Nutrient-rich dairy proteins improve appendicular skeletal muscle mass and physical performance, and attenuate the loss of muscle strength in older men and women subjects: a single-blind randomized clinical trial Nutritional status, body composition, and quality of life in community-dwelling sarcopenic and non-sarcopenic older adults: A case-control study. Physiological effects beyond the significant gain in muscle mass in sarcopenic elderly men: evidence from a randomized clinical trial using a protein-rich food 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. Low vitamin D and high parathyroid hormone levels as determinants of loss of muscle strength and muscle mass (sarcopenia): the Longitudinal Aging Study Amsterdam. Nutritional supplements with oral amino acid mixtures increases whole-body lean mass and insulin sensitivity in elderly subjects with sarcopenia. Associations between dietary nutrient intake and muscle mass and strength in community-dwelling older adults: the Tasmanian Older Adult Cohort Study. Skeletal site-dependent response of bone mineral density and quantitative ultrasound parameters following a 12-month dietary intervention using dairy products fortified with calcium and vitamin D: the Postmenopausal Health Study. Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study. Impacts of High-Protein Oral Nutritional Supplements Among Malnourished Men and Women with Sarcopenia: A Multicenter, Randomized, Double-Blinded, Controlled Trial. Consumption of vitamin D-and calcium-fortified soft white cheese lowers the biochemical marker of bone resorption TRAP 5b in postmenopausal women at moderate risk of osteoporosis fracture. Long-term effects of calcium-vitamin-D3-fortified milk on bone geometry and strength in older men. Inhibition of markers of bone resorption by consumption of vitamin D and calcium-fortified soft plain cheese by institutionalised elderly women. Similar effects of leucine rich and regular dairy products on muscle mass and functions of older polymyalgia rheumatica patients: A randomized crossover trial Calcium intake influences the association of protein intake with rates of bone loss in elderly men and women. Dairy intakes affect bone density in the elderly. Effects of exercise and nutrition on postural balance and risk of falling in elderly people with decreased bone mineral density: randomized controlled trial pilot study
Background At present , it is unknown whether the use of nutrient-rich dairy proteins improves the markers of sarcopenia syndrome . Therefore , our proposal was to investigate whether adding 210 g of ricotta cheese daily would improve skeletal muscle mass , h and grip strength , and physical performance in non-sarcopenic older subjects . Subjects and methods This was a single-blind r and omized clinical trial that included two homogeneous , r and omized groups of men and women over 60 years of age . Participants in the intervention group were asked to consume their habitual diet but add 210 g of ricotta cheese ( IG/HD + RCH ) , while the control group was instructed to consume only their habitual diet ( CG/HD ) . Basal and 12-week follow-up measurements included appendicular skeletal muscle mass ( ASMM ) by dual-energy X-ray absorptiometry , h and grip strength by a h and held dynamometer , and physical performance using the short physical performance battery ( SPPB ) and the stair-climb power test ( SCPT ) . The main outcomes were relative changes in ASMM , strength , SPPB , and SCPT . Results ASMM increased in the IG/HD + RCH ( 0.6±3.5 kg ) , but decreased in the CG/HD ( −1.0±2.6 ) . The relative change between groups was statistically significant ( P=0.009 ) . The relative change in strength in both groups was negative , but the loss of muscle strength was more pronounced in CG/HD , though in this regard statistical analysis found only a tendency ( P=0.07 ) . The relative change in the balance-test scores was positive for the IG/HD + RCH , while in the CG/HD it was negative , as those individuals had poorer balance . In this case , the relative change between groups did reach statistical significance . Conclusion The addition of 210 g of ricotta cheese improves ASMM and balance-test scores , while attenuating the loss of muscle strength . These results suggest that adding ricotta cheese to the habitual diet is a promising dietetic strategy that may improve the markers of sarcopenia in