Impact of Carbohydrate Co-ingestion on the Post-prandial Anabolic Response of Protein in Young and Elderly Men

NCT01576848 | Completed

• 1 other identifier: METC 11-3-040
• Study Type: interventional
• Target: 48
• Locations: 1 country
• Sites: 1

Brief Summary

Rationale: Age related muscle loss (sarcopenia) is assumed to be related to the impaired postprandial muscle protein synthetic response to protein and/or amino acid administration in the elderly vs the young. Co-ingestion of carbohydrate increases post-prandial insulin secretion. Insulin affects skeletal muscle blood flow and may therefore affect substrate availability and postprandial muscle protein synthesis. However, it is unclear whether the response to the combined intake of protein and carbohydrates is different in elderly compared to young subjects. Hypothesis: Adding carbohydrate to a bolus of protein represents an effective strategy to overcome the impaired postprandial muscle protein synthesis in the elderly. Objective: The primary objective of the study is to investigate whether carbohydrate co-ingestion augments the in vivo postprandial muscle protein synthetic response after protein ingestion and whether this response is different between young and elderly subjects. The secondary objective of the study is to assess the effect of carbohydrate co-ingestion on insulin levels and microvascular perfusion in young and elderly subjects. Intervention: The intervention consists of a single test day during which the subjects will receive a drink containing 20 gram intrinsically labelled casein with or without 60 gram carbohydrates. In addition, continuous intravenous tracer infusions of labeled amino acids will be administered. During the test day 18 plasma samples and 4 muscle biopsies will be collected over a period of 8½ h. Furthermore, muscle skeletal blood flow will be estimated using sidestream darkfield imaging (SDF) in sublingual position.

Conditions

Sarcopenia

Keywords

muscle metabolism; intrinsically labeled protein; protein synthesis; insulin; perfusion

Outcome Measures

Primary Outcomes (1)

• Change from fasted state in Muscle protein synthesis rate (expressed as Fractional Synthetic Rate, FSR) at different time points postprandial

  Participants will be followed in a fasted state over 2 hours and in a postprandial state over 5 hours

Secondary Outcomes (4)

• Change from fasted state in Whole body protein balance at different time ponits postprandial

  Participants will be followed in a fasted state over 2 hours and in a postprandial state over 5 hours

• Change from fasted state in Microvascular perfusion at different time points postprandial

  Participants will be followed in a fasted state over 2 hours and in a postprandial state over 5 hours

• Change from fasted state in Digestion kinetics of dietary intrinsically labeled protein at different time points postprandial

  Participants will be followed in a fasted state over 2 hours and in a postprandial state over 5 hours

• Change from fasted state in Absorption kinetics of dietary intrinsically labeled protein at different time points postprandial

  Participants will be followed in a fasted state over 2 hours and in a postprandial state over 5 hours

Study Arms (4)

GROUP 1 (OLD-PRO)

EXPERIMENTAL

test drink contains intrinsically labeled protein alone

Dietary Supplement: Protein

GROUP 2 (OLD-PRO/CARB)

EXPERIMENTAL

test drink contains intrinsically labeled protein and carbohydrate

Dietary Supplement: Protein + carbohydrate

GROUP 3 (YOUNG-PRO)

EXPERIMENTAL

test drink contains intrinsically labeled protein alone

Dietary Supplement: Protein

GROUP 4 (YOUNG-PRO/CARB)

EXPERIMENTAL

test drink contains intrinsically labeled protein and carbohydrate

Dietary Supplement: Protein + carbohydrate

Interventions

Protein DIETARY_SUPPLEMENT

Subjects will receive a drink containing 20 gram intrinsically labelled casein. Half of the subject are young males (YOUNG)(age between 18 and 35 y) and half of the subjects are elderly males (OLD)(age between 70 and 85 y).

Also known as: Intrinsically labelled casein

GROUP 1 (OLD-PRO); GROUP 3 (YOUNG-PRO)

Protein + carbohydrate DIETARY_SUPPLEMENT

subjects will receive a drink containing 20 gram intrinsically labelled casein plus 60 gram carbohydrates. Half of the subject are young males (YOUNG)(age between 18 and 35 y) and half of the subjects are elderly males (OLD)(age between 70 and 85 y).

