A high whey protein-, leucine-, and vitamin D–enriched supplement preserves muscle mass during intentional weight loss in obese older adults: a double-blind randomized controlled trial
Open accessAbstract
Background Intentional weight loss in obese older adults is a risk factor for muscle loss and sarcopenia.Objective The objective was to examine the effect of a high whey protein-, leucine-, and vitamin D-enriched supplement on muscle mass preservation during intentional weight loss in obese older adults.Design We included 80 obese older adults in a double-blind randomized controlled trial. During a 13-wk weight loss program, all subjects followed a hypocaloric diet (-600 kcal/d) and performed resistance training 3×/wk. Subjects were randomly allocated to a high whey protein-, leucine-, and vitamin D-enriched supplement including a mix of other macro- and micronutrients (150 kcal, 21 g protein; 10×/wk, intervention group) or an isocaloric control. The primary outcome was change in appendicular muscle mass. The secondary outcomes were body composition, handgrip strength, and physical performance. Data were analyzed by using ANCOVA and mixed linear models with sex and baseline value as covariates.Results At baseline, mean ± SD age was 63 ± 5.6 y, and body mass index (in kg/m(2)) was 33 ± 4.4. During the trial, protein intake was 1.11 ± 0.28 g · kg body weight(-1) · d(-1) in the intervention group compared with 0.85 ± 0.24 g · kg body weight(-1) · d(-1) in the control group (P < 0.001). Both intervention and control groups decreased in body weight (-3.4 ± 3.6 kg and -2.8 ± 2.8 kg; both P < 0.001) and fat mass (-3.2 ± 3.1 kg and -2.5 ± 2.4 kg; both P < 0.001), with no differences between groups. The 13-wk change in appendicular muscle mass, however, was different in the intervention and control groups [+0.4 ± 1.2 kg and -0.5 ± 2.1 kg, respectively; β = 0.95 kg (95% CI: 0.09, 1.81); P = 0.03]. Muscle strength and function improved over time without significant differences between groups.Conclusion A high whey protein-, leucine-, and vitamin D-enriched supplement compared with isocaloric control preserves appendicular muscle mass in obese older adults during a hypocaloric diet and resistance exercise program and might therefore reduce the risk of sarcopenia. This trial was registered at the Dutch Trial Register (http://www.trialregister.nl) as NTR2751.
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BIA has lower precision compared to DXA, the gold standard for body composition assessment.
“BIA has lower precision compared to dual-energy X-ray absorptiometry (DXA), the gold standard for body composition assessment used in similar studies [58].”
From The effects of a home-based resistance training programme on body composition and muscle function during weight loss in people living with overweight or obesity: a randomised controlled pilot trial (2025) · cites this paper as [58]
The “Measurement of body composition, muscle strength, and physical performance” section (page not provided) confirms that this study used DXA to assess body composition. It does not compare DXA with BIA or describe DXA as the gold standard, so it does not support the precision comparison. (LLM, conf=0.85)
Experimental — accuracy not yet measuredDiet-induced weight loss reduces muscle mass without adversely affecting muscle strength.
“diet-induced weight loss reduces muscle mass without adversely affecting muscle strength”
From Preserving Healthy Muscle during Weight Loss (2017) · cites this paper as [54]
In “Muscle mass, muscle strength, and muscle function” (page not provided), the control group had a numerical decline in appendicular muscle mass, while muscle strength improved in both groups. The decline in muscle mass was not statistically significant within the control group, and all participants also performed resistance training. The findings therefore do not establish that diet-induced weight loss alone reduces muscle mass without adversely affecting strength. (LLM, conf=0.86)
Experimental — accuracy not yet measuredWeight loss improves global physical function, most likely because of reduced fat mass.
“weight loss improves global physical function, most likely because of reduced fat mass”
From Preserving Healthy Muscle during Weight Loss (2017) · cites this paper as [54]
The Results report that fat mass decreased and muscle function improved during the 13-week intervention; the Discussion says physical-performance measures improved in both groups. The paper does not establish that reduced fat mass was the likely reason, and it discusses both training and weight loss as possible contributors. It also reports specific performance measures rather than a measure of global physical function. (LLM, conf=0.84)
Experimental — accuracy not yet measuredHigh protein intake does not improve muscle strength during weight loss.
“but does not improve muscle strength”
From Preserving Healthy Muscle during Weight Loss (2017) · cites this paper as [54]
The Results section (‘Muscle mass, muscle strength, and muscle function’; page not provided) reports that strength improved over 13 weeks in both groups, with no difference between them. This supports no additional strength benefit from the whey protein–, leucine–, and vitamin D–enriched supplement in obese older adults undergoing diet and resistance exercise, but not the broader claim that high protein intake does not improve strength during weight loss. (LLM, conf=0.88)
Experimental — accuracy not yet measuredWhether increasing protein intake during weight loss can limit the weight-loss-induced loss of fat-free mass is unclear because of conflicting results reported in the literature.
“Whether increasing protein intake during weight loss can limit the weight-loss-induced loss of fat-free mass is unclear because of conflicting results reported in the literature (54, 56, 96, 98, 101-108).”
