Advertisement

Daily Supplementation With Whey, Soy, or Whey-Soy Blended Protein for 6 Months Maintained Lean Muscle Mass and Physical Performance in Older Adults With Low Lean Mass

  • Author Footnotes
    # These authors contributed equally to this work and are the co-first authors for this article.
    Chunlei Li
    Footnotes
    # These authors contributed equally to this work and are the co-first authors for this article.
    Affiliations
    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    Department of Clinical Nutrition, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, People’s Republic of China
    Search for articles by this author
  • Author Footnotes
    # These authors contributed equally to this work and are the co-first authors for this article.
    Huicui Meng
    Footnotes
    # These authors contributed equally to this work and are the co-first authors for this article.
    Affiliations
    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People’s Republic of China
    Search for articles by this author
  • Shangling Wu
    Affiliations
    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
    Search for articles by this author
  • Aiping Fang
    Affiliations
    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
    Search for articles by this author
  • Gongcheng Liao
    Affiliations
    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
    Search for articles by this author
  • Xuying Tan
    Affiliations
    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
    Search for articles by this author
  • Peiyan Chen
    Affiliations
    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
    Search for articles by this author
  • Xiaoyan Wang
    Affiliations
    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
    Search for articles by this author
  • Si Chen
    Affiliations
    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
    Search for articles by this author
  • Huilian Zhu
    Correspondence
    Address correspondence to: Huilian Zhu, PhD, Department of Nutrition, School of Public Health, Sun Yat-sen University, 74th Zhongshan Er Road, Guangzhou, Guangdong, 510080, Peoples’ Republic of China.
    Affiliations
    Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China

    Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China
    Search for articles by this author
  • Author Footnotes
    # These authors contributed equally to this work and are the co-first authors for this article.
Published:February 18, 2021DOI:https://doi.org/10.1016/j.jand.2021.01.006

      Abstract

      Background

      Few studies have investigated the effect of long-term protein supplementation alone on muscle health in older adults with low lean mass.

      Objective

      To determine the effect of whey, soy or whey-soy blended protein supplementation on lean muscle mass and physical performance in older adults with low lean mass.

      Design

      A 4-arm randomized controlled trial.

      Participants/setting

      Chinese older adults (n = 123, 65-79 years) with low lean mass (appendicular skeletal muscle index < 7.0 kg/m2 in men and < 5.4 kg/m2 in women) living in the urban area of Guangzhou participated between October 2015 and June 2016.

      Intervention

      Participants were randomly assigned to receive approximately 16 g/d of whey, soy, or whey-soy blend protein or maintained habitual diets in control group for 6 months.

      Main outcome measures

      Lean mass, handgrip strength, and physical performance (gait speed, chair stand test, and Short Physical Performance Battery) were assessed at baseline and 6 months.

      Statistical analyses

      Two-way analysis of variance with the main effects of treatment and time and treatment × time interaction and analysis of covariance was used to determine differences in outcomes.

      Results

      Appendicular skeletal muscle index, lean mass, percent lean mass in legs and appendicular areas, gait speed, and Short Physical Performance Battery score were maintained in the treatment groups and decreased in the control group, resulting in significant reduction in these variables from baseline in the control compared with treatment groups (all P < .01; percent differences between treatment and control groups ranged from 80% to 156%). The chair stand test time at month 6 decreased from baseline in the treatment groups and increased in the control group, resulting in a significant increase in the control compared with treatment groups (all P < .01; percent differences between treatment and control groups ranged from 132% to 155%). Handgrip strength remained unchanged. There were no significant differences in outcomes among treatment groups.

