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Immune Function and Muscle Adaptations to Resistance Exercise in Older Adults

Immune Function and Muscle Adaptations to Resistance Exercise in Older Adults

Status
Completed
Phases
NA
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT02261961
Acronym
TDAP2
Enrollment
59
Registered
2014-10-10
Start date
2014-07-23
Completion date
2019-09-30
Last updated
2021-09-28

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Sarcopenia, Aging, Immune Function

Keywords

resistance exercise, Juven, exercise training, interleukin-1, insulin-like growth factor

Brief summary

The loss of muscle mass and strength due to aging leads to serious health problems for older adults. Muscle health can be improved by exercise training, but some people improve their strength substantially, whereas others improve little. The reason for this variation is unknown. This study will investigate whether function of the immune system influences how well people respond to exercise. Older Veterans who participate will have their muscle size, strength, and function measured periodically for almost a year. Participants will drink a nutritional supplement or placebo daily and complete a 36 session strength training program. Participants will be vaccinated for tetanus and donate small amounts of blood and muscle tissue during the study so that immune function can be compared to muscle outcomes during training and during a long-term follow-up. The study results should increase the investigators' understanding of the negative effects of aging on muscle and will possibly lead to better strategies for muscle maintenance and rehabilitation for older adults.

Detailed description

Objective: The study will examine the influence of immune function in older adults on improvement of muscle mass, strength, and function by resistance training. The maintenance of those benefits during long term follow-up will also be examined. This objective will be accomplished by a double-blind randomized placebo-controlled trial of a nutritional supplement (Muscle Armor) which evidence suggests can improve immune function, promote muscle growth, and counteract muscle loss. The study premise is that aging results in decreased ability of the immune system to respond to stimuli such as exercise. The study proposes that the supplement will improve muscle health by promoting a shift in immune function of older adults from a pro-inflammatory state towards a state which supports muscle growth and maintenance. Research Plan: The study will randomize Veterans (age 60-80, N=50) to participate in the supplement or placebo groups in a three phase study. The phases of participation correspond to the three specific aims. Aim 1 will determine if 2-weeks of supplementation improves immune function. Humoral immune function will be assessed as the response to vaccination. Innate immune function will be measured as systemic and cellular responses to acute resistance exercise that the investigators' previous studies indicate are affected by aging. Aim 2 will determine if supplementation during 36 sessions of progressive high-intensity resistance training boosts improvement in muscle size (CT scan), strength, and function (gait and balance). Muscle adaptations at the cellular levels will also be measured. Aim 3 will determine if continued supplementation for 26-weeks after completion of exercise training promotes the retention of the gains in muscle size, strength, and function. Multivariable testing will then be used to compare the results between Aims 1, 2, and 3 to determine whether or not immune function is correlated with muscle adaptation to training or detraining. Methods: Participants will undergo nine blood draws and five muscle biopsies of the vastus lateralis over the course of the study so that the effects of the supplement on immune function and cellular adaptations to training can be measured. Three of the blood draws will be used to assess the antibody response to the tetanus, pertussis, and diphtheria vaccine. Muscle and blood will be collected before and after a bout of exercise conducted before and after the 2-weeks of supplementation prior to training. Immune function will be measured using the blood based on pro- and anti-inflammatory cytokine levels, the balance between specific T-cell subpopulations, and the proliferative capacity of mononuclear cells. Immune function will be measured in muscle based on macrophage content of specific cytokines and growth factors. The investigators' previous study showed that these muscle measures strongly correlate with size and strength gain after training. Key signaling pathways including nuclear factor-k B and PI3 kinase will also be measured. The fifth biopsy will be collected post-training to measure adaptation at the cellular level based on changes in number of satellite cells and myonuclei and fiber size. Hypotheses related to these measures will be tested with 80% power to detect at least 0.8 standard deviations difference in means between the supplement and placebo groups. Clinical Relevance: Exercise is clearly able to affect immune function. However, the proposed study will attempt to modulate immune function and determine the effects on exercise outcomes. The study will also examine detraining, an important issue for older adults, that is usually omitted from training studies. Thus, the study will potentially advance the understanding of the mechanisms of muscle gain and loss in older adults, but more importantly, the study will evaluate a nutritional intervention as a complement to exercise for supporting muscle health during aging. Targeting the immune system may be the advantage needed for an older Veteran to successfully maintain or restore the muscle mass, strength, and function that is necessary for personal independence.

Interventions

BIOLOGICALTDAP

Both arms will receive the tetanus, diptheria, and pertussis vaccination after two weeks of treatment with supplement or placebo

Both arms will receive a single bout of resistance exercise twice, before and after two weeks of treatment with supplement or placebo, and be evaluated for the response within blood and muscle

OTHERResistance Exercise Training

Both arms will receive 36 sessions of progressive high-intensity resistance exercise training (thigh muscle) over the course of approximately 12 weeks.

Both arms will continue to receive treatment with supplement or placebo for approximately 26 weeks after completion of the exercise training. During this time subjects will not be allowed to perform resistance exercise.

DIETARY_SUPPLEMENTNutritional Supplement (Muscle Armor)

Subjects in the supplement group will consume orange-flavored Muscle Armor according to the manufacturer's directions: one serving (approximately 30g, i.e. one scoop provided with the product by its manufacturer), twice daily mixed with 12 ounces (oz) of water beginning after all baseline assessments are performed including assessment of the response to acute exercise and continuing until the end of study participation.

DIETARY_SUPPLEMENTPlacebo (Kool-Aid)

Subjects in the placebo group will consume orange-flavored Kool-Aid (Kraft Foods) according to the manufacturer's directions: one serving (approximately 13g, i.e. one scoop provided with the product by the pharmacy), twice daily mixed with 12 ounces (oz) of water beginning after all baseline assessments are performed including assessment of the response to acute exercise and continuing until the end of study participation.

