Active Snacking BeneVia 6.16 Ver 5 FINAL

8/8/2019 Active Snacking BeneVia 6.16 Ver 5 FINAL

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Nutritional Supplementation & Active SnackingNutritional Supplementation & Active Snacking

1

Presented by The HealthSpan Institute


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ObjectivesObjectives

Review the health risks in aging

Understand the important and unique role that

protein energy forms play in managing health

Recognize the differences in outcome betweennutrition supplementation vs. replacement

Evaluate the application of Active Snacking

Examine guidelines for therapeutic nutritionsupplementation

2


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Anorexia of

AgingSmell

OpioidsNPY

Nitric oxide

Taste

Testosterone

Adaptive

RelaxationLeptin

TNF

CholecystokininAntral stretch

occurs earlier

Decreased rate of

gastric emptying

Decreased

Food Intake

male > female

Vagus

E, et al.. Pharm, Biochem Behavior. 50(3):369-73, 1995

Fat

Mass

3

Physiological ChangesPhysiological Changes

Leading to Anorexia of AgingLeading to Anorexia of Aging


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0

500

1000

1500

2000

2500

3000

3500

20-29 30-39 40-49 50-59 60-69 70-79 80+

0

500

1000

1500

2000

20-29 30-39 40-49 50-59 60-69 70-79 80+

FEMALES

MALES

Calories

Decline in Food Intake Over Lifespan(NHANES)

Calories


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5

Optimal nutrition plays a key role in

slowing the loss of muscle mass andfunction with aging


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Muscle Mass decreases result in over a 100% increase in fat

Mass by the time we reach 70yrs vs when we were 25yrs old.

Loss of Muscle Mass : #1 Factor thatcomplicates our ability to Stay

Healthy


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7

Decreases in Skeletal Muscle MassDecreases in Skeletal Muscle Mass

With AgeWith Age

Age (years)Age (years)

Muscle

Size(mm

Muscle

Size (

mm

22))

1010 2020 3030 4040 5050 6060 7070 8080 909010001000

20002000

30003000

40004000

50005000


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Loss of Muscle Mass : How it happens through theLoss of Muscle Mass : How it happens through the

Sarcopenia processSarcopenia process


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10

The Conundrum of Aging andThe Conundrum of Aging and

the Role of Protein:the Role of Protein:

Decreased IntakeDecreased Intake

IncreasedIncreasedNeedNeed


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Optimal Protein IntakeOptimal Protein Intake

TypeType andandintakeintake of protein effect outcomeof protein effect outcome

Efficiency of protein utilization decreases with ageEfficiency of protein utilization decreases with age

Recd intake: ~1.5 g protein/kg body wt/dayRecd intake: ~1.5 g protein/kg body wt/day

~30% over 65 y/o consume~30% over 65 y/o consume lessless than 0.8 g protein/kgthan 0.8 g protein/kg

body wt/daybody wt/day

Layman. Nutrition and Metabolism 2009; 6: 12

www.barc.usda.gov/bhnrc/foodsurvey/home.htm
http://www.barc.usda.gov/bhnrc/foodsurvey/home.htmhttp://www.barc.usda.gov/bhnrc/foodsurvey/home.htm


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14

Solutions to Loss of Muscle MassSolutions to Loss of Muscle Mass

and Strengthand Strength

MUSCLE

MASS

Synthesis

Breakdown

Muscle

Growth

Nutrition

Exercise

Hormones

Insulinresistance

Inactivity

MuscleMuscle

LossLoss

Malnutrition


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15

Meal replacements vs Snacks vsMeal replacements vs Snacks vsSupplementsSupplements


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10g 15g 65g

30g 30g 30g

Daily Protein DistributionDaily Protein Distribution

Total Protein 90g

Typical Optimal

Total Protein 90g

Repeated maximal stimulation of protein synthesis

increase/maintenance of muscle mass

Anaboli s

m

Catabol ism

16

Six Critical Scientific Studies and Peer Reviewed Publications SupportSix Critical Scientific Studies and Peer Reviewed Publications Support


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Six Critical Scientific Studies and Peer Reviewed Publications SupportSix Critical Scientific Studies and Peer Reviewed Publications Support

The Need & Benefit of Superior Protein Sources with Leucine &The Need & Benefit of Superior Protein Sources with Leucine &

Essential Amino AcidsEssential Amino AcidsReference List and publications available at www.gobenevia.comReference List and publications available at www.gobenevia.com

