Effects of High-protein, Leucine-enriched Oral Nutritional Supplement and Resistance Exercise on Physical Performance among Malnourished Older Adults with Sarcopenia

Panas Jesadaporn¹, Nicha Somlaw², Aisawan Petchlorlian³, Natthapapath Boonsawat⁴, Supawan Buranapin⁵ and Narittaya Varothai^6,

¹Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

²Division of Clinical Nutrition, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hopsital, Bangkok, Thailand

³Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and

⁴Geriatric Excellence Center, King Chulalongkorn Memorial Hopsital, Bangkok, Thailand

⁵Department of Medicine, Khon Kaen Hospital, Khon Kaen, Thailand

⁶Division of Endocrinology and Metabolism, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

Cite this paper:
Panas Jesadaporn, Nicha Somlaw, Aisawan Petchlorlian, Natthapapath Boonsawat, Supawan Buranapin and Narittaya Varothai. Effects of High-protein, Leucine-enriched Oral Nutritional Supplement and Resistance Exercise on Physical Performance among Malnourished Older Adults with Sarcopenia. Journal of Food and Nutrition Research. 2023; 11(2):125-135. doi: 10.12691/jfnr-11-2-3

Abstract

Background: Malnutrition combined with sarcopenia among older adults has resulted in poor outcomes, diminished quality of life (QoL), and increased mortality rates. Inadequate calorie and protein intake are factors contributing to sarcopenia. Specific nutritional interventions and exercise regimens may improve muscle strength and health outcomes. Aim: To determine the effects of a high-protein, leucine-enriched oral nutritional supplement (ONS) and resistance training (RT) on physical performance, muscle strength, QoL, and other outcomes among adults with sarcopenia. Methods: This was a single arm, open-label, 12-week prospective, multicenter study that involved outpatient malnourished older adults with sarcopenia from four hospitals in Thailand. During the 12-week period, subjects were given two servings of high-protein, leucine-enriched ONS per day with RT four times/week. Accordingly, short physical performance battery (SPPB), hand grip strength, muscle mass by dual-energy x-ray absorptiometry (DXA), QoL, frailty, and functional status of all subjects were assessed. Results: A total of 47 participants were enrolled in this study. After 12 weeks, 5-time chair stand results decreased from 11.59 ± 3.31 to 8.97 ± 1.85 seconds (p<0.001), SPPB scores increased from 10.64 ± 1.51 to 11.84 ± 0.43 (p<0.001), hand grip strength increased from 20.24 ± 5.69 to 21.96 ± 5.75 kg (p<0.001), and appendicular lean mass index values increased from 5.15 ± 0.67 to 5.41 ± 0.93 kg/m2 (p=0.004). Recovery from sarcopenia was observed in 80% of the subjects. QoL and frailty improved significantly. Moreover, MNA scores changed from 21.63 ± 2.10 to 25.53 ± 2.01 (p<0.001). Caloric and protein intake values changed from 26.25 ± 8.77 to 35.21 ± 8.23 kcal/kg/day and 1.10 ± 0.51 to 1.60 ± 0.35 g/kg/day, respectively (p<0.001 both). Conclusions: High-protein, leucine-enriched ONS and RT have benefits for malnourished sarcopenic older adults through improvements in physical performance, muscle strength, muscle mass, recovery rates from malnutrition, frailty, and QoL.

Keywords:
sarcopenia malnutrition leucine-enriched formula older adults oral nutritional supplement

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