Sponsors

University of Arkansas
CollaboratorOTHER
VA Office of Research and Development
Lead SponsorFED

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
60 Years to 80 Years
Healthy volunteers
Yes

Inclusion criteria

* Veteran * Age 60-80 years * Body Mass Index of 18.5 - 29.9 kg/m2

Exclusion criteria

* Currently participating in any other research study involving an intervention * Smokes tobacco products * Tetanus or TDAP vaccine in previous two years * Allergic to vaccination * Seizure in past 3 months * Guillain-Barre Syndrome in past 3 months * Takes the medications heparin, plavix / clopidogrel, or coumadin / warfarin * Allergic to lidocaine * Significant problem with fainting * Problems walking or exercising with both legs * Participated in a weight-lifting program targeting the thighs in last 3 months * Pains, tightness or pressure in chest during physical activity * Metastatic cancer or undergoing chemotherapy * Cerebral aneurysm or intracranial bleed in past year * End-stage congestive heart failure (NYHA Stage IV) * Unstable abdominal or thoracic aortic aneurysm (\>4cm) * Renal disease requiring dialysis * Allergic to vaccination * Acute retinal hemorrhage or ophthalmologic surgery in past 3 months * Bone fractures in the pelvis, legs, or feet in the last 3 months * Hernia that causes pain during physical activity * Myocardial infarction or cardiac surgery in past 3 months * Pulmonary embolism or deep venous thrombosis in past 3 months * Proliferative diabetic retinopathy or severe nonproliferative retinopathy * Active suicidality or suicidal ideation * Systemic bacterial infection * Taking aspirin in any form and unable/unwilling to discontinue at least 10 days prior to muscle biopsy * Unwilling to halt concurrent use of amino acid or protein supplements * Unwilling to halt new use of nutritional supplements * Unwilling to maintain current normal diet * Encephalopathy in past 7 days * Active oral or genital herpes * Current use of appetite stimulants * Current treatment for mania or bipolar disorder or taking lithium. * Diagnosis of a significant cognitive deficit * Untreated severe aortic stenosis * Uncontrolled diabetes mellitus (HbA1C\>10) * Uncontrolled hypertension or hypotension (\>160/100, \<100 systolic) * Uncontrolled malignant cardiac arrhythmia * Unstable angina * Allergic to latex or tape * Bleeding or clotting disorders * Taking any non-ASA NSAID and unable or unwilling to discontinue use for 3 days prior to muscle biopsy * Taking Fish Oil, Gingko, Garlic, Saw Palmetto, Turmeric, or Vitamin E and unable or unwilling to discontinue use for 10 days prior to the muscle biopsy procedure * Significant problems with chronic pain * Uncontrolled asthma or allergies * Taking lactulose, nitrates plus hypertension medications or Viagra * Liver cirrhosis or other severe liver disease * History of peripheral artery disease * Certain Steroid or androgen use in past 3 months * Other physician judgment * Significantly abnormal complete blood count (CBC) or prothrombin time (PT)/partial thromboplastin time (PTT)/international normalized ratio (INR)

Design outcomes

Primary

MeasureTime frameDescription
Change in Plasma Concentration of Antibodies to Pertussis Antigen (1 Week Post-vaccine)change from baseline at 1 week post-vaccineThe change in plasma antibody concentration for response to the pertussis antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and one week post-vaccination.
Change in Muscle Strength After Exercise Training for 12 Weekschange from baseline at completion of exercise training phase (12 weeks)The change in muscle strength after exercise training will be measured as the difference in one-repetition maximum capability for knee extension from before and after completion of the exercise training program.
Change in the Number of Muscle Macrophages Per Myofiber (Pre- to Post-acute Exercise)change from baseline at 2 weeks of treatmentThe change in the number of muscle macrophages per myofiber will be calculated for muscle collected before and 72 hours after a single bout of resistance exercise. The changes in macrophage numbers before and after two weeks of treatment with supplement or placebo will be compared.
Change in Plasma Concentration of C-Reactive Proteinchange from baseline at 2 weeks of treatmentPlasma c-reactive protein will be measured before and after two weeks of treatment with supplement or placebo.
Change in Plasma Concentration of Antibodies to Pertussis Antigen (2 Weeks Post-vaccine)change from baseline at 2 weeks post-vaccineThe change in plasma antibody concentration for response to the pertussis antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and two weeks post-vaccination.

