scholarly journals Sarcopenia among the Elderly Population: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 650
Author(s):  
Di-Ya Tu ◽  
Fa-Min Kao ◽  
Shih-Tzer Tsai ◽  
Tao-Hsin Tung
Keyword(s):  
Muscle Mass ◽  
Physical Performance ◽  
Protein Intake ◽  
Skeletal Muscle Mass ◽  
Meta Analysis ◽  
Protein Supplementation ◽  
Randomized Controlled ◽  
Hand Grip ◽  
Skeletal Muscle Mass Index ◽  
Chair Rise

Purpose. This systematic review and meta-analysis was conducted to explore the effect of protein intake on the prevention and improvement of sarcopenia. Methods. We searched the Cochrane Library, PubMed, and EMBASE from inception to 20 May 2021. Two authors independently selected studies, assessed the quality of included studies, and extracted data. Any disagreement was resolved by discussion with a third author. Results. There were 12 studies that met the selection criteria among 53 eligible publications. The results of the study show that the protein intake has no significant effect on the physical performance—4 m gait speed, chair rise test, short physical performance battery, muscle mass—skeletal muscle mass index, and muscle strength—hand grip strength. Conclusion. Protein supplementation had no significant effect on 4 m gait speed and on improving skeletal muscle mass index, hand grip strength, chair rise test, and short physical performance battery. Additional randomized controlled trials are warranted to adequately assess the effect of protein supplementation on elderly sarcopenia.

scholarly journals A 12-week intervention with protein-enriched foods and drinks improved protein intake but not physical performance of older patients during the first 6 months after hospital release: a randomised controlled trial

2017 ◽  
Vol 117 (11) ◽  
pp. 1541-1549 ◽  
Author(s):  
Janne Beelen ◽  
Nicole M. de Roos ◽  
Lisette C. P. G. M. de Groot
Keyword(s):  
Older Adults ◽  
Body Weight ◽  
Physical Performance ◽  
Protein Intake ◽  
Controlled Trial ◽  
Leg Extension ◽  
Hand Grip ◽  
Randomised Controlled ◽  
Chair Rise ◽  
Physical Recovery

AbstractDuring and after hospitalisation, older adults are recommended to consume 1·2–1·5 g of protein/kg body weight per d (g/kg per d) to improve recovery. This randomised controlled trial studied the effectiveness of a 12-week intervention with protein-enriched foods and drinks by following-up seventy-five older patients (mean age: 76·8 (sd 6·9) years) during their first 6 months after hospital discharge. Primary outcomes were protein intake and physical performance (measured with Short Physical Performance Battery (SPPB)). Secondary outcomes for physical recovery were gait speed, chair-rise time, leg-extension strength, hand-grip strength, body weight, nutritional status (Mini Nutritional Assessment), independence in activities of daily living (ADL) and physical activity. The intervention group consumed more protein during the 12-week intervention period compared with the control group (P<0·01): 112 (sd 34) g/d (1·5 (sd 0·6) g/kg per d) v. 78 (sd 18) g/d (1·0 (sd 0·4) g/kg per d). SPPB total score, gait speed, chair-rise time, body weight and nutritional status improved at week 12 compared with baseline (time effect P<0·05), but were not different between groups. Leg-extension strength, hand-grip strength and independence in ADL did not change. In conclusion, protein-enriched products enabled older adults to increase their protein intake to levels that are higher than their required intake. In these older adults with already adequate protein intakes and limited physical activity, protein enrichment did not enhance physical recovery in the first 6 months after hospital discharge.

scholarly journals Does Beef Protein Supplementation Improve Body Composition and Exercise Performance? A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2019 ◽  
Vol 11 (6) ◽  
pp. 1429 ◽  
Author(s):  
Pedro L. Valenzuela ◽  
Fernando Mata ◽  
Javier S. Morales ◽  
Adrián Castillo-García ◽  
Alejandro Lucia
Keyword(s):  
Body Composition ◽  
Muscle Strength ◽  
Exercise Performance ◽  
Protein Intake ◽  
Meta Analysis ◽  
Protein Supplementation ◽  
Limb Muscle ◽  
Randomized Controlled ◽  
Total Protein Intake ◽  
Improve Body Composition

