Essential amino acid-enriched meal replacement promotes superior net protein balance in older, overweight adults

Clin Nutr. 2019 Dec;38(6):2821-2826. doi: 10.1016/j.clnu.2018.12.013. Epub 2018 Dec 19.


Background & aims: Older individuals are susceptible to the loss of muscle and accumulation of fat. To address this problem, we have compared protein kinetics following consumption of an essential amino acid (EAA)-enriched meal replacement (EMR) to consumption of a high-protein meal replacement beverage (Bariatric Advantage, BA) using stable isotope methodology.

Methods: Eight older (67 ± 2), obese (35 ± 2 kg/m2) female and male participants completed two studies using a randomized, crossover design in which they ingested each meal replacement. The isotopic tracers L-[2H5]phenylalanine & L-[2H2]tyrosine were delivered via primed, continuous intravenous infusion throughout a basal period and following consumption of EMR or BA. We determined changes in whole body protein synthesis (PS), protein breakdown (PB), and net protein balance (NB) from fasted states via analysis of plasma samples by LC-ESI-MS.

Results: PS was higher (P = 0.03) and PB was less (P = 0.005) with EMR in comparison to BA. As a result, NB was much greater (P = 0.00003) following the ingestion of EMR as compared to BA.

Conclusions: In comparison with BA, which has a higher amount of intact protein that any other meal replacement, EMR promoted a greater increment in NB. These data support the potential efficacy of EMR as a meal replacement for the preservation of lean tissue mass during weight loss in older, overweight individuals.

Keywords: Insulin resistance; Liver; Muscle; Protein intake; Stable isotope tracers.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alaska
  • Amino Acids, Essential / administration & dosage*
  • Amino Acids, Essential / metabolism*
  • Cross-Over Studies
  • Double-Blind Method
  • Female
  • Food, Fortified*
  • Geriatric Assessment / methods*
  • Geriatric Assessment / statistics & numerical data
  • Humans
  • Male
  • Meals
  • Middle Aged
  • Overweight / metabolism*
  • Proteins / metabolism*


  • Amino Acids, Essential
  • Proteins