Secondary

MeasureTime frameDescription
Change in Muscle Fiber Size After Exercise Training for 12 Weekschange from baseline at completion of exercise training (12 weeks)The change in the muscle fiber size will be measured as the difference in fiber size before and after completion of the exercise training program.
Change in Timed Up and Go at Week 16 of the Post-Training Perioddifference between after training and time point one of de-training follow-up period (week 16)The change in time required to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down will be measured as the difference between time points at the end of the training program and during the post-training period.
Change in Timed Up and Go at Week 26 of the Post-Training Perioddifference between after training and time point two of de-training follow-up period (week 26)The change in time required to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down will be measured as the difference between time points at the end of the training program and during the post-training period.
Percent Change in Resting Muscle Concentration of Interleukin-1 Betachange from baseline at 2 weeks of treatmentThe muscle concentration of interleukin-1 beta will be measured before and after two weeks of treatment with supplement or placebo.
Change in Muscle Concentration of Interleukin-1 Beta (Pre- to Post-acute Exercise)change from baseline at 2 weeks of treatmentThe change in the muscle concentration of interleukin-1 beta before and one hour after a single bout of resistance exercise. The changes in macrophage numbers before and after two weeks of treatment with supplement or placebo will be compared.
Change in Resting Muscle Atrophy Gene MURF Expressionpercent change from baseline at 2 weeks of treatmentThe change in resting muscle atrophy gene MURF expression will be measured before and after two weeks of treatment with supplement or placebo.
Change in Resting Muscle Atrophy Gene MURF Expression (Post-acute Exercise)change from baseline at 2 weeks of treatmentThe change in resting muscle atrophy gene MURF expression will be measured before and 72 hours after a single bout of exercise completed before and after two weeks of treatment with supplement or placebo.
Change in Resting Muscle Protein Kinase Bchange from baseline at 2 weeks of treatmentThe change in resting muscle Protein Kinase B will be measured before and after two weeks of treatment with supplement or placebo.
Change in Muscle Protein Kinase B (Post-acute Exercise)change from baseline at 2 weeks of treatmentThe change in muscle Protein Kinase B will be measured before and 72 hours after a single bout of exercise completed before and after two weeks of treatment with supplement or placebo.
Change in Number of Muscle Satellite Cells After Exercise Training for 12 Weekschange from baseline at completion of exercise training (12 weeks)The change in the satellite cell content of muscle will be measured as the difference in the number of satellite cells in muscle before and after completion of the exercise training program.
Change in Number of Myonuclei After Exercise Training for 12 Weekschange from baseline at completion of exercise training (12 weeks)The change in the myonuclear content of muscle will be measured as the difference in the number of myonuclei in muscle before and after completion of the exercise training program.
Change in Plasma Concentration of Antibodies to Tetanus Antigen (1 Week Post-vaccine)change from baseline at 1 week post-vaccineThe change in plasma antibody concentration for response to the tetanus antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and one week post-vaccination.
Change in Plasma Concentration of Antibodies to Tetanus Antigen (2 Weeks Post-vaccine)change from baseline at 2 weeks post-vaccineThe change in plasma antibody concentration for response to the tetanus antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and two weeks post-vaccination.
Change in Plasma Concentration of Antibodies to Diptheria Antigen (1 Week Post-vaccine)change from baseline at 1 week post-vaccineThe change in plasma antibody concentration for response to the diptheria antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and one week post-vaccination.
Change in Plasma Concentration of Antibodies to Diptheria Antigen (2 Weeks Post-vaccine)change from baseline at 2 weeks post-vaccineThe change in plasma antibody concentration for response to the diptheria antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and two weeks post-vaccination.
Number of Muscle Macrophages Per Myofiber (Resting)change from baseline at 2 weeks of treatmentThe number of muscle macrophages per myofiber will be counted for resting muscle collected before and after two weeks of treatment with supplement or placebo.
Change in Muscle Size After Exercise Training for 12 Weekschange from baseline at completion of exercise training phase (12 weeks)The change in size of the thigh muscle group after exercise training will be measured as the difference in cross-sectional area based on CT scan before and after completion of the exercise training program.
Change in Muscle Strength at Week 16 of the Post-Training Perioddifference between baseline and time point one of de-training follow-up period (week 16)The change in muscle strength (one-repetition maximum for knee extension) after completion of the exercise training program will be measured during a follow-up period lacking exercise.
Change in Balance After Exercise Training for 12 Weekschange from baseline at completion of exercise training (12 weeks)The change in balance ability after exercise training will be measured as the difference in Berg Balance Scale (Min 0, Max 56, Higher is Better) score between before and after completion of the exercise training program.
Change in Balance During the Post-Training Period at 26 Weeks of the Post-training Perioddifference between time of training completion and time point two of de-training follow-up period (26 weeks)The change in balance based on the Berg Balance Scale (Min 0, Max 56, Higher is Better) score will be measured during a follow-up period lacking exercise after completion of the exercise training program.
Change in Balance at Week 16 of the Post-Training Perioddifference between time of training completion and time point one of de-training follow-up period (week 16)The change in balance based on the Berg Balance Scale (Min 0, Max 56, Higher is Better) score will be measured during a follow-up period lacking exercise after completion of the exercise training program.
Change in Walking Ability After Exercise Training for 12 Weekschange from baseline at completion of exercise training (12 weeks)The change in walking ability after exercise training will be measured using the six minute walk test, i.e. the distance the participant can walk without shortness of breath in six minutes.
Change in Walking Ability at Week 16 of the Post-Training Perioddifference between end of training and time point one of de-training follow-up period (week 16)The change in walking ability based on the six-minute walk test will be measured during a follow-up period lacking exercise after completion of the exercise training program.
Change in Walking Ability at Week 26 of the Post-Training Perioddifference between end of training and time point two of de-training follow-up period (week 26)The change in walking ability based on the six-minute walk test will be measured during a follow-up period lacking exercise after completion of the exercise training program.
Change in Gait Speed After Exercise Training for 12 Weekschange from baseline at completion of exercise training (12 weeks)The change in gait speed ability after exercise training will be measured as the difference in habitual walking speed for 10 meters before and after completion of the exercise training program.
Change in Gait Speed at Week 16 of the Post-Training Perioddifference between after training and time point one of de-training follow-up period (week 16)The change in habitual walking speed over 10 meters will be measured as the difference between values at the end of the training program and time points during a follow-up period lacking exercise.
Change in Gait Speed During at Week 26 of the Post-Training Perioddifference between after training and time point two of de-training follow-up period (week 26)The change in habitual walking speed over 10 meters will be measured as the difference between values at the end of the training program and time points during a follow-up period lacking exercise.
Change in Muscle Size at Week 26 of the Post-Training Perioddifference between baseline and time point two of de-training follow-up period (week 26)The change in size of the thigh muscle group during the post-training period will be measured as the difference in cross-sectional area based on CT scan at the end of the training program and at the end of study participation.
Change in Timed Up and Go After Exercise Training for 12 Weekschange from baseline at completion of exercise training (12 weeks)The change in time required to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down will be measured as the difference between before and after completion of the exercise training program.

