Today we see an ageing population and this population is growing faster than all younger age groups.1 Ageing comes with a decrease in bone and muscle mass, which is often accompanied by a chronic low-grade inflammatory profile (CLIP).2 During inflammation, immune cells produce inflammatory factors, called cytokines. CLIP is reflected by subtle increases in circulating cytokines. CLIP is a well-known phenomenon in the aged and associated with frailty and sarcopenia in older adults. Additionally, CLIP is associated with higher vulnerability to poor health outcomes like disability, hospital admission and mortality.
Nutritional supplementation trial in sarcopenic older adults
Specific nutrients, such as the amino acid leucine and vitamin (Vit) D, have shown immune-modulatory potential, which could hypothetically translate into positive effects on reductions in inflammation, muscle- and bone-related functional impairment or disability.3 However, there is little evidence for the effect of nutritional supplementation on markers of CLIP in ageing people.
Journal Aging Clinical and Experimental Research published “13 weeks of supplementation of Vitamin D and leucine-enriched whey protein nutritional supplement attenuates chronic low grade inflammation in sarcopenic older adults: the PROVIDE study”.
This sub-study is part of the PROVIDE study exploring whether 13 weeks of supplementation of Vit D and leucine-enriched whey protein affects circulating inflammatory markers in 380 sarcopenic older adults enrolled in the PROVIDE study. Participants were randomly allocated to 2 daily-servings of the active product including 20g of whey protein, 3g of leucine and 800IU Vit D or an isocaloric control product for a period of 13 weeks. In this sub-study, markers of CLIP were measured at baseline and after 13 weeks of intervention.
The study shows that 13 weeks of nutritional supplementation with Vit D and leucine-enriched whey protein attenuates the progression of CLIP in sarcopenic older people with mobility limitations. This study can be of clinical significance owing to the relevant contribution of CLIP to the development of frailty and sarcopenia.
The PROVIDE study
The PROVIDE study is a multicenter, randomized, controlled, double-blind, 2 parallel-group trial among 380 sarcopenic older adults. The aim of the PROVIDE study was to investigate if a specific oral nutritional supplement can result in improvements in measures of sarcopenia. Although this study showed no effect of the supplement on the primary outcomes hand grip strength and Short Physical Performance Battery (SPPB), a significant treatment effect was shown on chair-stand-time (a proxy for lower extremity muscle strength) and muscle mass. The study showed proof-of-principle that specific nutritional supplementation alone might benefit geriatric patients.