Data_Sheet_2_Personalized Protein Supplementation Improves Total Protein, Leucine, and Energy Intake in (Pre)Sarcopenic Community-Dwelling Older Adults in the ENHANce RCT.PDF

Recommendations concerning protein quantity, source, and leucine intake for older adults are difficult to reach by regular dietary intake. This randomized clinical trial assesses in sarcopenic community-dwelling older adults (i) the regular (non-supplemented) daily protein and leucine intake; and (ii) the effect of personalized protein supplementation (aiming for an evenly distributed total protein intake of 1.5 g·kg−1·d−1 of body mass, accounting for energy intake) on regular and total (dietary and supplemental) intake. A preliminary feasibility study in participants of the ongoing Exercise and Nutrition for Healthy AgeiNg (ENHANce) study was performed with the objective to assess the intake and distribution of regular dietary protein and leucine, protein source and energy intake in (pre)sarcopenic community-dwelling older adults. Moreover, this study aimed to assess if personalized protein supplementation was feasible without negatively affecting regular dietary intake. ENHANce (NCT03649698) is a 5-armed RCT that assesses the effect of anabolic interventions on physical performance in (pre)sarcopenic older adults. In August 2019, n = 51 participants were included in ENHANce with complete available data on dietary intake at screening and thus eligible for inclusion in present analysis. Of these, n = 35 participants completed the intervention period of ENHANce at the moment of analysis, allowing an exploration of the effect of supplementation on regular dietary intake. The regular dietary protein intake of 51 (pre)sarcopenic adults (73.6 ± 6.5 years) was 1.06 ± 0.3 g·kg−1·d−1 of body mass. Protein supplementation (n = 20) improved total protein intake to 1.55 ± 0.3 g·kg−1·d−1 of body mass (P < 0.001) without affecting regular dietary protein (P = 0.176) or energy intake (P = 0.167). Placebo supplementation (n = 15) did not affect regular dietary protein intake (P = 0.910) but decreased regular dietary energy intake (P = 0.047). Regular leucine intake was unevenly distributed over the day, but increased by supplementation at breakfast (P < 0.001) and dinner (P = 0.010) to at least 2.46 g leucine·meal−1, without reducing regular dietary leucine intake (P = 0.103). Animal-based protein intake—the main protein source—was not affected by supplementation (P = 0.358). Personalized protein supplementation ensured an adequate quantity and even distribution of protein and leucine over the day, without affecting regular dietary protein or energy intake.

老年人群的蛋白质摄入量、来源及亮氨酸（leucine）摄入推荐量，往往难以通过常规膳食摄入达成。本随机对照试验（randomized clinical trial, RCT）针对社区居住的肌少症（sarcopenia）老年人群，开展了两项评估：一是常规（非补充剂来源）每日蛋白质与亮氨酸摄入水平；二是个性化蛋白质补充方案（旨在使总蛋白质摄入分布均匀，且达到1.5 g·kg⁻¹·d⁻¹体质量，同时兼顾能量摄入）对常规膳食摄入与总摄入（膳食+补充剂）的影响。本研究针对正在进行的健康老龄化运动与营养（Exercise and Nutrition for Healthy AgeiNg, ENHANce）研究的受试者开展了一项预可行性试验，旨在评估社区居住的（肌少症前期）老年人群的常规膳食蛋白质、亮氨酸摄入情况及其分布特征、蛋白质来源与能量摄入水平；此外，本研究还旨在验证个性化蛋白质补充方案在不负面影响常规膳食摄入的前提下是否具备可行性。ENHANce（临床试验注册号：NCT03649698）是一项5组随机对照试验，旨在评估合成代谢干预措施对（肌少症前期）老年人群身体机能的影响。2019年8月，ENHANce研究纳入了51名受试者，其筛查阶段的膳食摄入数据完整，符合本分析的纳入标准。截至本次分析时，其中35名受试者完成了ENHANce研究的干预阶段，由此可探究补充剂对常规膳食摄入的影响。51名（肌少症前期）老年受试者（年龄73.6±6.5岁）的常规膳食蛋白质摄入量为1.06±0.3 g·kg⁻¹·d⁻¹体质量。蛋白质补充组（n=20）的总蛋白质摄入量提升至1.55±0.3 g·kg⁻¹·d⁻¹体质量（P<0.001），且未对常规膳食蛋白质摄入（P=0.176）或能量摄入（P=0.167）造成显著影响。安慰剂补充组（n=15）的常规膳食蛋白质摄入未受影响（P=0.910），但常规膳食能量摄入出现下降（P=0.047）。受试者的常规亮氨酸摄入在一日内分布不均，但通过补充剂可使早餐（P<0.001）与晚餐（P=0.010）的亮氨酸摄入提升至至少2.46 g·餐⁻¹，且未降低常规膳食亮氨酸摄入（P=0.103）。作为主要蛋白质来源的动物源性蛋白质摄入未受补充方案影响（P=0.358）。个性化蛋白质补充方案可确保一日内蛋白质与亮氨酸摄入充足且分布均匀，同时不会对常规膳食蛋白质及能量摄入造成负面影响。