Other

MeasureTime frameDescription
Change in Muscle Strength at Week 26 of the Post-Training Perioddifference between baseline and time point two of de-training follow-up period (week 26)The change in muscle strength (one-repetition maximum for knee extension) after completion of the exercise training program will be measured during a follow-up period lacking exercise.
Plasma Concentration of Aspartate AminotransferasebaselinePlasma aspartate aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.
Plasma Concentration of Alanine AminotransferasebaselinePlasma Alanine Aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.
Ratio of Plasma Concentrations of Blood Urea Nitrogen to CreatininebaselinePlasma blood urea nitrogen and creatinine will be measured as a safety indicator of kidney function at baseline, after completion of the exercise training program, and at the end of the study.
Plasma Concentration of Alanine Aminotransferase After 42 Weeks of Product Consumptionend of study (42 weeks)Plasma Alanine Aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.
Plasma Concentration of Aspartate Aminotransferase After 42 Weeks of Product Consumptionend of study (42 weeks)Plasma aspartate aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.
Ratio of Plasma Concentrations of Blood Urea Nitrogen to Creatinine After Product Consumption for 15 Weekscompletion of the exercise training program (15 weeks)Plasma blood urea nitrogen and creatinine will be measured as a safety indicator of kidney function at baseline, after completion of the exercise training program, and at the end of the study.
Plasma Concentration of Alanine Aminotransferase After Product Consumption for 15 Weekscompletion of the exercise training program (15 weeks)Plasma Alanine Aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.
Plasma Concentration of Aspartate Aminotransferase After Product Consumption for 15 Weeksat completion of the exercise training program (15 weeks)Plasma aspartate aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.
Ratio of Plasma Concentrations of Blood Urea Nitrogen to Creatinine After 42 Weeks of Product Consumptionend of study (42 weeks)Plasma blood urea nitrogen and creatinine will be measured as a safety indicator of kidney function at baseline, after completion of the exercise training program, and at the end of the study.

Countries

United States

Participant flow

Recruitment details

59 consented but only 44 randomized due to 15 either being excluded or withdrawal prior to randomization

Participants by arm

ArmCount
Nutritional Supplement
Subjects in the supplement group will consume orange-flavored Muscle Armor according to the manufacturer's directions: one serving (approximately 30g, i.e. one scoop provided with the product by its manufacturer), twice daily mixed with 12 ounces (oz) of water beginning after all baseline assessments are performed including assessment of the response to acute exercise and continuing until the end of study participation. TDAP: Both arms will receive the tetanus, diptheria, and pertussis vaccination after two weeks of treatment with supplement or placebo Acute Resistance Exercise: Both arms will receive a single bout of resistance exercise twice, before and after two weeks of treatment with supplement or placebo, and be evaluated for the response within blood and muscle Resistance Exercise Training: Both arms will receive 36 sessions of progressive high-intensity resistance exercise training (thigh muscle) over the course of approx 12 wks and undergo a post-training Follow-up
13
Placebo
Subjects in the placebo group will consume orange-flavored Kool-Aid (Kraft Foods) according to the manufacturer's directions: one serving (approx 13g, i.e. one scoop provided with the product by the pharmacy), twice daily mixed with 12 ounces (oz) of water beginning after all baseline assessments are performed including assessment of the response to acute exercise and continuing until the end of study participation. TDAP: Both arms will receive the tetanus, diptheria, and pertussis vaccination after two weeks of treatment with supplement or placebo Acute Resistance Exercise: Both arms will receive a single bout of resistance exercise twice, before and after two weeks of treatment with supplement or placebo, and be evaluated for the response within blood and muscle Resistance Exercise Training: Both arms will receive 36 sessions of progressive high-intensity resistance exercise training (thigh muscle) over the course of approx 12 wks and undergo a Post-training Follow-up
20
Total33

Baseline characteristics

CharacteristicNutritional SupplementPlaceboTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
11 Participants16 Participants27 Participants
Age, Categorical
Between 18 and 65 years
2 Participants4 Participants6 Participants
Age, Continuous69.3 years
STANDARD_DEVIATION 4.8
69.1 years
STANDARD_DEVIATION 5
69.2 years
STANDARD_DEVIATION 4.8
Diptheria Antibody Levels0.6 units per ml
STANDARD_DEVIATION 0.7
0.7 units per ml
STANDARD_DEVIATION 1
0.7 units per ml
STANDARD_DEVIATION 0.8
Knee Curl135.7 pounds
STANDARD_DEVIATION 37.1
128.2 pounds
STANDARD_DEVIATION 26.5
130.9 pounds
STANDARD_DEVIATION 30.7
Knee Extension136.7 pounds
STANDARD_DEVIATION 37.1
132.3 pounds
STANDARD_DEVIATION 37.9
134.0 pounds
STANDARD_DEVIATION 37.1
Leg Press486.7 pounds
STANDARD_DEVIATION 112.1
519.3 pounds
STANDARD_DEVIATION 130.6
499.5 pounds
STANDARD_DEVIATION 118.8
Muscle Size144.5 centimeters squared
STANDARD_DEVIATION 22.2
139.1 centimeters squared
STANDARD_DEVIATION 21
141.2 centimeters squared
STANDARD_DEVIATION 21.3
Pertussis Antibody Levels48.8 units per ml
STANDARD_DEVIATION 32.9
59.7 units per ml
STANDARD_DEVIATION 41.2
55.4 units per ml
STANDARD_DEVIATION 38
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
4 Participants5 Participants9 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
9 Participants15 Participants24 Participants
Region of Enrollment
United States
13 Participants20 Participants33 Participants
Sex: Female, Male
Female
1 Participants1 Participants2 Participants
Sex: Female, Male
Male
12 Participants19 Participants31 Participants
Tetanus Antibody Levels4.3 units per ml
STANDARD_DEVIATION 2.1
3.7 units per ml
STANDARD_DEVIATION 2.5
3.9 units per ml
STANDARD_DEVIATION 2.3

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
deaths
Total, all-cause mortality
0 / 220 / 22
other
Total, other adverse events
11 / 2216 / 22
serious
Total, serious adverse events
4 / 227 / 22

Outcome results

Primary

Change in Muscle Strength After Exercise Training for 12 Weeks

The change in muscle strength after exercise training will be measured as the difference in one-repetition maximum capability for knee extension from before and after completion of the exercise training program.

Time frame: change from baseline at completion of exercise training phase (12 weeks)

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Muscle Strength After Exercise Training for 12 Weeks195.4 poundsStandard Deviation 54.4
PlaceboChange in Muscle Strength After Exercise Training for 12 Weeks182.9 poundsStandard Deviation 45.7
p-value: >0.05ANCOVA
Primary

Change in Plasma Concentration of Antibodies to Pertussis Antigen (1 Week Post-vaccine)

The change in plasma antibody concentration for response to the pertussis antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and one week post-vaccination.

