patients with parkinsonism undergoing intensive rehabilitation, a whey protein–based nutritional formula enriched with leucine and vitamin D increased distance walked on the 6MWT.

Whey protein and vitamin D supplementation in institutionalized older adults: A randomized trial

2021 ◽  
pp. 026010602110606
Author(s):  
Tamy Colonetti ◽  
Antônio Jose Grande ◽  
Franciani Rodrigues da Rocha ◽  
Eduardo Ronconi Dondossola ◽  
Lisiane Tuon ◽  
...  
Keyword(s):  
Older Adults ◽  
Vitamin D ◽  
Body Composition ◽  
Resistance Training ◽  
Whey Protein ◽  
Muscle Mass ◽  
Lean Mass ◽  
Vitamin D Supplementation ◽  
Relative Index ◽  
And Control

Background: The increase in life expectancy and in the number of individuals over 60 years old brings new demands to health professionals and services based on the physiological changes that occur in this population. The aging process results in changes in body composition, increasing body fat and reducing muscle mass, in addition to a reduction in bone mass. Aim: The aim of this study was to examine the effect of whey protein and vitamin D supplementation on body composition and skeletal muscle in older adults living in long-term care facilities. Methods: This study is a double-blind randomized controlled trial. Thirty older adults (>60 years old) were randomized and allocated in three groups: group receiving resistance training and supplementation receiving resistance training, whey protein and vitamin D; group received resistance and placebo training receiving resistance training and placebo, and control group without any intervention. Body composition was measured by dual-energy X-ray absorptiometry at baseline, 12 weeks, and 24 weeks. Results: The mean age was 74.87 (± 8.14) years. A significant difference ( p = 0.042) was observed between the group receiving resistance training and supplementation and control groups in relation to lean mass increase (kg) at 24 weeks. After 24 weeks of intervention, there was a significant increase in Relative index of muscle mass for the two groups that underwent resistance training, group received resistance and placebo training ( p = 0.042) and group receiving resistance training and supplementation ( p = 0.045), in relation to the control. Conclusion: Combined supplementation of whey protein and vitamin D with resistance training can significantly improve lean mass, total mass, and relative index of muscle mass in institutionalized older adults.

scholarly journals EFFECTS OF VITAMIN D SUPPLEMENTATION ON WELL-BEING, POSTURAL CONTROL, MUSCLE STRENGTH, BONE AND CALCITROPIC HORMONES – A RANDOMIZED DOUBLEBLIND PLACEBO CONTROLLED TRIAL

2019 ◽  
pp. 1-8
Author(s):  
S.A. Eriksen ◽  
J. Starup-Linde ◽  
R.P. Hirata ◽  
K.K. Petersen ◽  
T. Graven-Nielsen ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Major Depression ◽  
Postural Control ◽  
Pain Sensitivity ◽  
Handgrip Strength ◽  
Controlled Trial ◽  
Vitamin D Supplementation ◽  
Intact Parathyroid Hormone ◽  
Major Depression Inventory

Background: Antidepressants may increase the risk of fractures through negative effects on the musculoskeletal system that could be hindered by vitamin D supplements. Objectives: To study the pleiotropic effects of daily vitamin D supplementation in depressed patients treated with citalopram (patients) and healthy controls. Design: Randomised double blind placebo controlled trial. Setting: A study of Danish women in the age 50 to 90 years. Participants: A total of 21 patients and 50 controls. Intervention: Participants received daily vitamin D supplementation (50 micrograms) or placebo in one year. Measurements: Bone Densitometry by dual-energy x-ray absorptiometry. Serum 25-hydroxyvitamin D, intact-Parathyroid Hormone, type 1 procollagen N terminal peptide, tartrate resistant acid phosphatase type 5b. Pain sensitivity measures based on pain detection thresholds by cuff algometry, temporal summation of pain, conditioned pain modulation, and cutaneous pain sensitivity by pinprick test. Degree of depression by the Major Depression Inventory. Physical performance was assessed by Timed up and go, isomeric handgrip exercise, and postural control by force plate. Results: Serum 25(OH)D levels increased in the vitamin D treated patients compared with controls at the 12 months visit (P<0.05). Conversely, intact- Parathyroid Hormone decreased among the patients and controls receiving vitamin D compared with placebo (P<0.05). Vitamin D improved Major Depression Inventory scores in patients and controls compared with placebo (P<0.05). In patients receiving vitamin D, handgrip strength improved (P<0.05). Conclusions: Vitamin D may improve depressive symptoms, and improve handgrip strength among patients compared to controls.