subjects without a pronounced loss of ASMM or sarcopenia BACKGROUND & AIM Sarcopenia , the age-related decrease in muscle mass , strength , and function , is a main cause of reduced mobility , increased falls , fractures and nursing home admissions . Cross-sectional and prospect i ve studies indicate that sarcopenia may be influenced in part by reversible factors like nutritional intake . The aim of this study was to compare functional and nutritional status , body composition , and quality of life of older adults between age and sex-matched older adults with and without sarcopenia . METHODS In a multi-centre setting , non-sarcopenic older adults ( n = 66 , mean ± SD : 71 ± 4 y ) , i.e. Short Physical Performance Battery ( SPPB ) : 11 - 12 and normal skeletal muscle mass index , were recruited to match 1:1 by age and sex to previously recruited adults with sarcopenia : SPPB 4 - 9 and low skeletal muscle mass index . Health-related quality of life , self-reported physical activity levels and dietary intakes were measured using the EQ-5D scale and index , Physical Activity Scale for the Elderly ( PASE ) , and 3-day prospect i ve diet records , respectively . Concentrations of 25-OH-vitamin D , α-tocopherol ( adjusted for cholesterol ) , folate , and vitamin B-12 were assessed in serum sample s. RESULTS In addition to the defined components of sarcopenia , i.e. muscle mass , strength and function , reported physical activity levels and health-related quality of life were lower in the sarcopenic adults ( p < 0.001 ) . For similar energy intakes ( mean ± SD : sarcopenic , 1710 ± 418 ; non-sarcopenic , 1745 ± 513 , p = 0.50 ) , the sarcopenic group consumed less protein/kg ( -6 % ) , vitamin D ( -38 % ) , vitamin B-12 ( -22 % ) , magnesium ( -6 % ) , phosphorus ( -5 % ) , and selenium ( -2 % ) ( all p < 0.05 ) compared to the non-sarcopenic controls . The serum concentration of vitamin B-12 was 15 % lower in the sarcopenic group ( p = 0.015 ) , and all other nutrient concentrations were similar between groups . CONCLUSIONS In non-malnourished older adults with and without sarcopenia , we observed that sarcopenia substantially impacted self-reported quality of life and physical activity levels . Differences in nutrient concentrations and dietary intakes were identified , which might be related to the differences in muscle mass , strength and function between the two groups . This study provides information to help strengthen the characterization of this geriatric syndrome sarcopenia and indicates potential target areas for nutritional interventions Background Sarcopenia is strongly associated with an inadequate intake of dietary protein . Dietary protein supplementation boosts muscle-protein synthesis and increases muscle mass in the elderly . This study tested whether adding a protein-rich food , ricotta cheese , to the habitual diet increased total appendicular skeletal muscle mass and strength in elderly people . Methods Participants ( n = 40 ) , were sarcopenic elderly men and women over 60 years of age . Two comparison groups were formed at r and om and followed for 3 months : the intervention group received 210 g/day of ricotta cheese plus the habitual diet , while the control group followed the habitual diet with no additional intervention . Total appendicular skeletal muscle ( TASM ) was assessed by dual-energy X-ray absorptiometry , while strength was measured using a h and held dynamometer at baseline and after the intervention period . The primary outcomes were the percentage of relative change in TASM and strength . Results The percentage of relative change in TASM was not significant between the groups after the intervention period . Muscle strength improved in the intervention group , but showed only a tendency towards significance ( P = 0.06 ) . Secondary analysis showed that the men in the intervention group gained 270 g in TASM compared to those in the control group , and improved their fasting insulin levels ( P = 0.05 ) , muscle strength , lean body mass in the arms , and body weight variables . Conclusion The results of this study indicate that a nutritional intervention using a high- quality protein food , specifically ricotta cheese , in order to increase the amount of protein intake might not be regarded as fully promising in elderly men and women with sarcopenia . However , the gender effects on muscle strength , lean tissue in the