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

Abstract

A promising strategy to help older adults preserve or build muscle mass is to optimize muscle anabolism through providing an adequate amount of high-quality protein at each meal. This "proof of principle" study investigated the acute effect of supplementing breakfast with a vitamin D and leucine-enriched whey protein medical nutrition drink on postprandial muscle protein synthesis and longer-term effect on muscle mass in healthy older adults. A randomized, placebo-controlled, double-blind study was conducted in 24 healthy older men [mean ± SD: age 71 ± 4 y; body mass index (in kg/m) 24.7 ± 2.8] between September 2012 and October 2013 at the Unit of Human Nutrition, University of Auvergne, Clermont-Ferrand, France. Participants received a medical nutrition drink [test group; 21 g leucine-enriched whey protein, 9 g carbohydrates, 3 g fat, 800 IU cholecalciferol (vitamin D), and 628 kJ] or a noncaloric placebo (control group) before breakfast for 6 wk. Mixed muscle protein fractional synthesis rate (FSR) was measured at week 0 in the basal and postprandial state, after study product intake with a standardized breakfast with the use of l-[H]-phenylalanine tracer methodology. The longer-term effect of the medical nutrition drink was evaluated by measurement of appendicular lean mass, representing skeletal muscle mass at weeks 0 and 6, by dual-energy X-ray absorptiometry. Postprandial FSR (0-240 min) was higher in the test group than in the control group [estimate of difference (ED): 0.022%/h; 95% CI: 0.010%/h, 0.035%/h; ANCOVA, = 0.001]. The test group gained more appendicular lean mass than the control group after 6 wk (ED: 0.37 kg; 95% CI: 0.03, 0.72 kg; ANCOVA, = 0.035), predominantly as leg lean mass (ED: 0.30 kg; 95% CI: 0.03, 0.57 kg; ANCOVA, = 0.034). Supplementing breakfast with a vitamin D and leucine-enriched whey protein medical nutrition drink stimulated postprandial muscle protein synthesis and increased muscle mass after 6 wk of intervention in healthy older adults and may therefore be a way to support muscle preservation in older people. This trial was registered at www.trialregister.nl as NTR3471.

An Update on Protein, Leucine, Omega-3 Fatty Acids, and Vitamin D in the Prevention and Treatment of Sarcopenia and Functional Decline

“…While increased protein intakes and supplements in leucine, vitamin D, and n -3 PUFA support potential gains in muscle mass and function when consumed individually, the combination of these nutrients may provide further benefits. Four recent, randomized, double-blind placebo-controlled studies tested a combined supplement of high-quality protein and vitamin D, without exercise intervention, on lean mass, strength, and physical performance [ 123 , 124 , 125 , 126 ]; two of them included added leucine to the mix [ 124 , 126 ], and one included n -3 PUFA, and creatine [ 125 ]. A 13-week multicenter study conducted in 380 sarcopenic older individuals aged ≥65 years with high disability risk found a beneficial effect of a 800 IU vitamin D, 3 g of leucine, and 20 g of whey protein supplement, given twice daily, on the chair-stand time (−1.01 s, 95% CI: −1.77, −0.19), but not on physical performance, mobility, and strength compared to the control group receiving an isocaloric placebo [ 126 ].…”

“…A very slight increase in ALM (0.17 kg, 95% CI: 0.004, 0.338) was reported, although it was within the 1.2% lean body mass measurement error by dual-energy X-ray absorptiometry DXA [ 127 ]. The same supplement was provided before breakfast only to 24 healthy older men, and similarly showed a modest gain in ALM (estimate difference of 0.37 kg) and leg lean mass after six weeks [ 124 ]. Interestingly, dietary protein intake was displaced by the supplement in the intervention group, as shown by the same total protein intake between groups when accounting for the supplement.…”

Even effect of milk protein and carbohydrate intake but no further effect of heavy resistance exercise on myofibrillar protein synthesis in older men

“…Furthermore, we had basal measurements of MPS. The findings in a very recent study in older men illustrate that a basal FSR measurement can be important since the study document a positive response to a standard breakfast meal, which contained 1567 kJ in the form of 60 g carbohydrates, 11 g fat, and only 6 g of protein [51]. However, in this study, the standard breakfast meal was compared to intake of the breakfast with the addition of a vitamin D and leucine-enriched whey protein medical nutrition drink (containing 21 g of protein including 3 g of leucine).…”

Exercise and Nutrition Strategies to Counteract Sarcopenic Obesity

“…Another strategy would be to combine several anabolic nutrients, such as protein, amino acids, vitamin D, and omega 3. Indeed, recent studies have shown that combining whey protein, which has been enriched with leucine and with vitamin D, could increase protein synthesis and finally promote muscle mass gain in older adults [ 131 , 132 ]. It was reported that this combination was also effective in adults (35–65 years) [ 118 ] and in obese older adults [ 133 ].…”