scholarly journals Preservation of Lean Mass upon Combined Lifestyle Intervention in Older Adults with Obesity and Type 2 Diabetes During 6-Months Follow-Up After RCT (PROBE Study)

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 53-53
Author(s):  
Robert Memelink ◽  
Anke Bongers ◽  
Wilrike Pasman ◽  
Mariëtte van Rijmenam ◽  
Suzan Wopereis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Older Adults ◽  
Vitamin D ◽  
G Protein ◽  
Whey Protein ◽  
Muscle Mass ◽  
Lifestyle Intervention ◽  
Lean Mass

Abstract Objectives Weight loss is a key element in the treatment of obesity and type 2 diabetes (T2D), but also a risk factor for lean mass (LM) loss in older adults. We evaluated whether a whey protein drink enriched with leucine and vitamin D preserved LM during 3-month lifestyle intervention and whether effects sustained during 6 months follow-up after intervention (FU). Methods 123 older adults (66 ± 6 y) with obesity (BMI 34 ± 4 kg/m2) and T2D participated in a 3-month lifestyle intervention with dietary advice (−600 kcal/d) and resistance exercise (3×/wk). In this double-blind RCT (PROBE) subjects were randomised to receive 10×/wk a test (21 g protein) or isocaloric control (0 g protein) drink. LM, appendicular muscle mass (AMM), leg muscle mass (LMM), and fat mass (FM) were assessed with DXA. Mixed linear model analysis was used with baseline value in the outcome vector and adjustment for stratification factors sex and SU-derivate use. Data represent EMM ± SE (within group) or 95% CI (between groups). Results 105 subjects completed intervention and 76 subjects participated in FU. At 3 months, body weight (−2.2 ± 0.4 kg, P &lt; 0.001, test; −2.9 ± 0.4 kg, P &lt; 0.001, control) and FM (−2.6 ± 0.4 kg, P &lt; 0.001, test; −2.5 ± 0.4 kg, P &lt; 0.001, control) were reduced without differences between groups. LM and AMM were increased in test (+0.57 ± 0.27 kg, P = 0.03; +0.39 ± 0.13 kg, P &lt; 0.01) and unchanged in control (−0.35 ± 0.26 kg, P = 0.18; +0.03 ± 0.12 kg, P = 0.80), with significant difference between groups (+0.92 kg, 95% CI 0.19–1.65, P = 0.015; +0.36 kg, 95% CI 0.01–0.71, P = 0.047). At FU (without test or control drink), the difference in LM and AMM between groups had disappeared while both groups still had significantly improved body composition compared to baseline, as reflected by decreased FM (−2.4 ± 0.4 kg, &lt; 0.001, test; −2.6 ± 0.4 kg, &lt; 0.001, control) and increased or preserved LM (+0.88 ± 0.32 kg, 0.007; +0.54 ± 0.32 kg, 0.09) and AMM (+0.46 ± 0.15 kg, 0.002; +0.31 ± 0.15 kg, 0.03). Conclusions Use of a whey protein drink enriched with leucine and vitamin D during a combined lifestyle intervention showed beneficial effects on lean mass in older adults with obesity and type 2 diabetes. Preservation of lean mass was sustained after 6 months follow-up, without differences between treatment groups. Funding Sources Grant: Topsector Agri & Food, The Netherlands. Financial support for study conduct: Danone Nutricia Research.

scholarly journals Supplementing Breakfast with a Vitamin D and Leucine–Enriched Whey Protein Medical Nutrition Drink Enhances Postprandial Muscle Protein Synthesis and Muscle Mass in Healthy Older Men

2017 ◽  
Vol 147 (12) ◽  
pp. 2262-2271 ◽  
Author(s):  
Audrey Chanet ◽  
Sjors Verlaan ◽  
Jérôme Salles ◽  
Christophe Giraudet ◽  
Véronique Patrac ◽  
...  
Keyword(s):  
Vitamin D ◽  
Protein Synthesis ◽  
Whey Protein ◽  
Muscle Mass ◽  
Muscle Protein ◽  
Muscle Protein Synthesis ◽  
Older Men ◽  
Medical Nutrition

The Comparison of Sarcopenia Diagnostic Criteria using AWGS 2019 with the Other Five Criteria in West China