Time frame: change from baseline at 1 week post-vaccine

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Plasma Concentration of Antibodies to Pertussis Antigen (1 Week Post-vaccine)63.1 units per mlStandard Deviation 39.7
PlaceboChange in Plasma Concentration of Antibodies to Pertussis Antigen (1 Week Post-vaccine)63.2 units per mlStandard Deviation 40.7
p-value: >0.05ANCOVA
Primary

Change in Plasma Concentration of Antibodies to Pertussis Antigen (2 Weeks Post-vaccine)

The change in plasma antibody concentration for response to the pertussis antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and two weeks post-vaccination.

Time frame: change from baseline at 2 weeks post-vaccine

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Plasma Concentration of Antibodies to Pertussis Antigen (2 Weeks Post-vaccine)159.2 units per mlStandard Deviation 130.7
PlaceboChange in Plasma Concentration of Antibodies to Pertussis Antigen (2 Weeks Post-vaccine)216.7 units per mlStandard Deviation 240.1
p-value: >0.05ANCOVA
Primary

Change in Plasma Concentration of C-Reactive Protein

Plasma c-reactive protein will be measured before and after two weeks of treatment with supplement or placebo.

Time frame: change from baseline at 2 weeks of treatment

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Plasma Concentration of C-Reactive Protein0.34 mg/LStandard Deviation 1.52
PlaceboChange in Plasma Concentration of C-Reactive Protein-3.96 mg/LStandard Deviation 10.05
Primary

Change in the Number of Muscle Macrophages Per Myofiber (Pre- to Post-acute Exercise)

The change in the number of muscle macrophages per myofiber will be calculated for muscle collected before and 72 hours after a single bout of resistance exercise. The changes in macrophage numbers before and after two weeks of treatment with supplement or placebo will be compared.

Time frame: change from baseline at 2 weeks of treatment

Population: The overall number of participants analyzed was less than the total number of participants due to insufficient specimen.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in the Number of Muscle Macrophages Per Myofiber (Pre- to Post-acute Exercise)16.01 percent changeStandard Deviation 49.36
PlaceboChange in the Number of Muscle Macrophages Per Myofiber (Pre- to Post-acute Exercise)-8.54 percent changeStandard Deviation 25.7
Secondary

Change in Balance After Exercise Training for 12 Weeks

The change in balance ability after exercise training will be measured as the difference in Berg Balance Scale (Min 0, Max 56, Higher is Better) score between before and after completion of the exercise training program.

Time frame: change from baseline at completion of exercise training (12 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Balance After Exercise Training for 12 Weeks0.54 score on a scaleStandard Deviation 1.27
PlaceboChange in Balance After Exercise Training for 12 Weeks0.79 score on a scaleStandard Deviation 1.23
Secondary

Change in Balance at Week 16 of the Post-Training Period

The change in balance based on the Berg Balance Scale (Min 0, Max 56, Higher is Better) score will be measured during a follow-up period lacking exercise after completion of the exercise training program.

Time frame: difference between time of training completion and time point one of de-training follow-up period (week 16)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Balance at Week 16 of the Post-Training Period-0.08 score on a scaleStandard Deviation 0.49
PlaceboChange in Balance at Week 16 of the Post-Training Period0.11 score on a scaleStandard Deviation 0.32
Secondary

Change in Balance During the Post-Training Period at 26 Weeks of the Post-training Period

The change in balance based on the Berg Balance Scale (Min 0, Max 56, Higher is Better) score will be measured during a follow-up period lacking exercise after completion of the exercise training program.

Time frame: difference between time of training completion and time point two of de-training follow-up period (26 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Balance During the Post-Training Period at 26 Weeks of the Post-training Period0.08 score on a scaleStandard Deviation 0.49
PlaceboChange in Balance During the Post-Training Period at 26 Weeks of the Post-training Period0.05 score on a scaleStandard Deviation 1.27
Secondary

Change in Gait Speed After Exercise Training for 12 Weeks

The change in gait speed ability after exercise training will be measured as the difference in habitual walking speed for 10 meters before and after completion of the exercise training program.

Time frame: change from baseline at completion of exercise training (12 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Gait Speed After Exercise Training for 12 Weeks0.04 meters per secondStandard Deviation 0.11
PlaceboChange in Gait Speed After Exercise Training for 12 Weeks0.05 meters per secondStandard Deviation 0.14
Secondary

Change in Gait Speed at Week 16 of the Post-Training Period

The change in habitual walking speed over 10 meters will be measured as the difference between values at the end of the training program and time points during a follow-up period lacking exercise.

Time frame: difference between after training and time point one of de-training follow-up period (week 16)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Gait Speed at Week 16 of the Post-Training Period-0.02 meters per secondStandard Deviation 0.1
PlaceboChange in Gait Speed at Week 16 of the Post-Training Period-0.03 meters per secondStandard Deviation 0.14
Secondary

Change in Gait Speed During at Week 26 of the Post-Training Period

The change in habitual walking speed over 10 meters will be measured as the difference between values at the end of the training program and time points during a follow-up period lacking exercise.

Time frame: difference between after training and time point two of de-training follow-up period (week 26)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Gait Speed During at Week 26 of the Post-Training Period0.04 meters per secondStandard Deviation 0.13
PlaceboChange in Gait Speed During at Week 26 of the Post-Training Period0.03 meters per secondStandard Deviation 0.14
Secondary

Change in Muscle Concentration of Interleukin-1 Beta (Pre- to Post-acute Exercise)

The change in the muscle concentration of interleukin-1 beta before and one hour after a single bout of resistance exercise. The changes in macrophage numbers before and after two weeks of treatment with supplement or placebo will be compared.

Time frame: change from baseline at 2 weeks of treatment

Population: The overall number of participants analyzed was less than the total number of participants due to insufficient specimen.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Muscle Concentration of Interleukin-1 Beta (Pre- to Post-acute Exercise)110.52 percent changeStandard Deviation 424.92
PlaceboChange in Muscle Concentration of Interleukin-1 Beta (Pre- to Post-acute Exercise)-89.70 percent changeStandard Deviation 2744.35
Secondary

Change in Muscle Fiber Size After Exercise Training for 12 Weeks

The change in the muscle fiber size will be measured as the difference in fiber size before and after completion of the exercise training program.

