Effect of Structured Physical Activity and Nutritional Supplementation on Physical Function in Mobility-Limited Older Adults: Results from the VIVE2 Randomized Trial
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OBJECTIVES: The interactions between nutritional supplementation and physical activity on changes in physical function among older adults remain unclear. The primary objective of this study was to examine the impact of nutritional supplementation plus structured physical activity on 400M walk capacity in mobility-limited older adults across two sites (Boston, USA and Stockholm, Sweden). DESIGN: All subjects participated in a physical activity program (3x/week for 24 weeks), involving walking, strength, balance, and flexibility exercises. Subjects were randomized to a daily nutritional supplement (150kcal, 20g whey protein, 800 IU vitamin D) or placebo (30kcal, non-nutritive). SETTING: Participants were recruited from urban communities at 2 field centers in Boston MA USA and Stockholm SWE. PARTICIPANTS: Mobility-limited (Short Physical Performance Battery (SPPB) ≤9) and vitamin D insufficient (serum 25(OH) D 9 - 24 ng/ml) older adults were recruited for this study. MEASUREMENTS: Primary outcome was gait speed assessed by the 400M walk. RESULTS: 149 subjects were randomized into the study (mean age=77.5±5.4; female=46.3%; mean SPPB= 7.9±1.2; mean 25(OH)D=18.7±6.4 ng/ml). Adherence across supplement and placebo groups was similar (86% and 88%, respectively), and was also similar across groups for the physical activity intervention (75% and 72%, respectively). Both groups demonstrated an improvement in gait speed with no significant difference between those who received the nutritional supplement compared to the placebo (0.071 and 0.108 m/s, respectively (p=0.06)). Similar effects in physical function were observed using the SPPB. Serum 25(OH)D increased in supplemented group compared to placebo 7.4 ng/ml versus 1.3 ng/ml respectively. CONCLUSION: Results suggest improved gait speed following physical activity program with no further improvement with added nutritional supplementation.
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The VIVE2 trial demonstrated that six months of exercise alone improved gait speed, while adding whey protein and vitamin D supplements did not yield further enhancements, although they did improve muscle density.
“The VIVE2 trial demonstrated that six months of exercise alone improved gait speed, while adding whey protein and vitamin D supplements did not yield further enhancements [496] although they did improve muscle density [497].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [496]
The rise in intermuscular fat found in sarcopenia may be suppressed by physical activity; mobility-limited older people have a greater change in intermuscular adipose tissue over time.
“The rise in intermuscular fat found in sarcopenia may be suppressed by physical activity [78]; mobility-limited older people have a greater change in intermuscular adipose tissue over time [8].”
From Is There Enough Evidence for Osteosarcopenic Obesity as a Distinct Entity? A Critical Literature Review (2019) · cites this paper as [78]
In the VIVE-2 study, a combination of exercise intervention (3 times per week for 6 months) and nutritional supplementation with whey protein (20 g), vitamin D (800 IU), calcium, vitamins and minerals (150 kcal) among people aged 70+ years led to an increase in muscle density and a reduction in intermuscular fat.
“In the VIVE-2 study a combination of exercise intervention (3 times per week for 6 months) and nutritional supplementation with whey protein (20 g), vitamin D (800 IU), calcium, vitamins and minerals (150 kcal) among people aged 70 + years, led to an increase in muscle density and a reduction in intermuscular fat [78,93,94].”
From Is There Enough Evidence for Osteosarcopenic Obesity as a Distinct Entity? A Critical Literature Review (2019) · cites this paper as [78]
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References 54 · Cited by 58
Research works printed but not linked: 1
- [32]Guralnik JM, Simonsick EM, Ferucci L, A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality in nursing home admission. J Gerontol 1994; 49: M85– M94. 8126356
- Authors
- Fielding, R. A., Travison, T. G., Kirn, D. R., Koochek, A., Reid, K. F., von Berens, Å., Zhu, H., Folta, S. C., Sacheck, J. M., Nelson, M. E., Liu, C. K., Åberg, A. C., Nydahl, M., Lilja, M., Gustafsson, T., & Cederholm, T.
- Affiliations
- Tufts University (US)
- Harvard University (US)
- Uppsala University (SE)
- Hebrew SeniorLife (US)
- Boston University (US)
- Karolinska Institutet (SE)
- Corresponding author
- Fielding, Roger A.
- ORCID
- Venue
- The Journal of nutrition, health and aging
- Publisher
- Elsevier BV
- Published
- 2017-11
- Volume
- 21
- Issue
- 9
- Pages
- 936-942
- ISSN
- 1279-7707 (ISSN-L)
- PMC
- PMC6751564
- OpenAlex
- W2620914936
- Cited by
- 58
- References
- 54
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 6 · 2023: 2 · 2022: 2 · 2021: 13 · 2020: 7 · 2019: 10 · 2018: 9 · 2017: 2
- FWCI
- 5.66
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The journal of nutrition health & aging (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5p30ag031679-15)
- National Institute on Aging (P30-AG031679)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Balance, Gait, and Falls Prevention
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- structured physical activity, dietary supplementation, whey protein, vitamin D, physical function, walking speed, Short Physical Performance Battery, vitamin D insufficiency, strength and balance training, flexibility training, community-dwelling older adults
- MeSH terms
- Aged, Female, Humans, Male, Exercise, Nutrition Assessment, Walking, Dietary Supplements
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