A. Arnarson

Effects of whey proteins and carbohydrates on the efficacy of resistance training in elderly people: double blind, randomised controlled trial.

Background/objectives:A few previous studies indicate that protein supplementation increases gains in muscle mass and strength during a resistance exercise program. The purpose of this study was to investigate whether whey protein supplementation results in greater increases in lean body mass, muscle strength and physical function in elderly individuals during 12 weeks of resistance exercise when compared to isocaloric carbohydrate supplementation.Subjects/Methods:A total of 161 men and women, 65–91 years old, participated in a randomized, controlled, double-blind intervention study, involving dietary supplementation and a 12-week resistance exercise program, designed to increase muscle mass and strength of all major muscle groups. Participants exercised three times a week and received either 20 g of whey protein (n=83) or isocaloric carbohydrate (n=78) in liquid form immediately after each workout. Data were obtained at baseline and end point.Results:The primary outcomes, lean body mass, strength and physical function increased significantly during the course of the study. Type of dietary supplementation did not influence gains in lean body mass (P=0.365), quadriceps strength (P=0.776) or performance during a 6-min walk (P=0.726) or a timed up-and-go test (P=0.151). Twenty participants discontinued the intervention.Conclusions:Ingestion of 20 g of whey protein immediately after resistance exercise three times per week, does not lead to greater gains in lean body mass, strength and physical function in elderly people with sufficient energy and protein intakes when compared to isocaloric carbohydrate.

Effect of 12-Week Resistance Exercise Program on Body Composition, Muscle Strength, Physical Function, and Glucose Metabolism in Healthy, Insulin-Resistant, and Diabetic Elderly Icelanders

BACKGROUND Insulin is a stimulator of skeletal muscle protein anabolism and insulin resistance might therefore negatively affect muscle protein metabolism. We investigated muscle mass and physical function before and after a resistance exercise program in participants with prediabetes or type 2 diabetes mellitus (T2DM) in comparison to healthy controls. METHODS This was a secondary analysis of a randomized controlled intervention designed to investigate resistance training among older adults. Glucose metabolism status was not a selection criteria for the trial, and group designation was done retrospectively. Participants (N = 237, 73.7 ± 5.7 y, 58.2% women) participated in a 12-week resistance exercise program (3 times/week; three sets, six to eight repetitions at 75%-80% of the one-repetition maximum), designed to increase strength and muscle mass of major muscle groups. Body composition, muscular strength, timed up and go test, 6-minute walk for distance, and blood chemical variables were measured at baseline and endpoint. RESULTS Participants completing the study (n = 213) experienced significant changes in muscle strength or muscle function, which did not differ significantly between healthy (n = 198), prediabetic (n = 20), and T2DM participants (n = 17). Changes in serum glucose during the intervention differed by group: only glucose improved significantly in the prediabetic group, glucose and triacylglycerol improved significantly in the healthy group, whereas no serum parameter improved significantly in the T2DM group. CONCLUSIONS A 12-week resistance exercise program improves muscle strength and muscle function to a similar extent in healthy, prediabetic, and T2DM elderly people. However, according to our data, T2DM participants do not experience favorable changes in fasting glucose or HbA(1C).

Physical function predicts improvement in quality of life in elderly icelanders after 12 weeks of resistance exercise

BackgroundLittle is known about the effects of resistance training on health related quality of life (HRQL) in the elderly.AimThe main purpose of the study was to investigate the effects of resistance training on strength, body composition, functional capacity and HRQL in independent living elderly people. We hypothesised that resistance training would improve lean mass, muscle strength, physical function and HRQL.MethodsSubjects (N = 237, 73.7±5.7yrs, 58.2% female) participated in a 12-week resistance exercise program (3 times/week; 3 sets, 6–8 repetitions at 75–80% of the 1-repetition maximum) designed to increase strength and muscle mass of major muscle groups. Body composition, quadriceps- and grip strength, timed up and go test (TUG), six minute walk for distance (6MW) and HRQL were measured at baseline and endpoint.ResultsTwo hundred-and-four participants completed the study. Although the increase in lean mass was small (+0.8 kg, P<0.01), quadriceps strength (+53.5N), grip strength (+3.0lb), TUG (-0.6sec), 6MW (+33.6m) and HRQL (+1.2 t-score) improved significantly (all P<0.01). Changes in 6MW predicted improvement in HRQL after 12 weeks.ConclusionsOur study shows that a 12-week resistance exercise program significantly improves lean mass, muscle strength, physical function and HRQL in elderly individuals, and that improvements in physical function predict improvements in HRQL. Our study indicates that resistance training should be promoted for the elderly as it has the potential to improve physical performance, thereby prolonging healthy, independent aging.

