Changes in musculoskeletal health associated with advancing age contribute to sarcopenia and a decrease in bone mineral density (BMD) and bone strength.

A recent study tested the hypothesis that a particular oral nutritional supplement could improve measures of bone health. There were 380 participants, who had participated in the PROVIDE study - a 13-week, multicenter, randomized, controlled, double-blind, 2 parallel-group study among non-malnourished older adults (≥ 65 years) with sarcopenia [characterized by Short Physical Performance Battery (SPPB; 0-12) scores of 4-9, and a low skeletal muscle mass index (SMI; skeletal muscle mass/BW × 100) ≤37% in men and ≤28% in women using bioelectric impedance analysis].Investigators compared a vitamin D, calcium and leucine-enriched whey protein supplement (active; 2/day) 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 assessedbefore and after intervention.

Serum 25(OH)D increased in the active group (from 51.1 ± 22.9 nmol/L (mean ± SD) to 78.9 ± 21.1 nmol/L; p < 0.001 vs. control). A significant treatment difference was evident for serum PTH (p < 0.001), with a fall in the active group, and increase in the control group. Serum IGF-1 increased in the active group (p < 0.001 vs. control). Additionally, there was greater reduction in serum CTX in the active group (p = 0.001 vs. control). No significant differences in serum OC or P1NP could be noted between the two groups. There was a small (0.02 g/cm2; ~ 2%) but significant increase in total body BMD in the active group following supplementation (p = 0.033 vs. control).

It was concluded that a vitamin D, calcium and leucine-enriched whey protein supplement given for a period of 13 weeks enhanced 25(OH)D, suppressed PTH and had a small but positive effect on BMD, thus suggesting improved bone health, in sarcopenic non-malnourished older adults.

Reference

1. Hill TR, Verlaan S, Biesheuvel E, et al. 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.Calcif Tissue Int. 2019 Oct;105(4):383-391.