Gerontology ◽  
2021 ◽  
pp. 1-11
Author(s):  
Xiaolei Liu ◽  
Lisha Hou ◽  
Wanyu Zhao ◽  
Xin Xia ◽  
Fengjuan Hu ◽  
...  
Keyword(s):  
Vitamin D ◽  
Serum Albumin ◽  
Diagnostic Criteria ◽  
Walking Speed ◽  
Serum Albumin Level ◽  
Handgrip Strength ◽  
Insulin Level ◽  
Albumin Level ◽  
Community Dwelling ◽  
West China

Introduction: The aim of this study was to investigate the prevalence and associated factors of sarcopenia defined by different criteria in community-dwelling adults of west China using the baseline data of West-China Health and Aging Trend (WCHAT) study. Methods: Adults aged 50 years or older in communities of Yunnan, Guizhou, Sichuan, and Xinjiang provinces were enrolled in this study. We applied 6 ­diagnostic criteria (AWGS 2019, AWGS 2014, EWGSOP1, ­EWGSOP2, IWGS, and FNIH) to define sarcopenia. Muscle mass was measured based on bioimpedance analysis. Handgrip strength and walking speed were recorded, respectively. Different variables like anthropometry measures, lifestyles, chronic disease, and blood test were collected. Results: We included 4,500 participants. The prevalence of sarcopenia was 22.8, 19.3, 57.1, 11.8, 24.1, and 18.1% according to the AWGS 2019, AWGS 2014, EWGSOP 1, EWGSOP 2, IWGS, and FNIH criteria, respectively. We found that serum albumin level was independently associated with sarcopenia using AWGS 2019 and IWGS. And vitamin D level was independently associated with sarcopenia using AWGS 2014, ­EWGSOP2, and FNIH. While age, depressive status, BMI, hemoglobin, vitamin D, and insulin level were all significantly associated with sarcopenia using AWGS 2014, but all of these factors were not significant using AWGS 2019. Conclusions: Sarcopenia was highly prevalent in west China regardless of the diagnostic criteria. Serum albumin and vitamin D level were mostly associated with sarcopenia defined by different criteria. While most risk factors associated with the AWGS 2014-defined sarcopenia exhibited no consistent pattern with AWGS 2019, the validity of the AWGS 2019 consensus needs to be confirmed in further prospective studies.

scholarly journals Muscle strength and muscle mass in elderly women after cholecalciferol supplementation in Southern Brazil

2019 ◽  
Vol 7 (1) ◽  
pp. 32016
Author(s):  
Patrícia Zambone Da Silva ◽  
Rodolfo Herberto Schneider
Keyword(s):  
Vitamin D ◽  
Secondary Hyperparathyroidism ◽  
Muscle Mass ◽  
Lean Mass ◽  
Elderly Women ◽  
Handgrip Strength ◽  
Mineral Density ◽  
Lean Muscle Mass ◽  
Cholecalciferol Supplementation ◽  
Deficient Group

AimS: Vitamin D is known to be vital in sustaining musculoskeletal functions, with its deficiency may cause muscle weakness and decreased bone mineral density. Vitamin D inadequacy is highly prevalent and its deficiency or insufficiency estimated to affect one billion people worldwide. It causes secondary hyperparathyroidism, bone loss, fractures and it has been associated with a number of other conditions, such as impaired muscle function (1), we decided to verify if there is an association between 25(OH)D status and handgrip strength and with lean muscle mass after cholecalciferol supplementation in elderly women.Methods : We studied fifty-four postmenopausal women with serum 25(OH)D below 30 ng/mL during three months. Cholecalciferol supplementation was divided into two levels according to classification: deficient (10000 units/day) and insufficient (2000 units/day). Changes in biochemical response and in body composition were assessed using dual-x-ray energy absormetry, handgrip strength and blood tests before and after supplementation.Results: The majority of the sample were vitamin D deficient. There was no difference in the deficient group for handgrip strength after the supplementation (p=0,489), but PTH had a statistically significant reduction (p=0.001). Besides, the deficient group had a decrease in lean mass even after the intervention (p=0.006). The results were similar when comparing within results of the insufficient group, however lean mass remained stable (p=0.423).Conclusion: Three-month cholecalciferol supplementation alone in elderly women with doses according to 25(OH)D serum was insufficient to change handgrip strength and total lean muscle mass, however secondary hyperparathyroidism was corrected.

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