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Liao CD, Huang SW, Chen HC, Huang MH, Liou TH, Lin CL. Comparative Efficacy of Different Protein Supplements on Muscle Mass, Strength, and Physical Indices of Sarcopenia among Community-Dwelling, Hospitalized or Institutionalized Older Adults Undergoing Resistance Training: A Network Meta-Analysis of Randomized Controlled Trials. Nutrients 2024; 16:941. [PMID: 38612975 PMCID: PMC11013298 DOI: 10.3390/nu16070941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 04/14/2024] Open
Abstract
Aging-related sarcopenia exerts harmful impacts on muscle mass, strength, and physical mobility. Protein supplementation has been demonstrated to augment efficacy of resistance training (RT) in elderly. This study compared the relative effects of different protein supplements on muscle mass, strength, and mobility outcomes in middle-aged and older individuals undergoing RT. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of protein supplement plus RT in untrained community-dwelling adults, hospitalized, or institutionalized residents who suffered acute or chronic health conditions. Network meta-analysis (NMA) was performed using a frequentist method for all analyses. Treatment effects for main outcomes were expressed as standard mean difference (SMD) with 95% confidence interval (CI). We used the surface-under-the cumulative-ranking (SUCRA) scores to rank probabilities of effect estimation among all identified treatments. Meta-regression analyses were performed to identify any relevant moderator of the treatment efficacy and results were expressed as β with 95% credible interval (CrI). We finally included 78 RCTs (5272 participants) for analyses. Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on muscle mass (SMD = 1.29, 95% CI: 0.96, 1.62; SUCRA = 0.86), handgrip strength (SMD = 1.46, 95% CI: 0.92, 2.00; SUCRA = 0.85), and walking speed (SMD = 0.73, 95% CI: 0.39, 1.07; SUCRA = 0.84). Participant's health condition, sex, and supplementation dose were significant factors moderating the treatment efficacy on muscle mass (β = 0.74; 95% CrI: 0.22, 1.25), handgrip strength (β = -1.72; 95% CrI: -2.68, -0.77), and leg strength (β = 0.76; 95% CrI: 0.06, 1.47), respectively. Our findings suggest whey protein yields the optimal supplements to counter sarcopenia in older individuals undergoing RT.
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Affiliation(s)
- Chun-De Liao
- International Ph.D. Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, New Taipei City 110301, Taiwan;
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (S.-W.H.); (H.-C.C.); (T.-H.L.)
| | - Shih-Wei Huang
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (S.-W.H.); (H.-C.C.); (T.-H.L.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City 110301, Taiwan
| | - Hung-Chou Chen
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (S.-W.H.); (H.-C.C.); (T.-H.L.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City 110301, Taiwan
| | - Mao-Hua Huang
- Department of Biochemistry, University of Washington, Seattle, WA 98015, USA;
| | - Tsan-Hon Liou
- Department of Physical Medicine and Rehabilitation, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan; (S.-W.H.); (H.-C.C.); (T.-H.L.)
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City 110301, Taiwan
| | - Che-Li Lin
- Department of Orthopedic Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, Taiwan
- Department of Orthopedics, School of Medicine, College of Medicine, Taipei Medical University, New Taipei City 11031, Taiwan
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Noh KW, Park S. Effects of resistance training and protein supplementation interventions on muscle volume and muscle function: sex differences in humans. Phys Act Nutr 2023; 27:15-25. [PMID: 38297472 PMCID: PMC10847829 DOI: 10.20463/pan.2023.0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 10/31/2023] [Accepted: 11/24/2023] [Indexed: 02/02/2024] Open
Abstract
PURPOSE This review aimed to identify differences in the effects of co-intervention with resistance training (RT) and protein supplementation according to sex and provide meaningful information for future research on the development of exercise programs to improve muscle volume and muscle function. METHODS PubMed, Science Direct, and Google Scholar were searched to identify clinical and nonclinical studies that assessed the effects of RT in older adults with sarcopenia; these studies were published between 1990 and 2023. Cross-sectional and double-blind studies (randomized controlled trials, RCTs) were examined in this review. RESULTS The effects of parallel intervention with RT and protein supplementation on muscle volume and physical function were found to differ according to sex. Both males and females had improvements in muscle strength, muscle mass, and physical function after RT and protein supplementation; however, many studies found a greater increase in muscle volume and function in males than in females. Such difference may be due to differences in physiological characteristics between males and females. CONCLUSION Based on the findings of this review, the effects of combined intervention with RT and protein supplementation on muscle strength, muscle mass, and physical function to differ according to sex. Owing to these sex differences in the response and physiological characteristics caused by the parallel intervention of RT and protein supplementation, such differences must be considered to maximize the effects of RT and protein supplementation.
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Affiliation(s)
- Ki-Woong Noh
- Institute of Sports Medicine & Nutrition, Kwangwoon University, Seoul, Republic of Korea
| | - Sok Park
- Institute of Sports Medicine & Nutrition, Kwangwoon University, Seoul, Republic of Korea
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Nasimi N, Sohrabi Z, Nunes EA, Sadeghi E, Jamshidi S, Gholami Z, Akbarzadeh M, Faghih S, Akhlaghi M, Phillips SM. Whey Protein Supplementation with or without Vitamin D on Sarcopenia-Related Measures: A Systematic Review and Meta-Analysis. Adv Nutr 2023; 14:762-773. [PMID: 37196876 PMCID: PMC10334153 DOI: 10.1016/j.advnut.2023.05.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 05/05/2023] [Accepted: 05/11/2023] [Indexed: 05/19/2023] Open
Abstract
The effects of supplementation with whey protein alone or with vitamin D on sarcopenia-related outcomes in older adults are unclear. We aimed to assess the effect of whey protein supplementation alone or with vitamin D on lean mass (LM), strength, and function in older adults with or without sarcopenia or frailty. We searched PubMed, Web of Science, and SCOPUS databases. Randomized controlled trials (RCT) that investigated the effect of whey protein supplementation with or without vitamin D on sarcopenia outcomes in healthy and sarcopenic or frail older adults were included. Standardized mean differences (SMDs) were calculated for LM, muscle strength, and physical function data. The analysis showed that whey protein supplementation had no effect on LM and muscle strength; nevertheless, a significant improvement was found in physical function (SMD = 0.561; 95% confidence interval [CIs]: 0.256, 0.865, n = 33), particularly gait speed (GS). On the contrary, whey protein supplementation significantly improved LM (SMD = 0.982; 95% CI: 0.228, 1.736; n = 11), appendicular lean mass and physical function (SMD = 1.211; 95% CI: 0.588, 1.834; n = 16), and GS in sarcopenic/frail older adults. By contrast, co-supplementation with vitamin D enhanced LM gains (SMD =0.993; 95% CI: 0.112, 1.874; n = 11), muscle strength (SMD =2.005; 95% CI: 0.975, 3.035; n = 11), and physical function (SMD = 3.038; 95% CI: 2.196, 3.879; n = 18) significantly. Muscle strength and physical function improvements after whey protein supplementation plus vitamin D were observed without resistance exercise (RE) and short study duration subgroups. Moreover, the combination of whey protein and vitamin D with RE did not enhance the effect of RE. Whey protein supplementation improved LM and function in sarcopenic/frail older adults but had no positive effect in healthy older persons. By contrast, our meta-analysis showed that co-supplementation with whey protein and vitamin D is effective, particularly in healthy older adults, which is likely owing, we propose, to the correction of vitamin D insufficiency or deficiency. The trial was registered at https://inplasy.com as INPLASY202240167.
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Affiliation(s)
- Nasrin Nasimi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zahra Sohrabi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Everson A Nunes
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada; Laboratory of Investigation of Chronic Diseases, Department of Physiological Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Erfan Sadeghi
- Research Consultation Center (RCC), Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sanaz Jamshidi
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zohreh Gholami
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Akbarzadeh
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Stuart M Phillips
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada.
