BackgroundAging is associated with decreased muscle mass and functional capacity, which in turn decrease quality of life. The number of citizens over the age of 65 years in the Western world will increase by 50 % over the next four decades, and this demographic shift brings forth new challenges at both societal and individual levels. Only a few longitudinal studies have been reported, but whey protein supplementation seems to improve muscle mass and function, and its combination with heavy strength training appears even more effective. However, heavy resistance training may reduce adherence to training, thereby attenuating the overall benefits of training. We hypothesize that light load resistance training is more efficient when both adherence and physical improvement are considered longitudinally. We launched the interdisciplinary project on Counteracting Age-related Loss of Skeletal Muscle Mass (CALM) to investigate the impact of lifestyle changes on physical and functional outcomes as well as everyday practices and habits in a qualitative context.MethodsWe will randomize 205 participants older than 65 years to be given 1 year of two daily nutrient supplements with 10 g of sucrose and 20 g of either collagen protein, carbohydrates, or whey. Further, two groups will perform either heavy progressive resistance training or light load training on top of the whey supplement.DiscussionThe primary outcome of the CALM Intervention Study is the change in thigh cross-sectional area. Moreover, we will evaluate changes in physical performance, muscle fiber type and acute anabolic response to whey protein ingestion, sensory adaptation, gut microbiome, and a range of other measures, combined with questionnaires on life quality and qualitative interviews with selected subjects. The CALM Intervention Study will generate scientific evidence and recommendations to counteract age-related loss of skeletal muscle mass in elderly individuals.Trial registrationClinicalTrials.gov NCT02034760. Registered on 10 January 2014.ClinicalTrials.gov NCT02115698. Registered on 14 April 2014.Danish regional committee of the Capital Region H-4-2013-070. Registered on 4 July 2013.Danish Data Protection Agency 2012-58-0004 – BBH-2015-001 I-Suite 03432. Registered on 9 January 2015.

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Aims To examine satellite cell and myonuclear content in very old (≥83 years) individuals, and the response to heavy resistance training. Methods A group of very old men and women (Old, 83‐94 years, n = 29) was randomized to 12 weeks of heavy resistance training or untrained controls. A group of young men who did not resistance train (Young, 19‐27 years, n = 9) were included for comparison. Results Compared to young men, prior to training the old men had smaller type II fibres (−38%, P < 0.001), lower satellite cell content (−52%, P < 0.001), smaller myonuclear domain (−30%, P < 0.001), and a trend for lower myonuclear content (−13%, P = 0.09). Old women were significantly different from old men for these parameters, except for satellite cell content. Resistance training had no effect on these parameters in these old men and women. Fibre‐size specific analysis showed strong correlations between fibre size and myonuclei per fibre and between fibre size and myonuclear domain for both fibre types (r = 0.94‐0.99, P < 0.0001). In contrast, muscle fibre perimeter per myonucleus seemed to be constant across the range in fibre size, particularly in type I fibres (r = −0.31, P = 0.17). Conclusions The present data demonstrate that type II fibre size, satellite cell content and myonuclear domain is significantly smaller in very old men compared to young men, while myonuclear content is less affected. These parameters were not improved with heavy resistance training at the most advanced stage of ageing.