a novel medical nutrition product improves gait speed in
TRANSCRIPT
A novel medical nutrition product
improves gait speed in
undernourished older adults
Pol Grootswagers
Improving standard care
Introduction
Methods
Results
Discussion
Conclusion
Questions 1 Milne, A.C. et al. (2009) Protein and energy supplementation in elderly people at risk from malnutrition . Cochrane Metab and Endocr Dis.
• Undernutrition → Sarcopenia
• Medical nutrition
– Protein, energy, macro- and micronutrient supplementation
– Effective in weight gain1
Novel product:
Whey
BCAAs
Vitamin D
Ursolic acid
Standard care:
Aim
Introduction
Methods
Results
Discussion
Conclusion
Questions
• To compare effects of the intervention with standard care
on:
Body weight
Body composition
Physical functioning
12 week RCT
Introduction
Methods
Results
Discussion
Conclusion
Questions
N = 82Age > 65yrsMNA < 12
Undernourished community dwelling older adults
12 week RCT
Introduction
Methods
Results
Discussion
Conclusion
Questions
N = 82Age > 65MNA < 12
Intervention vs Standard care
Introduction
Methods
Results
Discussion
Conclusion
Questions
Standard care
New product
3 visits
Introduction
Methods
Results
Discussion
Conclusion
Questions
Standard care
New product
Week 0 Week 12Week 6
Measurements
Introduction
Methods
Results
Discussion
Conclusion
Questions
w0, w6, w12- Compliance- Side-effects- Dietary intake- Physical activity
- DXA- Body weight- Blood markers
Physical function
Introduction
Methods
Results
Discussion
Conclusion
Questions
SPPB
400 m
Physical function
Introduction
Methods
Results
Discussion
Conclusion
Questions
SPPB
400 m
4 m
High compliance
Introduction
Methods
Results
Discussion
Conclusion
Questions
Intervention (n=40) Standard care (n=41)
Drop-out (n=9)
• Related to treatment n=4
Drop-out (n=2)
• Related to treatment n=1
Compliance: 85%
Both groups gain weight
Introduction
Methods
Results
Discussion
Conclusion
Questions
Standard care: +1.8 ±0.2 kg (P<.0001)Intervention: +1.5 ±0.2 kg (P<.0001)
Time*Treatment p=0.968Treatment p=0.620Time p<.0001
Lean mass increases
Introduction
Methods
Results
Discussion
Conclusion
Questions
Standard care: +225 ±148 gIntervention: +279 ±168 g
Time p=0.003Time*treatment p=0.415
Fat mass increases
Introduction
Methods
Results
Discussion
Conclusion
Questions
Standard care: +1.6 ±0.2 kgIntervention: +1.3 ±0.1 kg
Time p<0.0001Time*treatment p=0.044
Faster on 400m
Introduction
Methods
Results
Discussion
Conclusion
Questions
400 m
Time*Treatment p=0.032Treatment p=0.346Time p=0.723
Δ 33 ± 21 s
Faster on 4m
Introduction
Methods
Results
Discussion
Conclusion
Questions
4 m
Time*Treatment p=0.047Treatment p=0.098Time p=0.043
Δ 0.5 ± 0.2 s
Physical function
Introduction
Methods
Results
Discussion
Conclusion
Questions
SPPB
400 m
4 m
Discussion
Introduction
Methods
Results
Discussion
Conclusion
Questions
• Intervention product seems to improve mechanisms
linked to gait speed
• Changes in bowel habits need further investigation
4 &
400 m
Mitochondrial biogenesis?
Muscle fibre change?
Neurological?
Conclusion
Introduction
Methods
Results
Discussion
Conclusion
Questions
• A novel medical nutrition containing whey protein,
ursolic acid, additional BCAAs and vitamin D
improves gait speed, as compared to standard care
in community-dwelling older adults
Conflict of interest statement
Introduction
Methods
Results
Discussion
Conclusion
Questions
– Study was financed by Vitalnext BV, the manufacturer of the new
product
– The funding party had no influence on data collection and data
analysis
– Clear agreements on publishing and data sharing have been
made
Appendices
Introduction
Methods
Results
Discussion
Conclusion
Questions
– Ingredients
– Dietary intake & physical activity
– Blood markers
– Ursolic acid overview
– Baseline table
– Lean mass extra data
– Alm extra data
– Fat mass extra data
Ingredients
• Aimed at improving muscle mass
Introduction
Methods
Results
Discussion
Conclusion
Questions
Component New product Standard treatment
Energy
Kcal 586 600
kJ 2461 2500
Protein (g) 24.0 23.6
Of which casein (g) 12.0 23.6
Of which whey (g) 12.0 0.0
BCAAs (g) 12.3 5.5
Vitamin D (µg) 10.8 4.4
Ursolic acid (mg) 205.4 0.0
Return to appendices
Dietary intake & physical activity
Introduction
Methods
Results
Discussion
Conclusion
Questions
week 0 week 12 week 0 week 12
Energy intake
(kj/day) 8757 10135 p=0.002 9477 10673 p=0.002
Protein intake
(g/day 83 100 p=0.003 84 101 p<0.001
Physical activity
(minutes MVPA/day) 27 20 p=1.000 16 10 p=1.000
Standard care New product
Return to appendices
Blood markers
Introduction
Methods
Results
Discussion
Conclusion
Questions
Return to appendices
Ursolic acid
Introduction
Methods
Results
Discussion
Conclusion
Questions Figure: Katashima et al. 2017
Return to appendices
Baseline table
Introduction
Methods
Results
Discussion
Conclusion
Questions
Return to appendices
Extra data lean mass
Introduction
Methods
Results
Discussion
Conclusion
Questions
Standard care: +225 ±148 g (P=1.000)New product: +279 ±168 g (P=1.000)
Time*Treatment p=0.415Treatment p=0.925Time p=0.003
*
Return to appendices
Extra data ALM
Introduction
Methods
Results
Discussion
Conclusion
Questions
Standard care: +178 ±99 g (P=1.000)New product: +162 ±110 g (P=1.000)
Time*Treatment p=0.990Treatment p=0.747Time p=0.065
Return to appendices
Extra data fat mass
Introduction
Methods
Results
Discussion
Conclusion
Questions
Standard care: +1.6 ±0.2 kg(P<.0001)New product: +1.1 ±0.2 kg (P<.0001)
Time*Treatment p=0.044Treatment p=0.759Time p<.0001
Return to appendices
*** *
***