arms , homeostatic assessment of insulin resistance , and body weight detected in this study suggest that additional research is needed on elderly male subjects with sarcopenia BACKGROUND Age-related losses of muscle mass , strength , and function ( sarcopenia ) pose significant threats to physical performance , independence , and quality of life . Nutritional supplementation could positively influence aspects of sarcopenia and thereby prevent mobility disability . OBJECTIVE To test the hypothesis that a specific oral nutritional supplement can result in improvements in measures of sarcopenia . DESIGN A multicenter , r and omized , controlled , double-blind , 2 parallel-group trial among 380 sarcopenic primarily independent-living older adults with Short Physical Performance Battery ( SPPB ; 0 - 12 ) scores between 4 and 9 , and a low skeletal muscle mass index . The active group ( n = 184 ) received a vitamin D and leucine-enriched whey protein nutritional supplement to consume twice daily for 13 weeks . The control group ( n = 196 ) received an iso-caloric control product to consume twice daily for 13 weeks . Primary outcomes of h and grip strength and SPPB score , and secondary outcomes of chair-st and test , gait speed , balance score , and appendicular muscle mass ( by DXA ) were measured at baseline , week 7 , and week 13 of the intervention . RESULTS H and grip strength and SPPB improved in both groups without significant between-group differences . The active group improved more in the chair-st and test compared with the control group , between-group effect ( 95 % confidence interval ) : -1.01 seconds ( -1.77 to -0.19 ) , P = .018 . The active group gained more appendicular muscle mass than the control group , between-group effect : 0.17 kg ( 0.004 - 0.338 ) , P = .045 . CONCLUSIONS This 13-week intervention of a vitamin D and leucine-enriched whey protein oral nutritional supplement result ed in improvements in muscle mass and lower-extremity function among sarcopenic older adults . This study shows proof-of-principle that specific nutritional supplementation alone might benefit geriatric patients , especially relevant for those who are unable to exercise . These results warrant further investigations into the role of a specific nutritional supplement as part of a multimodal approach to prevent adverse outcomes among older adults at risk for disability The age-related change in hormone concentrations has been hypothesized to play a role in the loss of muscle mass and muscle strength with aging , also called sarcopenia . The aim of this prospect i ve study was to investigate whether low serum 25-hydroxyvitamin D ( 25-OHD ) and high serum PTH concentration were associated with sarcopenia . In men and women aged 65 yr and older , participants of the Longitudinal Aging Study Amsterdam , grip strength ( n = 1008 ) and appendicular skeletal muscle mass ( n = 331 , using dual-energy x-ray absorptiometry ) were measured in 1995 - 1996 and after a 3-yr follow-up . Sarcopenia was defined as the lowest sex-specific 15th percentile of the cohort , translating into a loss of grip strength greater than 40 % or a loss of muscle mass greater than 3 % . After adjustment for physical activity level , season of data collection , serum creatinine concentration , chronic disease , smoking , and body mass index , persons with low ( < 25 nmol/liter ) baseline 25-OHD levels were 2.57 ( 95 % confidence interval 1.40 - 4.70 , based on grip strength ) and 2.14 ( 0.73 - 6.33 , based on muscle mass ) times more likely to experience sarcopenia , compared with those with high ( > 50 nmol/liter ) levels . High PTH levels ( > or=4.0 pmol/liter ) were associated with an increased risk of sarcopenia , compared with low PTH ( < 3.0 pmol/liter ) : odds ratio = 1.71 ( 1.07 - 2.73 ) based on grip strength , odds ratio = 2.35 ( 1.05 - 5.28 ) based on muscle mass . The associations were similar in men and women . The results of this prospect i ve , population -based study show that lower  25-OHD  and higher  PTH levels increase the risk of sarcopenia in older men and women Decreases in whole-body lean mass can cause sarcopenia , a disease frequently found in the elderly . This condition is frequently associated with frailty and disability in aging as well as the onset and progression of several geriatric syndromes . Sarcopenia therefore must be managed with multidimensional approaches