Sufficient levels of 25-hydroxyvitamin D and protein intake required to increase muscle mass in sarcopenic older adults - The PROVIDE study.
Clin Nutr. 2017 Jan 17. pii: S0261-5614(17)30010-9. doi: 10.1016/j.clnu.2017.01.005. Epub ahead of print
Verlaan S1, Maier AB2, Bauer JM3, Bautmans I4, Brandt K5, Donini LM6, Maggio M7, McMurdo ME8, Mets T4, Seal C5, Wijers SL9, Sieber C10, Boirie Y11, Cederholm T12.
RCT for 13 weeks. at 18 centers, no exercise
A mere 800 IU of vitamin D
Any of the following would doubtlessly have added even more muscle mass
- More Vitamin D
- More Protein
- Longer than 13 weeks
- Loading dose - to restore Vitamin levels to beneficial amount in days, not months
Clipped from PDF
“. . . vitamin D acted synergistically with leucine and insulin to stimulate muscle protein synthesis, likely through sensitizing the anabolic pathways induced by insulin and leucine’
See also Vitamin D Life
- Sarcopenia (muscle loss) and Vitamin D many studies
- Sarcopenia and non-alcoholic fatty liver disease (vitamin D not mentioned) – Sept 2013
- Hypothesis: Sarcopenia and other senior problems are related to low gastric acid
- Loss of muscle strength –sarcopenia – one of the suspects is vitamin D – Aug 2012
- Vitamin D and bicarbonate perhaps synergistically reduce muscle loss – June 2013
- Osteosarcopenic obesity (obese with low bone and muscle mass) twice as likely if low vitamin D – Oct 2016
- Muscle increased 17 percent in vitamin D insufficient elderly getting 4,000 IU for 4 months – RCT Oct 2013
- Frailty is associated with low Vitamin D
- 80 percent of the characteristics of frailty associated with low vitamin D – May 2013
- Vitamin D improves muscle strength, reduces falling, and reduces frailty – review March 2015
- Seniors gained 0.3 kg of muscle in 6 weeks with 800 IU and Leucine protein – Aug 2017
Download the PDF from Vitamin D Life
Red-shaded area shows the RCT arm with both Vitamin D and Protein
Inadequate nutritional intake and altered response of aging muscles to anabolic stimuli from nutrients contribute to the development of sarcopenia. Nutritional interventions show inconsistent results in sarcopenic older adults, which might be influenced by their basal nutritional status.
To test if baseline serum 25-hydroxyvitamin D (25(OH)D) concentrations and dietary protein intake influenced changes in muscle mass and function in older adults who received nutritional intervention.
METHODS AND DESIGN:
Post-hoc analysis was performed in the PROVIDE study that was a randomized controlled, double blind trial among 380 sarcopenic older adults. This study showed that those who received a vitamin D and leucine-enriched whey protein medical nutrition drink for 13 weeks gained more appendicular muscle mass (aMM), and improved lower-extremity function as assessed by the chair stand test compared with controls. To define low and high groups, a baseline serum concentration of 50 nmol/L 25(OH)D and baseline dietary protein intake of 1.0 g/kg/d were used as cut offs.
At baseline, participants with lower 25(OH)D concentrations showed lower muscle mass, strength and function compared with participants with a high 25(OH)D, while the group with lower protein intake (g/kg/day) had more muscle mass at baseline compared with the participants with higher protein intake. Participants with higher baseline 25(OH)D concentrations and dietary protein intake had, independent of other determinants, greater gain in appendicular muscle mass, skeletal muscle index (aMM/h2), and relative appendicular muscle mass (aMM/body weight × 100%) in response to the nutritional intervention. There was no effect modification of baseline 25(OH)D status or protein intake on change in chair-stand test.
Sufficient baseline levels of 25(OH)D and protein intake may be required to increase muscle mass as a result of intervention with a vitamin D and protein supplement in sarcopenic older adults. This suggests that current cut-offs in the recommendations for vitamin D and protein intake could be considered the "minimum" for adults with sarcopenia to respond adequately to nutrition strategies aimed at attenuating muscle loss.
PMID: 28132725 DOI: 10.1016/j.clnu.2017.01.005