Effects of protein supplementation combined with resistance exercise on body composition and physical function in older adults: a systematic review and meta-analysis

Abstract Background Sarcopenia, a progressive loss of muscle mass and function with advancing age, is a prevalent condition among older adults. As most older people are too frail to do intensive exercise and vibration therapy has low risk and ease of participation, it may be more readily accepted by elderly individuals. However, it remains unclear whether vibration therapy would be effective among older adults with sarcopenia. This systematic review and meta-analysis examined the effect of vibration therapy including local vibration therapy and whole-body vibration therapy, for enhancing muscle mass, muscle strength and physical function in older people with sarcopenia. Methods A systematic literature search was conducted in March 2019 in the following 5 electronic databases: PubMed, CINAHL, Embase, PEDro, and the Cochrane Central Register of Controlled Trials, with no restriction of language or the year of publication. Randomized controlled trials and quasi-experimental studies examining effects of vibration therapy on muscle mass, muscle strength or physical function in older adults with sarcopenia were included in this systematic review. Two reviewers independently assessed the methodological quality of the selected studies. Results Of the 1972 identified studies, seven publications from six studies involving 223 participants were included in this systematic review. Five of them conducted whole-body vibration therapy, while two conducted local vibration therapy. A meta-analysis of randomized controlled studies indicated that muscle strength significantly increased after whole-body vibration therapy (SMD 0.69, 95% CI 0.28 to 1.11, I2 = 0%, P = 0.001) and local vibration therapy (SMD 3.78, 95% CI 2.29 to 5.28, P < 0.001). Physical performance measured by the sit-to-stand test and the timed-up-and-go test were significantly improved after the intervention (SMD -0.79, 95% CI − 1.21 to − 0.37, I2 = 0%, P < 0.001) and SMD -0.83, 95% CI − 1.56 to − 0.11, I2 = 64%, P = 0.02, respectively). Conclusion Vibration therapy could be a prospective strategy for improving muscle strength and physical performance in older adults with sarcopenia. However, due to the limited number of the included studies, caution is needed when interpreting these results. More well-designed, large sample size studies should be conducted to further explore and validate the benefits of vibration therapy for this population.

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Supplementation with the Leucine Metabolite β-hydroxy-β-methylbutyrate (HMB) does not Improve Resistance Exercise-Induced Changes in Body Composition or Strength in Young Subjects: A Systematic Review and Meta-Analysis

Nutrients ◽

10.3390/nu12051523 ◽

2020 ◽

Vol 12 (5) ◽

pp. 1523 ◽

Cited By ~ 1

Author(s):

Josephine S. Jakubowski ◽

Everson A. Nunes ◽

Filipe J. Teixeira ◽

Victoria Vescio ◽

Robert W. Morton ◽

...

Keyword(s):

Systematic Review ◽

Body Composition ◽

Resistance Exercise ◽

Body Mass ◽

Meta Analysis ◽

Fat Free Mass ◽

Strength Analysis ◽

Composition Analysis ◽

Total Body Mass ◽

Leucine Metabolite

β-hydroxy-β-methylbutyrate (HMB) is a leucine metabolite that is purported to increase fat-free mass (FFM) gain and performance in response to resistance exercise training (RET). The aim of this systematic review and meta-analysis was to determine the efficacy of HMB supplementation in augmenting FFM and strength gains during RET in young adults. Outcomes investigated were: total body mass (TBM), FFM, fat mass (FM), total single repetition maximum (1RM), bench press (BP) 1RM, and lower body (LwB) 1RM. Databases consulted were: Medical Literature Analysis and Retrieval System Online (Medline), Excerpta Medica database (Embase), The Cumulative Index to Nursing and Allied Health Literature (CINAHL), and SportDiscus. Fourteen studies fit the inclusion criteria; however, 11 were analyzed after data extraction and funnel plot analysis exclusion. A total of 302 participants (18–45 y) were included in body mass and composition analysis, and 248 were included in the strength analysis. A significant effect was found on TBM. However, there were no significant effects for FFM, FM, or strength outcomes. We conclude that HMB produces a small effect on TBM gain, but this effect does not translate into significantly greater increases in FFM, strength or decreases in FM during periods of RET. Our findings do not support the use of HMB aiming at improvement of body composition or strength with RET.