that include physical training , nutritional support , and metabolic and anabolic treatment . The purpose of our study was to assess the effect of an orally administered special mixture of amino acids ( AAs ) in elderly subjects with reduced lean body mass and sarcopenia . A r and omized , open-label , crossover study was conducted in 41 elderly subjects ( age range : 66 - 84 years ) with sarcopenia , assigned to 2 distinct treatments ( AAs and placebo ) . All subjects had normal body weight ( body mass index within 19 - 23 ) . The AA treatment consisted of 70.6 kcal/day ( 1 kcal = 4.2 kJ ) of 8 g of essential AA snacks , given at 10:00 am and 5:00 pm . Lean mass was measured with dual-energy x-ray absorptiometry in leg , arm , and trunk tissues . Significant increases in whole-body lean mass in all areas were seen after 6 months and more consistently after 18 months of oral nutritional supplementation with AAs .  Fasting blood glucose , serum insulin , and homeostatic model assessment of insulin resistance ( an index of insulin resistance ) significantly decreased during AA treatment . Furthermore , a significant reduction in serum tumor necrosis factor-alpha ( TNF-alpha ) and a significant increase in both insulin-like growth factor-1 ( IGF-1 ) serum concentrations and in the IGF-1/TNF-alpha ratio were also found . No significant adverse effects were observed during AA treatment . These preliminary data indicate that nutritional supplements with the oral AA mixture significantly increased whole-body lean mass in elderly subjects with sarcopenia . The improvement in the amount of whole-body lean mass could be linked to increased insulin sensitivity and anabolic conditions related to IGF-1 availability OBJECTIVES To describe associations between dietary nutrient intake and progression of sarcopenia , the age-related loss of muscle mass and strength . DESIGN Prospect i ve cohort study of community-dwelling older adults . SETTING Southern Tasmania , Australia . PARTICIPANTS Seven hundred forty noninstitutionalized older adults ( 50 % female ; mean age 62 ± 7 ) r and omly sample d from electoral rolls .  MEASUREMENTS Dietary nutrient intake  was examined at baseline and follow-up ( 2.6 ± 0.4 years later ) using The Cancer Council Victoria 's Food Frequency Question naire ( FFQ ) . Appendicular lean mass ( aLM ) was assessed using dual X-ray absorptiometry and muscle strength of the knee extensors using a dynamometer . RESULTS Failing to meet the recommended dietary intake for protein was associated with significantly lower aLM at baseline ( -0.81 kg , 95 % confidence interval ( CI ) = -1.54 to -0.08 ) and follow-up ( -0.79 kg , 95%CI = -1.42 to -0.17 ) . Energy-adjusted protein intake was a positive predictor of change in aLM over 2.6 years ( β = 0.10 , P = .003 ) . Energy-adjusted intake of iron ( β = 0.07 , P = .02 ) , magnesium ( β = 0.07 , P=.02 ) , phosphorus ( β = 0.07 , P = .047 ) , and zinc ( β = 0.08 , P = .02 ) were positive predictors of change in aLM , whereas retinol ( β = -0.09 , P = .005 ) was a negative predictor of change in aLM after adjustment for protein intake . No significant associations were observed between nutrient intake and muscle strength . CONCLUSION Protein and several other dietary nutrients are associated with muscle mass and rate of muscle loss ( but not strength ) in older adults , suggesting that multiple dietary components may ameliorate the progression of sarcopenia The aim of the current study was to examine whether calcium supplementation could prevent bone loss in postmenopausal women or more favourable outcomes could be obtained via the consumption of dairy products fortified with calcium and vitamin D3 . For this purpose changes in bone mineral density ( BMD ) at different skeletal sites , assessed by dual-energy X-ray absorptiometry , as well as in quantitative ultrasound ( QUS ) parameters of the calcaneus over 12 months were estimated . A population of 101 postmenopausal women ( 55 - 65 years old ) was r and omized into a dairy group ( DG : n 39 ) , receiving approximately 1200 mg calcium/d and 7.5 microg vitamin D3/d through fortified dairy products ; a calcium-supplemented group ( CaG : n 26 ) provided with a calcium supplement of 600 mg/d ; and a control group ( CG : n 36 ) . Over the intervention period the DG was found to have more favourable changes in pelvis ( P=0.040 ) , total spine ( P<0.001 ) and