Interventions for better muscle ageing
Can a milk and resistance exercise intervention improve muscle function in older adults at risk of sarcopenia?
Supported by the NIHR Newcastle Biomedical Research Centre, the MIlk Intervention Muscle AgeiNg (MIlkMAN) Study examined the practicality and acceptability of a whole milk with resistance exercise intervention as a strategy for improving muscle function in community-dwelling older adults at risk of sarcopenia.
Protein-rich foods and exercise for better muscle ageing
Sarcopenia is a progressive skeletal muscle disease leading to loss of muscle mass, strength and function. It is very common in older adults and increases their risk of poor health, including falls, frailty, disability, loss of independence and death. It is a costly disease resulting in additional health care costs of £2.5 billion per year in the UK.
The loss of muscle mass and strength can be hastened by inactivity and poor diet. Intervention studies have shown that higher intake of dietary protein and protein supplements combined with resistance exercise (RE) are effective in reducing decline in muscle function. However, there is a lack of studies looking at the benefits of readily available, protein-rich foods for better muscle health. Whole milk may be such food. Milk is a source of high-quality nutrients, including proteins, vitamins, minerals and bioactive fats, which in combination, may be good for ageing muscle.
The MIlkMAN study is a project supported by the NIHR Newcastle Biomedical Research Centre that tested the practicality and acceptability of a whole milk with RE intervention as a strategy for improving muscle function in older adults aged 65 and over who are at risk of sarcopenia and who live in the community. The intervention took place at The Parks sports and leisure center, North Shields with thirty participants from January until June this year.
Dr Antoneta Granic, principal investigator for the study, described the reasons for this work:
‘Developing interventions to preserve and optimize muscle strength and function in later life is of a great interest for research community and general public, especially for older adults, who value their ability to function independently very highly. The AGE research group has a keen interest in developing strategies related to diet and exercise for better muscle ageing. Particularly, we are interested in nutrient-rich whole foods that are readily available, affordable, appealing and acceptable to older adults.
We know, for example, that protein supplements in combination with resistance exercise (RE) can be effective in reducing physical decline in older adults. However, protein supplements are costly and not very tasty, and may be harder to adopt as a behavioral change in older adults. Whole milk is a well-rounded whole food rich in several nutrients that are important for muscle.’
Dr Christopher Hurst, exercise physiologist for the MIlkMAN study, commented further:
‘Strength exercise with weights (resistance exercise) has been shown to improve muscle weakness and function in other studies with older adults. However, many older adults are reluctant to engage in strength exercises in the gym. Instructing older adults which strength exercises are helpful for ageing muscle and how to perform these exercises may help in overcoming the reluctance to engage in more structured strength exercise.’
‘Because this is a feasibility study, participants’ feedback about their experiences while taking part in the pilot are extremely valuable for planning a larger study. We are now in the process of entering and analysing data, and we are looking forward to find out what the results will tell us.’
Lorelle Dismore, Research assistant for the MIlkMAN.
The NIHR Newcastle Biomedical Research Centre has funded this study, building on the work of other funded projects, the MASS Pilot and MASS LifeCourse Study. The results of this project will inform future clinical trials.
Taking part in the MIlkMAN study
The study was supported by the NIHR North East and North Cumbria Clinical Research Network (NENC CRN) that recruited participants through two local GP surgeries. After completing detailed baseline questionnaires about their health and functioning during home visits, 30 participants were allocated randomly into three intervention groups. The first group consumed 500ml whole milk (3.6% fat, 20 g of protein); the second group consumed 500ml of skimmed milk (0.3% fat, 20 g of protein), and the third group consumed control drink (juice with added carbohydrates) after a structured RE programme at a local gym (The Parks, North Shields). Participants visited the gym twice a week over 6 weeks and exercised under the supervision of exercise physiologist, Dr Christopher Hurst. All participants consumed another 500ml of their allocated drink at home with their regular diet. After completing the RE programme, participants were tested again for health and functioning at their own home.
The first three participants completing the intervention described their experience of taking part in the study.
‘This is the first study I have taken part in. I also never exercised in a gym before. I found the study very interesting, and I am looking forward to the results. The team was very helpful and friendly, and other participants, too. I will miss coming here (at the Parks) as I really enjoyed it.’
‘When I was invited by my GP to take part in the study, I thought that it would be good to have a new experience as I never done the gym before. I hoped that physical part of the study will benefit me at my age. I am delighted to say that I noticed improvements in my physical ability, especially with my scoliosis and scoliosis-related pain – and this is sufficient to me. I was also hoping that what I did here will benefit someone in the future. I have really enjoyed it: I had good time, good laughs, made friends, and the MIlkMAN team has been lovely.’ Participant Two
‘When I first got the invitation, I was quite intrigued. I spoke to Lorelle, and I was pleased that I could take part. When I started the study I was on my own, and I thought ‘Great!’ because I am not quite ‘a social animal’. But then I met John, my training partner, and we immediately bonded. My training partner is wonderful and your ‘band of brothers’ (MIlkMAN team) are just so nice. We always got an answer to our questions, and the experience with exercise was just great. I have to admit that I feel much fitter. Overall, I have a super experience. I would do this study again, even longer if needed, and especially with John as my partner. Chris, Ellie (Eleanor Hynes, CIMA MRes/PhD student) and John were great in cheering me up when I would struggle with my exercise. It helped greatly with my determination to finish the study.’ Participant Three
Reflecting on the completion of the study, Chief Investigator Dr Terry Aspray, said:
‘We are very grateful to our participants for their interest and dedication to the study. Over the study period, they have being in contact with our research team at least 18 times, either over the telephone or face-to-face. We got the opportunity to know them better and share their experiences, which was priceless to our research team.’