Protein supplementation might improve body composition and exercise performance. Supplements containing whey protein (WP) have received the most attention, but other protein sources such as beef protein (BP) are gaining popularity. We conducted a systematic review and meta-analysis of randomized controlled trials that compared the effects of exercise training combined with BP, WP or no protein supplementation (NP), on body composition or exercise performance. Secondary endpoints included intervention effects on total protein intake and hematological parameters. Seven studies (n = 270 participants) were included. No differences were found between BP and WP for total protein intake (standardized mean difference (SMD) = 0.04, p = 0.892), lean body mass (LBM) (SMD = −0.01, p = 0.970) or fat mass (SMD = 0.07, p = 0.760). BP significantly increased total daily protein intake (SMD = 0.68, p < 0.001), LBM (SMD = 0.34, p = 0.049) and lower-limb muscle strength (SMD = 0.40, p = 0.014) compared to NP, but no significant differences were found between both conditions for fat mass (SMD = 0.15, p = 0.256), upper-limb muscle strength (SMD = 0.16, p = 0.536) or total iron intake (SMD = 0.29, p = 0.089). In summary, BP provides similar effects to WP on protein intake and body composition and, compared to NP, might be an effective intervention to increase total daily protein intake, LBM and lower-limb muscle strength.

scholarly journals β-Hydroxy-β-methylbutyrate and its impact on skeletal muscle mass and physical function in clinical practice: a systematic review and meta-analysis

2019 ◽  
Vol 109 (4) ◽  
pp. 1119-1132 ◽  
Author(s):  
Danielle E Bear ◽  
Anne Langan ◽  
Eirini Dimidi ◽  
Liesl Wandrag ◽  
Stephen D R Harridge ◽  
...  
Keyword(s):  
Systematic Review ◽  
Skeletal Muscle ◽  
Physical Function ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Clinical Conditions

ABSTRACT Background Loss of skeletal muscle mass and muscle weakness are common in a variety of clinical conditions with both wasting and weakness associated with an impairment of physical function. β-Hydroxy-β-methylbutyrate (HMB) is a nutrition supplement that has been shown to favorably influence muscle protein turnover and thus potentially plays a role in ameliorating skeletal muscle wasting and weakness. Objectives The aim of this study was to investigate the efficacy of HMB alone, or supplements containing HMB, on skeletal muscle mass and physical function in a variety of clinical conditions characterized by loss of skeletal muscle mass and weakness. Methods A systematic review and meta-analysis of randomized controlled trials reporting outcomes of muscle mass, strength, and physical function was performed. Two reviewers independently performed screening, data extraction, and risk-of-bias assessment. Outcome data were synthesized through meta-analysis with the use of a random-effects model and data presented as standardized mean differences (SMDs). Results Fifteen randomized controlled trials were included, involving 2137 patients. Meta-analysis revealed some evidence to support the effect of HMB alone, or supplements containing HMB, on increasing skeletal muscle mass (SMD = 0.25; 95% CI: –0.00, 0.50; z = 1.93; P = 0.05; I2 = 58%) and strong evidence to support improving muscle strength (SMD = 0.31; 95% CI: 0.12, 0.50; z = 3.25; P = 0.001; I2 = 0%). Effect sizes were small. No effect on bodyweight (SMD = 0.16; 95% CI: –0.08, 0.41; z = 1.34; P = 0.18; I2 = 67%) or any other outcome was found. No study was considered to have low risk of bias in all categories. Conclusion HMB, and supplements containing HMB, increased muscle mass and strength in a variety of clinical conditions, although the effect size was small. Given the bias associated with many of the included studies, further high-quality studies should be undertaken to enable interpretation and translation into clinical practice. The trial was registered on PROSPERO as CRD42017058517.

scholarly journals The Role of Protein Intake and its Timing on Body Composition and Muscle Function in Healthy Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 150 (6) ◽  
pp. 1443-1460 ◽  
Author(s):  
Janine Wirth ◽  
Elaine Hillesheim ◽  
Lorraine Brennan
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Muscle Function ◽  
Protein Intake ◽  
Handgrip Strength ◽  
Meta Analysis ◽  
Protein Supplementation ◽  
Controlled Trials ◽  
Leg Press ◽  
Randomized Controlled

