Whey Protein and High Resistance Training Improve Osteosarcopenia in Older Men

by | Sep 1, 2020 | 2020, Aging, Bone Health, Fitness and Exercise

Written by Joyce Smith, BS. High-intensity dynamic resistance training over a total 18-month period improved bone mineral density (BMD), skeletal muscle mass index (SMI), and muscle strength in elderly men with osteopenia.

agingOsteopenia (loss of bone density) and sarcopenia (loss of muscle mass) are age-related chronic conditions that share many disease symptoms 1 and when combined, are referred to as osteosarcopenia 2. Common to both conditions is the significantly increasing occurrence of falls and fractures that require hospitalization and can result in loss of independence and even death 3. A substantial body of evidence has shown that sarcopenia and sarcopenic obesity are related to inflammation 4, mitochondrial abnormalities, 5 and oxidative stress 6. Dynamic resistance exercise (DRT) supported by protein supplementation is considered the gold standard management of sarcopenia 7 and its related falls and fractures 8. DRT has been only moderately effective as an intervention for sarcopenia in women 9 and with an absence of studies on men, Kemmler and team were inspired to investigate the effect of high-intensity, dynamic resistance exercise training (HIT-RT) along with whey protein supplementation on osteopenia and sarcopenia in older men with osteosarcopenia.

The FrOST (Franconian Osteopenia and Sarcopenia Trial) 10 is an 18-month randomized parallel group exercise trial that ran from February, 2018 to February, 2020 with baseline and post intervention analysis addressing  SMI and BMD at the lumbar spine (LS) and hip (TH) using Dual-Energy Absorptiometry (DXA). Hand grip strength and gait velocity were measured as well.

Individuals were categorized based on three SMIs (<6.70 kg/m2 versus 6.70-7.00 kg/m2 versus >7.00 kg/m2) and members of each category were randomly assigned to either an exercise group (n=21; mean age, 77.8±3.6 years) or a control group (n=22; mean age, 79.2±4.7 years). Individuals in the exercise group participated in 2 weekly supervised exercise sessions at a centrally located gym. Using various single-set, high-intensity, machine-assisted resistance exercises, the program was able to target all major and minor muscle groups. During the initial 4 weeks, participants learned exercise techniques.  The following 8 weeks involved body conditioning, while the remainder of the 18-month program consisted of high-intensity exercise. All participants were provided with whey protein powder that contained 100 g protein powder (360 kcal) containing 80 g of (whey) protein, 9 g of L-Leucine and 1200 mg of calcium. In addition, calcium and vitamin D supplements were taken based on baseline serum levels of the participants.

Based on the sarcopenia Z-score, the HIT-RT group improved significantly from baseline in SMI, grip strength and gait velocity (p<0.001) while the control group decreased significantly (P=0.018) in all three categories. LS-BMD also improved significantly in the HIT-RT group (0.9 ± 1.3%; p = 0.006), but remained unchanged in the control group (0.0 ± 1.6%; p = 0.807). The changes in LS-BMD between the two groups were significant (p = 0.0237). Although TH-BMD decreased significantly in the CG (-1.6 ± 2.1%; p = 0.003), it remained stable in the HIT-RT (0.0 ± 1.3%, p = 0.847). The changes between the HIT-RT and control groups were significant (p = 0.0247).

Collectively, these findings demonstrated that elderly osteopenic or osteoporotic men who engaged in a twice-weekly program of high-intensity dynamic resistance training over a total 18-month period improved their BMD, SMI, and muscle strength parameters.

Limitations include the trial’s exclusive use of men which does not allow for generalization other groups. In their recent 12 –month report 11, the research team found that their use of quantitative computed tomography was more sensitive than the DXA used in this 18 month report. Upon review of the training logs, the researchers noted that up to one-third of the exercises were possibly conducted with inadequate physical effort on the part of the participants; however, the positive results demonstrated the positive effect of dynamic resistance training in spite of this limitation. The study did not cover the potentially negative effect of HIT-RT and protein supplementation on renal hepatic and cardiac function; therefore, the issue should be addressed in future studies.

Source: Kemmler W, Kohl M, Fröhlich M, et al. Effects of high-intensity resistance training on osteopenia and sarcopenia parameters in older men with osteosarcopenia—one-year results of the randomized controlled Franconian Osteopenia and Sarcopenia Trial (FrOST) [published online April 9, 2020]. J Bone Miner Res. doi:10.1002/jbmr.4027

© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open accessarticle distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Posted September 1, 2020.

Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from  the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.

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