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Puente-Fernández J, Larumbe-Zabala E, Jiménez A, Liguori G, Rossato CJL, Mayo X, Naclerio F. No impact of combining multi-ingredient supplementation with exercise on body composition and physical performance, in healthy middle-aged and older adults: A systematic review and meta-analysis. Exp Gerontol 2023; 172:112079. [PMID: 36587797 DOI: 10.1016/j.exger.2022.112079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 10/07/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Protein-based multi-ingredient (MTN) supplements have been suggested as a safe and effective way of enhancing exercise outcomes. However, their effectiveness remains controversial when compared to isocaloric and single-nutrient supplements. This review aims to systematically summarise the current knowledge of multi-ingredient supplementation to optimise body composition and physical performance in middle-aged and older adults. MATERIAL AND METHODS A systematic review with meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search of the literature was conducted using PubMed, EBSCOhost, Google Scholar, Web of Science, and SPORTDiscus from June to October 2021. Every publication identified from the outset to October 2021 was considered. The main inclusion criteria comprised randomized controlled trial (RCT) studies conducted in adults (≥45 years old), following resistance- or endurance-based training programmes for a period of 6 weeks or longer, combined with MTN supplementation and a calorie equivalent comparator (COMP) supplement (e.g., carbohydrates). Continuous data on body composition [fat-free mass (FFM) or lean body mass], strength, and functional capacity as markers of physical performance were pooled using a random-effects model. RESULTS Initially, 3329 publications were identified. Data from nine RCTs were ultimately included, involving 476 participants. The overall quality of the included studies was high, demonstrating a low risk of bias. Compared to COMP, no significant further benefits of ingesting MTN were identified for FFM (kg) (g = 0.044, 95 % CI -0.14 to 0.22), upper-body strength (kg) (g = 0.046, 95 % CI -0.24 to 0.33), lower-body strength, leg press exercise (kg) (g = 0.025, 95 % CI -0.26 to 0.31), leg extension exercise (kg) (g = 0.106, 95 % CI -0.15 to 0.36) and functional capacity (time in seconds) (g = 0.079, 95 % CI -0.12 to 0.27). CONCLUSIONS No additional benefits of ingesting MTN vs. COMP to maximise exercise-induced outcomes on body composition and physical performance in healthy physically active middle-aged and older adults have been identified.
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Affiliation(s)
- Joel Puente-Fernández
- Institute for Lifecourse Development, School of Human Sciences, Centre for Exercise Activity and Rehabilitation, University of Greenwich, Eltham SE9 2TB, UK; GO Fit LAB, Ingesport, 28108 Madrid, Spain
| | - Eneko Larumbe-Zabala
- Canary Islands Health Research Institute Foundation (FCIISC), 38320 La Laguna, Tenerife, Spain
| | - Alfonso Jiménez
- Observatory of Healthy and Active Living of Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, 28942 Fuenlabrada, Spain; GO Fit LAB, Ingesport, 28108 Madrid, Spain; Advanced Well-Being Research Centre, Sheffield Hallam University, Sheffield S1 1WB, UK
| | - Gary Liguori
- College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Claire J L Rossato
- Institute for Lifecourse Development, School of Human Sciences, Centre for Exercise Activity and Rehabilitation, University of Greenwich, Eltham SE9 2TB, UK
| | - Xian Mayo
- Observatory of Healthy and Active Living of Spain Active Foundation, Centre for Sport Studies, King Juan Carlos University, 28942 Fuenlabrada, Spain; GO Fit LAB, Ingesport, 28108 Madrid, Spain
| | - Fernando Naclerio
- Institute for Lifecourse Development, School of Human Sciences, Centre for Exercise Activity and Rehabilitation, University of Greenwich, Eltham SE9 2TB, UK.
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Effect of Intake of Leucine-Rich Protein Supplement in Parallel with Resistance Exercise on the Body Composition and Function of Healthy Adults. Nutrients 2022; 14:nu14214501. [PMID: 36364764 PMCID: PMC9655197 DOI: 10.3390/nu14214501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/17/2022] Open
Abstract
Although sarcopenia has been dealt with in several studies, the standardized guidelines for preventing sarcopenia resulting from increased life expectancy are still insufficient. Therefore, this study evaluated the effects of daily resistance exercise and the intake of leucine-rich protein supplements daily for 12 weeks on the body composition and physical function of healthy adults aged >50 years living in Korea. The study analyzed 50 healthy people without medical conditions, who were randomly assigned to two groups (taking either protein powder or placebo powder) twice a day for 12 weeks. All participants performed resistance exercises regularly that could be repeated 8−12 times using a TheraBand for 12 weeks. A total of 41 participants completed the study. When measured via bioimpedance analysis (BIA), body fat mass (kg) and body fat (%) significantly decreased, and lean body mass (LBM) (kg) and skeletal muscle mass (SMM) (kg) significantly increased, in both groups. However, when measured via dual-energy X-ray absorptiometry (DXA), LBM was significantly increased only in the protein powder group. The LBM and SMM change measured via BIA was significantly greater in the protein powder group than in the placebo powder group (LBM: 0.95 ± 0.91 kg in the protein powder group vs. 0.38 ± 1.06 kg in the placebo powder group, p = 0.043; SMM: 0.69 ± 0.58 kg in the protein powder group vs. 0.29 ± 0.65 kg in the placebo powder group, p = 0.039, respectively). In the senior fitness test (SFT), significant functional improvement was found within the two groups, but no significant difference was found between the groups in the degree of improvement. In conclusion, in older people aged >50, to prevent sarcopenia, is more effective to combine resistance exercise and leucine-rich protein supplementation than to simply perform resistance exercise.
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Effect of Whey Protein Supplementation in Postmenopausal Women: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14194210. [PMID: 36235862 PMCID: PMC9572824 DOI: 10.3390/nu14194210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/07/2022] [Accepted: 10/07/2022] [Indexed: 11/17/2022] Open
Abstract
(1) Background: Whey protein (WP) in combination with resistance training (RT) is beneficial in improving sarcopenic obesity and its damaging effects in older adults, while the difference between men and women should be considered while interpreting results. This review aims to investigate WP's efficacy on postmenopausal women with or without RT; (2) Material and Methods: We searched electronic databases including PubMed, EMBASE, and the Cochrane Library from inception to August 2021 for randomized controlled trials that included comparison groups to evaluate WP's efficacy in women aged 55 years and above. The outcomes included body composition, muscular strength, functional capacity, and dietary intake. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to estimate the effect of WP. We also performed subgroup analysis with or without RT; (3) Results: We included 14 studies in the systematic review and 10 studies in the meta-analysis. Subgroup analyses showed RT was a major confounder for muscle strength, lean mass, and dietary protein intake (PI). In the RT subgroup, WP supplementation had a significant positive effect on biceps curl strength (BC) (SMD: 0.6805, 95% CI: 0.176, 1.185, I2: 0%), and lower limb lean-mass (LLLM) (SMD: 1.103, 95% CI: 0.632, 1.574, I2: 14%). In the subgroup without RT, a significant negative effect on PI (SMD: -0.4225, 95% CI: -0.774, -0.071, I2: 47%) was observed, while no significant effect on muscle strength or lean mass was revealed. WP supplementation did not show a significantly different effect on fat mass or body weight loss in both the subgroups; (4) Conclusions: In postmenopausal women, WP supplementation only in combination with RT enhances BC and LLLM compared to placebo controls. Without RT, WP has no significant benefit on muscle strength or lean mass.
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Protein Supplementation for Strength and Functionality in Older Adults: Is There Still Any Doubt? A Brief Update Review. J Aging Phys Act 2022; 31:311-318. [PMID: 35940583 DOI: 10.1123/japa.2022-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/17/2022] [Accepted: 06/21/2022] [Indexed: 11/18/2022]
Abstract
It is widely known that the aging process induces relevant impairments on both muscle morphology and function. In this sense, resistance training alongside proper protein intake are important strategies to mitigate the sarcopenia process in older individuals. However, adding protein supplementation (PS) to resistance training interventions for enhancing muscle strength and functional performance has shown mixed results in this population. Therefore, the present study aimed to review the most recent evidence regarding PS and its effects on muscle strength and functional parameters of older adults. In addition, the effect size of each individual study (post-pre intervention) was also calculated to provide further clinical relevance on the topic. The results of the studies included do not seem to support PS for healthy older adults with proper protein intake. However, further studies with other sample characteristics (very old, frail, obese, and inadequate protein consumption) must be carried out to better understand the effects of PS in an older population.