total body BMD ( P<0.001 ) than the other groups . A significant increase was also observed for DG in lumbar spine BMD ( 2.0 % ; 95 % CI 0.5 , 3.5 ) although it did not differentiate significantly compared to the other groups . No significant differences were observed with respect to the changes in QUS parameters . The current study revealed that recommended intakes of vitamin D3 and calcium via fortified dairy products for 12 months can induce favourable changes in pelvis , total spine and total body BMD in postmenopausal women but not in QUS parameters . No such favourable changes were observed via supplementation of calcium alone OBJECTIVE The aim of the Intervention by Nutrition and Exercise ( INE ) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults . DESIGN A cluster-r and omized controlled trial . SETTING AND PARTICIPANTS This trial recruited community-dwelling adults aged 65 years and older in Japan . The 227 participants were cluster r and omized into a  walking and nutrition ( W/N ) group ( n = 79 ) , a  walking ( W ) group ( n = 71 ) , and a  control ( C ) group ( n = 77 ) . We analyzed the physical and biochemical measurements in this sub study . INTERVENTION Six months of mail-based intervention ( a pedometer-based walking program and nutritional supplementation ) . MEASUREMENTS The skeletal muscle mass index ( SMI ) using the bioelectrical impedance data acquisition system , biochemical measurements , such as those of insulinlike growth factor ( IGF-1 ) , dehydroepi and rosterone sulfate ( DHEA-S ) , and 25-hydroxy vitamin D ( 25[OH]D ) , as well as frailty , were assessed by the Cardiovascular Health Study criteria . RESULTS Participants in the W/N and W groups had significantly greater improvements in SMI , IGF-1 , and 25(OH)D ( P < .05 ) than those in the C group . Participants in the W/N group had significantly greater improvements in DHEA-S ( P < .05 ) than in the other groups . These effects were more pronounced in frail , older adults . CONCLUSION These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults , particularly in those who are frail BACKGROUND Recent evidence suggests that nutritional interventions may improve muscle outcomes in malnutrition and sarcopenia . OBJECTIVES We evaluated the effects of 2 high- quality oral nutritional supplements ( ONS ) differing in amount and type of key nutrients in older adult men and women . DESIGN A multicenter , r and omized , double-blinded , controlled clinical trial . PARTICIPANTS Malnourished and sarcopenic men and women , 65 years and older ( n = 330 ) . INTERVENTION A 24-week intervention period with 2 energy-rich ( 330 kcal ) ONS treatment groups : Control ONS ( CONS , 14 g protein ; 147 IU vitamin D3 ) versus Experimental ONS ( EONS , 20 g protein ; 499 IU vitamin D3 ; 1.5 g CaHMB ) taken twice daily . Both ONS also contained other vitamins , minerals , and nutrients in varying amounts . MEASUREMENTS Isokinetic peak torque ( PT , Nm ) leg strength , grip strength ( kg ) , and gait speed ( m·s-1 ) were assessed at baseline and 12 and 24 weeks . Left and right leg muscle mass ( LMM , kg ) were assessed by dual-energy x-ray absorptiometry ( DXA ) . Muscle quality ( MQ ) was leg strength expressed relative to the tested LMM ( Nm·kg-1 ) . Subgroup analyses were performed : severe sarcopenia ( low skeletal mass index , low grip strength [ < 30 kg men ; < 20 kg women ] , low gait speed [ < 0.8 m·s-1 ] ) and mild-moderate sarcopenia ( low skeletal mass index , normal gait speed , or normal grip strength ) . RESULTS Both ONS groups ( EONS and CONS ) improved PT , MQ , grip strength , and gait speed from baseline with no treatment differences . Those with severe sarcopenia ( 44 % ) exhibited lower baseline PT and MQ , with no differences in strength improvements between treatments . However , participants with mild-moderate sarcopenia exhibited higher baseline PT and MQ , with differences in strength improvements at 12 weeks ( EONS > CONS , P = .032 ) in those with normal grip strength . There were no treatment differences based on sarcopenic severity for either grip strength or gait speed . CONCLUSION ONS improved strength outcomes in malnourished older adults with sarcopenia . In those with mild-moderate sarcopenia , but not severe sarcopenia , consumption of the EONS improved leg muscle strength and quality compared with the st and ard CONS The prevention of increased bone