Effects of Whey Protein, Leucine, and Vitamin D Supplementation in Patients with Sarcopenia: A Systematic Review and Meta-Analysis

Nutrients
Q1
Jan 2023
Citations:71
Influential Citations:6
Systematic Reviews / Meta-Analyses
88
S2 IconPDF Icon

Enhanced Details

Methods
Three randomized controlled trials in older adults with sarcopenia. Bauer et al. 2015: randomized, double-blind, placebo-controlled; elderly participants (mean ages around 77–78); mixed gender; N=380. Rondanelli et al. 2016: randomized controlled trial; older adults with sarcopenia; N=130; exercise program included for all participants. Rondanelli 2020: randomized-controlled trial; older adults with sarcopenia; N=127; exercise program included.
Intervention
Bauer 2015: per-serving powder (40 g) delivering 20.7 g whey protein, 2.8 g total leucine, 800 IU vitamin D, 10.6 g essential amino acids, 9.4 g carbohydrates, 3 g fat, 1.3 g fiber, 1.3 g minerals, and 0.3 g trace elements; 150 kcal; consumed before breakfast and lunch; duration 13 weeks; no exercise. Rondanelli 2016: per-serving powder (32 g) delivering 22 g whey protein, 4 g leucine, 100 IU vitamin D, 4.7 g carbohydrates, 0.4 g fat, 2.2 g fiber, 0.4 g minerals; 112 kcal; taken once daily at mealtime; duration 12 weeks; concurrent moderate-intensity physical training 5x/week. Rondanelli 2020: per-serving powder (40 g) delivering 20 g whey protein, 2.8 g leucine, 800 IU vitamin D, 9 g carbohydrates, 3 g fat, minerals; 150 kcal; taken morning and afternoon; duration 4–8 weeks; concurrent physical exercise program.
Results
Supplementation increased appendicular muscle mass in sarcopenic older adults (overall effect: SMD 0.27; 95% CI 0.09-0.44; p=0.003; I2=26%). Subgroups show larger gains with concurrent exercise (SMD 0.45; 95% CI 0.10-0.80; p=0.01) and still positive without exercise (SMD 0.21; 95% CI 0.01-0.41; p=0.04). Handgrip strength and SPPB improved significantly when supplementation was combined with exercise (handgrip: SMD 1.52; 95% CI 0.62-2.41; p=0.0009; I2=90; SPPB: SMD 1.97; 95% CI 1.54-2.40; p<0.00001; I2=90); without exercise, changes were not significant (handgrip: SMD 1.03; -0.10 to 2.16; p=0.07; SPPB: SMD 1.01; -0.86 to 2.88; p=0.29). Authors conclude that whey protein, leucine, and vitamin D supplementation can increase appendicular muscle mass in sarcopenic older adults, and combining with a structured exercise program enhances muscle strength and function.
Limitations
Only three RCTs (n=637) in older adults with sarcopenia; regimens and exercise co-interventions varied across trials; durations ranged 4–13 weeks; some risk-of-bias concerns in individual studies; results may not generalize to non-sarcopenic older populations.

Abstract

(1) Background: In this study, a meta-analysis was performed to investigate the effects of whey protein, leucine, and vitamin D in sarcopenia; (2) Methods: We searched PubMed, Cochrane Library, Embase, and Scopus databases and retrieved studies publi...