      Conclusions

      Supplementation with whey, soy, or whey-soy blended protein for 6 months equally maintained lean muscle mass and physical performance in older adults with low lean mass.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of the Academy of Nutrition and Dietetics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • The L.
        Ageing in China: A ticking bomb.
        Lancet. 2016; 388: 2058
        • Zeng Y.
        • Feng Q.
        • Hesketh T.
        • Christensen K.
        • Vaupel J.W.
        Survival, disabilities in activities of daily living, and physical and cognitive functioning among the oldest-old in China: A cohort study.
        Lancet. 2017; 389: 1619-1629
        • Cruz-Jentoft A.J.
        • Bahat G.
        • Bauer J.
        • et al.
        Sarcopenia: Revised European consensus on definition and diagnosis.
        Age Ageing. 2019; 48: 16-31
        • Chen L.K.
        • Woo J.
        • Assantachai P.
        • et al.
        Asian Working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment.
        J Am Med Dir Assoc. 2020; 21: 300-307 e302
        • Bortz 2nd, W.M.
        A conceptual framework of frailty: A review.
        J Gerontol A Biol Sci Med Sci. 2002; 57: M283-M288
        • Cruz-Jentoft A.J.
        • Baeyens J.P.
        • Bauer J.M.
        • et al.
        Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People.
        Age Ageing. 2010; 39: 412-423
        • Cawthon P.M.
        • Marshall L.M.
        • Michael Y.
        • et al.
        Frailty in older men: Prevalence, progression, and relationship with mortality.
        J Am Geriatr Soc. 2007; 55: 1216-1223
        • Topinkova E.
        Aging, disability and frailty.
        Ann Nutr Metab. 2008; 52: 6-11
        • Houston D.K.
        • Nicklas B.J.
        • Ding J.
        • et al.
        Dietary protein intake is associated with lean mass change in older, community-dwelling adults: The Health, Aging, and Body Composition (Health ABC) Study.
        Am J Clin Nutr. 2008; 87: 150-155
        • Mangano K.M.
        • Sahni S.
        • Kiel D.P.
        • Tucker K.L.
        • Dufour A.B.
        • Hannan M.T.
        Dietary protein is associated with musculoskeletal health independently of dietary pattern: The Framingham Third Generation Study.
        Am J Clin Nutr. 2017; 105: 714-722
        • Francis P.
        • Mc Cormack W.
        • Toomey C.
        • et al.
        Twelve weeks’ progressive resistance training combined with protein supplementation beyond habitual intakes increases upper leg lean tissue mass, muscle strength and extended gait speed in healthy older women.
        Biogerontology. 2017; 18: 881-891
        • Verlaan S.
        • Maier A.B.
        • Bauer J.M.
        • et al.
        Sufficient levels of 25-hydroxyvitamin D and protein intake required to increase muscle mass in sarcopenic older adults—the PROVIDE study.
        Clin Nutr. 2018; 37: 551-557
        • Shahar S.
        • Kamaruddin N.S.
        • Badrasawi M.
        • et al.
        Effectiveness of exercise and protein supplementation intervention on body composition, functional fitness, and oxidative stress among elderly Malays with sarcopenia.
        Clin Interv Aging. 2013; 8: 1365-1375
        • Liao C.D.
        • Tsauo J.Y.
        • Wu Y.T.
        • et al.
        Effects of protein supplementation combined with resistance exercise on body composition and physical function in older adults: A systematic review and meta-analysis.
        Am J Clin Nutr. 2017; 106: 1078-1091
        • Morton R.W.
        • Murphy K.T.
        • McKellar S.R.
        • et al.
        A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults.
        Br J Sports Med. 2018; 52: 376-384
        • Park Y.
        • Choi J.E.
        • Hwang H.S.
        Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects: A randomized, double-blind, placebo-controlled trial.
        Am J Clin Nutr. 2018; 108: 1026-1033
        • Rossato L.T.
        • Nahas P.C.
        • de Branco F.M.S.
        • et al.
        Higher protein intake does not improve lean mass gain when compared with RDA recommendation in postmenopausal women following resistance exercise protocol: A randomized clinical trial.