remodeling in postmenopausal women at low 10-y risk of osteoporotic fractures essentially relies on reinforcement of environmental factors known to positively influence bone health , among which nutrition plays an important role . In institutionalized women in their mid-eighties , we previously found that consumption of fortified soft plain cheese increased vitamin D , calcium , and protein intakes , reduced bone resorption biochemical markers , particularly the serum bone specific acid phosphatase tartrate resistant acid phosphatase , isoform 5b ( TRAP 5b ) that reflects osteoclast activity , and stimulated the serum bone anabolic factor insulin-like growth factor-I ( IGF-I ) . Whether these effects occur in much younger women was tested in a prospect i ve control study . Seventy-one healthy postmenopausal women aged 56.6 ± 3.9 y ( mean ± SD ) with low spontaneous supply of both Ca and vitamin D were r and omized to consume daily ( treated , n = 36 ) or not ( controls , n = 35 ) two servings ( 2 × 100 g ) of skimmed-milk , soft plain cheese for 6 wk . The vitamin D and Ca-fortified dairy product provided daily : 661 kJ , 2.5 μg vitamin D , 400 mg calcium , and 13.8 g protein . At the end of the intervention , the decrease in TRAP 5b and the increase in IGF-I were greater in the treated than in the control group ( P < 0.02 ) . The changes in serum carboxy terminal crosslinked telopeptide of type I collagen did not differ significantly between the two groups . In conclusion , like in elderly women , consumption by healthy postmenopausal women of a vitamin D and calcium-fortified dairy product that also increases the protein intake , reduces the serum concentration of the bone resorption biomarker TRAP 5b . This response , combined with the increase in serum IGF-I , is compatible with a nutrition-induced reduction in postmenopausal bone loss rate The long-term effects of calcium and vitamin D supplementation on bone material and structural properties in older men are not known . The aim of this study was to examine the effects of high calcium ( 1000 mg/day)- and vitamin-D(3 ) ( 800 IU/day)-fortified milk on cortical and trabecular volumetric BMD ( vBMD ) and bone geometry at the axial and appendicular skeleton in men aged over 50 years . One hundred and eleven men who were part of a larger 2-year r and omized controlled trial had QCT scans  of the mid-femur and lumbar spine ( L(1)-L(3 ) ) to assess vBMD , bone geometry and indices of bone strength [ polar moment of inertia ( I(polar ) ) ] . After 2 years , there were no significant differences between the milk supplementation and control group for the change in any mid-femur or L(1)-L(3 ) bone parameters for all men aged over 50 years . However , the mid-femur skeletal responses to the fortified milk varied according to age , with a split of < or=62 versus > 62 years being the most significant for discriminating the changes between the two groups . Subsequent analysis revealed that , in the older men ( > 62 years ) , the expansion in mid-femur medullary area was 2.8 % ( P < 0.01 ) less in the milk supplementation compared to control group , which helped to preserve cortical area in the milk supplementation group ( between group difference 1.1 % , P < 0.01 ) . Similarly , for mid-femur cortical vBMD and I(polar ) , the net loss was 2.3 and 2.8 % less in the milk supplementation compared to control group ( P < 0.01 and < 0.001 , respectively ) . In conclusion , calcium-vitamin-D(3)-fortified milk may represent an effective strategy to maintain bone strength by preventing endocortical bone loss and slowing the loss in cortical vBMD in elderly men Acceleration of bone remodelling increases the risk of fragility fractures . The objective of the present study was to explore in elderly women whether a vitamin D and Ca-fortified dairy product providing about 17 - 25 % of the recommended intakes in vitamin D , Ca and proteins would reduce secondary hyperparathyroidism and bone remodelling in a way that may attenuate age-related bone loss in the long term . Thirty-seven institutionalised women , aged 84.8 ( sd 8.1 ) years , with low serum 25-hydroxyvitamin D ( 5.5 ( sd 1.7 ) ng/ml ) were enrolled into a multicentre open trial to consume during 1 month two servings of soft plain cheese made of semi-skimmed milk providing daily 686 kJ ( 164 kcal ) , 2.5 microg vitamin D , 302 mg Ca and 14.2 g proteins . The primary