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Ribeiro AS, Pereira LC, Schoenfeld BJ, Nunes JP, Kassiano W, Nabuco HCG, Sugihara Junior P, Fernandes RR, Antunes M, Aguiar AF, Cyrino ES. Moderate and Higher Protein Intakes Promote Superior Body Recomposition in Older Women Performing Resistance Training. Med Sci Sports Exerc 2022; 54:807-813. [PMID: 35019903 DOI: 10.1249/mss.0000000000002855] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE Resistance training (RT) combined with appropriate dietary intake can promote a concomitant increase in skeletal muscle mass (SMM) and reduction in fat mass, a condition termed body recomposition. This study's primary purpose was to explore the effects of protein ingestion on body recomposition after 24 wk of RT in older women. METHODS Data from 130 untrained older women (68.7 ± 5.6 yr, 66.5 ± 11.5 kg, 155.5 ± 6.0 cm, and 27.4 ± 4.0 kg·m-2) across six studies were retrospectively analyzed. The participants were divided into tertiles according to their customary protein intake (g·kg-1·d-1): lower (LP; n = 45), moderate (MP; n = 42), and higher (HP; n = 43) protein intake. Participants performed a whole-body RT program carried out over 24 wk (eight exercises, three sets, 8-15 repetitions, three sessions a week). SMM and fat mass were determined by dual-energy x-ray absorptiometry. RESULTS All groups increased SMM from baseline (P < 0.05), with the HP and MP groups showing greater increases than the LP group (LP, 2.3%; MP, 5.4%; and HP, 5.1%; P < 0.05). Reductions in fat mass were similar for all three groups (LP, 1.7%; MP, 3.7%; and HP, 3.1%; P > 0.05). The composite z-score of the percentage changes from pretraining to posttraining indicated greater positive body recomposition values for HP and MP compared with LP (P < 0.05). CONCLUSIONS Results suggest that protein intake is a moderating variable for body recomposition in older women undergoing RT, with a low protein intake having a less favorable effect on body recomposition.
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Affiliation(s)
| | | | | | - João Pedro Nunes
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, PR, BRAZIL
| | - Witalo Kassiano
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, PR, BRAZIL
| | - Hellen C G Nabuco
- Federal Institute of Science and Technology of Mato Grosso, Cuiabá, MT, BRAZIL
| | - Paulo Sugihara Junior
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, PR, BRAZIL
| | - Rodrigo R Fernandes
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, PR, BRAZIL
| | - Melissa Antunes
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, PR, BRAZIL
| | | | - Edilson S Cyrino
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, State University of Londrina, Londrina, PR, BRAZIL
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Kirwan RP, Mazidi M, Rodríguez García C, Lane KE, Jafari A, Butler T, Perez de Heredia F, Davies IG. Protein interventions augment the effect of resistance exercise on appendicular lean mass and handgrip strength in older adults: a systematic review and meta-analysis of randomized controlled trials. Am J Clin Nutr 2022; 115:897-913. [PMID: 34673936 DOI: 10.1093/ajcn/nqab355] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 10/19/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Increased protein intake is suggested as a strategy to slow or reverse the loss of muscle mass and strength observed in sarcopenia, but results from studies that directly tested this possibility have been inconsistent. OBJECTIVES We assessed the evidence on the effects of whole protein supplementation or higher-protein diets, without the use of amino acids or supplements known to stimulate hypertrophy, alone or in combination with resistance exercise (RE) interventions, on lean body mass (LBM) and strength in older adults. METHODS A systematic search was conducted using PubMed, Medline, Web of Science, and Cochrane CENTRAL databases from January 1990 to July 2021. Randomized controlled trials that assessed the effects of protein supplementation and/or higher-protein dietary interventions in older adults (mean age ≥50 y) on total LBM, appendicular lean mass (ALM), and handgrip (HG) and knee extension (KE) strength were included. RESULTS Twenty-eight studies were identified. In pooled analysis, compared with lower protein controls, protein supplementation did not have a significant positive effect on total LBM [weighted mean difference in change (WMD): 0.34; 95% CI: -0.21, 0.89; I2 = 90.01%], ALM (WMD: 0.4; 95% CI: -0.01, 0.81; I2 = 90.38%), HG strength (WMD: 0.69; 95% CI: -0.69, 2.06; I2 = 94.52%), or KE strength (WMD: 1.88; 95% CI: -0.6, 4.35; I2 = 95.35%). However, in interventions that used also RE, statistically significant positive effects of protein were observed for ALM (WMD: 0.54; 95% CI: 0.03, 1.05; I2 = 89.76%) and HG (WMD: 1.71; 95% CI: 0.12, 3.30; I2 = 88.71%). Meta-regression revealed no significant association between age, per-meal protein dose, duration, and baseline protein intake with change in any outcome. Subgroup analysis revealed the statistically significant effects on ALM occurred only in sarcopenic/frail populations (WMD: 0.88; 95% CI: 0.51, 1.25; I2 = 79.0%). Most studies (n = 22) had some risk of bias. CONCLUSIONS In older adults performing RE, increased protein intake leads to greater ALM and HG strength compared with lower protein controls. Without RE, protein has no additional benefit on changes in total LBM, ALM, or HG strength.
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Affiliation(s)
- Richard P Kirwan
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Mohsen Mazidi
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK.,Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Carmen Rodríguez García
- Department of Health Sciences, Faculty of Experimental Sciences, University of Jaén, Jaén, Spain
| | - Katie E Lane
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Alireza Jafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Tom Butler
- School of Applied Health and Social Care and Social Work, Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, UK
| | - Fatima Perez de Heredia
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Ian G Davies
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
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Griffen C, Duncan M, Hattersley J, Weickert MO, Dallaway A, Renshaw D. Effects of resistance exercise and whey protein supplementation on skeletal muscle strength, mass, physical function, and hormonal and inflammatory biomarkers in healthy active older men: a randomised, double-blind, placebo-controlled trial. Exp Gerontol 2021; 158:111651. [PMID: 34896568 DOI: 10.1016/j.exger.2021.111651] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/18/2021] [Accepted: 12/06/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE To determine the individual and combined effects of 12 weeks of resistance exercise (RE) and whey protein supplementation on skeletal muscle strength (primary outcome), mass and physical function, and hormonal and inflammatory biomarkers in older adults. METHODS Thirty-six healthy older men [(mean±SE) age: 67±1 y; BMI: 25.5±0.4 kg/m2] were randomised to either control (CON; n=9), whey protein (PRO; n=9), RE+control (EX+CON; n=9), or RE+whey protein (EX+PRO; n=9) in a double-blinded fashion. Whole-body RE (2 sets of 8 repetitions and 1 set to volitional failure at 80% 1RM) was performed twice weekly. Supplements (PRO, 25 g whey protein isolate; CON, 23.75 g maltodextrin) were consumed twice daily. RESULTS EX+CON and EX+PRO increased leg extension (+19±3 kg and +20±3 kg, respectively) and leg press 1RM (+27±3 kg and +39±2 kg, respectively) greater than the CON and PRO groups (P<0.001, Cohen's d=1.50-1.90). RE (EX+CON and EX+PRO groups pooled) also increased fat-free mass (FFM) (+0.9±0.3 kg) and 6-min walk test distance (+21±5 m) and decreased fat mass (-0.4±0.4 kg), and interleukin-6 (-1.0±0.4 pg/mL) and tumor necrosis factor-alpha concentration (-0.7±0.3 pg/mL) greater than non-exercise (CON and PRO groups pooled; P<0.05, Cohen's f=0.37-0.45). Whey protein supplementation (PRO and EX+PRO groups pooled) increased 4-m gait speed greater than control (CON and EX+CON groups pooled) (+0.08±0.03 m/s; P=0.007, f=0.51). CONCLUSION RE increased muscle strength, FFM and physical function, and decreased markers of systemic inflammation in healthy active older men. Whey protein supplementation alone increased gait speed. No synergistic effects were observed. This study was registered at clinicaltrials.gov as NCT03299972.