StudyStudy TypeType FindingsFindings ProductProductPositionPosition

CompetitiveCompetitiveDifferenceDifference

Role of AminoAcids instimulation ofprotein synthesis

Humanexperimental

15-18g EAA aseffective as 40gintact protein

Proprietary blendand volumecontrol

Smaller volumewith greatereffect; non-milk

Response to16wk supplementof EAA

Human Control Significant gainsin functionalperformance

Effective andconvenient useof blend

Specific outcomeimprovements

Effect of Age onResponse to 7gEAA

HumanExperimentalControls

Specific needsand response ofaged vs youth

Age SpecificBenefit and Effect

Specializedblends for targetconsumer

Comparisons ofEAAs & Leucinevs other proteinsand products

Humanexperimental

Dose andcombination use

Optimalavailability

Superiorstimulation ofprotein synthesis

Relationship ofProtein

Metabolism andInflammatory

In Vivo andHuman

experimental

Omega-3 effecton inflammation

and proteinmetabolism

Control ofinflammation

Protein andInflammatory

control assynergistic


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An effective nutritionAn effective nutritionsupplement should stimulatesupplement should stimulate

muscle protein synthesismuscle protein synthesis


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Oral Nutritional SupplementsOral Nutritional Supplements

Improve OutcomesImprove Outcomes

Increases energy and protein intake Improves weight loss

Reduces complications (RR 0.71; 95% CI 0.61-0.82)

Reduces pressure ulcers (n=1224, OR 0.75; 0.62-0.82)

0 10 20 30 40 50

% with pressure ulcers

Control

ONS

19

Protein and energy supplementation in elderly people at risk from malnutrition Milne AC, Potter, J., Vivati A., Avenell, A.

June 2009 Cochrane Reports. John Wiley & Sons


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Response of Elderly toResponse of Elderly to

Meal Replacement vs. Supplement ofMeal Replacement vs. Supplement of

360 Kcal/16 g Protein360 Kcal/16 g Protein

Fiatarone et al. J Am Ger Soc 41: 333-7, 1993, NEJM, 1994

Normal Dietary Intake Total Caloric Intake

(meals + supplement)

20

Increase of only 20 kcal/day


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Stresses of Aging require HigherProtein Amounts and Better sources

of Protein

Not all Protein Sources have the same ability to build muscle mass and

strength. To overcome the resistance of aging, more potent forms of

protein is required that can help grow muscle mass and strength. (Exp

Geront. 2006; 41:215-219)

By 40, high levels of certain amino acids create the ability to improvemuscle strength as we age. This must include high levels of essential

amino acids and especially one called Leucine. (Am.J.Physiol 2006;

291:381)


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Not All Proteins are Corrected Equally.

15 years of clinical research by leading scientists at the Reynolds Institute on15 years of clinical research by leading scientists at the Reynolds Institute on

Aging at the University of Arkansas for Medical Services and the USDAAging at the University of Arkansas for Medical Services and the USDA

Center on Aging at Tufts University confirm these scientific factsCenter on Aging at Tufts University confirm these scientific facts

To improve muscle building, specialized sources of protein with high

levels of Leucine are Required (Am.J.Clin Nutr. 2006; 84:475-482)

Specialized Leucine Protein Blends are 4x more effective at overcoming

the resistance of aging and building muscle faster. (Exp.Geront.

2006;41:215-219)

High Levels of Leucine with Essential Amino Acids Overcome the

muscles resistance to aging and help build stronger and more energeticmuscle for active living


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The most effective protein energy source

must include specific combinations of

essential amino acids including Leucine.

0

10

20

30

40

50

6070

80

90

100Percent Change in Muscle Building by

selected sources or blends of protein

Soy Casein Whey ViaLeuPro


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The most effective protein energy source

must include specific combinations of

essential amino acids including Leucine.

