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Safety and tolerability of 6-month supplementation with a vitamin D, calcium and leucine-enriched whey protein medical nutrition drink in sarcopenic older adults.
Bauer, JM, Mikušová, L, Verlaan, S, Bautmans, I, Brandt, K, Donini, LM, Maggio, M, Mets, T, Wijers, SLJ, Garthoff, JA, et al
Aging clinical and experimental research. 2020;32(8):1501-1514
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Older adults who have sarcopenia and osteoporosis are at risk of falls, fractures and hospitalisation. Sufficient dietary protein intake and an adequate vitamin D and calcium status has been proposed as a way to attenuate age-related loss of muscle and bone. This however may cause safety concerns with regard to kidney function and potential vitamin D or calcium toxicity. The aim of this randomised placebo-controlled trial was to determine the effect of 6 months supplementation with a vitamin D, calcium and leucine-enriched whey protein medical nutrition drink (WP-MND) on kidney function and on vitamin D, parathyroid hormone (PTH) and calcium levels in sarcopenic older adults. In conclusion, a 6-month intake of a vitamin D, calcium and leucine-enriched whey protein medical nutrition drink in addition to a regular diet does not impair kidney function or disturb vitamin D and calcium metabolism in sarcopenic older adults.
Abstract
AIMS: Safety and tolerability of prolonged supplementation with a vitamin D, calcium and leucine-enriched whey protein medical nutrition drink (WP-MND) was evaluated in sarcopenic older adults. METHODS A 13-week double-blinded, randomized, isocaloric placebo-controlled trial (PROVIDE study; n = 380) was extended with a voluntary 13-week open-label extension (OLE). OLE participants were randomized to receive daily 1 or 2 servings of WP-MND (21 g protein, 3 g leucine, 10 µg vitD and 500 mg calcium per serving). Gastro-intestinal tolerability, kidney function and serum levels of calcidiol, parathyroid hormone (PTH) and calcium were evaluated at week 0, 13 and 26. RESULTS AND DISCUSSION In response to the high daily protein intake (median1.5; IQR: 1.3, 1.7 g/kg BW/day), the estimated glomerular filtration rate (eGFR) increased in the test group during the RCT (p = 0.013). The same trend was observed for those participants with moderate chronic kidney disease. During OLE no eGFR change was observed in any of the groups. Serum calcidiol and calcium reached a plateau after 13-week WP-MND supplementation. As expected, PTH significantly changed in the opposite direction, decreasing during RCT in the test group (T vs C: p < 0.001) and during OLE in former control groups. During RCT, 20/366 participants with normal baseline calcidiol reached levels ≥ 100 nmol/L (T: n = 18; C: n = 2) and 6 developed albumin-corrected calcium levels > 2.55 mmol/L (T: n = 3; C: n = 3), without associated adverse events. CONCLUSION A 6 months intervention with up to 2 servings of WP-MND did neither result in kidney function deterioration nor symptoms of vitamin D or calcium toxicity. The product was overall well tolerated.
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Is a vegan diet detrimental to endurance and muscle strength?
Boutros, GH, Landry-Duval, MA, Garzon, M, Karelis, AD
European journal of clinical nutrition. 2020;74(11):1550-1555
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There is a common belief amongst the general population that a vegan diet leads to lower exercise performance due to the potential lack of dietary protein and nutrients. However, previous research that compared aerobic capacity and muscle strength between different diet groups only showed marginal variance, if any at all. But it is criticized that these studies did not always distinguish between the multiple subtypes of vegetarian or veganism. Hence this study sought to focus specifically on the comparison of strict plant-based eaters with omnivores. The participants involved were 56 active women, around their mid-twenties, with an average Body Mass Index of 22. Assessed were estimated VO2 max (an indicator of aerobic fitness), submaximal endurance performance and upper and lower body muscle strength. The 3-day food diaries of each participant was analysed and showed a similar intake of energy and fats in both groups. Vegans had higher carbohydrate, fibre, vitamin C, iron, and magnesium consumption and lower intake of protein, leucine, alanine, saturated fat, vitamin D, and vitamin B12, when compared to omnivores. Whilst upper body strength appeared to be marginally lower in the vegan group, higher levels of estimated VO2 max and significantly higher submaximal endurance levels were observed. The results contradict the common belief, demonstrating that a vegan diet appears to have no detrimental impact on endurance and muscle strength in healthy, young and lean women. In fact, the findings suggest that a vegan diet can be advantageous on endurance performance compared to omnivores. The authors propose that the higher intake of carbohydrates amongst vegans could be linked to better endurance performance and that such a plant-based diet can have favourable effects on oxidative stress and inflammatory profiles. The outcomes of this study may be of interest to those supporting the sports performance of strict plant-based eaters.