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Affiliation(s)
- Corbin Griffen
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom.
| | - Michael Duncan
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; School of Life Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, CV1 2DS, United Kingdom
| | - John Hattersley
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; School of Engineering, University of Warwick, Coventry, CV4 7HL, United Kingdom
| | - Martin O Weickert
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Department of Endocrinology and Diabetes, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom; Warwick Medical School, University of Warwick, Coventry, CV4 7AL, United Kingdom
| | - Alexander Dallaway
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom; Human Metabolism Research Unit, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, United Kingdom
| | - Derek Renshaw
- Centre for Sport, Exercise and Life Sciences, Research Institute of Health and Wellbeing, Coventry University, Coventry, CV1 2DS, United Kingdom
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11
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Hengeveld LM, de Goede J, Afman LA, Bakker SJL, Beulens JWJ, Blaak EE, Boersma E, Geleijnse JM, van Goudoever J(HB, Hopman MTE, Iestra JA, Kremers SPJ, Mensink RP, de Roos NM, Stehouwer CDA, Verkaik-Kloosterman J, de Vet E, Visser M. Health Effects of Increasing Protein Intake Above the Current Population Reference Intake in Older Adults: A Systematic Review of the Health Council of the Netherlands. Adv Nutr 2021; 13:1083-1117. [PMID: 35016214 PMCID: PMC9340973 DOI: 10.1093/advances/nmab140] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/07/2021] [Accepted: 11/17/2021] [Indexed: 01/06/2023] Open
Abstract
Whether older adults need more protein than younger adults is debated. The population reference intake for adults set by the European Food Safety Authority is 0.83 g/kg body weight (BW)/d based primarily on nitrogen balance studies, but the underlying data on health outcomes are outdated. An expert committee of the Health Council of the Netherlands conducted a systematic review (SR) of randomized controlled trials (RCTs) examining the effect of increased protein intake on health outcomes in older adults from the general population with an average habitual protein intake ≥0.8 g/(kg BW · d). Exposures were the following: 1) extra protein compared with no protein and 2) extra protein and physical exercise compared with physical exercise. Outcomes included lean body mass, muscle strength, physical performance, bone health, blood pressure, serum glucose and insulin, serum lipids, kidney function, and cognition. Data of >1300 subjects from 18 RCTs were used. Risk of bias was judged as high (n = 9) or "some concerns" (n = 9). In 7 of 18 RCTs, increased protein intake beneficially affected ≥1 of the tested outcome measures of lean body mass. For muscle strength, this applied to 3 of 8 RCTs in the context of physical exercise and in 1 of 7 RCTs without physical exercise. For the other outcomes, <30% (0-29%) of RCTs showed a statistically significant effect. The committee concluded that increased protein intake has a possible beneficial effect on lean body mass and, when combined with physical exercise, muscle strength; likely no effect on muscle strength when not combined with physical exercise, or on physical performance and bone health; an ambiguous effect on serum lipids; and that too few RCTs were available to allow for conclusions on the other outcomes. This SR provides insufficiently convincing data that increasing protein in older adults with a protein intake ≥0.8 g/(kg BW · d) elicits health benefits.
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Affiliation(s)
| | | | - Lydia A Afman
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Stephan J L Bakker
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands,Amsterdam Cardiovascular Sciences Research Institute, Amsterdam University Medical Center, location VUmc, Amsterdam, The Netherlands,Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Ellen E Blaak
- Department of Human Biology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
| | - Eric Boersma
- Erasmus MC, University Medical Center, Department of Cardiology, Rotterdam, The Netherlands
| | - Johanna M Geleijnse
- Health Council of the Netherlands, The Hague, The Netherlands,Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Johannes (Hans) B van Goudoever
- Amsterdam UMC, University of Amsterdam, Vrije Universiteit, Emma Children's Hospital, Department of Pediatrics, Amsterdam, The Netherlands
| | - Maria T E Hopman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jolein A Iestra
- Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Stef P J Kremers
- Department of Health Promotion, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Ronald P Mensink
- Department of Nutrition and Movement Sciences, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nicole M de Roos
- Division of Human Nutrition and Health, Wageningen University and Research, Wageningen, The Netherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, the Netherlands,Department of Internal Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Emely de Vet
- Department of Social Sciences, Chair group Consumption and Healthy Lifestyles, Wageningen University and Research, Wageningen, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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12
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Choi M, Kim H, Bae J. Does the combination of resistance training and a nutritional intervention have a synergic effect on muscle mass, strength, and physical function in older adults? A systematic review and meta-analysis. BMC Geriatr 2021; 21:639. [PMID: 34772342 PMCID: PMC8588667 DOI: 10.1186/s12877-021-02491-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 09/17/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Health-promoting interventions are important for preventing frailty and sarcopenia in older adults. However, there is limited evidence that nutritional interventions yield additional effects when combined with resistance training. This systematic review and meta-analysis aimed to compare the effectiveness of nutritional interventions with resistance training and that of resistance training alone. METHODS Randomized controlled trials published in peer-reviewed journals prior to July 2020 were retrieved from databases and other sources. The articles were screened according to the inclusion and exclusion criteria. The methodological quality of the included studies was assessed using Cochrane's risk of bias tool 2. A meta-analysis was performed using the RevMan 5.4 program and STATA 16 program. RESULTS A total of 22 studies were included in the meta-analysis. The results of the meta-analysis showed no significant differences between groups in muscle mass, muscle strength, or physical functional performance. In the subgroup analysis regarding the types of nutritional interventions, creatine showed significant effects on lean body mass (n = 4, MD 2.61, 95% CI 0.51 to 4.72). Regarding the other subgroup analyses, there were no significant differences in appendicular skeletal muscle mass (p = .43), hand grip strength (p = .73), knee extension strength (p = .09), chair stand test results (p = .31), or timed up-and-go test results (p = .31). In the meta-regression, moderators such as the mean age of subjects and duration of interventions were not associated with outcome variables. CONCLUSIONS This meta-analysis showed that nutritional interventions with resistance training have no additional effect on body composition, muscle strength, or physical function. Only creatine showed synergistic effects with resistance training on muscle mass. TRIAL REGISTRATION CRD42021224843 .
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Affiliation(s)
- MoonKi Choi
- College of Nursing, Kangwon National University, Chuncheon-si, Gangwon-do, Republic of Korea, 24341
| | - Hayeon Kim
- Seoul Women's College of Nursing, Ganhodae-ro 38, Seodaemun-gu, Seoul, Republic of Korea, 03617
| | - Juyeon Bae
- Department of Nursing, Yeoju Institute of Technology, Sejong-ro 338, Yeoju-si, Gyeonggi-do, Republic of Korea, 12652.
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13
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Ransdell LB, Wayment HA, Lopez N, Lorts C, Schwartz AL, Pugliesi K, Pohl PS, Bycura D, Camplain R. The impact of resistance training on body composition, muscle strength, and functional fitness in older women (45-80 years): A systematic review (2010-2020). WOMEN 2021; 1:143-168. [PMID: 35702064 PMCID: PMC9191851 DOI: 10.3390/women1030014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
As women age, they typically experience a progressive decrease in skeletal muscle mass and strength, which can lead to a decline in functional fitness and quality of life. Resistance training (RT) has the potential to attenuate these losses. Although well established for men, evidence regarding the benefits of RT for women is sparse and inconsistent: prior reviews include too few studies with women and do not adequately examine the interactive or additive impacts of workload, modalities, and nutritional supplements on outcomes such as muscle mass (MM), body composition (BC), muscle strength (MS), and functional fitness (FF). The purpose of this review is to identify these gaps. Thirty-eight papers published between 2010 and 2020 (in English) represent 2519 subjects (mean age = 66.89 ± 4.91 years). Intervention averages include 2 to 3 × 50 min sessions across 15 weeks with 7 exercises per session and 11 repetitions per set. Twelve studies (32%) examined the impact of RT plus dietary manipulation. MM, MS, and FF showed positive changes after RT. Adding RT to fitness regimens for peri- to postmenopausal women is likely to have positive benefits.
