Objective: To evaluate whether a multi-nutrient fortified dairy drink (SUPP) can augment the effects of exercise on physical performance, body composition, bone and cartilage turnover and inflammation during the mid-adult and menopausal years when muscle and bone loss begin to accelerate.
Methods: In this 4-month double-blind, placebo RCT, 244 sedentary women (45-65 y) participated in a multimodal exercise program 3 d/week with random allocation to twice daily SUPP (2x150 ml) containing added protein, calcium, vitamin D, milk fat globule membrane and other micronutrients or an energy matched placebo. Outcomes included: functional muscle power [stair climb, vertical jump height (VJH), 5 sit-to-stand], DXA total body BMC, lean mass (LM) and fat mass (FM), pQCT 50% femur and 66% tibia muscle CSA and muscle adiposity, leg press muscle strength and power, mobility [gait speed, four-square step test, timed-up-and-go], single leg balance (SLB), bone (CTx and P1NP) and cartilage turnover (urinary CTX-II) and inflammation (serum IL-6, IL-10, TNF-a).
Results: 216 women (89%) completed the study. Adherence was 90-92% for SUPP and placebo and 78-79% for Ex. After 4-months, Ex+SUPP experienced a greater improvement in stair descent (0.09 sec, P<0.05) and ascent time (0.07, P=0.07), VJH (0.5cm, P<0.05), SLB eyes closed (3.3 sec, P<0.01), BMC (0.4%, P<0.05), LM (0.3kg, P<0.05) and muscle CSA (femur 1.8%; tibia 0.9%, P<0.01) and a greater reduction in FM (-0.6 kg, P<0.01) than Ex+placebo. Femur and tibia muscle adiposity decreased in Ex+SUPP only (P<0.01). There was also a significant net 16-17% reduction in bone turnover in Ex+SUPP vs Ex+placebo (P<0.001). Other measures of muscle function, strength and power improved similarly in both groups, with no changes in inflammatory markers or cartilage metabolism (CTX-II).
Conclusion: Daily supplementation with a multi-nutrient fortified dairy drink enhanced the effects of exercise on functional performance, body composition and bone health in sedentary middle-aged women.