Dietary protein intake is associated with lean body mass in community-dwelling older adults.

Lean body mass (LBM) is important to maintain physical function during aging. We hypothesized that dietary protein intake and leisure-time physical activity are associated with LBM in community-dwelling older adults. To test the hypothesis, participants (n = 237; age, 65-92 years) did 3-day weighed food records and reported physical activity. Body composition was assessed using dual-energy x-ray absorptiometry. Protein intake was 0.98 ± 0.28 and 0.95 ± 0.29 g/kg body weight in male and female participants, respectively. Protein intake (in grams per kilogram of body weight) was associated with LBM (in kilograms); that is, the differences in LBM were 2.3 kg (P < .05) and 2.0 kg (P = .054) between the fourth vs the first and the fourth vs the second quartiles of protein intake, respectively. Only a minor part of this association was explained by increased energy intake, which follows an increased protein intake. Our study shows that dietary protein intake was positively associated with LBM in older adults with a mean protein intake higher than the current recommended daily allowance of 0.8 g/kg per day. Leisure-time physical activity, predominantly consisting of endurance type exercises, was not related to LBM in this group.

Regional and total body bioelectrical impedance analysis compared with DXA in Icelandic elderly

Background/Objectives:The aims were (1) to compare fat free mass (FFM) estimates from regional hand-held bioelectrical impedance analysis (HHBIA) with conventional BIA (CBIA) and dual energy X-ray absorptiometry (DXA) and (2) to develop a population specific equation for FFM prediction in Icelandic elderly.Subjects/Methods:DXA, CBIA and HHBIA data were available for 98 free-living Icelandic elderly (age=73.0±5.6 years, body mass index=28.8±5.2 kg/m2). Participants were randomized into a development block (n=50) and validation block (n=48). A population specific equation for FFM prediction was calculated using CBIA-derived resistance and anthropometric data from the development block and then compared with other BIA equations (Deurenberg, Segal, company-specific equations) and DXA estimates using the validation block.Results:The correlations between BIA methods and DXA were very high, that is, >0.9; however, mean differences compared with DXA were quite variable, ranging from −5.0 (Deurenberg) to +2.5 (Segal, HHBIA) and +3.3 kg (CBIA). Mean difference of the population-specific equation was below 0.1 kg. The standard deviations of the differences ranged from 2.6 to 3.3 kg. The limits of agreement of the BIA methods were similar and between 9.9 and 12.9 kg.Conclusions:In Icelandic elderly, HHBIA and CBIA produce similar FFM estimates when using company-specific prediction equations. CBIA provides the additional possibility to use a population-specific prediction equation, which yields best results. However, limits of agreement were wide and similar of all employed BIA methods, which indicates principal limitations of BIA analysis in the determination of FFM.

Muscular strength and physical function in elderly adults 6–18 months after a 12-week resistance exercise program

Aims: Benefits of resistance exercise in elderly people are well documented; however, sustaining these benefits can be difficult and adherence is often poor. Muscular strength and physical function usually decline after a supervised resistance exercise program (REP). We investigated these changes in older adults during an observational follow-up and whether leisure time physical activity (LTPA) or unsupervised resistance exercise (RE) limit these changes. Methods: Subjects (N=236, 73.7±5.7 years, 58.2% female) had participated in a supervised 12-week REP. Quadriceps strength and timed-up-and-go performance (TUG) at follow-up were compared to values before and after REP. Multivariate statistics were used to predict changes in strength or function. Results: Two hundred and eleven (90.3%) participants completed REP and 149 (63.1%) completed follow-up (11.4±2.9 months). Quadriceps strength at follow-up decreased significantly compared to after REP (–27N), but was higher than before REP (+30N). TUG did not decrease during follow-up and was better than before REP (–0.9 seconds). LTPA (+38.0N, p<0.001) and RE (+31.6N, p=0.006) predicted strength at follow-up, although they did not completely prevent loss of strength during follow-up. Conclusions: Quadriceps strength declines after a 12-week resistance exercise program in older adults. Neither LTPA nor RE completely prevents loss of quadriceps strength during follow-up, although they limited the loss. TUG did not change during follow-up and was better at follow-up than before the start of the resistance exercise program.

