Medium-Chain Triglycerides in Combination with Leucine and Vitamin D Increase Muscle Strength and Function in Frail Elderly Adults in a Randomized Controlled Trial

Background: Sarcopenia, the loss of skeletal muscle mass, strength, and function, is common in elderly individuals but difficult to treat. Objective: A combination of nutrients was investigated to treat sarcopenia in very frail elderly adults. Methods: We enrolled 38 elderly nursing home residents (11 men and 27 women with a mean +/- SD age of 86.6 +/- 4.8 y) in a 3-mo randomized, controlled, single-blind, parallel group trial. The participants were randomly allocated to 3 groups. The first group received a daily L-leucine (1.2 g) and cholecalciferol (20 mu g)-enriched supplement with 6 g medium-chain triglycerides (TGs) (MCTs) (LD + MCT); the second group received the same leucine and cholecalciferol-enriched supplement with 6 g long-chain TGs (LD + LCT); and the third group did not receive any supplements (control). The supplement and oils were taken at dinner, and changes in muscle mass, strength, and function were monitored. Results: The increase in body weight in the LD + MCT (1.1 +/- 1.0 kg) and LD + LCT (0.8 +/- 1.1 kg) groups was greater than that in the control group (-0.5 +/- 0.9 kg) (P < 0.05). After 3 mo, participants in the LD + MCT group had a 13.1% increase in right-hand grip strength (1.2 +/- 1.0 kg, P < 0.01), a 12.5% increase in walking speed (0.078 +/- 0.080 m/s, P < 0.05), a 68.2% increase in a 10-s leg open-and-close test performance (2.31 +/- 1.68 n/10 s, P < 0.001), and a 28.2% increase in peak expiratory flow (53 +/- 59 L/min, P < 0.01). No significant improvements in muscle mass, strength, or function were observed in the LD + LCT or control groups. Conclusion: The combined supplementation of MCTs (6 g), leucine-rich amino acids, and cholecalciferol at dinner may improve muscle strength and function in frail elderly individuals.