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Affiliation(s)
- Lynda B Ransdell
- College of Health and Human Sciences, Northern Illinois University, DeKalb, IL
| | - Heidi A Wayment
- Department of Psychological Sciences, Northern Arizona University, Flagstaff, AZ
| | - Nanette Lopez
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ
| | - Cori Lorts
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ
| | - Anna L Schwartz
- School of Nursing, Northern Arizona University, Flagstaff, AZ
| | - Karen Pugliesi
- Department of Sociology, Northern Arizona University, Flagstaff, AZ
| | - Patricia S Pohl
- Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ
| | - Dierdra Bycura
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ
| | - Ricky Camplain
- Department of Health Sciences, Northern Arizona University, Flagstaff, AZ
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14
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Effects of Milk Protein in Resistance Training-Induced Lean Mass Gains for Older Adults Aged ≥ 60 y: A Systematic Review and Meta-Analysis. Nutrients 2021; 13:nu13082815. [PMID: 34444975 PMCID: PMC8398205 DOI: 10.3390/nu13082815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 11/16/2022] Open
Abstract
This review evaluated the effects of milk-based protein supplementation on resistance training (RT)-induced gains in lean body mass or fat free mass (LBM/FFM) and muscle strength for older adults. A systematic search of PubMed, Scopus and EBSCOhost/SPORTDiscus was conducted. Eligibility criteria: Randomized controlled trials comparing all types of milk-based protein supplements with control supplements for the training older adults at mean age ≥ 60 y. Twenty studies were included in the qualitative synthesis, whilst seventeen studies were included in the quantitative synthesis. A dose of 10-15 g of milk protein supplementation was sufficient to augment RT-induced LBM/FFM. Intriguingly, four out of five studies show negative effect of whey protein supplementation at the same dose range (or even higher) compared with control supplementation (-0.49 kg, 95% CI: -0.69, -0.29, I2 = 14%, Z = 4.82, p < 0.001). For milk-based protein supplementation, RT-induced improvements in muscle strength were observed only when the protein doses ≥22 g (+0.66 kg, 95% CI: 0.07, 1.25, I2 = 0%, Z = 2.18, p = 0.03). Conclusion: Milk protein is superior to whey protein in enhancing RT-induced LBM/FFM gains for older adults. Optimal daily protein intake can dilute the protein supplementation effect.
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15
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The Combination of Preoperative Skeletal Muscle Quantity and Quality is an Important Indicator of Survival in Elderly Patients Undergoing Curative Gastrectomy for Gastric Cancer. World J Surg 2021; 45:2868-2877. [PMID: 34235561 DOI: 10.1007/s00268-021-06204-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/31/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND The diagnosis of sarcopenia emphasizes both, the quantity and quality of skeletal muscle. However, the impact of the combination of muscle quantity and quality on long-term survival remains unclear. This study aimed to assess the impact of the combination of skeletal muscle quantity and quality on long-term outcomes in patients with gastric cancer who underwent curative resection. METHODS We retrospectively assessed 242 patients aged ≥ 65 ears who underwent curative gastrectomy between 2006 and 2015. The psoas muscle mass index (PMI) and intramuscular adipose tissue content (IMAC) were measured on preoperative computed tomography as skeletal muscle quantity and quality, respectively. The sarcopenia stage was classified by the combination of preoperative skeletal muscle quantity and quality (non-sarcopenia, sarcopenia, and severe sarcopenia). Prognostic factors for the 5-year overall survival (OS), non-cancer-specific survival (non-CSS), and cancer-specific survival (CSS) were evaluated by multivariable Cox regression. RESULTS The median follow-up period was 63.2 months. The non-sarcopenia, sarcopenia, and severe sarcopenia groups comprised 88, 121, and 33 patients (36.4%, 50.0%, and 13.6%), respectively. The severe sarcopenia group was older, and had a greater depth of invasion, than the non-sarcopenia group. Multivariable analysis revealed severe sarcopenia as an independent predictive indicator of OS (hazard ratio [HR] 4.01; 95% confidence interval [CI] 1.75 to 9.22) and non-CSS (HR 3.27; 95% CI 1.61 to 6.67), but not CSS. CONCLUSIONS The combination of preoperative skeletal muscle quantity and quality was useful for predicting survival, especially death from other diseases, in elderly patients who underwent gastrectomy for gastric cancer.
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16
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Muscle function, quality, and relative mass are associated with knee pain trajectory over 10.7 years. Pain 2021; 163:518-525. [PMID: 34490853 DOI: 10.1097/j.pain.0000000000002383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 06/01/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT Periarticular muscle plays an important role in the pathogenesis of musculoskeletal pain. We recently reported that pain population consists of distinct subgroups of which the causes and mechanisms may differ. This study aimed to examine the association of lean mass, muscle strength, and quality with 10.7-year pain trajectory. Nine hundred forty-seven participants from a population-based cohort study were analysed. Dual-energy X-ray absorptiometry was used to assess lean and fat mass. Leg strength, knee extensor strength, and lower-limb muscle quality were measured/calculated. Knee pain was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index pain questionnaire. Radiographic knee osteoarthritis was assessed by X-ray. Three distinct pain trajectories were identified: "Minimal pain" (53%), "Mild pain" (34%), and "Moderate pain" (13%). Higher total and lower-limb lean mass were associated with an increased risk of "Mild pain" and "Moderate pain" trajectories relative to the "Minimal pain" trajectory group, but these associations became nonsignificant after further adjustment for fat mass. Total lean mass percentage was associated with a lower risk of "Mild pain" (relative risk ratio [RRR]: 0.95, 95% confidence interval 0.92-0.98) and "Moderate pain" trajectory (RRR: 0.92, 95% confidence interval 0.87-0.96). Greater leg and knee extensor strength and muscle quality were associated with "Mild pain" and "Moderate pain" trajectories (RRR: 0.52-0.65, all P < 0.05). Similar results were found in those with radiographic knee osteoarthritis. Higher lower-limb muscle strength and quality, and relative lean mass, are associated with a reduced risk of severe knee pain trajectories, suggesting that improving muscle function and composition may protect against persistent unfavourable knee pain courses.
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17
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Lu Y, Wang YJ, Lu Q. The effect of oral nutritional supplement on muscle fitness of patients undergoing dialysis: A systematic review and meta-analysis. J Adv Nurs 2020; 77:1716-1730. [PMID: 33270269 DOI: 10.1111/jan.14684] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/18/2020] [Accepted: 10/29/2020] [Indexed: 12/14/2022]
Abstract
AIM To summarize evidence regarding the effects of oral nutritional supplement on muscle fitness of patients undergoing dialysis. DESIGN A systematic review and meta-analysis. REVIEW SOURCES Five English databases (CENTRAL, PubMed, EMBASE, CINHAL, and Web of Science) and four Chinese databases (CNKI, WanFang, SinoMed, and VIP) were searched from inception to 31 July 2019 and only randomized controlled trials were included. REVIEW METHODS Two reviewers independently searched these databases, selected trials, conducted bias assessment, extracted the data. Random-effects meta-analysis was conducted to assess the effect size. The predetermined subgroup included type of oral nutritional supplement (a mixture of macronutrients, whey protein, essential amino-acids, and other nutrients) and intervention duration (over and less than 48 weeks). The subgroup analyses and sensitivity analyses were conducted to explore source of heterogeneity and robustness of results. RESULTS Sixteen studies (910 participants) meeting the inclusion criteria were identified and included in this systematic review. Subgroup analysis showed that supplying a mixture of macronutrients (MD [MD] = 2.36 kg, 95% CI [0.45, 4.26], I2 = 0.00%), an intervention duration of 48 weeks (MD = 4.05 kg, 95% CI [1.43, 6.67], I2 = 0.00%) had some effects on increasing lean body mass. No effects of oral nutritional supplement were found on improving muscle strength or physical performance. CONCLUSION A mixture of macronutrients and an intervention duration as long as 48 weeks had some significant effects on improving lean body mass of patients undergoing dialysis. No effect of oral nutritional supplement on muscle strength or physical performance were found but with limited evidence. IMPACT No existing reviews have ever focused on improving muscle fitness of patients undergoing dialysis. This systematic review and meta-analysis provided evidence of oral nutritional supplement on keeping muscle fitness of these patients and suggested possible type of oral nutritional supplement and intervention duration for clinical practice.