ABSTRACT Background Increased protein intake has been suggested to improve gains in muscle mass and strength in adults. Furthermore, the timing of protein intake has been discussed as a margin of opportunity for improved prevention measures. Objective This systematic review investigated the effect of protein supplementation on body composition and muscle function (strength and synthesis) in healthy adults, with an emphasis on the timing of protein intake. Methods Randomized controlled trials were identified using PubMed, Web of Science, CINAHL, and Embase, up to March 2019. For meta-analyses, data on lean body mass (LBM), handgrip strength, and leg press strength were pooled by age group (mean age 18–55 or &gt;55 y) and timing of protein intake. The quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluations approach. Results Data from 65 studies with 2907 participants (1514 men and 1380 women, 13 unknown sex) were included in the review. Twenty-six, 8, and 24 studies were used for meta-analysis on LBM, handgrip strength, and leg press strength, respectively. The protein supplementation was effective in improving (mean difference; 95% CI) LBM in adults (0.62 kg; 0.36, 0.88) and older adults (0.46 kg; 0.23, 0.70), but not handgrip strength (older adults: 0.26 kg; −0.51, 1.04) and leg press strength (adults: 5.80 kg; −0.33, 11.93; older adults: 1.97 kg; −2.78, 6.72). Sensitivity analyses removing studies without exercise training had no impact on the outcomes. Data regarding muscle synthesis were scarce and inconclusive. Subgroup analyses showed no beneficial effect of a specific timing of protein intake on LBM, handgrip strength, and leg press strength. Conclusion Overall, the results support the positive impact of protein supplementation on LBM of adults and older adults, independently of intake timing. Effects on muscle strength and synthesis are less clear and need further investigation. This systematic review was registered on PROSPERO as CRD42019126742.

scholarly journals Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects: a randomized, double-blind, placebo-controlled trial

2018 ◽  
Vol 108 (5) ◽  
pp. 1026-1033 ◽  
Author(s):  
Yongsoon Park ◽  
Jeong-Eun Choi ◽  
Hwan-Sik Hwang
Keyword(s):  
Skeletal Muscle ◽  
G Protein ◽  
Muscle Mass ◽  
Physical Performance ◽  
Frail Elderly ◽  
Skeletal Muscle Mass ◽  
Controlled Trial ◽  
Protein Supplementation ◽  
Elderly Subjects ◽  
Double Blind

ABSTRACTBackgroundAge-related loss of muscle mass and function is a major component of frailty. Nutrition supplementation with exercise is an effective strategy to decrease frailty by preventing sarcopenia, but the effect of protein alone is controversial.ObjectiveThe present study was performed to investigate a dose-dependent effect of protein supplementation on muscle mass and frailty in prefrail or frail malnourished elderly people.DesignA 12-wk double-blind randomized controlled trial was conducted in elderly subjects aged 70–85 y with ≥1 of the Cardiovascular Health Study frailty criteria and a Mini Nutritional Assessment score ≤23.5 (n = 120). Participants were randomly assigned to 1 of 3 groups: 0.8, 1.2, or 1.5 g protein · kg–1 · d–1, with concealed allocation and intention-to-treat analysis. Primary outcomes were appendicular skeletal muscle mass (ASM) and skeletal muscle mass index (SMI) measured by dual-energy X-ray absorptiometry.ResultsAfter the 12-wk intervention, the 1.5-g protein · kg–1 · d–1 group had higher ASM (mean ± SD: 0.52 ± 0.64 compared with 0.08 ± 0.68 kg, P = 0.036) and SMI (ASM/weight: 0.87% ± 0.69% compared with 0.15% ± 0.89%, P = 0.039; ASM/BMI: 0.02 ± 0.03 compared with 0.00 ± 0.04, P = 0.033; ASM:fat ratio: 0.04 ± 0.11 compared with −0.02 ± 0.10, P = 0.025) than the 0.8-g protein · kg–1 · d–1 group. In addition, gait speed was improved in the 1.5-g protein · kg–1 · d–1 group compared with the 0.8-g protein · kg–1 · d–1 group (0.09 ± 0.07 compared with 0.04 ± 0.07 m/s, P = 0.039). There were no significant differences between the 1.2- and 0.8-g protein · kg–1 · d–1 groups in muscle mass and physical performance. No harmful adverse effects were observed.ConclusionsThe present study indicates that protein intake of 1.5 g · kg–1 · d–1 has the most beneficial effects in regard to preventing sarcopenia and frailty compared with protein intakes of 0.8 and 1.2 g · kg–1 · d–1 in prefrail or frail elderly subjects at risk of malnutrition. This trial was registered at cris.nih.go.kr as KCT0001923.

scholarly journals The Optimal Strategy of Vitamin D for Sarcopenia: A Network Meta-Analysis of Randomized Controlled Trials