Also known as: Casein plus dextrose monohydrate and maltodextrin

GROUP 2 (OLD-PRO/CARB); GROUP 4 (YOUNG-PRO/CARB)

Eligibility Criteria

• Age: 18 Years - 85 Years
• Sex: male
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Males
• Age 70-85 years or Age 18-30 years
• BMI \< 30 kg∙m2

You may not qualify if:

• Diabetes
• HbA1c \> 7.0%
• Obesity (BMI \> 30 kg/m2)
• Diagnosed impaired renal or liver function
• All co-morbidities interacting with mobility and muscle metabolism of the lower limbs (e.g. arthrosis, arthritis, spasticity/rigidity, all neurological disorders and paralysis).
• Hypertension (according to WHO criteria) (36)
• Use of anticoagulants, blood diseases, allergy for lidocain
• Use of NSAIDs and acetylsalicylic acid
• Use of gastric acid inhibitors
• Patients suffering from PKU (Phenylketonuria)
• Participation in any regular exercise program
• Unstable body weight over the last 3 months

Sponsors & Collaborators

• Maastricht University Medical Center: lead

Study Sites (1)

Maastricht University

Maastricht, Limburg, 6200 MD, Netherlands

Location

Related Publications (3)

• Gorissen SHM, Trommelen J, Kouw IWK, Holwerda AM, Pennings B, Groen BBL, Wall BT, Churchward-Venne TA, Horstman AMH, Koopman R, Burd NA, Fuchs CJ, Dirks ML, Res PT, Senden JMG, Steijns JMJM, de Groot LCPGM, Verdijk LB, van Loon LJC. Protein Type, Protein Dose, and Age Modulate Dietary Protein Digestion and Phenylalanine Absorption Kinetics and Plasma Phenylalanine Availability in Humans. J Nutr. 2020 Aug 1;150(8):2041-2050. doi: 10.1093/jn/nxaa024.

  PMID: 32069356 DERIVED

• Kouw IW, Gorissen SH, Burd NA, Cermak NM, Gijsen AP, van Kranenburg J, van Loon LJ. Postprandial Protein Handling Is Not Impaired in Type 2 Diabetes Patients When Compared With Normoglycemic Controls. J Clin Endocrinol Metab. 2015 Aug;100(8):3103-11. doi: 10.1210/jc.2015-1234. Epub 2015 Jun 2.

  PMID: 26037513 DERIVED

• Gorissen SH, Burd NA, Hamer HM, Gijsen AP, Groen BB, van Loon LJ. Carbohydrate coingestion delays dietary protein digestion and absorption but does not modulate postprandial muscle protein accretion. J Clin Endocrinol Metab. 2014 Jun;99(6):2250-8. doi: 10.1210/jc.2013-3970. Epub 2014 Mar 14.

  PMID: 24628553 DERIVED

MeSH Terms

Conditions

Sarcopenia; Insulin Resistance

Interventions

Proteins; Carbohydrates; Caseins; Glucose; maltodextrin

Condition Hierarchy (Ancestors)

Muscular Atrophy; Neuromuscular Manifestations; Neurologic Manifestations; Nervous System Diseases; Atrophy; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Hyperinsulinism; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases

Intervention Hierarchy (Ancestors)

Amino Acids, Peptides, and Proteins; Milk Proteins; Animal Proteins, Dietary; Dietary Proteins; Phosphoproteins; Hexoses; Monosaccharides; Sugars

Study Officials

• Luc JC van Loon, Prof.

  Maastricht University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: MSc

Study Record Dates

• First Submitted: August 9, 2011
• First Posted: April 13, 2012
• Study Start: August 1, 2011
• Primary Completion: March 1, 2012
• Study Completion: March 1, 2012
• Last Updated: April 13, 2012

Record last verified: 2012-04

Locations

NL (1)