Muscle Building Capacity in Young vs Elderly with low

vs high levels of Leucine and essential amino acid

intake

40 yr old

Low Leu Hi Leu Low Leu Hi Leu


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0

20

40

60

Non-Supplementation

With Amino AcidSupplementation

Muscle Building

*

nmolphe

/min/10

0ml

Balance of Protein Synthesis &Balance of Protein Synthesis &

BreakdownBreakdown

Biolo et al. Am J Physiol 1997; 273: E122-E129

Muscle Breakdown


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Less is Better:

ViaLeuPro (including EAA) formula provides

greater anabolic effectthan a larger amount of protein

provided by other sources

Volpi E, Kobayashi H, Sheffield-Moore M, et al: Essential amino acids are primarily responsible for the amino acidstimulation of muscle protein anabolism in healthy elderly adults.Am J Clin Nutr2003;78:250-258

26Paddon Jones et al. Am J Physiol 286: E321-E325, 2004; Am J Physiol 288: E761-E767, 2005


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12g

20g 20g

Essential Amino Acids

(ViaLeuPro)

Casein Whey0

100

200

MuscleAnab

olism

12g

20g20g

Muscle Synthesis andMuscle Synthesis and

Protein TypeProtein Type

27


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Effect of Essential Amino AcidsEffect of Essential Amino Acids

(EAA) on Muscle Strength(EAA) on Muscle Strength

-25

-20

-15

-10

-5

0

5 Bed rest Bed rest + EAA

Lo

ssof1

RM*leg

extension

strength(kg)

Day 10

28*RM repetition Max score


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Bottom Line:Bottom Line:

Meal Replacement vs EAA SupplementMeal Replacement vs EAA Supplement

0

5

10

15

20

25

30

35

ProteinS

ynthesis

perGra

m

Supplement

Meal Replacement 8 oz

360 kcals/14 gm proEAA

Formulation

Paddon Jones et al. Am J Physiol 286: E321-E325, 2004; Am J Physiol 288: E761-E767, 200529


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Muscle Protein Synthesis is similar withMuscle Protein Synthesis is similar with

Testosterone or Use of EAA SupplementTestosterone or Use of EAA Supplement

EAA Supplement containing

15g proteinTestosterone (125mg)

M

uscleAnabo

lis

m

Fasted

Post-Treatment

Paddon-Jones, AM J Physiol, Endrocinol. Metab 2003


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Effect of EAA Supplementation on Leg

Strength in the elderly

Borsheim et al. Clin Nutr 27:189-195, 2008

* P


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EAA intake and muscle protein synthesis

Dillon EL et al J Clin Endocrinol Metab 2009;94:1630-7

15 gram EAA supplement daily for 3 months


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The Conundrum Solved!The Conundrum Solved!

Obtaining smaller portions of food ordrink between meals to enhance or

supplement intake of essential nutrients

Compensates for:

Poor food selection Anorexia of aging

33

Active Snacking


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Maintaining Muscle BalanceMaintaining Muscle Balance

Typical Supplement

BreakfastSupplement

LunchSupplement

Dinner

Muscle

Growth-

ProteinSynthesis

Muscle

Loss-

Protein

Breakdown

34


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EAA Supplement throughout dayEAA Supplement throughout day

Effective and ConvenientEffective and Convenient

35

Volpi E, Kobayashi H, Sheffield-Moore M, et al: Essential amino acids areprimarily responsible for the amino acid

stimulation of muscle protein anabolism in healthy elderly adults.Am J Clin Nutr2003;78:250-258


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Frequent Intake Elevates Protein SynthesisFrequent Intake Elevates Protein Synthesis

Paddon-Jones D and Rasmussen BB. Curr Opin Clin Nutr Metab Care 2009;12:86-90.


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Exercise

Empty stomach

No Exercise

Empty stomach-50

0

50

25

-25

75

NutritionNutrition andandExerciseExercise

Exercise with

EAAAmino Acids

Alone

Muscle

Anab

oli

sm

38


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Before After 1 Hour After

0

100

200

300

Muscl e

Ana b

olism

Effect of EAAs on Muscle RecoveryEffect of EAAs on Muscle Recovery

Before and After ActivityBefore and After Activity

39


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Stepwise Solution forStepwise Solution forNutrition SupplementationNutrition Supplementation

Across the ContinuumAcross the Continuum


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Young at Heart Mature Health

Seekers

Very Elderly Malnourished &

Seriously Ill

Elderly Infirm

Clinical States Help Define the Need forClinical States Help Define the Need for

Medical Nutrition TherapyMedical Nutrition Therapy

Goal

Role ofMNT

Diseasestate

Format

Health

Target

Acute, Chronic and/orPalliative Care

Specific Supplementation& Replacement

Complications & SpecificIssues in Care

ONS (+ EF)

Care & Complications

Assisted Care

Supplementation &

Replacement

EF (+ ONS)

