L-Leucine Supplementation for Preserving Lean Mass During Low Calorie Diet in Sarcopenic Obese Women: A Pilot Study

Background: In sarcopenic obese subjects it is essential to reduce body weight and to preserve lean mass, in order to avoid a worsening of muscle function (1). Several studies have shown that leucine supplementation can be useful to improve skeletal muscle mass in sarcopenic patients (2). Aim: Evaluate the effectiveness of a short-term low calorie diet (LCD) combined with combined supplementation with whey protein, leucine and vitamin D on weight loss, lean mass and muscle strength in sarcopenic, obese, hyperinsulinemic and menopause women. Materials and methods: 16 female with mean age: 58.1 years (range: 47–69 years), BMI 37.6 Kg/m(2) (range: 31,7 - 44,1 Kg/m(2)), HOMA-index ≥ 2.5, were assigned to an LCD regimen (1000 kcal/day) with supplementation of 18 g protein, 4 g leucine and 5 mcg vitamin D for 45 days. Anthropometric indexes, blood and urine chemistry, body composition by DEXA, muscle strength by handgrip test and Short Physical Performance Battery (SPPB) were assessed at baseline and at the end of the treatment. Results: A significant reduction of BMI (35,7 vs 37,6 Kg/m(2)), waist circumference (102,4 vs 107 cm), HOMA index (2,3 vs 4,8) and fasting insulin (10,4 vs 17,4 μIU/ml) was observed in all patients. Women preserved total lean body mass (57 vs 55 %) and improved significantly muscle strength, as measured by handgrip (22,2 vs 18,6 Kg) and SPPB (8,9 vs 7,5). Conclusion: We conclude that LCD with adequate protein intake and a supplementation with whey protein, leucine and vitamin D should be promoted to maintain muscle mass and improve muscle strength in menopause women with sarcopenic obesity. References: 1. Batsis JA, Villareal DT. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol. 2018 Sep;14(9):513–5372. Bauer JM, Verlaan S, Bautmans I, Brandt K, Donini LM, Maggio M, McMurdo ME, Mets T, Seal C, Wijers SL, Ceda GP, De Vito G, Donders G, Drey M, Greig C, Holmbäck U, Narici M, McPhee J, Poggiogalle E, Power D, Scafoglieri A, Schultz R, Sieber CC, Cederholm T. Effects of a vitamin D and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the PROVIDE study: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2015 Sep 1;16(9)