Time frame: change from baseline at completion of exercise training (12 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to insufficient specimen.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Muscle Fiber Size After Exercise Training for 12 Weeks35.26 percent changeStandard Deviation 51.59
PlaceboChange in Muscle Fiber Size After Exercise Training for 12 Weeks47.28 percent changeStandard Deviation 54.87
Secondary

Change in Muscle Protein Kinase B (Post-acute Exercise)

The change in muscle Protein Kinase B will be measured before and 72 hours after a single bout of exercise completed before and after two weeks of treatment with supplement or placebo.

Time frame: change from baseline at 2 weeks of treatment

Population: The overall number of participants analyzed was less than the total number of participants due to insufficient specimen.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Muscle Protein Kinase B (Post-acute Exercise)-27.24 percent changeStandard Deviation 127.78
PlaceboChange in Muscle Protein Kinase B (Post-acute Exercise)9.48 percent changeStandard Deviation 85.32
Secondary

Change in Muscle Size After Exercise Training for 12 Weeks

The change in size of the thigh muscle group after exercise training will be measured as the difference in cross-sectional area based on CT scan before and after completion of the exercise training program.

Time frame: change from baseline at completion of exercise training phase (12 weeks)

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Muscle Size After Exercise Training for 12 Weeks155.8 centimeters squaredStandard Deviation 24.1
PlaceboChange in Muscle Size After Exercise Training for 12 Weeks146.4 centimeters squaredStandard Deviation 22.6
p-value: >0.05ANCOVA
Secondary

Change in Muscle Size at Week 26 of the Post-Training Period

The change in size of the thigh muscle group during the post-training period will be measured as the difference in cross-sectional area based on CT scan at the end of the training program and at the end of study participation.

Time frame: difference between baseline and time point two of de-training follow-up period (week 26)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Muscle Size at Week 26 of the Post-Training Period143.6 centimeters squaredStandard Deviation 24.4
PlaceboChange in Muscle Size at Week 26 of the Post-Training Period140.5 centimeters squaredStandard Deviation 19.9
p-value: >0.05ANCOVA
Secondary

Change in Muscle Strength at Week 16 of the Post-Training Period

The change in muscle strength (one-repetition maximum for knee extension) after completion of the exercise training program will be measured during a follow-up period lacking exercise.

Time frame: difference between baseline and time point one of de-training follow-up period (week 16)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Muscle Strength at Week 16 of the Post-Training Period175.5 poundsStandard Deviation 50
PlaceboChange in Muscle Strength at Week 16 of the Post-Training Period162.9 poundsStandard Deviation 34.5
p-value: >0.05ANCOVA
Secondary

Change in Number of Muscle Satellite Cells After Exercise Training for 12 Weeks

The change in the satellite cell content of muscle will be measured as the difference in the number of satellite cells in muscle before and after completion of the exercise training program.

Time frame: change from baseline at completion of exercise training (12 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to insufficient specimen.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Number of Muscle Satellite Cells After Exercise Training for 12 Weeks18.24 percent changeStandard Deviation 48.93
PlaceboChange in Number of Muscle Satellite Cells After Exercise Training for 12 Weeks9.96 percent changeStandard Deviation 40.72
Secondary

Change in Number of Myonuclei After Exercise Training for 12 Weeks

The change in the myonuclear content of muscle will be measured as the difference in the number of myonuclei in muscle before and after completion of the exercise training program.

Time frame: change from baseline at completion of exercise training (12 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to insufficient specimen.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Number of Myonuclei After Exercise Training for 12 Weeks6.88 percent changeStandard Deviation 36.99
PlaceboChange in Number of Myonuclei After Exercise Training for 12 Weeks20.28 percent changeStandard Deviation 27.65
Secondary

Change in Plasma Concentration of Antibodies to Diptheria Antigen (1 Week Post-vaccine)

The change in plasma antibody concentration for response to the diptheria antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and one week post-vaccination.

Time frame: change from baseline at 1 week post-vaccine

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Plasma Concentration of Antibodies to Diptheria Antigen (1 Week Post-vaccine)1.1 units per mlStandard Deviation 1.2
PlaceboChange in Plasma Concentration of Antibodies to Diptheria Antigen (1 Week Post-vaccine)1.1 units per mlStandard Deviation 1.4
p-value: >0.05ANCOVA
Secondary

Change in Plasma Concentration of Antibodies to Diptheria Antigen (2 Weeks Post-vaccine)

The change in plasma antibody concentration for response to the diptheria antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and two weeks post-vaccination.

Time frame: change from baseline at 2 weeks post-vaccine

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Plasma Concentration of Antibodies to Diptheria Antigen (2 Weeks Post-vaccine)2.1 units per mlStandard Deviation 1.6
PlaceboChange in Plasma Concentration of Antibodies to Diptheria Antigen (2 Weeks Post-vaccine)1.7 units per mlStandard Deviation 1.5
Comparison: Outcomes were compared as percent change from the baseline measure using multiple methods by a blinded statistician. Differences between groups were assessed using ANCOVA, Welch's t-test, and Wilcoxon. No significant differences were found between groups for any outcome regardless of method used.p-value: >0.05ANCOVA
Secondary

Change in Plasma Concentration of Antibodies to Tetanus Antigen (1 Week Post-vaccine)

The change in plasma antibody concentration for response to the tetanus antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and one week post-vaccination.

Time frame: change from baseline at 1 week post-vaccine

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Plasma Concentration of Antibodies to Tetanus Antigen (1 Week Post-vaccine)5.6 units per mlStandard Deviation 2.4
PlaceboChange in Plasma Concentration of Antibodies to Tetanus Antigen (1 Week Post-vaccine)4.1 units per mlStandard Deviation 2.6
p-value: >0.05ANCOVA
Secondary

Change in Plasma Concentration of Antibodies to Tetanus Antigen (2 Weeks Post-vaccine)

The change in plasma antibody concentration for response to the tetanus antigen within the tetanus, diphtheria, and pertussis (TDAP) vaccination will be measured between baseline and two weeks post-vaccination.

