Sarcopenia Stoppers: Nutritional ingredients to combat age-related muscle loss

Photo © AdobeStock.com/shurkin_son

The United States Census Bureau predicts that by 2034, people over age 65 will outnumber people under age 18 for the first time in history.¹ Meanwhile, average life expectancy continues to grow, with those born in 1990 expected to live an average of five years longer than those born in 1960.² A graying population with a longer life expectancy will be a continuing trend for decades to come, and as more consumers stay in the workforce past age 65 and in general look to stay mobile longer, demand for products that can help prevent age-related muscle loss, or sarcopenia, will only increase. Mordor Intelligence forecasts that the sarcopenia-prevention market will post a 5.71% CAGR through 2025.³

As interest grows in nutritional ingredients that may help combat sarcopenia, consumers will seek out clinically validated products supported by robust research. Here are some of the muscle-health ingredients that are performing well in clinical trials.

Beta-Alanine Improves Muscle Strength and Nerve Function

A growing body of research is demonstrating that beta-alanine can promote muscle growth and improve nerve function in older adults. Mark LeDoux, chairman and CEO of Natural Alternatives International (Carlsbad, CA), says building muscle is critical for seniors in order to maintain an active lifestyle.

“The number of men and women working past the age of 65 rose sharply over the past 30 years, and it appears this trend will continue,” LeDoux says. “This should create enormous demand for products that can elevate health and well-being through one’s golden years.”

One randomized, double-blind, placebo-controlled, parallel-arm clinical trial⁴ examined the effects of beta-alanine supplementation on exercise capacity and executive function in 12 healthy adults between the ages of 51 and 74. Subjects were randomly assigned to receive either one 800-mg capsule of Sigma-Aldrich (St. Louis) beta-alanine three times per day (n=7) or a matching placebo (n=5) for 28 days. Subjects’ exercise capacity was assessed via a time-to-exhaustion (TTE) trial performed on a cycle ergometer. Executive function was assessed via the Stroop test. After an initial screening visit, subjects participated in one pre-supplementation visit and one post-supplementation visit.

Both groups exhibited similar TTE scores at the pre-supplementation visit. On the visit following supplementation, the experimental group experienced a statistically significant increase in TTE scores, while the placebo group did not. Beta-alanine supplementation subjects also experienced a statistically significant improvement in Stroop test performance relative to placebo. The study authors concluded that beta-alanine improves exercise capacity and mitigates post-exercise executive function deficits in older adults.

LeDoux says this and other trials demonstrate the efficacy of beta-alanine in promoting muscle function and mental acuity in seniors. With over 74 million baby boomers turning 65 to 85 within the next decade, LeDoux notes, there will be enormous demand for clinically proven products that can support muscle health in old age.

“Strong muscles aren’t just for bodybuilders,” LeDoux says. “Muscle mass decreases as we age, so building muscle is critical to help maintain activities of daily living and to reduce the risk of falls and fractures. As the workforce and the general population gets older, many will need help pushing through the daily grind without suffering from physical and mental fatigue.”

Whey Protein Products Promote Muscle Synthesis

Protein powders aren’t just for 20-something athletes. Vicky Davies, global marketing director of performance, active, and medical nutrition for FrieslandCampina Ingredients (Amersfoort, The Netherlands), says whey protein isolate has a well-established mechanism of action in building muscle, making it an ideal base for sarcopenia-related products like FrieslandCampina’s Sarcopenia Powder.

“Our Sarcopenia Powder offers 25 g of protein per serving,” she says. “It’s a blend that brings together whey protein, leucine, vitamin D, and calcium to support the needs of elderly people who wish to stay active and mobile for longer.”

Past studies have found that protein supplementation increases muscle synthesis, and the addition of leucine enhances this effect. One meta-analysis⁵ of 22 randomized clinical trials involving 680 subjects examined a subset of six randomized placebo-controlled trials involving a total of 325 older subjects with an average age of 62. These six trials found that protein supplementation improved muscle strength and increased the maximum load participants could press on the 1-leg press test by an average of 13.1 kg.

Another clinical trial⁶ on Arla Foods Ingredients’ (Viby, Denmark) branded ingredient Lacprodan Hydro.Rebuild, a hydrolyzed whey protein, examined the effects of whey protein on skeletal muscle mass and functional capacity in 30 women between the ages of 64 and 73. Subjects were randomly assigned to receive either 35 g of whey protein per day, or a matching placebo, for 12 weeks. Subjects in both conditions participated in resistance-training sessions three times per week for the duration of the study. Participants were assessed for blood pressure, strength, and body composition at the start and at the end of the study.

After 12 weeks, the subjects receiving Lacprodan Hydro.Rebuild saw statistically significant improvements in muscle mass and functional capacity relative to the control group. Whey protein administration was also associated with reductions in body fat and waist circumference.

Mads Dyrvig, head of sales development for the health and performance business unit at Arla Foods Ingredients, says a growing consumer awareness of age-related muscle loss is increasing demand for protein ingredients. As more health-conscious seniors look to live longer, healthier lives, new whey protein ingredients are launching to meet their needs.

Davies predicts that muscle-building products for seniors will see significant growth in the coming years, particularly in convenience formats. She says active seniors will reach for shots and drinks that can deliver protein without being heavy to consume, as well as powders and gels that are easy to add to a daily routine.

