Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study

Abstract

The present study aimed to evaluate the effect of high intensity dynamic resistance exercise (HIT-DRT) and whey protein supplementation (WPS) on bone mineral density (BMD) and sarcopenia parameters in osteosarcopenic men. Men ≥ 72 years with osteosarcopenia (n = 43) were randomly assigned to a HIT-RT (HIT-RT: n = 21) or a non-training control group (n = 22). Supervised HIT-RT twice/week was applied for 18 months, while the control group maintained their habitual lifestyle. Supplying WPS, total protein intake amounted to 1.5–1.6 (HIT-RT) and 1.2 g/kg/body mass/d (control). Both groups were supplied with calcium and vitamin D. Primary study outcomes were BMD and the sarcopenia Z-score. After adjusting for multiplicity, we observed significant positive effects for sarcopenia Z-score (standardized mean difference (SMD): 1.40), BMD at lumbar spine (SMD: 0.72) and total hip (SMD: 0.72). In detail, effect sizes for skeletal muscle mass changes were very pronounced (1.97, p < 0.001), while effects for functional sarcopenia parameters were moderate (0.87, p = 0.008; handgrip strength) or low (0.39, p = 0.209; gait velocity). Apart from one man who reported short periods of temporary worsening of existing joint pain, no HIT-RT/WPS-related adverse effects or injuries were reported. We consider HIT-RT supported by whey protein supplementation as a feasible, attractive, safe and highly effective option to fight osteosarcopenia in older men.

Changes in Body Composition and Cardiometabolic Health After Detraining in Older Men with Osteosarcopenia: 6-Month Follow-Up of the Randomized Controlled Franconian Osteopenia and Sarcopenia Trial (FrOST) Study

“… 46 , 47 ) and cardio-metabolic risk factors (review in 48 ) in older adults. We are unable to separate the exercise vs WPS effects on our outcomes during training 18 , 31 and detraining; however, (1) based on the rather high dietary protein intake ( Tables 1 and 2 ) considering that the 1.5 g/d/kg WPS of the HIT-RT was derived from recommendations of the PROT-AGE group 26 for exercising older adults, we speculate that the cessation of WPS after the end of the intervention had only a minor additional impact on our result of detraining effects on body composition and cardiometabolic risk.…”

“…The recruitment process of FrOST started in February 2018 and has been described in detail in previous articles. 18 , 21 , 22 Briefly, cdw men, 72 years and older with (a) morphometric sarcopenia (skeletal muscle mass index lower than −2 SD T-Score 23 , 24 ) and (b) osteopenia or osteoporosis (bone mineral density at LS or proximal femur lower than −1 SD T-Score 25 ) were included in the study. Men (a) with diseases and/or (b) taking pharmaceutical agents (eg bisphosphonates, alfacalcidol, glucocorticoids) that either affected muscle/bone metabolism or hinder intense resistance exercise, (c) with experience in resistance-type exercise (≥60 min/week previous 2 years) and (d) with alcohol abuse (>60 g/d ethanol consumption) were excluded.…”

“…The randomization and blinding procedures have been described in detail in previous publications. 18 , 21 , 22 Briefly, participants allocated themselves to the HIT-RT or control group by drawing lots. Of importance, neither the participants nor the researcher knew the allocation beforehand (allocation concealment).…”

“…The HIT-RT intervention has been described in detail in previous publications 18 , 22 thus only a brief overview will be provided here. In summary, we applied a progressive, periodized single set, dynamic resistance exercise protocol (HIT-RT) without any other type of exercise, be it in parallel or during warm-up or cool down.…”

“… 3 However, most of the studies focus on the detraining effect on musculoskeletal outcomes after short-term interventions (ie 12–16 weeks), while the effects on body composition and cardiometabolic parameters after resistance training (RT) periods that exceed 6 months were rarely evaluated. This refers particularly to older obese people with low muscle and bone mass, 17 , 18 who can be considered as a high-risk group. In order to close this gap, the aim of this study was to determine the effect of 6 months of detraining after an 18-month HIT-RT intervention on body composition and cardiometabolic risk in older, predominately obese, osteosarcopenic men.…”