Time frame: change from baseline at 2 weeks post-vaccine

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Plasma Concentration of Antibodies to Tetanus Antigen (2 Weeks Post-vaccine)8.6 units per mlStandard Deviation 3.7
PlaceboChange in Plasma Concentration of Antibodies to Tetanus Antigen (2 Weeks Post-vaccine)8.2 units per mlStandard Deviation 5.1
p-value: >0.05ANCOVA
Secondary

Change in Resting Muscle Atrophy Gene MURF Expression

The change in resting muscle atrophy gene MURF expression will be measured before and after two weeks of treatment with supplement or placebo.

Time frame: percent change from baseline at 2 weeks of treatment

Population: The overall number of participants analyzed was less than the total number of participants due to insufficient specimen.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Resting Muscle Atrophy Gene MURF Expression20.98 percent changeStandard Deviation 99.61
PlaceboChange in Resting Muscle Atrophy Gene MURF Expression148.17 percent changeStandard Deviation 325.87
Secondary

Change in Resting Muscle Atrophy Gene MURF Expression (Post-acute Exercise)

The change in resting muscle atrophy gene MURF expression will be measured before and 72 hours after a single bout of exercise completed before and after two weeks of treatment with supplement or placebo.

Time frame: change from baseline at 2 weeks of treatment

Population: The overall number of participants analyzed was less than the total number of participants due to insufficient specimen.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Resting Muscle Atrophy Gene MURF Expression (Post-acute Exercise)38.69 percent changeStandard Deviation 224.53
PlaceboChange in Resting Muscle Atrophy Gene MURF Expression (Post-acute Exercise)-76.98 percent changeStandard Deviation 423.64
Secondary

Change in Resting Muscle Protein Kinase B

The change in resting muscle Protein Kinase B will be measured before and after two weeks of treatment with supplement or placebo.

Time frame: change from baseline at 2 weeks of treatment

Population: The overall number of participants analyzed was less than the total number of participants due to insufficient specimen.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Resting Muscle Protein Kinase B78.15 percent changeStandard Deviation 187.21
PlaceboChange in Resting Muscle Protein Kinase B51.24 percent changeStandard Deviation 112.35
Secondary

Change in Timed Up and Go After Exercise Training for 12 Weeks

The change in time required to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down will be measured as the difference between before and after completion of the exercise training program.

Time frame: change from baseline at completion of exercise training (12 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Timed Up and Go After Exercise Training for 12 Weeks-0.22 secondsStandard Deviation 0.65
PlaceboChange in Timed Up and Go After Exercise Training for 12 Weeks-0.26 secondsStandard Deviation 0.71
Secondary

Change in Timed Up and Go at Week 16 of the Post-Training Period

The change in time required to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down will be measured as the difference between time points at the end of the training program and during the post-training period.

Time frame: difference between after training and time point one of de-training follow-up period (week 16)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Timed Up and Go at Week 16 of the Post-Training Period0.33 secondsStandard Deviation 1.12
PlaceboChange in Timed Up and Go at Week 16 of the Post-Training Period0.18 secondsStandard Deviation 0.77
Secondary

Change in Timed Up and Go at Week 26 of the Post-Training Period

The change in time required to rise from a chair, walk three meters, turn around, walk back to the chair, and sit down will be measured as the difference between time points at the end of the training program and during the post-training period.

Time frame: difference between after training and time point two of de-training follow-up period (week 26)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Timed Up and Go at Week 26 of the Post-Training Period0.14 secondsStandard Deviation 1.18
PlaceboChange in Timed Up and Go at Week 26 of the Post-Training Period-0.15 secondsStandard Deviation 0.65
Secondary

Change in Walking Ability After Exercise Training for 12 Weeks

The change in walking ability after exercise training will be measured using the six minute walk test, i.e. the distance the participant can walk without shortness of breath in six minutes.

Time frame: change from baseline at completion of exercise training (12 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Walking Ability After Exercise Training for 12 Weeks18.03 metersStandard Deviation 31.74
PlaceboChange in Walking Ability After Exercise Training for 12 Weeks22.25 metersStandard Deviation 40.91
Secondary

Change in Walking Ability at Week 16 of the Post-Training Period

The change in walking ability based on the six-minute walk test will be measured during a follow-up period lacking exercise after completion of the exercise training program.

Time frame: difference between end of training and time point one of de-training follow-up period (week 16)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Walking Ability at Week 16 of the Post-Training Period-13.62 metersStandard Deviation 38.91
PlaceboChange in Walking Ability at Week 16 of the Post-Training Period-29.02 metersStandard Deviation 55.89
Secondary

Change in Walking Ability at Week 26 of the Post-Training Period

The change in walking ability based on the six-minute walk test will be measured during a follow-up period lacking exercise after completion of the exercise training program.

Time frame: difference between end of training and time point two of de-training follow-up period (week 26)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Walking Ability at Week 26 of the Post-Training Period1.34 metersStandard Deviation 38.24
PlaceboChange in Walking Ability at Week 26 of the Post-Training Period-20.85 metersStandard Deviation 52.33
Secondary

Number of Muscle Macrophages Per Myofiber (Resting)

The number of muscle macrophages per myofiber will be counted for resting muscle collected before and after two weeks of treatment with supplement or placebo.

Time frame: change from baseline at 2 weeks of treatment

Population: The overall number of participants analyzed was less than the total number of participants due to insufficient specimen.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementNumber of Muscle Macrophages Per Myofiber (Resting)6.89 percent changeStandard Deviation 21.99
PlaceboNumber of Muscle Macrophages Per Myofiber (Resting)42.42 percent changeStandard Deviation 51.74
Secondary

Percent Change in Resting Muscle Concentration of Interleukin-1 Beta

The muscle concentration of interleukin-1 beta will be measured before and after two weeks of treatment with supplement or placebo.