“Globally, muscle and mobility is the number-one concern for older people,” Davies says. She notes that “47% of consumers aged 55 to 64, and 49% of consumers over 65, are worried about their strength as they age. Older adults also have a reduced appetite and can find it difficult to get enough protein through diet. Applications set to grow in this space include shots, drinks, jellies, powders, and snacks.”

HMB and Vitamin D3 Boost Functional Strength Independent of Exercise

While exercise is an important component of a healthy lifestyle and an effective way to build muscle, new research indicates that seniors may benefit from certain nutritional interventions even if they cannot or will not exercise. One randomized, double-blind, placebo-controlled, 2x2 factorial-design clinical trial⁷ published last year examined the effects of TSI Group’s (Missoula, MT) branded ingredient myHMB, a blend of calcium beta-hydroxy-beta-methylbutyrate (HMB) and vitamin D3, on muscle strength, physical functioning, and body composition in 117 men and women over age 60.

Subjects were randomly assigned to receive either 3 g/day of calcium HMB plus 2,000 IU/day of vitamin D3, or a placebo, for 12 months. The subjects were then further subdivided into four groups. The first group (n=27) received HMB and vitamin D3 but was instructed to abstain from exercise for 12 months. The second group (n=26) received a placebo and also abstained from exercise. The third group (n=30) received HMB and vitamin D3 and was placed on a resistance-training exercise regimen. The fourth group (n=34) received a placebo and followed an exercise regimen. The exercise groups performed 60 minutes of supervised resistance training three times per week for 12 months.

Participants were assessed for bilateral elbow and knee extension and flexion peak torque using isokinetic dynamometers. The subjects were also given the Timed Up and Go Test and the Get Up Test to measure physical function, and a handgrip dynamometer test to assess grip strength. All functional test scores were aggregated into the Composite Functional Index, a score approximating overall changes across all tests. These tests were administered at baseline and after three, six, nine, and 12 months.

HMB+D3 supplementation was found to improve lean body mass without exercise after six months; however, this improvement was not observed at the 12-month follow-up. In the non-exercise group, HMB+D3 supplementation caused a statistically significant improvement in composite functional index scores after three months that continued to increase on subsequent assessments. Both exercise groups exhibited statistically significant improvements in composite functional index scores after three months that continued to increase at all subsequent assessments; however, no statistically significant differences were found between the HMB+D3 subgroup and the control subgroup. The study authors determined that calcium HMB and vitamin D3 did improve muscle strength independent of exercise, but did not have an additive effect in exercising older adults.

Larry Kolb, president of TSI Group, says this study is significant because prior to this clinical trial, the only known intervention that consistently improved muscle strength and function was exercise. Many older adults are unable or unwilling to exercise at a high enough frequency and intensity to maintain or improve muscle health, Kolb says, which is why myHMB may be a viable alternative for these sedentary consumers. However, Kolb cautions that this study doesn’t necessarily mean that exercise isn’t important.

Kolb says, “myHMB has been shown to boost muscle strength benefits in combination with resistance training in younger adults, [which is why] it was unexpected that similar results were not observed in the Rathmacher study⁷. myHMB provides the most benefit when combined with high-intensity exercise, so it’s possible that the resistance-training program used in this study wasn’t sufficiently stressful to the system to see an additional benefit of HMB over and above exercise, or vice versa. Regardless, when considering the small proportion of older adults that participate in resistance training, the benefit of myHMB+D3 in those who do not is likely to be more impactful overall.”

Muscle Preservation Market Set for Growth, Diversification

Longer lifespans and a growing population of senior citizens are creating new opportunities for muscle-health products. As more aging consumers look for ways to maintain their vitality and muscle strength well into their old age, this market will offer a variety of opportunities for a diverse array of products. The old adage that none of us are getting any younger will ensure that these products remain in demand for decades to come.

References

1. “Older People Projected to Outnumber Children for First Time in U.S. History.” United States Census Bureau press release. Published March 13, 2018. Updated October 8, 2019.
2. Medina L et al. “Living Longer: Historical and Projected Life Expectancy in the United States, 1960 to 2060.” United States Census Bureau website. Published February 2020.
3. Mordor Intelligence. “Sarcopenia Treatment Market—Growth, Trends, and Forecast (2020-2025).” Published online July 7, 2020.
4. Furst T et al. “β-alanine supplementation increased physical performance and improved executive function following endurance exercise in middle aged individuals.” Journal of the International Society of Sports Nutrition, vol. 15, no. 1 (July 11, 2018): 32
5. Cermak NM et al. “Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis.” American Journal of Clinical Nutrition, vol. 96, no. 6 (December 2012): 1454-1464
6. Nabuco HCG et al. “Effects of protein intake beyond habitual intakes associated with resistance training on metabolic syndrome-related parameters, isokinetic strength, and body composition in older women.” Journal of Aging and Physical Activity, vol. 27, no. 4 (August 1, 2019): 545-552
7. Rathmacher JA et al. “Long-term effects of calcium β-hydroxy- β-methylbutyrate and vitamin D3 supplementation on muscular function in older adults with and without resistance training: A randomized, double-blind, controlled study.” The Journals of Gerontology, vol. 75, no. 11 (October 15, 2020): 2089-2097.