MaintenanceCare &

Complications

Monitored Care

Supplemented MealsDysregulation

SpecificTarget & Benefits

ONS (+ EF)

Issue Specific &complications of

Disease

Active DiseaseManagers

Optimal NutritionPermissible

SnackingBenefit Specific

ONS

Issue Specific Care

Preventive Care

Nutritional InsuranceConvenient Snacking

General healthconcerns

ONS

General Maintenance

Be HealthyBe Healthy Be WellBe Well Get WellGet Well Hang OnHang OnStay HealthyStay Healthy

Out-Patients In-Patients

< Diabetes, CVD, Oncology, Geriatrics, Cognitive/Mood >


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St i S l ti fStepwise Solution for


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Stepwise Solution forStepwise Solution for

Nutrition SupplementationNutrition SupplementationWho needs nutrition supplementation?Who needs nutrition supplementation?

When Nutrition Risk is Present, Consider

supplementation:Utilize clinically supported supplementswith high quality protein supplements Concentrated and therapeutic nutrient

levels to improve outcomes Great Taste = Better Compliance


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Juice-based supplementation helps patients increase daily

intakes of protein and energy (Hammond et al, 2005; Neuman et al, 2004)

Supplementation delivers macro- and micro-nutrients in line

with dietary guideline recommendations

Protein-enriched supplementation

helps patients increase daily intakes

of key micronutrients involved

in remodeling (Neuman et al, 2004)

Supplementation improves nutrient intake

50g

63g

0

10

20

30

40

50

60

70

StandardBalanced Form

Special ProteinFormats

High Leucine Protein Blends & Increased Total


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45

g

Protein Intake Help Muscle overcome the resistance

to Aging.

3 year observation results of subjects consuming 5

different levels of protein daily, ranging from below

RDA amount to slightly higher than RDA levels of

intake. Those with higher protein intake (Quintile 5)

show smallest amount of muscle e loss (AGS 2010

Seminar)

Eight to 16 weeks of supplementation with High

Leucine Protein Blend results in Significant

improvement in Muscle Functional tests of distance

and time. On average a 20% improvement is seen

with improved protein intake in 8 weeks of

consumption of BeneVia with ViaLeuPro (Am.J.Clin

Nutr 2003; 78:250)

Specialized Protein Blends with High Leucine prevent and reduce the

loss of lean muscle mass seen with aging and help build muscleenergy and strength better than other protein sources available in food

or nutritional supplements and replacements.

Results of Supplementation are seen in 4 to 8 weeks and longer
http://www.ajcn.org/content/vol87/issue1/images/large/znu0010848380001.jpeg


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Promotes lean body mass retention and prevention of

lean body mass loss (Berneis et al, 2000)

Promotes weight maintenance (


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Mortality and complications reduced in hospitalized

patients with malnutrition (Milne et al, 2006)

Indices of wound healing and cognitive function improve(Collins et al, 2005)

Hip fracture patients have shorter stay in rehabilitative

care (Schurch et al, 1998)

Indices of immune function improve in frail elderly(Wouters-Wesseling et al, 2005)

Functional independence improves (Potter et al, 2001)

Supplementation improves outcome


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Supplementation reduces cost of care

Saves staff time and reduce overall costs of care

-Reduced cost of hospital care (Smith and Smith, 1997; Rypkema, 2004)

-Reduced number of home nurse visits (Arnoud-Battandier, 2004)-Reduced cost of home nursing and other medical care

(Arnaud-Battandier, 2004)

Contributes to more effective use of resources Part of improved patient management practices

C l iC l i


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ConclusionsConclusions

Loss of muscle mass and increased riskof health problems due to decreased

intake and appetite is common with aging

Use of a unique EAA Supplement

improves outcomes and enhances

muscle protein synthesis and retention

and does not impede intake at meals

C l iC l i


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ConclusionsConclusions

Nutritional supplementation (activesnacking) with essential amino acids is

key for muscle protein synthesis in the

elderly

Active snacking promotes

muscle retention and growth

superior outcomes compared to meal

replacements


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Learn More on theLearn More on theUse of Superior Protein SourcesUse of Superior Protein Sources

At our website: www.gobenevia.com

By email: [email protected] phone: 1-888-855-4442
http://www.gobenevia.com/mailto:[email protected]:[email protected]:[email protected]://www.gobenevia.com/http://www.gobenevia.com/http://www.gobenevia.com/

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Active Snacking BeneVia 6.16 Ver 5 FINAL