Where does the funding for the NUTRIMAL project come from?

NUTRIMAL is funded by the Department of Agriculture Food and Marine (DAFM) under the Food Institutional Research Measure. In 2014, Professor Helen Roche and Dr. Brendan Egan, in collaboration with a number of other researchers, applied for a highly competitive grant offered by DAFM. The (50 page!) NUTRIMAL project grant proposal was scrutinized by an Expert Evaluation Panel made up of experts in research, the agri-food industry and the public service and was selected to receive the funding.

After I joined the team we successfully applied for additional funding to add some extra measurements to the project. This involved a few more applications and an interview! The NUTRIMAL project has received funding from European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 666010 and the European Society of Clinical Nutrition and Metabolism (ESPEN) under the 2017 ESPEN Fellowship programme.

The ingredients for the NUTRIMAL project drinks have been kindly donated by Smartfish and Glanbia Nutritionals. Here is in UCD we spotted that both of these companies were producing ingredients with the potential to improve muscle health in older adults and brought them together to produce a custom-made product for the NUTRIMAL project that is not commercially available.

SmartfishGlanbia

What are the NUTRIMAL nutritional supplements?

The supplements are fruit flavoured drinks approximately the size of a small apple juice carton (200 ml).

They are produced by a Norwegian company called Smartfish and incorporate a food ingredient produced by the Irish company Glanbia.Nutritionals. I think they taste great!

Me tasting NUTRIMAL drinks

 

The drinks are not commercially available and were custom-made for the NUTRIMAL project. Each participant will be randomly allocated to receive one of the following supplements for the 6 month period:

Supplement 1

Supplement 1 contains milk protein (whey).  Evidence from previous research studies suggests that whey protein from milk is especially effective for increasing the rate of muscle building in older adults. In addition, this supplement has added leucine. Leucine is one of building blocks that makes up protein in foods and is known to have a special role as a ‘trigger’ for muscle building.

There is also some carbohydrate (from fruit sugars) and fat (from sunflower oil) in this supplement.

There are 200 calories per drink.

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Supplement 2

Supplement 2 contains milk protein with added leucine (just like supplement 1) but it also contains omega 3 fatty acids from fish oil. A previous study found that older adults supplemented with fish oil for 6 months had an increase in muscle mass and strength. However, no studies have examined if a combination of whey protein, added leucine and fish oil can lead to an even greater improvement in muscle mass and strength than whey protein and added leucine alone…and that is what we want to find out in the NUTRIMAL study.

There is also some carbohydrate (from fruit sugars) in this supplement.

There are 200 calories per drink.

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Supplement 3

Supplement 3 placebo (contains no milk protein or fish oil). This supplement contains fat (from sunflower oil) and carbohydrate from fruit sugars as well as added sugars (~ 3 tsp added sugar per drink).

There are 200 calories per drink.

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Who are the participants who will take part in the NUTRIMAL project?

We are currently looking for men and women to take part who are:

  • 65 years of age and over
  • Non-smokers
  • Have low muscle mass and/or have low strength (we will test this)

Older adults group

Unfortunately men and women are not eligible if they:

  • Regularly perform strenuous weightlifting exercise (why?)
  • Have diabetes (why?)
  • Have advanced kidney disease (why?)
  • Have a gut disease that impair their ability to properly absorb their food (why?)
  • Are on certain medications (i.e. high dose anti-inflammatories, hormone replacements or hormone suppressants) (why?)
  • Have had substantial (>3 kg) weight loss in the past 3 months (why?)
  • Have normal muscle mass and strength (why?)

Why are we doing the NUTRIMAL project?

The NUTRIMAL project is going to be a lot of work and is going to cost a lot of money. So…why are we bothering?

Muscle mass and strength decline with age…and this is a BIG problem

Beginning in our forties we lose ~1% of our muscle every year. For an average man that’s the equivalent of losing a 10oz steak of muscle every year [2]!

steak-png-2

Strength is lost even faster, at a rate of about 2-3% per year [3]. This can make physical tasks like walking and rising from a chair more difficult. This loss of muscle mass and function is called sarcopenia.

Sarcopenia is big problem because it increases the risk of physical disability, falls and hospitalization [4,5]. Importantly it also reduces quality of life in older adults [6].

Sarcopenia cartoon

 

Therefore, is it critical that we identify strategies to slow the loss of muscle mass and strength with age in order to promote independence and well-being amongst older adults.

What do we know already?

Nutrition plays an important role in helping to slow the loss of muscle mass and strength with age.

Previous research studies have reported that:

  • Increasing milk protein in the diet can improve physical performance in older adults [7].

milk-1l-png

  • Proteins seem to be especially effective for increasing muscle building if they are high in leucine [8]. Leucine is one of the building blocks that makes up protein in foods and is known to have a special role as a ‘trigger’ for muscle building.

 

  • When older adults were supplemented with fish oil for 6 months they had an increase in muscle mass and strength [9].

gel capsules

What will the NUTRIMAL project tells us?

We want to find out:

  1. If consuming milk protein and extra leucine can slow the loss of muscle mass and strength loss with age
  2. If consuming milk protein, extra leucine AND fish oil is even more effective than milk protein and extra leucine alone

The results of the NUTRIMAL project will help to identify nutritional strategies to assist older adults in preserving their muscle mass and strength. This in turn could help to prevent physical disability and support independent and healthy aging. 

Overview of the NUTRIMAL project

NUTRIMAL is a nutrition and healthy aging research project that is currently ongoing in University College Dublin.

The aim of the NUTRIMAL project is to investigate whether a food-based nutritional supplement can improve muscle mass and strength in men and women aged 65 and over who have low muscle mass and/or strength.

In this study we will recruit 120 men and women and will randomly assign them to consume a fruit-flavoured drink containing either:

1) Milk protein 

2) Milk protein plus fish oil

3) A placebo (no milk protein or fish oil)

Participants will be asked to drink their allocated beverage twice per day (once with breakfast and once with lunch) for 6 months. We will test whether participants improve the amount of muscle they have (their muscle mass), their strength and their physical performance after 6 months of supplementation.

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How will we measure changes in muscle mass, strength and physical performance?

Muscle mass: Changes in muscle mass will be measured using a DXA scan (stands for dual-energy x-ray absorptiometry). This is the same scanner used to perform a bone density scan but it can also tell us how much fat and muscle is in the body.

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Muscle strength: We will measure upper body strength using a device called a handgrip dynamometer. Participants are asked to squeeze the handgrip as hard as possible. We will measure leg strength using a Cybex. The participant sits on the Cybex chair and their leg is strapped to a metal arm. The participant is then asked to kick their leg out as hard as possible to measure the maximum strength.

Handgrip dynamometer                                             Cybex

Physical performance: Being strong and having lots of muscle is important but what matters most is muscle function. Muscle function or physical performance refers to the ability of an individual to perform basic physical tasks like getting out of a chair, walking or balancing. To test physical performance we use a set of tests: 1) balance tests, 2) a walking speed test, 3) a test to see if the participant can rise from a chair 5 times in a row (without using their hands!).

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Optional additional measurements: The rate of muscle building 

Of the 120 men and women that participate in the NUTRIMAL project,  39 participants will also take in an additional, optional measurement.

We think that the milk protein and fish oil will improve muscle mass in the NUTRIMAL participants by increasing the rate of muscle building . To test this theory we are going to measure to rate of muscle building in 39 of the participants. We will do this on two occasions: 1) before the participants begin the supplements and 2) in the final week of the 6 months of supplementation.

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