体力活动联合营养补充改善行动受限老年人的肌肉组成：VIVE2研究，一项随机、双盲、安慰剂对照试验
Nutritional Supplementation With Physical Activity Improves Muscle Composition in Mobility-Limited Older Adults, The VIVE2 Study: A Randomized, Double-Blind, Placebo-Controlled Trial.
作者信息
Englund Davis A, Kirn Dylan R, Koochek Afsaneh, Zhu Hao, Travison Thomas G, Reid Kieran F, von Berens Åsa, Melin Michael, Cederholm Tommy, Gustafsson Thomas, Fielding Roger A
机构信息
Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Sweden.
出版信息
J Gerontol A Biol Sci Med Sci. 2017 Dec 12;73(1):95-101. doi: 10.1093/gerona/glx141.
BACKGROUND
Nutritional supplementation and physical activity have been shown to positively influence muscle mass and strength in older adults. The efficacy of long-term nutritional supplementation in combination with physical activity in older adults remains unclear.
METHODS
Mobility-limited (short physical performance battery [SPPB] ≤9) and vitamin D insufficient (serum 25(OH) D 9-24 ng/mL) older adults were recruited for this study. All subjects participated in a physical activity program. Subjects were randomized to consume a daily nutritional supplement (150 kcal, 20 g whey protein, 800 IU vitamin D, 119 mL beverage) or placebo (30 kcal, nonnutritive, 119 mL). In a prespecified secondary analysis, we examined total-body composition (dual energy X-ray absorptiometry), thigh composition (computed tomography), and muscle strength, power, and quality before and after the 6-month intervention.
RESULTS
One hundred and forty-nine subjects were randomized into the study [mean (standard deviation, SD) age 78.5 (5.4) years; 46.3% female; mean (SD) short physical performance battery 7.9 (1.2); mean (SD) vitamin D 18.7 (6.4) ng/mL]. After the intervention period both groups demonstrated improvements in muscle strength, body composition, and thigh composition. Nutritional supplementation lead to further losses of intermuscular fat (p = .049) and increased normal muscle density (p = .018).
CONCLUSIONS
Six months of physical activity resulted in improvements in body composition, subcutaneous fat, intermuscular fat, and strength measures. The addition of nutritional supplementation resulted in further declines in intermuscular fat and improved muscle density compared to placebo. These results suggest nutritional supplementation provides additional benefits to mobility-limited older adults undergoing exercise training. ClinicalTrials.gov Identifier: NCT01542892.
背景
营养补充和体育活动已被证明对老年人的肌肉质量和力量有积极影响。长期营养补充与体育活动相结合对老年人的疗效仍不明确。
方法
招募行动受限（简短体能表现量表[SPPB]≤9）且维生素D不足（血清25(OH)D 9 - 24 ng/mL）的老年人参与本研究。所有受试者都参加了体育活动计划。受试者被随机分为两组，一组每天服用营养补充剂（150千卡、20克乳清蛋白、800国际单位维生素D、119毫升饮料），另一组服用安慰剂（30千卡、无营养、119毫升）。在一项预先设定的二次分析中，我们在6个月干预前后检查了全身成分（双能X线吸收法）、大腿成分（计算机断层扫描）以及肌肉力量、功率和质量。
结果
149名受试者被随机纳入研究[平均（标准差，SD）年龄78.5（5.4）岁；46.3%为女性；平均（SD）简短体能表现量表7.9（1.2）；平均（SD）维生素D 18.7（6.4）ng/mL]。干预期后，两组在肌肉力量、身体成分和大腿成分方面均有改善。营养补充导致肌间脂肪进一步减少（p = 0.049），正常肌肉密度增加（p = 0.018）。
结论
六个月的体育活动使身体成分、皮下脂肪、肌间脂肪和力量指标得到改善。与安慰剂相比，添加营养补充剂导致肌间脂肪进一步减少，肌肉密度提高。这些结果表明，营养补充对接受运动训练的行动受限老年人有额外益处。ClinicalTrials.gov标识符：NCT01542892。
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