Abstract
BACKGROUND/OBJECTIVES In the general population, there is a popular belief that a vegan diet may be associated with a lower exercise performance due to the lack of certain nutrients in vegan individuals. Thus, the purpose of the present study was to examine endurance and muscle strength differences between vegan and omnivore participants. SUBJECTS/METHODS We studied 56 healthy young lean physically active women (age: 25.6 ± 4.1 years; body mass index: 22 ± 1.9 kg/m2). Participants were classified as vegan (n = 28) or omnivore (n = 28) based on their eating habits. All volunteers followed either a vegan or an omnivore diet for at least 2 years. Anthropometric measurements, body composition, estimated maximal oxygen consumption (VO2 max), a submaximal endurance test (70% of VO2 max), muscle strength (leg and chest press), and dietary factors were measured. RESULTS Both groups were comparable for physical activity levels, body mass index, percent body fat, lean body mass, and muscle strength. However, vegans had a significantly higher estimated VO2 max (44.5 ± 5.2 vs. 41.6 ± 4.6 ml/kg/min; p = 0.03, respectively) and submaximal endurance time to exhaustion (12.2 ± 5.7 vs. 8.8 ± 3.0 min; p = 0.007, respectively) compared with omnivores. CONCLUSIONS The results suggest that a vegan diet does not seem to be detrimental to endurance and muscle strength in healthy young lean women. In fact, our study showed that submaximal endurance might be better in vegans compared with omnivores. Therefore, these findings contradict the popular belief of the general population.
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The effects of 12 weeks of beta-hydroxy-beta-methylbutyrate free acid supplementation on muscle mass, strength, and power in resistance-trained individuals: a randomized, double-blind, placebo-controlled study.
Wilson, JM, Lowery, RP, Joy, JM, Andersen, JC, Wilson, SM, Stout, JR, Duncan, N, Fuller, JC, Baier, SM, Naimo, MA, et al
European journal of applied physiology. 2014;114(6):1217-27
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Supplementation of a leucine metabolite in the free acid form, beta-hydroxy-beta-methylbutyrate free acid (HMB-FA), has been found to increase skeletal muscle and attenuate muscle damage. Currently research on HMB-FA supplementation is limited, and no long-term studies have been conducted. The aim of this trial was to investigate the effects of HMB-FA supplementation on skeletal muscle, body composition and performance in 24 resistance-trained athletes. This study found that HMB-FA enhances lean body mass, muscle hypertrophy, strength and power following resistance training. Additionally, during overreaching phases of training, HMB-FA supplementation prevented typical declines in performance.
Abstract
INTRODUCTION Studies utilizing beta-hydroxy-beta-methylbutyrate (HMB) supplementation in trained populations are limited. No long-term studies utilizing HMB free acid (HMB-FA) have been conducted. Therefore, we investigated the effects of 12 weeks of HMB-FA supplementation on skeletal muscle hypertrophy, body composition, strength, and power in trained individuals. We also determined the effects of HMB-FA on muscle damage and performance during an overreaching cycle. METHODS A three-phase double-blind, placebo- and diet-controlled randomized intervention study was conducted. Phase 1 was an 8-week-periodized resistance-training program; Phase 2 was a 2-week overreaching cycle; and Phase 3 was a 2-week taper. Muscle mass, strength, and power were examined at weeks 0, 4, 8, and 12 to assess the chronic effects of HMB-FA; and assessment of these, as well as cortisol, testosterone, and creatine kinase (CK) was performed at weeks 9 and 10 of the overreaching cycle. RESULTS HMB-FA resulted in increased total strength (bench press, squat, and deadlift combined) over the 12-week training (77.1 ± 18.4 vs. 25.3 ± 22.0 kg, p < 0.001); a greater increase in vertical jump power (991 ± 168 vs. 630 ± 167 W, p < 0.001); and increased lean body mass gain (7.4 ± 4.2 vs. 2.1 ± 6.1 kg, p < 0.001) in HMB-FA- and placebo-supplemented groups, respectively. During the overreaching cycle, HMB-FA attenuated increases in CK (-6 ± 91 vs. 277 ± 229 IU/l, p < 0.001) and cortisol (-0.2 ± 2.9 vs. 4.5 ± 1.7 μg/dl, p < 0.003) in the HMB-FA- and placebo-supplemented groups, respectively. CONCLUSIONS These results suggest that HMB-FA enhances hypertrophy, strength, and power following chronic resistance training, and prevents decrements in performance following the overreaching.