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Affiliation(s)
- Yue Lu
- School of Nursing, Peking University, Beijing, China
| | - Yu-Jie Wang
- School of Nursing, Peking University, Beijing, China
| | - Qian Lu
- School of Nursing, Peking University, Beijing, China
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18
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Ben-Harchache S, Roche HM, Corish CA, Horner KM. The Impact of Protein Supplementation on Appetite and Energy Intake in Healthy Older Adults: A Systematic Review with Meta-Analysis. Adv Nutr 2020; 12:490-502. [PMID: 33037427 PMCID: PMC8009738 DOI: 10.1093/advances/nmaa115] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/10/2020] [Accepted: 08/25/2020] [Indexed: 01/04/2023] Open
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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Affiliation(s)
- Sana Ben-Harchache
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Belfield, Dublin, Ireland,Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
| | - Helen M Roche
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Belfield, Dublin, Ireland,Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland,Nutrigenomics Research Group, UCD Conway Institute, University College Dublin, Belfield, Dublin, Ireland,Institute for Global Food Security, Queen's University Belfast, Belfast, Northern Ireland
| | - Clare A Corish
- School of Public Health, Physiotherapy and Sport Science, University College Dublin, Belfield, Dublin, Ireland,Institute of Food and Health, University College Dublin, Belfield, Dublin, Ireland
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19
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Montalcini T, Pujia A, Donini LM, Frittitta L, Galvano F, Natali A, Pironi L, Porrini M, Riso P, Rivellese AA, Russo D, Scapagnini G, Serafini M, Tagliabue A, De Lorenzo A. A Call to Action: Now Is the Time to Screen Elderly and Treat Osteosarcopenia, a Position Paper of the Italian College of Academic Nutritionists MED/49 (ICAN-49). Nutrients 2020; 12:E2662. [PMID: 32878316 PMCID: PMC7550989 DOI: 10.3390/nu12092662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 08/24/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023] Open
Abstract
Aging is a risk factor for the development of multiple chronic diseases, including cardiovascular disease, cancer and dementia. Life expectancy has increased in certain countries but this phenomenon is associated with a reduction of years of healthy life. Aging is associated with a number of physical and functional changes, especially sarcopenia. Sarcopenia is a clinical condition associated with a decrease in skeletal muscle and muscle strength, however, sarcopenia is a reversible condition. On the basis of the current scientific literature, sarcopenia could more appropriately capture an individual's vulnerability to negative health-related outcomes since it represents an early form of the chronic diseases. Recognition of this clinical condition can improve the management of older individuals in many different clinical settings. Despite the limitations of the indirect methods used to study body composition, the Italian College of the Academic Nutritionists ME/49 recommends that health authorities and health professionals around the world should make a greater effort to diagnose sarcopenia earlier and to manage it more effectively. In line with the development of cancer screening, the use of two diagnostic tools for sarcopenia (BIA and DXA) should be implemented.
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Affiliation(s)
- Tiziana Montalcini
- Department of Clinical and Experiment Medicine, University of Catanzaro Magna Grecia, Viale Europa, 88100 Catanzaro, Italy;
| | - Arturo Pujia
- Department of Clinical and Experiment Medicine, University of Catanzaro Magna Grecia, Viale Europa, 88100 Catanzaro, Italy;
| | - Lorenzo M. Donini
- Department of Experimental Medicine, University of la Sapienza, Piazzale Aldo Moro 5, 00185 Rome, Italy;
| | - Lucia Frittitta
- Department of Clinical and Experiment Medicine, University of Catania, Via Santa Sofia, 86-95123 Catania, Italy;
| | - Fabio Galvano
- Department of Biomedical and Biotechnology Science, University of Catania, Via Santa Sofia, 86-95123 Catania, Italy;
| | - Andrea Natali
- Department of Clinical and Experiment Medicine, University of Pisa, Lungarno Antonio Pacinotti, 43, 56126 Pisa, Italy;
| | - Loris Pironi
- Department of Medical and Surgical Science, University of Bologna, Via Pupilli, 1, 40136 Bologna, Italy;
| | - Marisa Porrini
- Department of Food, Nutrition and Environment Science, University of Milan, Via Festa del Perdono, 7, 20122 Milano, Italy; (M.P.); (P.R.)
| | - Patrizia Riso
- Department of Food, Nutrition and Environment Science, University of Milan, Via Festa del Perdono, 7, 20122 Milano, Italy; (M.P.); (P.R.)
| | - Angela Albarosa Rivellese
- Department of Clinical and Experiment Medicine, University of Naples Federico II, Corso Umberto I, 40, 80138 Napoli, Italy;
| | - Diego Russo
- Department of Health Science, University of Catanzaro Magna Grecia, Viale Europa, 88100 Catanzaro, Italy;
| | - Giovanni Scapagnini
- Department of Medicine and Health Science, University of Molise, Via F. De Sanctis, 86100 Campobasso, Italy;
| | - Mauro Serafini
- Department of Bioscience and food technology, University of Teramo, Via Renato Balzarini, 1, 64100 Teramo, Italy;
| | - Anna Tagliabue
- Department of Public Health, University of Pavia, Corso Str. Nuova, 65, 27100 Pavia, Italy;
| | - Antonino De Lorenzo
- Biomedicine and Prevention, University of Tor Vergata, Via Montpellier, 1, 00133 Roma, Italy;
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Effectiveness of Protein Supplementation Combined with Resistance Training on Muscle Strength and Physical Performance in Elderly: A Systematic Review and Meta-Analysis. Nutrients 2020; 12:nu12092607. [PMID: 32867103 PMCID: PMC7551830 DOI: 10.3390/nu12092607] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/21/2020] [Accepted: 08/25/2020] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to evaluate the effectiveness of the combination of resistance training (RT) and protein supplementation (PS), compared to RT alone or combined with a placebo (plS), in the improvement of muscle strength and physical performance. The search strategy in PubMed, Cochrane Library, and Web of Sciences databases found a total of 294 studies. Once inclusion and exclusion criteria were applied, 16 studies were included for the qualitative analysis. A total of 657 healthy elderly (>60 years) participants were analysed. Finally, 15 articles were included in the quantitative analysis with one being excluded due to issues with data availability. Upper-limb, lower-limb, and handgrip strength were the primary outcomes of the meta-analysis. The secondary outcomes, related to physical performance, were Short Physical Performance Battery (SPPB), gait speed, and the five-chair-rise test (5CRT). The main results of the meta-analysis show no statistical differences for upper-limb (SMD: 0.56, 95% CI: −0.09, 1.21, p = 0.09, I2 = 68%), lower-limb (SMD: 0.00, 95% CI: −0.18, 0.18, p = 1.0, I2 = 11%), and handgrip strength (SMD: 0.03, 95% CI: −0.26, 0.32, p = 0.84, I2 = 0%) between the RT + PS and the RT alone (or combined with plS). Moreover, no statistical differences were found relating to physical performance. In view of these results, protein supplementation combined with RT does not provide additional benefits compared to RT alone or with plS in healthy elderly adults.
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The Effects of Cow-Milk Protein Supplementation in Elderly Population: Systematic Review and Narrative Synthesis. Nutrients 2020; 12:nu12092548. [PMID: 32842497 PMCID: PMC7551861 DOI: 10.3390/nu12092548] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 08/20/2020] [Accepted: 08/21/2020] [Indexed: 12/13/2022] Open
Abstract
Background. To review currently available evidence on the effect of cow-milk proteins supplementation (CPS) on health in the elderly. Methods. Five electronic databases (Pubmed, Web of Science, Embase, Cochrane Library, ClinicalTrials.gov) were searched for studies about CPS among older people. All types of publications were included, with the exception of systematic reviews, meta-analyses, opinion letters, editorials, case reports, conference abstracts and comments. An additional search in Google Scholar and a manual review of the reference lists were performed. Results. Overall, 103 studies were included. Several studies explored the role of CPS in the preservation or improvement of muscle mass among healthy subjects (40 studies) and pre-frail, frail or sarcopenic patients (14), with evidence of beneficial effects. Other studies assessed the effect of CPS on bones (12), cardiovascular disease (8), inflamm-aging (7), chronic pulmonary disease (4), neurocognitive function (4), and vaccines (2), with weak evidence of positive effects. Seven studies in the field of protein metabolism investigated the role of CPS as an important contributor to nutritional needs. Other investigational areas are considered in the last five studies. Conclusions. The beneficial effects of CPS in achieving aged-related nutritional goals, in preserving muscle mass and in recovering after hospitalization may be particularly relevant in the elderly.
