My dairy RCT

Population

Older adults (65y+) not meeting 1-1.2g/kg/d

šŸŽ¤ 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

šŸŽ¤ 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.

šŸŽ¤ Heather's work with nutrition in disguise is very interesting to provide nutrient dense foods packed with key nutrients (done in LTC).