Glomerular filtration rate after a 12-wk resistance exercise program with post-exercise protein ingestion in community dwelling elderly.

OBJECTIVE Increased protein intake and resistance exercise can be beneficial for maintenance of lean body mass (LBM) in older adults. However, these factors could also negatively affect renal function. We investigated changes in renal function after a 12-wk resistance exercise program combined with protein supplementation in community dwelling older adults. METHODS Patients (N = 237, 73.7 ± 5.7 y, 58.2% female) participated in a 12-wk resistance exercise program (3 times/wk) designed to increase strength and muscle mass of major muscle groups. Participants were randomly assigned to one of three dietary supplements consumed directly after training: whey protein drink (20 g whey protein, 20 g carbohydrates), milk protein drink (20 g milk protein, 20 g carbohydrates), or carbohydrate drink (40 g carbohydrates). Renal function was estimated as glomerular filtration rate (GFR, Cockcroft-Gault formula), and dietary intake was measured as 3-d-weighed food record at baseline and endpoint. RESULTS During the intervention, energy intake did not increase. Carbohydrate intake increased in the carbohydrate group and protein intake increased in the milk group, both approximately in accordance with the supplementation. In the whey group, protein intake did not increase, but carbohydrate intake did. GFR increased after the intervention (+4.4 mL/min/1.73 m2; P < 0.001), and the changes were similar in men and women or in the age quartiles. Changes in GFR at endpoint were not associated with LBM, dietary supplements, or total protein intake. CONCLUSIONS A 12-wk resistance exercise program combined with protein supplementation in community dwelling older adults does not negatively affect GFR. The supplementation had only minor effects on total dietary intake.

Insulin-Like Growth Factor-1 and Resistance Exercise in Community Dwelling Old Adults.

BackgroundInsulin-like growth factor-1 (IGF-1) is related to the preservation of lean body mass. Its decline during ageing is thought to make old adults more susceptible to sarcopenia and functional dependency. The aim of the present study was to investigate circulating total IGF-1 in old adults who engaged in a 12-weeks of progressive resistance training.DesignIntervention study.SettingCommunity.ParticipantsOld Icelandic adults (N = 235, 73.7 ± 5.7 years, 58.2% female). Intervention: Twelve-week resistance exercise program (3 times/week; 3 sets, 6-8 repetitions at 75-80% of the 1-repetition maximum) designed to increase strength and muscle mass of major muscle groups.MeasurementsIGF-1.ResultsAt baseline IGF-1 was significantly associated with lean body mass and appendicular muscle mass (also when corrected for age, gender and various covariates). After the training IGF-1 decreased significantly from 112.1 ± 35.6 to 106.1 ± 35.2 µg/L during the course of the study. On and individual level, IGF-1 decreased in 59% and increased in 39% of the participants. Changes in IGF-1 were inversely related to changes in lean body mass (rho = -0.176, P = 0.013 ) and appendicular muscle mass (rho = −0.162, P = 0.019) also when corrected for protein intake, age, gender, and other covariates.ConclusionSerum total IGF-1 decreases after 12 weeks of resistance exercise in community dwelling old adults. When looked at IGF-1 changes for participants individually it becomes clear that IGF-1 response to resistances exercise is highly variable. Changes in IGF-1 are negatively related to changes in lean body mass during training, which supports the hypothesis that IGF-1 is redistributed from circulation into tissue during periods of active muscle building.

Response to 'Increasing physical activity requires increasing energy intake in elderly'.

We are grateful for the review of our article1 by Dr Safer et al.2 The question is whether or not the benefits of protein intake would have been more pronounced if energy intake had been adequate in the study population.

Sensory analysis and consumer surveys of fat- and salt-reduced meat products and their use in an energy-reduced diet in overweight individuals

Meat and meat products are of high nutritional value; however, they frequently provide salt and fat in high amounts, which can have negative health effects when consumed in excess. We investigated salt- and fat-reduced meat products, i.e. sensory evaluation and consumer surveys were carried out as well as a dietary intervention study was carried out in overweight individuals who used salt- and fat-reduced products as a part of an energy-restricted diet. Although differences were detected in the sensory evaluation between reduced and regular meat products, the participants in the consumer surveys and in the dietary intervention study gave good ratings for the fat and fat-reduced meat products. The intervention study led to weight loss and improved cardiovascular risk, but did not reveal side effects associated with the consumption of these products. Our study indicates that such products are well accepted by potential consumers and can be included successfully in a weight loss programme.