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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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“There is evidence suggesting that preserving muscle mass requires ingesting a sufficient amount of high quality protein [1, 10].”
From In a single-blind, matched group design: Branched-chain amino acid supplementation and resistance training maintains lean body mass during a caloric restricted diet (2016) · cites this paper as [1]
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“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]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“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]
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In the citing paper
“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]
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“but does not improve muscle strength”
From Preserving Healthy Muscle during Weight Loss (2017) · cites this paper as [54]
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“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]
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“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]
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“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]
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“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]
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“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]
In the citing paper
“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].”
In the citing paper
“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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Metadata
- 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
- 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 (medical) › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › 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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