Effect of protein supplementation associated with resistance exercises on glycemia, advanced glycation endproducts (AGE), body composition, balance, and muscle strength in older adults with type 2 Diabetes Mellitus: a randomized triple-blind placebo-cont

Abstract

The aim of this study is to investigate the effect of protein supplementation associated with 12 weeks of resistance exercises on glycemic control, formation of Advanced Glycation Products (AGE), body composition, postural balance, and muscle strength in elderly, living with Type 2 Diabetes Mellitus (DM2). Secondly, to evaluate the evolution of loads and the effect on the lipid profile that composes the cardiovascular risk assessment. Methods: This is a randomized, triple-blind clinical trial. The subjects of the present study consist of men living with DM2, aged between 65 and 79 years old, with a body mass index (BMI) between 22 and 32 kg/m2. The individuals will be randomly divided into two groups: The Protein Group and the Control Group. Both will be engaged in resistance training twice a week for 12 weeks. For each exercise, 3 sets of 8 to 12 repetitions will be executed. The intensity should be between 7 - 8, according to the Subjective Perception of Effort, using a scale from 0 to 10, as present in the recommendations of the American College of Sports Medicine (ACSM). Besides this, they will receive protein supplementation or placebo, according to the group they belong to. Exercises for large muscle groups compose each session: chest press, row, leg-press, extensor chair, plantar flexions of the gastrocnemius, and abdominal flexions. Supplementation of 20 g of whey protein or maltodextrin (control) will be administered just after strength training, both of which are diluted in water. All participants will be instructed to eat 1.0 to 1.2g of protein/kg of body weight per day. The following pre- and post-training assessments will be applied: Anthropometric: body composition, including total body mass, fat mass, lean mass, height, BMI, and waist-to-hip ratio. Functional Assessment: isokinetic dynamometry of knee extensors and flexors, maximum repetition (1RM), and handgrip strength. Postural Balance: Balance Master® equipment will be used with the protocols of going up and down steps, sitting and standing, walking and returning, and the Short Performance Battery Test (SPPB). Assessment of food intake: will be obtained through a 24-hour recall and the food frequency questionnaire. The AGE reader will obtain the AGE measurement. Glycemic control, as well as cardiovascular risk, will be obtained by biochemical analyzes, in which peripheral blood samples (20 ml) will be collected at baseline and 12 weeks after the beginning of the protocol. For statistical analysis, the Shapiro Wilk test will be used, to verify whether the continuous variables will have a normal distribution, and then we will use the corresponding tests. (AU)