        Nutrients. 2017, 1007; 9
        • Bhasin S.
        • Apovian C.M.
        • Travison T.G.
        • et al.
        Effect of protein intake on lean body mass in functionally limited older men: A randomized clinical trial.
        JAMA Intern Med. 2018; 178: 530-541
        • Kim C.O.
        • Lee K.R.
        Preventive effect of protein-energy supplementation on the functional decline of frail older adults with low socioeconomic status: A community-based randomized controlled study.
        J Gerontol A Biol Sci Med Sci. 2013; 68: 309-316
        • Smoliner C.
        • Norman K.
        • Scheufele R.
        • Hartig W.
        • Pirlich M.
        • Lochs H.
        Effects of food fortification on nutritional and functional status in frail elderly nursing home residents at risk of malnutrition.
        Nutrition. 2008; 24: 1139-1144
        • Kerstetter J.E.
        • Bihuniak J.D.
        • Brindisi J.
        • et al.
        The effect of a whey protein supplement on bone mass in older Caucasian adults.
        J Clin Endocrinol Metab. 2015; 100: 2214-2222
        • Pennings B.
        • Boirie Y.
        • Senden J.M.
        • Gijsen A.P.
        • Kuipers H.
        • van Loon L.J.
        Whey protein stimulates postprandial muscle protein accretion more effectively than do casein and casein hydrolysate in older men.
        Am J Clin Nutr. 2011; 93: 997-1005
        • Chanet A.
        • Verlaan S.
        • Salles J.
        • et al.
        Supplementing breakfast with a vitamin D and leucine-enriched whey protein medical nutrition drink enhances postprandial muscle protein synthesis and muscle mass in healthy older men.
        J Nutr. 2017; 147: 2262-2271
        • Borack M.S.
        • Reidy P.T.
        • Husaini S.H.
        • et al.
        Soy-dairy protein blend or whey protein isolate ingestion induces similar postexercise muscle mechanistic target of rapamycin complex 1 signaling and protein synthesis responses in older men.
        J Nutr. 2016; 146: 2468-2475
        • Clarkson P.M.
        Antioxidants and physical performance.
        Crit Rev Food Sci Nutr. 1995; 35: 131-141
        • Volek J.S.
        • Volk B.M.
        • Gomez A.L.
        • et al.
        Whey protein supplementation during resistance training augments lean body mass.
        J Am Coll Nutr. 2013; 32: 122-135
        • Wroblewska B.
        • Juskiewicz J.
        • Kroplewski B.
        • et al.
        The effects of whey and soy proteins on growth performance, gastrointestinal digestion, and selected physiological responses in rats.
        Food Funct. 2018; 9: 1500-1509
        • Reidy P.T.
        • Walker D.K.
        • Dickinson J.M.
        • et al.
        Protein blend ingestion following resistance exercise promotes human muscle protein synthesis.
        J Nutr. 2013; 143: 410-416
        • Wang S.S.
        • Lay S.
        • Yu H.N.
        • Shen S.R.
        Dietary guidelines for Chinese residents (2016): Comments and comparisons.
        J Zhejiang Univ Sci B. 2016; 17: 649-656
        • Deutz N.E.
        • Bauer J.M.
        • Barazzoni R.
        • et al.
        Protein intake and exercise for optimal muscle function with aging: Recommendations from the ESPEN Expert Group.
        Clin Nutr. 2014; 33: 929-936
        • Li C.Y.
        • Fang A.P.
        • Ma W.J.
        • et al.
        Amount rather than animal vs plant protein intake is associated with skeletal muscle mass in community-dwelling middle-aged and older Chinese adults: Results from the Guangzhou Nutrition and Health Study.
        J Acad Nutr Diet. 2019; 119: 1501-1510
        • Ainsworth B.E.
        • Haskell W.L.
        • Herrmann S.D.
        • et al.
        2011 compendium of physical activities: A second update of codes and MET values.
        Med Sci Sports Exerc. 2011; 43: 1575-1581
        • Lan Q.Y.
        • Zhang Y.J.
        • Liao G.C.
        • et al.
        The association between dietary vitamin A and carotenes and the risk of primary liver cancer: A case-control study.
        Nutrients. 2016, 624; 8