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3589
Author(s):  
Shih-Hao Cheng ◽  
Kee-Hsin Chen ◽  
Chiehfeng Chen ◽  
Woei-Chyn Chu ◽  
Yi-No Kang
Keyword(s):  
Skeletal Muscle ◽  
Vitamin D ◽  
Grip Strength ◽  
Muscle Mass ◽  
Gait Speed ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Chair Stand ◽  
Randomized Controlled ◽  
Hand Grip

Sarcopenia is a disease of gradual loss of muscle mass in elderly people, and the most common treatment options include nutritional supplementation and exercise. Vitamin D has potential beneficial effects for skeletal muscle tissue and has often been included in nutritional therapy formulations. However, the therapeutic effect of vitamin D for the treatment of sarcopenia has not yet been determine and there is a lack of high-quality supporting evidence. We searched three databases for randomized controlled trials (RCTs) on this topic. Changes in hand grip strength, gait speed, chair-stand test, fat mass, relative skeletal muscle index, and muscle mass were assessed for analysis. Network meta-analysis was further employed, based on the frequentist approach. Outcomes were reported as weighted mean differences (WMD) with 95% confidence intervals (CIs). A total of 9 RCTs (n = 1420) met our eligibility criteria, which treated patients with vitamin D (D), protein (P, n = 165), exercise (E, n = 124), iso-caloric product (I, n = 226), usual care without nutritional supplement (n = 65), P + D (n = 467), D + E (n = 72), P + E (n = 69), D + E + I (n = 73), and P + D + E (n = 159). The pooled estimate showed that the P + D + E intervention induced a greater improvement in hand grip strength than iso-caloric product intervention (WMD = 3.86; 95%CI, 0.52–7.21). Vitamin D intervention could lead to shorter chair-stand time (WMD = −1.32; 95%CI, −1.98 to −0.65), but no significant findings could be found for gait speed and muscle mass outcomes. Our synthesis found that combining vitamin D supplementation with protein supplementation and exercise can significantly increase grip strength and also showed a trend toward increasing muscle mass. This result implies that adding vitamin D to a standard treatment protocol for sarcopenia may be helpful for regaining function.

scholarly journals Effects of Resistance Exercise on Muscle Mass, Strength, and Physical Performances in Elderly with Diagnosed Sarcopenia: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 29 (2) ◽  
pp. 109-120
Author(s):  
Kyung Min Kim ◽  
Hyun Joo Kang
Keyword(s):  
Resistance Exercise ◽  
Grip Strength ◽  
Muscle Mass ◽  
Physical Performance ◽  
Meta Analysis ◽  
Knee Extension ◽  
Timed Up And Go ◽  
Knee Extension Strength ◽  
Hand Grip ◽  
Appendicular Muscle Mass

PURPOSE: Sarcopenia, also known as the age-related loss of muscle mass and muscle fitness, and physical performance, has been related to many adverse health outcomes. Resistance exercise may have an important role in effecting strategy for sarcopenia in aging populations. The purpose of this study is to systematically assess the effects resistance exercise interventions on muscle mass, muscle strength, and physical performance in elderly diagnosed with sarcopenia.METHODS: A comprehensive search on electronic databases, including PubMed, EMBASE, CINAHLPlus, SPORTDiscus, KERIS, KISS, and NAL were conducted. Eligible studies were divided into exercise and randomized controlled trials in elderly with sarcopenia. Searches retrieved 1,067 titles. Eighty full texts were evaluated, and seven studies were used for final systematic reviews. CMA (Comprehensive Meta-Analysis) ver 3.0 was used for meta-analysis.RESULTS: Meta-analysis showed that lower muscle mass (ES=0.579, 95% CI: 0.266-0.892, <i>p</i>=.000), appendicular muscle mass (ES=0.341, 95% CI: 0.006-0.676, <i>p</i>=.046), right hand grip strength (ES=0.739, 95% CI: 0.216-1.262, <i>p</i>=.006), left hand grip strength (ES=0.692, 95% CI: 0.167-1.217, <i>p</i>=.010), knee extension strength (ES=1.448, 95% CI: 0.273-2.624, <i>p</i>=.016), and timed up and go (ES=1.471, 95% CI: 0.492-2.450, <i>p</i>=.003) significantly improved in response to resistance exercise programs.CONCLUSIONS: Sarcopenia is increasing with the growing elderly population; thus prevention and effective interventions are very important. The data suggest that resistance exercise may be actual in enhancing not only appendicular muscle mass, but also knee extension strength and timed up and go in elderly diagnosed with sarcopenia. Further follow-up studies on larger populations and a variety of approaches are required to reconfirm these results.