Time frame: change from baseline at 2 weeks of treatment

Population: The overall number of participants analyzed was less than the total number of participants due to insufficient specimen.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementPercent Change in Resting Muscle Concentration of Interleukin-1 Beta58.00 percent changeStandard Deviation 172.57
PlaceboPercent Change in Resting Muscle Concentration of Interleukin-1 Beta40.93 percent changeStandard Deviation 148.8
Other Pre-specified

Change in Muscle Strength at Week 26 of the Post-Training Period

The change in muscle strength (one-repetition maximum for knee extension) after completion of the exercise training program will be measured during a follow-up period lacking exercise.

Time frame: difference between baseline and time point two of de-training follow-up period (week 26)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementChange in Muscle Strength at Week 26 of the Post-Training Period171.2 poundsStandard Deviation 50.6
PlaceboChange in Muscle Strength at Week 26 of the Post-Training Period165.0 poundsStandard Deviation 36.3
p-value: >0.05ANCOVA
Other Pre-specified

Plasma Concentration of Alanine Aminotransferase

Plasma Alanine Aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.

Time frame: baseline

Population: The overall number of participants analyzed was less than the total number of participants due to clinical lab error.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementPlasma Concentration of Alanine Aminotransferase21.54 Units/LStandard Deviation 6.24
PlaceboPlasma Concentration of Alanine Aminotransferase27.42 Units/LStandard Deviation 16.68
Other Pre-specified

Plasma Concentration of Alanine Aminotransferase After 42 Weeks of Product Consumption

Plasma Alanine Aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.

Time frame: end of study (42 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementPlasma Concentration of Alanine Aminotransferase After 42 Weeks of Product Consumption22.38 Units/LStandard Deviation 8.49
PlaceboPlasma Concentration of Alanine Aminotransferase After 42 Weeks of Product Consumption25.32 Units/LStandard Deviation 10.11
Other Pre-specified

Plasma Concentration of Alanine Aminotransferase After Product Consumption for 15 Weeks

Plasma Alanine Aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.

Time frame: completion of the exercise training program (15 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to a clinical lab error and a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementPlasma Concentration of Alanine Aminotransferase After Product Consumption for 15 Weeks24.83 Units/LStandard Deviation 13.9
PlaceboPlasma Concentration of Alanine Aminotransferase After Product Consumption for 15 Weeks24.53 Units/LStandard Deviation 13.21
Other Pre-specified

Plasma Concentration of Aspartate Aminotransferase

Plasma aspartate aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.

Time frame: baseline

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementPlasma Concentration of Aspartate Aminotransferase26.62 Units/LStandard Deviation 7.52
PlaceboPlasma Concentration of Aspartate Aminotransferase27.55 Units/LStandard Deviation 10.97
Other Pre-specified

Plasma Concentration of Aspartate Aminotransferase After 42 Weeks of Product Consumption

Plasma aspartate aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.

Time frame: end of study (42 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementPlasma Concentration of Aspartate Aminotransferase After 42 Weeks of Product Consumption28.31 Units/LStandard Deviation 8.83
PlaceboPlasma Concentration of Aspartate Aminotransferase After 42 Weeks of Product Consumption27.16 Units/LStandard Deviation 9.5
Other Pre-specified

Plasma Concentration of Aspartate Aminotransferase After Product Consumption for 15 Weeks

Plasma aspartate aminotransferase will be measured as a safety indicator of liver function at baseline, after completion of the exercise training program, and at the end of the study.

Time frame: at completion of the exercise training program (15 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to a clinical lab error and a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementPlasma Concentration of Aspartate Aminotransferase After Product Consumption for 15 Weeks29.25 Units/LStandard Deviation 7.79
PlaceboPlasma Concentration of Aspartate Aminotransferase After Product Consumption for 15 Weeks26.37 Units/LStandard Deviation 7.78
Other Pre-specified

Ratio of Plasma Concentrations of Blood Urea Nitrogen to Creatinine

Plasma blood urea nitrogen and creatinine will be measured as a safety indicator of kidney function at baseline, after completion of the exercise training program, and at the end of the study.

Time frame: baseline

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementRatio of Plasma Concentrations of Blood Urea Nitrogen to Creatinine14.06 ratioStandard Deviation 3.75
PlaceboRatio of Plasma Concentrations of Blood Urea Nitrogen to Creatinine14.52 ratioStandard Deviation 5.18
Other Pre-specified

Ratio of Plasma Concentrations of Blood Urea Nitrogen to Creatinine After 42 Weeks of Product Consumption

Plasma blood urea nitrogen and creatinine will be measured as a safety indicator of kidney function at baseline, after completion of the exercise training program, and at the end of the study.

Time frame: end of study (42 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementRatio of Plasma Concentrations of Blood Urea Nitrogen to Creatinine After 42 Weeks of Product Consumption20.98 ratioStandard Deviation 9.1
PlaceboRatio of Plasma Concentrations of Blood Urea Nitrogen to Creatinine After 42 Weeks of Product Consumption14.44 ratioStandard Deviation 4.95
Other Pre-specified

Ratio of Plasma Concentrations of Blood Urea Nitrogen to Creatinine After Product Consumption for 15 Weeks

Plasma blood urea nitrogen and creatinine will be measured as a safety indicator of kidney function at baseline, after completion of the exercise training program, and at the end of the study.

Time frame: completion of the exercise training program (15 weeks)

Population: The overall number of participants analyzed was less than the total number of participants due to a clinical lab error and a participant not completing entire study.

ArmMeasureValue (MEAN)Dispersion
Nutritional SupplementRatio of Plasma Concentrations of Blood Urea Nitrogen to Creatinine After Product Consumption for 15 Weeks20.40 ratioStandard Deviation 5.22
PlaceboRatio of Plasma Concentrations of Blood Urea Nitrogen to Creatinine After Product Consumption for 15 Weeks13.35 ratioStandard Deviation 3.98

Source: ClinicalTrials.gov · Data processed: Mar 5, 2026