endpoint was the change in serum carboxy terminal cross-linked telopeptide of type I collagen ( CTX ) , selected as a marker of bone resorption . Thirty-five subjects remained compliant . Mean serum changes were : 25-hydroyvitamin D , + 14.5 % ( P = 0.0051 ) ; parathyroid hormone ( PTH ) , - 12.3 % ( P = 0.0011 ) ; CTX , - 7.5 % ( P = 0.01 ) ; tartrate-resistant acid phosphatase isoform 5b ( TRAP 5b ) , - 9.9 % ( P < 0.0001 ) ; albumin , + 6.2 % ( P < 0.0001 ) ; insulin-like growth factor-I (IGF-I),+16.9 % ( P < 0.0001 ) ; osteocalcin , + 8.3 % ( P = 0.0166 ) ; amino-terminal propeptide of type 1 procollagen (P1NP),+19.3 % ( P = 0.0031 ) . The present open trial suggests that fortified soft plain cheese consumed by elderly women with vitamin D insufficiency can reduce bone resorption markers by positively influencing Ca and protein economy , as expressed by decreased PTH and increased IGF-I , respectively . The rise in the bone formation marker P1NP could be explained by a protein-mediated increase in IGF-I. Thus , such a dietary intervention might uncouple , at least transiently , bone resorption from bone formation and thereby attenuate age-related bone loss Objectives Leucine-rich milk and whey proteins have been suggested for prevention of age related loss of muscle mass and strength i.e. sarcopenia . The effects of milk protein supplementation and low intensity home based physical exercise on body composition and muscle functions were investigated . Design A r and omized double blind crossover trial . Setting Community dwelling members of Helsinki rheumatoid association . Participants Older people ( N = 47 , mean age 69.5 years ) suffering from polymyalgia rheumatica . Intervention Patients performed as many st and ups as possible twice a day after which they ingested a regular ( Control ) or a whey protein enriched dairy product with high leucine content ( Test ) . The 8-week intervention periods were separated by a 4-week wash-out . Measurements Body composition was measured by dual x-ray absorptiometry and muscle functions by h and grip strength , force platform countermovement jump performance , chair st and test , and walking speed . Results The 16-week home-based post-exercise supplementation result ed in a 1.8 % increase ( p = 0.052 ) in lower limb muscle mass . Walking speed ( + 5.3 % , p = 0.007 ) and chair st and test performance ( −12.2 % , p < 0.001 ) were also improved . Furthermore , a tendency for increased jump power ( + 3.0 % , p = 0.084 ) was observed . However , significant and consistent differences were not found in the changes of muscle mass indices or muscle functions between supplements , but the test supplement tended to prevent accumulation of body fat . Conclusion A low intensity home based exercise program combined with post-exercise milk protein supplementation is feasible despite some gastrointestinal complaints and seems effective in improving the muscle mass and functions of older persons with a inflammatory disease . Further studies are needed to establish , whether and to what extent the use of leucine-enriched whey products prevent or treat age-associated sarcopenia and whether they are superior to the present commercial milk products BACKGROUND There is currently no consensus on the effect of dietary protein intake on the skeleton , but there is some indication that low calcium intakes adversely influence the effect of dietary protein on fracture risk . OBJECTIVE The objective of the present study was to determine whether supplemental calcium citrate malate and vitamin D influence any associations between  protein intake and change in bone mineral density ( BMD ) . DESIGN Associations between protein intake and change in BMD were examined in 342 healthy men and women ( aged > or = 65 y ) who had completed a 3-y , r and omized , placebo-controlled trial of calcium and vitamin D supplementation . Protein intake was assessed at the midpoint of the study with the use of a food-frequency question naire and  BMD  was assessed every 6 mo by dual-energy X-ray absorptiometry . RESULTS The mean ( + /-SD ) protein intake of all subjects was 79.1 + /- 25.6 g/d and the mean total calcium intakes of the supplemented and placebo groups were 1346 + /- 358 and 871 + /- 413 mg/d , respectively . Higher protein intake was significantly associated with a favorable 3-y change in total-body BMD in the supplemented group ( in a