From Preserving Healthy Muscle during Weight Loss (2017) · cites this paper as [54]
The Results (Muscle mass, muscle strength, and muscle function; page unavailable) report that the enriched-supplement group preserved appendicular muscle mass better than controls during weight loss. The Introduction says data in obese older adults are limited, but the paper does not report conflicting results in the literature or conclude that the effect of increasing protein intake is unclear. Its intervention also combined protein with leucine and vitamin D, rather than testing protein alone. (LLM, conf=0.84)
Experimental — accuracy not yet measured
The reductions in muscle mass in young and old men and women with obesity after diet-induced weight loss of 8-10% were about 2-10%.
“The reductions in muscle mass in young and old men and women with obesity after diet-induced weight-loss of 8-10% were ;2-10% (47, 52-56, 59, 62-66).”
From Preserving Healthy Muscle during Weight Loss (2017) · cites this paper as [54]
The Results sections (page not supplied) report a 0.5 kg mean reduction in appendicular muscle mass in the control group of obese older adults, so the paper supports the possibility of muscle loss during weight loss. But weight loss was about 3%, not 8–10%; the paper does not establish a 2–10% muscle-mass reduction or findings across young and old men and women. (LLM, conf=0.88)
Experimental — accuracy not yet measuredGrip strength and global measures of physical function, such as balance, walking speed, or climbing stairs, improve after weight loss.
“Grip strength and global measures of physical function, such as balance, walking speed, or climbing stairs, improve after weight loss (52, 54-56, 93, 115, 127).”
From Preserving Healthy Muscle during Weight Loss (2017) · cites this paper as [54]
The Results section (page not specified) says muscle strength and function improved over the 13-week weight-loss intervention, and Table 4 reports increased handgrip strength. The Methods section lists walking tests, but not balance or stair-climbing tests, so this paper does not support those specific examples. (LLM, conf=0.87)
Experimental — accuracy not yet measuredHigh protein intake helps preserve lean body and muscle mass during weight loss.
“high protein intake helps preserve lean body and muscle mass during weight loss”
From Preserving Healthy Muscle during Weight Loss (2017) · cites this paper as [54]
Randomized controlled trials in overweight and obese older adults without coexisting sarcopenia indicate that supplemental protein in combination with physical training is more effective in improving or preserving muscle mass and muscle strength than exercise alone.
“Randomized controlled trials in overweight and obese older adults (without coexisting sarcopenia) indicate that supplemental protein in combination with physical training is more effective in improving or preserving muscle mass and muscle strength than exercise alone.45,46”
From Nutritional and exercise interventions in individuals with sarcopenic obesity around retirement age: a systematic review and meta-analysis (2023) · cites this paper as [46]
Preserving muscle mass requires ingesting a sufficient amount of high quality protein.
“There is evidence suggesting that preserving muscle mass requires ingesting a sufficient amount of high quality protein [1, 10].”
Dietary protein intake among recreational athletes and adults engaging in intentional weight loss via caloric restriction is often insufficient to avoid muscle wasting.
“However, dietary protein intake among recreational athletes and adults engaging in intentional weight loss via caloric restriction is often insufficient to avoid muscle wasting [1, 5].”
The combination of high quality protein and resistance exercise is suggested to have a synergistic effect on muscle mass preservation during intentional weight loss.
“The combination of high quality protein and resistance exercise is suggested to have a synergistic effect on muscle mass preservation during intentional weight loss [1].”
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“…a hypocaloric diet combined with resistance training, supplementation with whey proteins, leucine, and vitamin D, associated to a protein intake of ~ 1.1 g/kg vs. 0.85 g/kg in the isocaloric control group, preserved appendicular muscle mass during weight loss compared to the control condition [51].”
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- Authors
- Verreijen, A. M., Verlaan, S., Engberink, M. F., Swinkels, S., de Vogel-van den Bosch, J., & Weijs, P. J.
- Affiliations
- Nutricia Research (Netherlands) (NL)
- Corresponding author
- Verreijen, Amely M
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2015-02
- Volume
- 101
- Issue
- 2
- Pages
- 279-286
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2167583811
- Cited by
- 237
- References
- 41
- Citations by year
- 2026: 15 · 2025: 17 · 2024: 16 · 2023: 17 · 2022: 18 · 2021: 23 · 2020: 33 · 2019: 20 · 2018: 24 · 2017: 20 · 2016: 13 · 2015: 20 · 2014: 1
- FWCI
- 11.98
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Funders
- Nutricia Research
- Nutricia Advanced Medical Nutrition
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- whey protein supplements, leucine, vitamin D, sarcopenia, muscle mass preservation, intentional weight loss, obesity, older adults, appendicular skeletal muscle mass, grip strength, physical performance, resistance training, hypocaloric diet, body composition, protein intake, fat loss, sarcopenic obesity
- MeSH terms
- Whey Proteins, Aged, Aged, 80 and over, Body Composition, Body Weight, Energy Intake, Diet, Reducing, Dietary Proteins, Double-Blind Method, Female, Humans, Leucine, Male, Middle Aged, Milk Proteins, Motor Activity, Obesity, Vitamin D, Weight Loss, Body Mass Index, Treatment Outcome, Muscle, Skeletal, Hand Strength, Dietary Supplements, Muscle Strength, Resistance Training, Sarcopenia
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