My dairy RCT
Population
Older adults (65y+) not meeting 1-1.2g/kg/d
š¤ Screening is easier than screening for sarcopenia. Step 1 screen for protein intake and other nutrients (vit D, n-3 PUFA, B12, iron). I think using a webbased approach or app will be easy to do remotely and efficiently. There's the Pro55+ (Protein Screener) by Marjolein Visser. It was validated in Netherlands. They have a web version of it, and if you could received the results instantly that would be easier for researcher to proceed with next steps. Unfortunately I think it is less so adapted for us in Canada. No question on legumes at all. I took it myself (although I am not an older adult), not question on soy, quinoa, interesting grains. Might have to be validated first.
Stratify on sarcopenia
have them perform a DXA
Intervention
high intake of fermented products
low intake of fermented products
Outcomes
Cognitive performance tests over 6 months
PET FDG for glucose uptake
MRI for brain volume and hyperintensities
With a vit D and n-3 PUFA supplement. Although could not identify which is responsible for effect if found.
DXA for fat mass and ALM
handgrip strength and leg strength
pQCT for myosteatosis, and muscle volume
Secondary outcomes
serum BDNF
š¤ Suzuki et al. JAMDA 2019 - Shown to increase following camembert cheese (33 g/d) supp in MCI x 3 months; no effect on MMSE (maybe due to global test)
Myostatin
Inflammatory markers such as CRP, IL-6, IL-4,
B12
Compliance with: serum odd chains c15:0 and c17:0 (but could not be a good marker if high fish cnsumers because they are found in these foods as well - but supplement in EPA and DHA could be ok). If vit d: serum levels and plasma PL or erythrocyte EPA and DHA.
EXPECTATIONS OF.... meaningful difference
Sample size
Combined supplements showed favorable (prot, leucine, vit D, n-3 PUFA, creat, vit E) effects on muscle mass but may be more effective at stimulating MPS in healthy and promoting muscle mass maintenance in sarcopenic older adults
Aleman-Mateo et al. Clin Interv Aging 2014. 210 g (that's 22g prot) ricotta cheese x 12 wks (3 mo), increased ALM and balance and attenuated MS decline in 100 men and women above 60y.
I would really perceive it as supplement and not changing dietary habits for it to be feasible and sustainable
Keenoa - as smartphones are becoming ubiquitous among older adults
no sig effect from supplement of protein alone on MM and MS
Slight effect from n-3 PUFA on MS and MM. Clinically meaningful? unsure
Vit D moderate effect on physical performance (TUG) among those with baseline deficiency.
š¤ Heather's work with nutrition in disguise is very interesting to provide nutrient dense foods packed with key nutrients (done in LTC).