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Effects of low-dose milk protein supplementation following low-to-moderate intensity exercise training on muscle mass in healthy older adults: a randomized placebo-controlled trial. Eur J Nutr 2020; 60:917-928. [PMID: 32524231 PMCID: PMC7900046 DOI: 10.1007/s00394-020-02302-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 06/05/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE The purpose of this study was to examine whether long-term ingestion of low-dose milk protein supplementation causes a greater increase in muscle mass and strength of older adults during low-to-moderate intensity exercise training intervention than isocaloric carbohydrate. METHODS In a randomized, double-blind, and placebo-controlled design, 122 healthy older adults (60-84 year) received either an acidified milk protein drink containing 10 g of milk protein (MILK; n = 61) or an isocaloric placebo drink (PLA; n = 61) daily throughout 6 months of body weight and medicine ball exercise training. Measurements before and after the intervention included body composition, physical performance and blood biochemistry. RESULTS Lean body mass significantly increased in the MILK group (+ 0.54 kg, p < 0.001), but did not change in the PLA group (- 0.10 kg, p = 0.534). The increases in the MILK group were significantly greater than in the PLA group (p = 0.004). Fat mass (- 0.77 kg) and plasma uric acid levels (- 0.3 mg/dL) significantly decreased only in the MILK group (p < 0.001), with a significant group difference (p = 0.002 and p < 0.001, respectively). Most of the physical performance tests significantly improved in both groups, but no group differences were found. CONCLUSION We conclude that low-dose milk protein supplementation (10 g of protein/day) combined with low-to-moderate intensity exercise training is associated with increased muscle mass, but not improved physical performance compared to carbohydrate combined with exercise in healthy older adults. This study was registered in the UMIN Clinical Trials Registry (UMIN000032189).
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23
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Whey for Sarcopenia; Can Whey Peptides, Hydrolysates or Proteins Play a Beneficial Role? Foods 2020; 9:foods9060750. [PMID: 32517136 PMCID: PMC7353484 DOI: 10.3390/foods9060750] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/29/2020] [Accepted: 06/02/2020] [Indexed: 12/20/2022] Open
Abstract
As the human body ages, skeletal muscle loses its mass and strength. It is estimated that in 10% of individuals over the age of 60, this muscle frailty has progressed to sarcopenia. Biomarkers of sarcopenia include increases in inflammatory markers and oxidative stress markers and decreases in muscle anabolic markers. Whey is a high-quality, easily digested dairy protein which is widely used in the sports industry. This review explores the evidence that whey protein, hydrolysates or peptides may have beneficial effects on sarcopenic biomarkers in myoblast cell lines, in aged rodents and in human dietary intervention trials with the older consumer. A daily dietary supplementation of 35 g of whey is likely to improve sarcopenic biomarkers in frail or sarcopenia individuals. Whey supplementation, consumed by an older, healthy adult certainly improves muscle mTOR signaling, but exercise appears to have the greatest benefit to older muscle. In vitro cellular assays are central for bioactive and bioavailable peptide identification and to determine their mechanism of action on ageing muscle.
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de Carvalho Bastone A, Nobre LN, de Souza Moreira B, Rosa IF, Ferreira GB, Santos DDL, Monteiro NKSS, Alves MD, Gandra RA, de Lira EM. Independent and combined effect of home-based progressive resistance training and nutritional supplementation on muscle strength, muscle mass and physical function in dynapenic older adults with low protein intake: A randomized controlled trial. Arch Gerontol Geriatr 2020; 89:104098. [PMID: 32446170 DOI: 10.1016/j.archger.2020.104098] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 05/02/2020] [Accepted: 05/05/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND With the aging phenomenon, there is growing interest in developing effective strategies to counteract dynapenia, the age-related loss of muscle strength. The positive effect of progressive resistance training on muscle strength is well known, however, the effect of nutritional supplementation or its synergistic effect along with exercise on muscle strength is not a consensus in the literature, especially in populations with low protein intake. METHODS We analyzed the muscle strength (handgrip strength and sit-to-stand test), muscle mass, body mass index, insulin resistance, and physical function (gait speed, timed up & go test, and single-leg-stance test) of 69 dynapenic older adults with low protein intake, before and after the intervention period of three months. The participants were randomly allocated into four groups: resistance training, supplementation, resistance training plus supplementation, and control. RESULTS There was a significant group x time interaction on the following outcome measures: handgrip strength (p < 0.001), gait speed (p = 0.023), and sit-to-stand test (p < 0.001). Considering the outcomes that showed a significant difference between and within groups, only the resistance training group and the resistance training plus supplementation group showed a large effect size in handgrip strength, gait speed, and sit-to-stand test, whereas the supplementation group showed a moderate effect size in gait speed. After the intervention period, there was no difference between the resistance training and the resistance training plus supplementation groups. CONCLUSION This study reinforces the value of resistance training in improving muscle strength. The nutritional supplementation added no further benefits in this specific population. Registration number at the Brazilian registry of clinical trials: RBR-4HRQJF.
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Affiliation(s)
- Alessandra de Carvalho Bastone
- Postgraduate Program in Reabilitation and Functional Performance, Department of Physical Therapy - Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
| | - Luciana Neri Nobre
- Department of Nutrition - Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
| | - Bruno de Souza Moreira
- Postgraduate Program in Public Health - Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
| | - Iramaya Francielle Rosa
- Department of Physical Therapy - Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
| | - Gabrielle Bemfica Ferreira
- Department of Nutrition - Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
| | - Dayane Deyse Lee Santos
- Department of Physical Therapy - Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
| | | | - Michelle Dullya Alves
- Department of Nutrition - Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
| | - Rômulo Amaral Gandra
- Department of Physical Therapy - Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
| | - Elane Marinho de Lira
- Postgraduate Program in Reabilitation and Functional Performance, Department of Physical Therapy - Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, Minas Gerais, Brazil.
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Effects of Protein Intake Beyond Habitual Intakes Associated With Resistance Training on Metabolic Syndrome-Related Parameters, Isokinetic Strength, and Body Composition in Older Women. J Aging Phys Act 2019; 27:545–552. [PMID: 30676196 DOI: 10.1123/japa.2018-0370] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective of this study was to investigate the effects of protein intake beyond habitual intakes associated with resistance training on metabolic syndrome (MetS)-related parameters, isokinetic strength, and body composition in health older women. A total of 30 older women (68.8 ± 4.3 years) participated in this investigation and were assigned to receive 35 g of whey protein or placebo combined with resistance training, over 12-weeks, three times per week. Blood samples, blood pressure, dietary intake, strength, and body composition were assessed before and after the intervention period. Two-way analysis of variance for repeated measures was applied for comparisons. Both groups improved the skeletal muscle mass, muscular strength, waist circumference, triglycerides, high-density lipoprotein, glucose, resistance, reactance, and MetS Z-score risk. However, the improvements in skeletal muscle mass, waist circumference, and MetS Z-score risk were significantly greater in protein group when compared with control group. Moreover, protein group significantly decreased %body fat when compared with control group. Higher protein intake combined with resistance training promoted greater improvements in skeletal muscle mass, %body fat, waist circumference, and MetS Z-score risk in older women.
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26
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Nabuco HC, Tomeleri CM, Junior PS, Fernandes RR, Cavalcante EF, Nunes JP, Cunha PF, Dos Santos L, Cyrino ES. Effects of higher habitual protein intake on resistance-training-induced changes in body composition and muscular strength in untrained older women: A clinical trial study. Nutr Health 2019; 25:103-112. [PMID: 30909813 DOI: 10.1177/0260106019838365] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Aging is accompanied by progressive and accentuated decline in muscular strength and skeletal muscle mass, affecting health and functional autonomy. Both resistance training (RT) and diet are strategies that may contribute to improvement in the health of the elderly. AIM The purpose of this study was to evaluate the effects of higher habitual protein intake on RT-induced changes in body composition and strength in untrained postmenopausal women. METHODS Seventy older women were submitted to an RT program. Body composition, muscular strength, and dietary intake (24 h dietary recall) were performed pre- and post-intervention. To verify different intervention effects according to protein intake of the participants, the sample was separated into tertiles according to protein intake: low, moderate, and high protein intake. RESULTS A time vs. group interaction ( p < 0.05) was observed, with high protein intake presenting greater increases compared with low protein intake, for skeletal muscle mass (5.3% vs. 1.3%), lower limb lean soft tissue (4.9% vs. 1.4%), upper lean soft tissue (4.9% vs. 1.2%), preacher curl (24% vs. 15.2%), and total strength (16.4% vs. 11.7%). A time vs. group interaction ( p < 0.05) was observed, with high protein intake presenting greater increases compared with moderate protein intake, for skeletal muscle mass (5.3% vs. 3.2%). In all groups, a main effect of time ( p < 0.05) was observed for knee extension and chest press. CONCLUSIONS We conclude that intake of >1.0 g/kg/day of protein promotes gains in skeletal muscle mass and muscular strength after RT in untrained older women.
