Written by Jessica Patella, ND. Supplementation with a combination of L-leucine, vitamin D 3 and medium-chain triglycerides significantly improved muscle strength and function in the thirty-eight participating elderly adults.

agingSarcopenia is the combination of loss of muscle mass, strength and function that occurs due to aging 1,2. It is estimated that sarcopenia may effect up to 50% of people 80 years and older 3. It is of concern because loss of muscle mass is a major risk factor for disability, hospitalization and death in older adults 3. Recent research has found supplementing a combination of medium-chain triglycerides with leucine and vitamin D can increase muscle mass in elderly adults 1.

Sarcopenia is a major concern in the elderly due to the negative risk factors associated, as mentioned above. Regular exercise and adequate protein intake are considered two of the major ways to treat and slow the progression of sarcopenia 1. Although these both have challenges with compliance, very few elderly will partake in exercise training. It is difficult in increase their protein intake because of the decreased appetite 1; therefore, researchers considered several supplements that might increase muscle strength and function in the elderly 1: leucine supplementation, promotes protein synthesis 4; vitamin D supplementation reduces the risk of falling in the elderly at doses of 700-1000 IU/day 5; and medium-chain triglycerides support energy production in skeletal muscles 6. Researchers, hypothesized that a combination of all three nutrients would improve muscle functioning in elderly adults 1.

The study included 38 elderly nursing home residents (11 men, 27 women, average age 86.6 +/- 4.8 years). Participants were randomly assigned to one of three groups:

  • Group 1: L-leucine (1.2g), vitamin D3 (20 micrograms) and medium-chain triglycerides (6g) (n=13)
  • Group 2: L-leucine (1.2g), vitamin D3 (20 micrograms) and long-chain triglycerides (6g) (n=13)
  • Group 3: control- no supplements (n=12)

The supplements were taken at dinner time for 3 months, with no reported negative side effects. After the 3 months the following results were observed:

  • Body weight increased in Group 1 (2.5%; 1.1 +/- 1.0 kg) and Group 2 (1.8%; 0.8 +/- 1.1 kg) which was significantly greater than in the control group (-0.5 +/- 0.9 kg) (p<0.05).
  • Group 1 also had significant improvements of 13.1% increase in right-hand grip strength (1.2 +/- 1.0 kg; P<0.01); 12.5 % increase in walking speed (0.078 +/- 0.080 m/s; P<0.05); 68.2% increase in a 10-second leg open and close test (2.31 +/- 1.68n/10seconds; P<0.001); and 28.2% increase in peak expiratory flow (53 +/- 59 L/min, P<0.01).
  • No significant changes were observed in Group 2 or the control group.

In conclusion, three months of daily supplementation with a combination of L-leucine, vitamin D 3 and medium-chain triglycerides significantly improved muscle strength and function in elderly adults 1. Future research should include more participants and investigate whether the combination of all three or just the medium-chain triglycerides provide the improvement in muscle strength and function 1.

Source: Abe, Sakiko, Osamu Ezaki, and Motohisa Suzuki. “Medium-chain triglycerides in combination with leucine and vitamin D increase muscle strength and function in frail elderly adults in a randomized controlled trial.” The Journal of nutrition 146, no. 5 (2016): 1017-1026. 

© 2016 American Society for Nutrition.

Posted January 23, 2018.

Jessica Patella, ND, is a naturopathic physician specializing in nutrition and homeopathic medicine and offers a holistic approach to health. She earned her ND from Southwest College of Naturopathic Medicine in Tempe, AZ, and is a member of the North Carolina Association of Naturopathic Physicians. Visit her website at www.awarenesswellness.com.

References:

  1. Abe S, Ezaki O, Suzuki M. Medium-chain triglycerides in combination with leucine and vitamin D increase muscle strength and function in frail elderly adults in a randomized controlled trial. The Journal of nutrition. 2016;146(5):1017-1026.
  2. Rosenberg IH. Sarcopenia: origins and clinical relevance. The Journal of nutrition. 1997;127(5):990S-991S.
  3. Kalyani RR, Corriere M, Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. The lancet Diabetes & endocrinology. 2014;2(10):819-829.
  4. Nicastro H, Artioli GG, Costa Ados S, et al. An overview of the therapeutic effects of leucine supplementation on skeletal muscle under atrophic conditions. Amino acids. 2011;40(2):287-300.
  5. Bischoff-Ferrari HA, Dawson-Hughes B, Staehelin HB, et al. Fall prevention with supplemental and active forms of vitamin D: a meta-analysis of randomised controlled trials. Bmj. 2009;339:b3692.
  6. Lindgren B, Ruokonen E, Magnusson-Borg K, Takala J. Nitrogen sparing effect of structured triglycerides containing both medium-and long-chain fatty acids in critically ill patients; a double blind randomized controlled trial. Clinical Nutrition. 2001;20(1):43-48.