Nutrition and Exercise for Sarcopenia

NCT ID: NCT00872911

Last Updated: 2016-12-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

108 participants

Study Classification

INTERVENTIONAL

Study Start Date

2009-03-31

Study Completion Date

2016-08-31

Brief Summary

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The investigators' general hypothesis is that nutritional factors, including protein/energy malnutrition and/or an impaired response of muscle to nutrition, and inactivity play significant roles in developing sarcopenia, the involuntary loss of muscle mass and function with age. Therefore, age-specific prolonged interventions including nutritional manipulations and/or exercise may help to reduce, stabilize, or even reverse sarcopenia.

Detailed Description

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Our preliminary studies indicate that, in older adults, muscle protein anabolism is normally stimulated by amino acids alone, but impaired when nutritional stimuli contain carbohydrate due to a relative insulin resistance of muscle protein synthesis. We have also found that amino acids are the most efficient nutrients for the acute stimulation of muscle protein anabolism and our pilot data suggest that they can also increase muscle mass in healthy older adults.

Inactivity is another likely contributor to sarcopenia. Exercise increases not only muscle protein synthesis,mass and strength, but also energy expenditure. Hence, exercise may improve the response of muscle to nutritional interventions in older subjects via increased energy requirements and food consumption, thereby allowing for achievement of true supplementation.

We will test the following specific hypotheses in older, community indwelling, sedentary subjects:

Using a factorial design we will address in older, community-indwelling, sedentary subjects the following hypotheses:

1. Nutritional supplementation with amino acids will improve muscle mass, strength, function, quality, and protein synthesis.
2. Progressive exercise training for 24 weeks will improve muscle mass strength,function, quality, perfusion, and protein metabolism.
3. Combined treatment with nutritional supplementation and progressive exercise training for 24 weeks will improve muscle mass, strength, function, quality, perfusion, and protein metabolism more than either intervention alone.

Our goal is to establish if specific interventions that can acutely increase muscle protein synthesis can also effectively translate into increased muscle mass and/or performance in older sedentary people, thus preventing frailty and promoting physical independence. To this end we will use stable isotope methodologies to measure muscle protein metabolism and contrast enhanced ultrasound to measure muscle perfusion, in order to determine if the treatments' acute effects can predict their chronic impact on muscle mass and function. We will also determine if chronic treatment leads to metabolic and/or vascular adaptations that may explain the measured changes in muscle mass and function.

Conditions

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Sarcopenia

Keywords

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Sarcopenia nutrition aging metabolism exercise

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

FACTORIAL

Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Nutritional supplement

Group Type EXPERIMENTAL

Amino acids

Intervention Type DIETARY_SUPPLEMENT

mixed pure crystalline amino acids for human use (Ajinomoto), 15 g/d

Placebo + Exercise

Group Type EXPERIMENTAL

Exercise

Intervention Type DRUG

progressive exercise training

Nutritional Supplement + Exercise

Group Type EXPERIMENTAL

Amino acids

Intervention Type DIETARY_SUPPLEMENT

mixed pure crystalline amino acids for human use (Ajinomoto), 15 g/d

Exercise

Intervention Type DRUG

progressive exercise training

Placebo

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Amino acids

mixed pure crystalline amino acids for human use (Ajinomoto), 15 g/d

Intervention Type DIETARY_SUPPLEMENT

Exercise

progressive exercise training

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. age 65-85 yrs
2. ability to sign consent form (score \>25 on the 30 item Mini Mental State Examination, MMSE)
3. stable body weight for at least 1 year (verified via medical records).

Exclusion Criteria

1. physical dependence or frailty (impairment in any of the Activities of Daily Living (ADL), history of falls (≥2/year) or significant weight loss in the past year)
2. exercise training (≥2 weekly sessions of moderate-to-high intensity aerobic or resistance exercise)
3. significant heart, liver, kidney, blood or respiratory disease
4. peripheral vascular disease
5. diabetes or other untreated endocrine disease
6. active cancer
7. recent (within 6 months) treatment with anabolic steroids, or corticosteroids
8. alcohol or drug abuse
9. tobacco use (smoking or chewing, verified via medical records)
10. depression (\>5 on the 15-item Geriatric Depression Scale (GDS))
11. malnutrition (BMI \<20 kg/m2; hypoalbuminemia or hypotransferrenemia; protein intake\<0.66 g/kg/day at run-in)
12. obesity (BMI\>30 kg/m2).
Minimum Eligible Age

65 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Institute on Aging (NIA)

NIH

Sponsor Role collaborator

The University of Texas Medical Branch, Galveston

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Elena Volpi, MD,PhD

Role: PRINCIPAL_INVESTIGATOR

The University of Texas Medical Branch, Galveston

Locations

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Sealy Center on Aging, University of Texas Medical Branch

Galveston, Texas, United States

Site Status

Countries

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United States

References

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Randolph AC, Markofski MM, Rasmussen BB, Volpi E. Effect of essential amino acid supplementation and aerobic exercise on insulin sensitivity in healthy older adults: A randomized clinical trial. Clin Nutr. 2020 May;39(5):1371-1378. doi: 10.1016/j.clnu.2019.06.017. Epub 2019 Jun 28.

Reference Type DERIVED
PMID: 31307843 (View on PubMed)

Markofski MM, Jennings K, Timmerman KL, Dickinson JM, Fry CS, Borack MS, Reidy PT, Deer RR, Randolph A, Rasmussen BB, Volpi E. Effect of Aerobic Exercise Training and Essential Amino Acid Supplementation for 24 Weeks on Physical Function, Body Composition, and Muscle Metabolism in Healthy, Independent Older Adults: A Randomized Clinical Trial. J Gerontol A Biol Sci Med Sci. 2019 Sep 15;74(10):1598-1604. doi: 10.1093/gerona/gly109.

Reference Type DERIVED
PMID: 29750251 (View on PubMed)

Other Identifiers

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5R01AG030070

Identifier Type: NIH

Identifier Source: secondary_id

View Link

08-085

Identifier Type: -

Identifier Source: org_study_id