        • Zhang C.X.
        • Ho S.C.
        Validity and reproducibility of a food frequency questionnaire among Chinese women in Guangdong province.
        Asia Pac J Clin Nutr. 2009; 18: 240-250
        • Yang Y.
        Chinese Food Composition Table 2004.
        Peking University Medical Press, Beijing, China2005
        • Chen Y.M.
        • Liu Y.
        • Liu Y.H.
        • Wang X.
        • Guan K.
        • Zhu H.L.
        Higher serum concentrations of betaine rather than choline is associated with better profiles of DXA-derived body fat and fat distribution in Chinese adults.
        Int J Obes (Lond). 2015; 39: 465-471
        • Tieland M.
        • Verdijk L.B.
        • de Groot L.C.
        • van Loon L.J.
        Handgrip strength does not represent an appropriate measure to evaluate changes in muscle strength during an exercise intervention program in frail older people.
        Int J Sport Nutr Exerc Metab. 2015; 25: 27-36
        • Guralnik J.M.
        • Ferrucci L.
        • Pieper C.F.
        • et al.
        Lower extremity function and subsequent disability: Consistency across studies, predictive models, and value of gait speed alone compared with the short physical performance battery.
        J Gerontol A Biol Sci Med Sci. 2000; 55: M221-M231
      1. SAS. Version 9.4. SAS Institute, Cary, NC2013
      2. IBM SPSS statistics for windows. Version 20.0. IBM Corp, Armonk, NY2013
        • Calvani R.
        • Miccheli A.
        • Landi F.
        • et al.
        Current nutritional recommendations and novel dietary strategies to manage sarcopenia.
        J Frailty Aging. 2013; 2: 38-53
        • Bauer J.
        • Biolo G.
        • Cederholm T.
        • et al.
        Evidence-based recommendations for optimal dietary protein intake in older people: A position paper from the PROT-AGE Study Group.
        J Am Med Dir Assoc. 2013; 14: 542-559
        • Bauer J.M.
        • Verlaan S.
        • Bautmans I.
        • et al.
        Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: A randomized, double-blind, placebo-controlled trial.
        J Am Med Dir Assoc. 2015; 16: 740-747
        • Kramer I.F.
        • Verdijk L.B.
        • Hamer H.M.
        • et al.
        Both basal and post-prandial muscle protein synthesis rates, following the ingestion of a leucine-enriched whey protein supplement, are not impaired in sarcopenic older males.
        Clin Nutr. 2017; 36: 1440-1449
        • Walrand S.
        • Gryson C.
        • Salles J.
        • et al.
        Fast-digestive protein supplement for ten days overcomes muscle anabolic resistance in healthy elderly men.
        Clin Nutr. 2016; 35: 660-668
        • Isanejad M.
        • Mursu J.
        • Sirola J.
        • et al.
        Association of protein intake with the change of lean mass among elderly women: The Osteoporosis Risk Factor and Prevention—Fracture Prevention Study (OSTPRE-FPS).
        J Nutr Sci. 2015; 4: e41
        • Ottestad I.
        • Lovstad A.T.
        • Gjevestad G.O.
        • et al.
        Intake of a protein-enriched milk and effects on muscle mass and strength. A 12-week randomized placebo controlled trial among community-dwelling older adults.
        J Nutr Health Aging. 2017; 21: 1160-1169
        • Tieland M.
        • van de Rest O.
        • Dirks M.L.
        • et al.
        Protein supplementation improves physical performance in frail elderly people: A randomized, double-blind, placebo-controlled trial.
        J Am Med Dir Assoc. 2012; 13: 720-726
        • Misic M.M.
        • Rosengren K.S.
        • Woods J.A.
        • Evans E.M.
        Muscle quality, aerobic fitness and fat mass predict lower-extremity physical function in community-dwelling older adults.
        Gerontology. 2007; 53: 260-266
        • Phillips S.M.
        • Tang J.E.
        • Moore D.R.
        The role of milk- and soy-based protein in support of muscle protein synthesis and muscle protein accretion in young and elderly persons.
        J Am Coll Nutr. 2009; 28: 343-354
        • Tang J.E.
        • Phillips S.M.
        Maximizing muscle protein anabolism: The role of protein quality.
