Pol Grootswagers, Ellen Smeets, Antwi-Boasiako Oteng, Lisette de Groot
Journal: Aging 2021;13(7):9398-9418
PMID: 33799307
Undernutrition is a medical condition that is highly prevalent in older adults and is often accompanied by a loss of skeletal muscle mass and impaired physical functioning. Undernutrition is mainly addressed by oral nutritional supplements. These supplements are often energy and protein-dense and contain a wide range of macronutrients and micronutrients such that they form complete nutrition. The aim of this study was to assess the effect of 12-weeks supplementation with a novel supplement on lean body mass. This study is a randomized, standard-care controlled, open-label trial. Participants were randomly assigned to one of the two arms: novel or standard. The study was open-label: the supplements of the novel and the standard supplement group differed in appearance and taste, but all participants assumed that they were given a product with novel characteristics. Results showed that: - self-measured body weight increased in a similar manner in both treatment arms. However, participants receiving standard supplement gained significantly more fat mass compared to those receiving the novel supplement. - the performance on the walk tests of 400 m and 4 m changed differentially over the two treatments arms during the study period in favour of the novel supplement group. - the novel supplement led to an improved gait speed over short and long distance. - physical activity was equal between the two arms. - in both groups, participants showed high compliance to the study products and rated both products equally well, suggesting that nutrition supplementation in fluid or powder form is both acceptable for patients. Authors conclude that 12-week supplementation with a novel oral nutritional supplement improved walking performance in older adults with (or at risk of) undernutrition, possibly via improvements in mitochondrial mechanisms in the muscle.
Undernutrition in older adults is mainly addressed by oral nutritional supplements, which do not affect physical functioning. In this study, we tested a novel oral nutritional supplement that included whey and casein protein, ursolic acid, free branch-chained amino acids and vitamin D against a standard supplement. We included older adults (>65y) with (or at risk of) undernutrition (n=82) and randomized them to 12 weeks of novel or standard supplement. Both groups showed significant increases in body mass. No within or between-group differences in lean body mass were observed. Fat mass increased significantly more in the standard than the novel supplement group (time*treatment effect P=0.045). The novel supplement group showed a larger improvement in walking performance on distances of 4m (treatment x time interaction P=0.048) and 400m (treatment x time interaction P=0.038) than the standard treatment group. Gene sets related to mitochondrial functioning and oxidative phosphorylation were upregulated in the novel supplement group and downregulated in the standard supplement group. We conclude that a 12-week intervention with the novel supplement improved walking performance both during short and long distance as compared to a standard supplement, which can largely be explained by increased mitochondrial functioning in the group receiving the novel supplement.
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