This is the first such study assessing the impact of polyphenols, omega-3 fatty acids and whey protein combined with EMS treatment.
Researchers said the antioxidant and anti-inflammatory activities from polyphenols and omega-3 fatty acids coupled with protein’s role in preserving muscle functionality could help reduce the effects of sarcopenia in elderly.
Researchers from Nestle Research, Nestle Health Sciences and Kyoto University published their findings in the journal Nutrients.
This RCT recruited 37 participants aged between 60 and 90 years in Japan. All participants had some form of mobility limitation, classified by either Care support level 1, Care support level 2, Long-term care level 1 (LTC1) or Long-term care level 2 (LTC2) according to the LTCI system.
LTCI is a national system in Japan for individuals aged 65 and above to determine the amount of services covered by insurance. It covers seven categories including physical strength, nutritional status, oral function, socialisation, memory, mood and lifestyle.
In this current study, participants were randomised and assigned to one of the three groups differing in dietary supplementation.
Group one (n=12) was given a beverage with 20g of carbohydrate (maltodextrin glucose syrup) and placebo capsules (dextrin, medium chain triglycerides).
Group two (n=15) was given a beverage containing 20g of whey protein isolate (Prolacta) and placebo capsules.
Group three (n=10) was given a beverage with 20g of whey protein isolate and hard capsules containing rutin (500mg/day) and fish oil-derived omega-3 fatty acids/curcumin in soft capsules (1.5 g/day fish oil type NAD from Sofinol). The fish oil provided 18% eicosapentaenoic acid (EPA) and 7% docosahexaenoic acid DHA and 500 mg/day curcumin. Curcumin and rutin were supplied by Sankyo Ltd. (Tokyo, Japan).
Participants were instructed to ingest the beverages and seven capsules (2 at breakfast, 3 at lunch and 2 at dinner) daily for 12 weeks.
They also went through a twice weekly EMS treatment for 12 weeks at 20 minutes each time. The treatment contracts muscles using electrical impulses.
The primary outcome was the change in thickness of the thigh and calf using ultrasonography. Secondary outcomes were walking speed, knee extension strength and nutritional assessments.
Muscle thickness in the thigh and calf were assessed at baseline, week four, week eight and week 12.
Physical performance in terms of knee extension strength and walking speed was assessed at baseline and week 12.
Increase in muscle thickness
The calf and thigh muscle thickness were significantly increased in all groups between 3% to 5% from baseline. However, there were no significant difference between the groups.
Researchers said this finding suggest that the muscle size increase could be due to EMS treatment only. They attributed this effect to the stimulation of muscle protein synthesis and the decrease of protein degradation observed with EMS treatment, and suggested that EMS could be a valuable alternative and efficient solution to counteract age-related loss of muscle health in elderly adults.
In terms of knee extension strength, it was significantly higher in group three compared to the placebo group, with a 13% improvement in muscle strength after 12 weeks (p=0.025).
Group one and two experienced between 5% and 6% improvement.
In terms of walking (gait) speed in a six meters walking test, group three experienced a significant increase by 8% from baseline to week 12 (p=0.032). There was no significant increase in group one and two, with about a 3% increase from baseline.
Protein alone not enough
The study showed that a combination of polyphenol, omega-3 and protein supplementation coupled with EMS could increase muscle knee extension strength and walking speed after 12 weeks, possibly related to the positive interaction between polyphenols, fish oil and protein.
“The underlying mechanism of action needs to be elucidated but such combinations of ingredients may help to manage the oxidative stress that could interfere with mitochondrial function or help to reverse the anabolic resistance,” researchers wrote.
While protein supplementation is a known nutritional solution for sarcopenia, in this present study, group two did not demonstrate any benefit as compared to the placebo group.
Researchers pointed out: “We can therefore speculate that protein alone is not sufficient to have a long-term beneficial effect on muscle mass and functionality.”
They acknowledged several limitations in this study including a small sample size and unequal distribution of male and female in each group.
Researchers concluded that their findings could provide an innovative treatment for limiting the development of sarcopenia with ageing.
“Supplementation with Whey Protein, Omega-3 Fatty Acids and Polyphenols Combined with Electrical Muscle Stimulation Increases Muscle Strength in Elderly Adults with Limited Mobility: A Randomized Controlled Trial”
Authors: Claire Boutry-Regard, et al.