“Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study.”
The takeaway from this is that it is never too late to make a difference in your health. To quote the authors
Why is this important?
Whilst I appreciate this paper does not relate directly to triathletes, I think we can all accept that we will all become old at one point in our life or know some people (read parents or grandparents) that are older than us and this can be applied. Recently there has been a lot of interest in sarcopenia, sarcopenic obesity and osteosarcopenia. For those unaccustomed to these words, they relate to progressive loss of muscle as we age, loss of muscle as we age whilst getting fatter and loss of muscle with concurrent loss of bone density respectively. All pretty grim reading and a very real issue in today’s society and potentially a major health crisis in the making.
What was studied?
This study was cool because they recruited a group of 74+-year-old men - think about your dad right about now. Forty-three in total and had them follow a resistance training program on machines over the course of 18 months. The training was performed twice a week and they periodised the training with changes to repetitions, sets, time under tension and speed of lifting in line with a training program that someone much younger may follow.
In conjunction, they had the experimental group consume a higher amount of protein (1.6g/kg/body weight/day) versus 1.2g/kg/body weight/day in the control group and utilised a whey protein powder to assist hitting the target. They also supplied vitamin D3 in differing doses depending on their blood test results at the start of the study. They were supplied either 10000IU/week for those with lower than 30ng/mL or 2500IU/week for those with more than 40ng/mL. This is much higher than the RDI for Vitamin D3.
Further baselines including grip strength, DEXA, Sarcopenic Z-score and gait velocity were assessed. They tracked compliance with the training program through a microchip, gated entry to the gym, food diary review (4 days diary at baseline, 28,54 & 78 weeks) and supplements ordering.
The outcomes were significant and favoured the high protein, resistance-based group in a big way. The chance of it being chance was 1 in 1000 (P<0.001). The exercise-high protein group had marked improvement in their Z-score (improved bone mineral density in the lumbar spine & hip)and a significant increase in lean muscle mass. The control group actually lost muscle mass during the same period. The functional markers were moderate in effect and this may be a reflection of lack of specific training to improve walking speed. Vitamin D levels did not rise significantly by the end of the trial despite the higher than RDI recommendations.
A few limitations need to be acknowledged in this study. The load applied was often underpowered and this was likely due to the population and an unwillingness to lift very heavy weights. The older men gave it a good shot yet perhaps could have gone a bit harder according to the authors. Also, the food diary aspect was limited in terms of tracking food intake and the accuracy of it.
The inclusion of creatine monohydrate would have been an excellent supplement to include as well. Finally, it would have been nice to see an even high protein intake to around 1.6-1.8/gkg/body weight. This amount has been shown to be the range most beneficial for muscle growth and repair, certainly in younger men.
Interestingly, despite 10000IU/week vitamin D supplementation, the vast majority remained insufficient or deficient in vitamin D3. This further provides evidence that the current recommendation of 400IU/week is completely outdated and requires urgent review. Personally, I recommend 50000IU/week to individuals who are deficient or insufficient for at least 8 weeks before having a follow-up blood test.