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Physical function and all-cause mortality in older adults diagnosed with cancer: A systematic review and meta-analysis

The Journals of Gerontology Series A ◽

10.1093/gerona/glaa305 ◽

2020 ◽

Author(s):

Yasmin Ezzatvar ◽

Robinson Ramírez-Vélez ◽

Mikel L Sáez de Asteasu ◽

Nicolás Martínez-Velilla ◽

Fabricio Zambom-Ferraresi ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Physical Function ◽

Handgrip Strength ◽

Meta Analysis ◽

Timed Up And Go ◽

Hazard Ratios ◽

Inverse Variance ◽

All Cause Mortality ◽

Prospective Association

Abstract Background Physical function is an independent predictor of numerous chronic diseases, but its association with all-cause mortality in older adults diagnosed with cancer has received little attention. Objective The aim of this study was to conduct a systematic review and meta-analysis on the prospective association between physical function and all-cause mortality in older adults diagnosed with cancer. Methods Two authors systematically searched MEDLINE, EMBASE, and SportsDiscus databases. Prospective studies reporting associations of baseline physical function with all-cause mortality in patients aged 60 years or older diagnosed with any type of cancer were included. Hazard Ratios (HR) with associated 95% confidence intervals (CI) were extracted from studies for all-cause mortality and pooled HRs were then calculated using the random-effects inverse-variance model with the Hartung-Knapp-Sidik-Jonkman adjustment. Results Data from 25 studies with 8,109 adults diagnosed with cancer aged ≥60 years were included in the study. Higher levels of physical function (short physical performance battery, HR=0.44 95% CI, 0.29–0.67; I 2=16.0%; timed up and go, HR=0.40 95% CI, 0.31–0.53; I 2=61.9%; gait speed, HR=0.41 95% CI, 0.17–0.96; I 2=73.3%; handgrip strength: HR=0.61 95% CI, 0.43–0.85, I 2=85.6%; and overall, HR=0.45 95% CI, 0.35–0.57; I 2=88.6%) were associated with a lower risk of all-cause mortality compared to lower levels of functionality. Neither age at baseline nor length of follow-up had a significant effect on the HR estimates for lower all-cause mortality risk. Conclusion Physical function may exert an independent protective effect on all-cause mortality in older adults diagnosed with cancer.

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Impact of dietary protein supplementation on length of hospital stay and mortality in older adults: A systematic review and meta-analysis

Clinical Nutrition ◽

10.1016/j.clnu.2018.09.003 ◽

2018 ◽

Vol 37 ◽

pp. S336

Author(s):

J. Verstappen ◽

C. van Dronkelaar ◽

M. Streppel ◽

M. Tieland ◽

G. Biolo ◽

...

Keyword(s):

Systematic Review ◽

Older Adults ◽

Hospital Stay ◽

Dietary Protein ◽

Meta Analysis ◽

Length Of Hospital Stay ◽

Protein Supplementation

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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

Journal of Nutrition ◽

10.1093/jn/nxaa049 ◽

2020 ◽

Vol 150 (6) ◽

pp. 1443-1460 ◽

Cited By ~ 1

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 >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.

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The Impact of Protein Supplementation on Appetite and Energy Intake in Healthy Older Adults: A Systematic Review with Meta-Analysis

Advances in Nutrition ◽

10.1093/advances/nmaa115 ◽

2020 ◽

Author(s):

Sana Ben-Harchache ◽

Helen M Roche ◽

Clare A Corish ◽

Katy M Horner

Keyword(s):

Systematic Review ◽

Older Adults ◽

Longitudinal Studies ◽

Energy Intake ◽

Energy Content ◽

Meta Analysis ◽

Protein Supplementation ◽

Cochrane Library ◽

Healthy Older Adults ◽

The Impact

ABSTRACT Protein supplementation is an attractive strategy to prevent loss of muscle mass in older adults. However, it could be counterproductive due to adverse effects on appetite. This systematic review and meta-analysis aimed to determine the effects of protein supplementation on appetite and/or energy intake (EI) in healthy older adults. MEDLINE, The Cochrane Library, CINAHL, and Web of Science were searched up to June 2020. Acute and longitudinal studies in healthy adults ≥60 y of age that reported effects of protein supplementation (through supplements or whole foods) compared with control and/or preintervention (for longitudinal studies) on appetite ratings, appetite-related peptides, and/or EI were included. Random-effects model meta-analysis was performed on EI, with other outcomes qualitatively reviewed. Twenty-two studies (9 acute, 13 longitudinal) were included, involving 857 participants (331 males, 526 females). In acute studies (n = 8), appetite ratings were suppressed in 7 out of 24 protein arms. For acute studies reporting EI (n = 7, n = 22 protein arms), test meal EI was reduced following protein preload compared with control [mean difference (MD): −164 kJ; 95% CI: −299, −29 kJ; P = 0.02]. However, when energy content of the supplement was accounted for, total EI was greater with protein compared with control (MD: 649 kJ; 95% CI: 438, 861 kJ; P < 0.00001). Longitudinal studies (n = 12 protein arms) showed a higher protein intake (MD: 0.29 g ⋅ kg−1 ⋅ d−1; 95% CI: 0.14, 0.45 g ⋅ kg−1 ⋅ d−1; P < 0.001) and no difference in daily EI between protein and control groups at the end of trials (MD: −54 kJ/d; 95% CI: −300, 193 kJ/d; P = 0.67). While appetite ratings may be suppressed with acute protein supplementation, there is either a positive effect or no effect on total EI in acute and longitudinal studies, respectively. Therefore, protein supplementation may represent an effective solution to increase protein intakes in healthy older adults without compromising EI through appetite suppression. This trial was registered at PROSPERO as https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019125771 (CRD42019125771).

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