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Background  Increasing protein intake (above the Recommended Dietary Amount) alone or with resistance‐based exercise is suggested to improve cardiometabolic health; however, randomized controlled trials (RCTs) are needed to confirm this.    Methods  The Liverpool Hope University‐Sarcopenia Aging Trial (LHU‐SAT) was a 16 week RCT ( ClinicalTrials.gov  Identifier: NCT02912130) of 100 community‐dwelling older adults [mean age: 68.73 ± 5.80 years, body mass index: 27.06 ± 5.18 kg/m 2  (52% women)] who were randomized to four independent groups [Control (C), Exercise (E), Exercise + Protein (EP), Protein (P)]. E and EP completed supervised and progressive resistance‐based exercise (resistance exercise: two times per week, functional circuit exercise: once per week), while EP and P were supplemented with a leucine‐enriched whey protein drink (three times per day) based on individual body weight (0.50 g/kg/meal, 1.50 g/kg/day). Outcome measures including arterial stiffness (pulse wave velocity), fasting plasma/serum biomarkers [glucose/glycated haemoglobin, total cholesterol, low‐density lipoprotein (LDL), high‐density lipoprotein, insulin, resistin, leptin, adiponectin, C‐reactive protein, tumour necrosis factor‐alpha, interleukin‐6, cystatin‐C, & ferritin], insulin resistance (HOMA‐IR), and kidney function (eGFR) were measured before and after intervention.    Results  Total protein intake (habitual diet plus supplementation) increased to 1.55 ± 0.69 g/kg/day in EP and to 1.93 ± 0.72 g/kg/day in P, and remained significantly lower ( P  < 0.001) in unsupplemented groups (E: 1.08 ± 0.33 g/kg/day, C: 1.00 ± 0.26 g/kg/day). At 16 weeks, there was a group‐by‐time interaction whereby absolute changes in LDL‐cholesterol were lower in EP [mean difference: −0.79 mmol/L, 95% confidence interval (CI): −1.29, −0.28,  P  = 0.002] and P (mean difference: −0.76 mmol/L, 95% CI: −1.26, −0.26,  P  = 0.003) vs. C. Serum insulin also showed group‐by‐time interactions at 16 weeks whereby fold changes were lower in EP (mean difference: −0.40, 95% CI: −0.65, −0.16,  P  = 0.001) and P (mean difference: −0.32, 95% CI: −0.56, −0.08,  P  = 0.009) vs. C, and fold changes in HOMA‐IR improved in EP (mean difference: −0.37, 95% CI: −0.64, −0.10,  P  = 0.007) and P (mean difference: −0.27, 95% CI: −0.53, −0.00,  P  = 0.048) vs. C. Serum resistin declined in P only (group‐by‐time interaction at 16 weeks:  P  = 0.009). No other interactions were observed in outcome measures ( P  > 0.05), and kidney function (eGFR) remained unaltered.    Conclusions  Sixteen weeks of leucine‐enriched whey protein supplementation alone and combined with resistance‐based exercise improved cardiometabolic health markers in older adults.

Leucine‐enriched whey protein supplementation, resistance‐based exercise, and cardiometabolic health in older adults: a randomized controlled trial