Egg protein supplementation improved upper body muscle strength and protein intake in community-dwelling older adult females who attended congregate meal sites or adult learning centers: A pilot randomized controlled trial

2021 ◽  
pp. 026010602110515
Author(s):  
Sarah L. Ullevig ◽  
Krystle Zuniga ◽  
C. Austin Lobitz ◽  
Alejandra Santoyo ◽  
Zenong Yin
Keyword(s):  
Older Adults ◽  
Muscle Strength ◽  
Muscle Mass ◽  
Protein Intake ◽  
Egg White ◽  
Protein Supplementation ◽  
Community Dwelling ◽  
Upper Body ◽  
Egg White Protein ◽  
Randomized Controlled

Background: Older adults that utilize community-based nutrition services are at higher nutritional risk than the general aging population, yet studies on the efficacy of protein interventions in this population are lacking. Aim: A double-blinded randomized controlled pilot study trial evaluated the impact of egg white protein supplementation on muscle mass, strength, and physical function in predominantly low-income Latina community-dwelling adult females aged 60 or older with reduced muscle strength or function. Methods: Participants (mean age = 73.6  ±  8.3 years) were randomly assigned to receive a daily dried egg white (20 g protein) or isocaloric maltodextrin supplement for 6 months (n = 16 intervention; n = 13 control). The primary outcome measure was appendicular skeletal muscle mass. Secondary outcomes were measures of muscle strength and function and dietary protein intake. Comparisons of baseline demographics were conducted using t-tests and χ2 or Fisher's exact tests. Differences between groups were assessed using general linear models, adjusted for baseline values, and differences within groups were assessed using paired t-tests or Kruskal–Wallis. Results: No significant between-group differences were found for all measures, but protein intake, handgrip strength, and the number of arm curls significantly improved in the intervention group. Under-recruitment of study participants and a high dropout rate impacted the ability of this study to detect significant differences between groups. Conclusion: Daily egg white protein supplementation increases protein intake and supports upper body physical function in older adults, but additional studies are needed to investigate its role in the prevention of age-related muscle mass decline in older adults. Trial #NCT03530774 ( https://clinicaltrials.gov/ct2/show/NCT03530774 ).

scholarly journals Total protein, animal protein and physical activity in relation to muscle mass in middle-aged and older Americans

2012 ◽  
Vol 109 (7) ◽  
pp. 1294-1303 ◽  
Author(s):  
Martha Savaria Morris ◽  
Paul F. Jacques
Keyword(s):  
Physical Activity ◽  
Skeletal Muscle ◽  
Muscle Mass ◽  
Protein Intake ◽  
Skeletal Muscle Mass ◽  
Muscle Strengthening ◽  
Appendicular Skeletal Muscle ◽  
Obese Subjects ◽  
Skeletal Muscle Mass Index ◽  
Appendicular Skeletal Muscle Mass

Resistance training is recognised as a good strategy for retarding age-related declines in muscle mass and strength. Recent studies have also highlighted the potential value of protein intakes in excess of present recommendations. The roles that leisure-time physical activity and protein quality play in the preservation of skeletal muscle during ageing, and how such influences interact in free-living people are unclear. We sought to clarify these issues using data collected on 2425 participants aged ≥ 50 years in the US National Health and Nutrition Examination Survey (2003–2006). We estimated subjects’ usual intakes of total protein and beef from two 24 h diet recalls and computed the appendicular skeletal muscle mass index from anthropometric measures. Participants self-reported their physical activity levels. Analyses accounted for demographic factors and smoking. The association between muscle-strengthening activity and the appendicular skeletal muscle mass index varied with protein intake. Furthermore, among obese subjects with protein intakes < 70 g/d, those who performed such activities had a lower appendicular skeletal muscle mass index than those who were physically inactive. Protein intakes above the present recommendations were associated with benefits to obese subjects only. The appendicular skeletal muscle mass index of non-obese subjects who performed vigorous aerobic activities was consistently high; in obese subjects, it varied with protein intake. High-protein intake was associated with a modest increase in the appendicular skeletal muscle mass index in non-obese, physically inactive subjects. The present findings reinforce the idea that muscle-strengthening exercise preserves muscle when combined with adequate dietary protein. Vigorous aerobic activity may also help.

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