        Curr Opin Clin Nutr Metab Care. 2009; 12: 66-71
        • Paul G.L.
        The rationale for consuming protein blends in sports nutrition.
        J Am Coll Nutr. 2009; 28: 464S-472S
        • Li F.
        • Yin Y.
        • Tan B.
        • Kong X.
        • Wu G.
        Leucine nutrition in animals and humans: mTOR signaling and beyond.
        Amino Acids. 2011; 41: 1185-1193
        • Goodman C.A.
        The role of mTORC1 in mechanically-induced increases in translation and skeletal muscle mass.
        J Appl Physiol (1985). 2019, 581-590;
        • Candow D.G.
        • Burke N.C.
        • Smith-Palmer T.
        • Burke D.G.
        Effect of whey and soy protein supplementation combined with resistance training in young adults.
        Int J Sport Nutr Exerc Metab. 2006; 16: 233-244
        • Noakes M.
        The role of protein in weight management.
        Asia Pac J Clin Nutr. 2008; 17: 169-171
        • Reidy P.T.
        • Walker D.K.
        • Dickinson J.M.
        • et al.
        Soy-dairy protein blend and whey protein ingestion after resistance exercise increases amino acid transport and transporter expression in human skeletal muscle.
        J Appl Physiol (1985). 2014; 116: 1353-1364
        • Maltais M.L.
        • Ladouceur J.P.
        • Dionne I.J.
        The Effect of resistance training and different sources of postexercise protein supplementation on muscle mass and physical capacity in sarcopenic elderly men.
        J Strength Cond Res. 2016; 30: 1680-1687
        • Messina M.
        • Lynch H.
        • Dickinson J.M.
        • Reed K.E.
        No difference between the effects of supplementing with soy protein versus animal protein on gains in muscle mass and strength in response to resistance exercise.
        Int J Sport Nutr Exerc Metab. 2018; 28: 674-685
        • Devries M.C.
        • Phillips S.M.
        Supplemental protein in support of muscle mass and health: Advantage whey.
        J Food Sci. 2015; 80: A8-A15
        • Rondanelli M.
        • Klersy C.
        • Terracol G.
        • et al.
        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.
        Am J Clin Nutr. 2016; 103: 830-840
        • Kramer I.F.
        • Verdijk L.B.
        • Hamer H.M.
        • et al.
        Impact of the macronutrient composition of a nutritional supplement on muscle protein synthesis rates in older men: A randomized, double blind, controlled trial.
        J Clin Endocrinol Metab. 2015; 100: 4124-4132

      Biography

      C. Li is a master of medicine graduate, Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China, and a clinical dietitian, Department of Clinical Nutrition, Guangzhou Red Cross Hospital, Jinan University, Guangzhou, People’s Republic of China.

      Biography

      H. Meng is an associate professor, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China and School of Public Health (Shenzhen), Sun Yat-sen University, Shenzhen, People’s Republic of China.

      Biography

      S. Wu is a master of medicine graduate, Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China.

      Biography

      A. Fang is an associate professor, Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China.

      Biography

      G. Liao is a master of medicine graduate, Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China.

      Biography

      X. Tan is a PhD graduate, Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China.

      Biography

      P. Chen is a master of medicine graduate, Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China.

      Biography

      X. Wang is a master of medicine graduate, Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China.

      Biography

      S. Chen is a master of medicine graduate, Guangdong Provincial Key Laboratory of Food, Nutrition and Health and Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China.

      Biography

      H. Zhu is a professor, Guangdong Provincial Key Laboratory of Food, Nutrition and Health, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China and professor and chair, Department of Nutrition, School of Public Health, Sun Yat-sen University, Guangzhou, People’s Republic of China