Whey protein, amino acids, and vitamin D supplementation with physical activity increases fat-free mass and strength, functionality, and quality of life and decreases inflammation in sarcopenic elderly.

Randomized, placebo-controlled trial in elderly men and women with sarcopenia admitted to a geriatric rehabilitation unit in Pavia, Italy. For the active supplement arm, 69 participants were randomized in a 1:1 design and participated in a supervised moderate-intensity exercise program with a hospital-provided balanced diet.

Oral dietary supplement, 32 g once daily with meals for 12 weeks, compared with isocaloric maltodextrin placebo. Each 32 g serving contained whey protein 22 g, essential amino acids 10.9 g including leucine 4 g, and vitamin D 2.5 mg (100 IU).

The supplement plus exercise improved fat-free mass, strength, function, nutritional status, inflammation, and quality of life versus placebo, and was well tolerated with no serious adverse events. Fat-free mass increased by 1382 (847, 1918) in the supplement group versus 2312 (2930, 307) with placebo; the treatment difference was 1695 (892, 2498). Relative skeletal muscle mass changed 0.21 (0.07, 0.35) versus -0.06 (-0.21, 0.90), handgrip changed 3.20 (2.23, 4.18) versus -0.47 (-1.07, 0.12), ADL changed 0.54 (0.39, 0.68) versus -0.61 (-0.79, -0.42), and MNA changed 1.76 (1.23, 2.28) versus 0.24 (-0.63, 1.11). Many participants moved from sarcopenic to nonsarcopenic, although the study could not separate the effects of vitamin D from the amino acids.

The intervention combined supplementation with exercise, so the supplement effect cannot be isolated from training. Vitamin D could not be separated from the amino acid and whey protein effects. The trial was short, single-center, and conducted in a geriatric rehabilitation population, which limits generalizability.