Effect of exercise and nutritional supplementation on health-related quality of life and mood in older adults: the VIVE2 randomized controlled trial

Åsa von Berens, Roger A Fielding, Thomas Gustafsson, Dylan Kirn, Jonathan Laussen, Margaretha Nydahl, Kieran Reid, Thomas G Travison, Hao Zhu, Tommy Cederholm, Afsaneh Koochek, Åsa von Berens, Roger A Fielding, Thomas Gustafsson, Dylan Kirn, Jonathan Laussen, Margaretha Nydahl, Kieran Reid, Thomas G Travison, Hao Zhu, Tommy Cederholm, Afsaneh Koochek

Abstract

Background: Health-related quality of life (HRQoL) and absence of depressive symptoms are of great importance for older people, which may be achieved through lifestyle interventions, e.g., exercise and nutrition interventions. The aim of this investigation was to analyze the effects of a physical activity program in combination with protein supplementation on HRQoL and depressive symptoms in community-dwelling, mobility-limited older adults.

Methods: In the Vitality, Independence, and Vigor 2 Study (VIVE2), community-dwelling men and women with an average age of 77.5 ± 5.4 years, some mobility limitations and low serum vitamin D levels (25(OH)Vit D 22.5-60 nmol/l) from two study sites (Stockholm, Sweden and Boston, USA) were randomized to receive a nutritional supplement or a placebo for 6 months. All took part in a physical activity program 2-3 times/ week. The primary outcome examined in VIVE2 was 400 M walk capacity. HRQoL was measured using the Medical Outcomes Study 36-item Short Form Health Survey (SF36), consisting of the Physical Component Summary (PCS) and Mental Component Summary (MCS), and depressive symptoms were measured using The Centre for Epidemiologic Studies Depression Scale (CES-D). In the sensitivity analyses, the sample was divided into sub-groups based on body measures and function (body mass index (BMI), appendicular lean mass index (ALMI), handgrip strength and gait speed).

Results: For the whole sample, there was a significant improvement in both MCS, mean (95% CI) 2.68 (0.5, 4.9) (p 0.02), and CES-D -2.7 (- 4.5, - 0.9) (p 0.003) during the intervention, but no difference was detected between those who received the nutritional supplement and those who received the placebo. The results revealed no significant change in PCS or variation in effects across the sub-categories.

Conclusions: This study demonstrates that a six-month intervention using a physical activity program had positive effects on mental status. No additional effects from nutritional supplementation were detected.

Trial registration: Registered at ClinicalTrials.gov, March 2 2012, NCT01542892 .

Keywords: Depressive symptoms; Health-related quality of life; Nutritional supplementation; Physical activity.

Conflict of interest statement

Ethics approval and consent to participate

The Tufts University Health Sciences Campus Institutional Review Board and the Regional Ethical Committee of Uppsala, Sweden (Dnr 2012/154) reviewed and approved the study protocol. All participants were provided with written and oral information about the study and all signed an informed consent form.

Consent for publication

Not applicable.

Competing interests

ÅvB has received grants from Nestlé Health Science, the Swedish Nutrition Foundation, SWESPEN and Aleris AB during the conduct of the study. No other competing interests to declare. RAF reports receiving grant support from Nestle, Astellas, Axcella; RAF reports consultancy honoraria from Nestle, Abbott, Axcella, Astellas, GSK, Biophytis and Amaxentis; RAF reports the following advisory board memberships Axcella, BIophytis. TG, DK, JL, KR, TGT and HZ declare that they have no competing interests.

MN reports receiving grant support from Nestle Health science, no other competing interests to declare. TC has received unconditional research grants and speaking engagement honoraries from Nestle Health Science and Nutricia, and speaking engagement honoraries from Fresenius-Kabi and Arla Food. AK has been employed as a Nutritional translator at Nestlé Health Science (sep 2016-october 2017), no other competing interests to declare.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
CONSORT diagraming. Flow of participants through the trial and analytical sample for this report
Fig. 2
Fig. 2
a and b Effect of the intervention on the eight domains of SF-36. Measurements at baseline and after 6 months of intervention, in the physical activity + placebo group (a) and in the physical activity + nutritional supplementation group (b). The eight domains are physical function (PF), role physical (RP), bodily pain (BP), general health (GH), vitality (VT), social function (SF), role emotional (RE) and mental health (MH)

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