model containing terms for age , sex , weight , total energy intake , and dietary calcium intake ) but not in the placebo group . The pattern of change in femoral neck BMD with increasing protein intake in the supplemented group was similar to that for the total body . CONCLUSION Increasing protein intake may have a favorable effect on change in BMD in elderly subjects supplemented with calcium citrate malate and vitamin BACKGROUND Race and sex differences in the effect of diet on bone mineral density ( BMD ) at the hip in the elderly are unknown . OBJECTIVES This study related cross-sectional nutrient and dairy product consumption to hip BMD in white and black men and women aged > 60 y and evaluated the influence of nutrient and dairy product consumption on changes in BMD in a white cohort participating in a calcium , vitamin D , or placebo trial . DESIGN The Health Habits and History Question naire was used in 289 white women and 116 white men who participated in the trial and in 265 black women and 75 black men to predict total hip and femoral neck BMD or  changes in BMD . RESULTS Blacks had higher calcium intakes than did whites ( 700 and 654 mg/d , respectively ; P = 0.0094 ) , and men had higher calcium intakes than did women ( 735 and 655 mg/d , respectively ; P = 0.0007 ) . For men , the correlation between total hip BMD and dairy calcium intake after adjustment for age , race , and weight was 0.23 ( P < 0.005 ) ; this relation was not significant in women ( r = 0.02 , P = 0.12 ) . Similar results were found for femoral neck BMD . In the longitudinal study , calcium supplementation reduced bone loss from the total hip and femoral neck in those who consumed < 1.5 servings of dairy products/d and were < 72 y old . CONCLUSIONS Cross-sectional results indicated that higher dairy product consumption is associated with greater hip BMD in men , but not in women . Calcium supplementation protected both men and women from bone loss in the longitudinal study of whites Objective : To compare the effect of calcium/vitamin D supplements with a combination of calcium/vitamin D supplements and exercise/protein on risk of falling and postural balance . Design : R and omized clinical trial . Setting : University hospital physiotherapy department . Subjects : Twenty-four independently living elderly females aged 65 years and older with osteopenia or osteoporosis and mean total hip T-score ( SD ) of —1.8 ( 0.8 ) . Interventions : A three-month programme consisting of exercise/protein including training of muscular strength , co-ordination , balance and endurance . Calcium/ vitamin D was supplemented in all participants for a 12-month period . Outcome measures : Assessment took place prior to and following the months 3 , 6 , 9 and at the end of the study ; primary dependent variables assessed were risk of falling ( Berg Balance Test ) and postural balance ( forceplate ) . Secondary measures included body composition , strength , activity level , number of falls , bone mineral content , biochemical indices , nutritional status and general health . Results : Significant reductions of risk of falling ( repeated measures ANOVA F = 8.90 , P = 0.008 ) , an increase in muscular strength ( ANOVA F = 3.0 , P = 0.03 ) , and an increase in activity level ( ANOVA F = 3.38 , P = 0.02 ) were found in the experimental group as compared to the control group . Further on , there was 89 % reduction of falls reported in the experimental group ( experimental pre/post 8/1 falls ; control group pre/post 5/6 falls ) . Conclusion : This study provides support for our intervention programme aim ed at reducing the risk of falling in elderly participants diagnosed with osteopenia or osteoporosis . The data obtained from the pilot study allow the calculation of the actual sample size needed for a larger r and omized trial
This systematic review highlights the effects of dairy products on muscle mass , muscle strength and body performance in the elderly population in the perspective of Ca , P , vitamin D and protein
The risk of sarcopenia increases with aging .
Malnutrition in the elderly population is an important risk factor for sarcopenia .
Calcium ( Ca ) , phosphate ( P ) , vitamin D and protein are key nutrients for the human body and affect muscle mass and quality .
Dairy products are rich in these nutrients , which implicates that dairy products might be ideal for elderly population .