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Affiliation(s)
- Hellen Cg Nabuco
- 1 Federal Institute of Science and Technology of Mato Grosso, Cuiabá, Mato Grosso, Brazil
- 2 Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
| | - Crisieli M Tomeleri
- 2 Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
- 3 Faculty of Physical Education, University of Campinas - Unicamp, Brazil
| | - Paulo Sugihara Junior
- 2 Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
| | - Rodrigo R Fernandes
- 2 Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
| | - Edilaine F Cavalcante
- 2 Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
| | - João Pedro Nunes
- 2 Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
| | - Paolo F Cunha
- 2 Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
| | - Leandro Dos Santos
- 2 Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
| | - Edilson S Cyrino
- 2 Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil
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Nabuco HCG, Tomeleri CM, Sugihara Junior P, Fernandes RR, Cavalcante EF, Venturini D, Barbosa DS, Silva AM, Sardinha LB, Cyrino ES. Effects of pre- or post-exercise whey protein supplementation on body fat and metabolic and inflammatory profile in pre-conditioned older women: A randomized, double-blind, placebo-controlled trial. Nutr Metab Cardiovasc Dis 2019; 29:290-300. [PMID: 30639252 DOI: 10.1016/j.numecd.2018.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/16/2018] [Accepted: 11/22/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIM Protein supplementation and resistance training (RT) are interventions that may counteract decline in muscle mass and increase in fat mass, thus reducing the risk of developing chronic diseases during the aging process. The objective of this study was to investigate the effect of whey protein (WP) pre- or post-RT on metabolic and inflammatory profile in pre-conditioned older women. METHODS AND RESULTS Seventy older women participated in this investigation and were randomly assigned to one of three groups: WP pre-RT and placebo post-RT (WP-PLA, n = 24), placebo pre-RT and WP post-RT (PLA-WP, n = 23) and placebo pre and post-RT (PLA-PLA, n = 23). Each group ingested 35 g of PLA or WP pre- and post-RT. RT was carried out over 12 weeks (three times/week; 3 x 8-12 repetition maximum). Body composition, blood pressure, blood samples and dietary intake were assessed pre- and post-intervention. After the intervention, WP groups showed greater improvements in appendicular lean soft tissue (ALST: WP-PLA, 3.1%; PLA-WP, 3.9%; PLA-PLA, 1.8%) and total cholesterol/high density lipoprotein cholesterol ratio (TC/HDL-C: WP-PLA, -12.11%; PLA-WP, -13.2%; PLA-PLA, -0.7) when compared with PLA-PLA. WP post-RT also showed improvements (P < 0.05) in ALST/appendicular fat mass ratio (PLA-WP, 5.8%; PLA-PLA, 1.3%), total body fat (PLA-WP, -3.8%; PLA-PLA: -0.1) and trunk fat mass (PLA-WP, -3.1%; PLA-PLA, -0.3%) when compared with PLA-PLA. CONCLUSION WP pre- or post- RT promotes improvements in ALST and TC/HDL-C ratio in pre-conditioned older women. WP administered after RT was more effective in improving metabolic health Z-score and in reducing body fat compared to placebo group.
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Affiliation(s)
- H C G Nabuco
- Federal Institute of Science and Technology of Mato Grosso, Highway BR-364, Km 329, Cuiabá, Mato Grosso 78106-970, Brazil; Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Highway Celso Garcia Cid, Londrina, Paraná 86057-970, Brazil.
| | - C M Tomeleri
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Highway Celso Garcia Cid, Londrina, Paraná 86057-970, Brazil; Exercise Physiology Laboratory, Faculty of Physical Education, University of Campinas, Érico Veríssimo avenue, Campinas, São Paulo, 13083-970, Brazil.
| | - P Sugihara Junior
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Highway Celso Garcia Cid, Londrina, Paraná 86057-970, Brazil.
| | - R R Fernandes
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Highway Celso Garcia Cid, Londrina, Paraná 86057-970, Brazil.
| | - E F Cavalcante
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Highway Celso Garcia Cid, Londrina, Paraná 86057-970, Brazil.
| | - D Venturini
- Clinical Analyses Laboratory. Londrina State University, Londrina, Paraná 86057-970, Brazil.
| | - D S Barbosa
- Clinical Analyses Laboratory. Londrina State University, Londrina, Paraná 86057-970, Brazil.
| | - A M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, Dafundo 1499-002, Portugal.
| | - L B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, Cruz Quebrada, Dafundo 1499-002, Portugal.
| | - E S Cyrino
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Highway Celso Garcia Cid, Londrina, Paraná 86057-970, Brazil.
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Li M, Liu F. Effect of whey protein supplementation during resistance training sessions on body mass and muscular strength: a meta-analysis. Food Funct 2019; 10:2766-2773. [DOI: 10.1039/c9fo00182d] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
This study evaluates the effect of whey protein (WP) supplementation with resistance training (RT) on body mass and muscular strength through randomized controlled trials (RCTs).
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Affiliation(s)
- Meng Li
- The Speed Skating Department
- The Winter Sports Management Center
- The General Administration of Sport of China
- Beijing 100044
- China
| | - Feng Liu
- Scientific Research Department
- Beijing Fresta Medical Research Center
- Beijing 100031
- China
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29
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Effects of Whey Protein Supplementation Pre- or Post-Resistance Training on Muscle Mass, Muscular Strength, and Functional Capacity in Pre-Conditioned Older Women: A Randomized Clinical Trial. Nutrients 2018; 10:nu10050563. [PMID: 29751507 PMCID: PMC5986443 DOI: 10.3390/nu10050563] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 04/26/2018] [Accepted: 05/01/2018] [Indexed: 12/24/2022] Open
Abstract
Aging is associated with sarcopenia and dynapenia, with both processes contributing to functional dependence and mortality in older adults. Resistance training (RT) and increased protein intake are strategies that may contribute to health improvements in older adults. Therefore, the aim was to investigate the effects of whey protein (WP) supplementation consumed either immediately pre- or post-RT on skeletal muscle mass (SMM), muscular strength, and functional capacity in pre-conditioned older women. Seventy older women participated in this investigation and were randomly assigned to one of three groups: whey protein pre-RT and placebo post-RT (WP-PLA, n = 24), placebo pre-RT and whey protein post-RT (PLA-WP, n = 23), and placebo pre- and post-RT (PLA-PLA, n = 23). Each group ingested 35 g of WP or PLA. The RT program was carried out over 12 weeks (three times per week; 3 × 8⁻12 repetition maximum). Body composition, muscular strength, functional capacity, and dietary intake were assessed pre- and post-intervention. Two-way analysis of covariance (ANCOVA) for repeated measures, with baseline scores as covariates were used for data analysis. A time vs. group interaction (p < 0.05) was observed with WP-PLA and PLA-WP presenting greater increases compared with PLA-PLA for SMM (WP-PLA = 3.4%; PLA-WP = 4.2%; PLA-PLA = 2.0%), strength (WP-PLA = 8.1%; PLA-WP = 8.3%; PLA-PLA = 7.0%), and the 10-m walk test (WP-PLA = −10.8%; PLA-WP = −11.8%; PLA-PLA = −4.3%). Whey protein supplementation was effective in promoting increases in SMM, muscular strength, and functional capacity in pre-conditioned older women, regardless of supplementation timing. This trial was registered at ClinicalTrials.gov: NCT03247192.
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