Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review

Mar 3, 2017Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA

Nutrition and exercise for preventing and treating muscle loss

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Abstract

A total of 37 randomized controlled trials (RCTs) were analyzed, indicating that 79% showed increased muscle mass from exercise in individuals aged 65 and older.

Physical exercise positively impacts muscle mass in 79% of studies involving older adults.
Muscle strength increased in 82.8% of studies following exercise interventions.
Only a small number of studies (23.5%) indicated additional benefits of dietary supplementation on muscle mass.
Increased physical performance was observed in 92.8% of studies after exercise intervention, with limited interaction from nutrition supplementation.
The variability in dietary supplementation protocols was significant across the included studies, suggesting no consistent effect on muscle function.

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UNLABELLED: This systematic review summarizes the effect of combined exercise and nutrition intervention on muscle mass and muscle function. A total of 37 RCTs were identified. Results indicate that physical exercise has a positive impact on muscle mass and muscle function in subjects aged 65 years and older. However, any interactive effect of dietary supplementation appears to be limited.

INTRODUCTION: In 2013, Denison et al. conducted a systematic review including 17 randomized controlled trials (RCTs) to explore the effect of combined exercise and nutrition intervention to improve muscle mass, muscle strength, or physical performance in older people. They concluded that further studies were needed to provide evidence upon which public health and clinical recommendations could be based. The purpose of the present work was to update the prior systematic review and include studies published up to October 2015.

METHODS: Using the electronic databases MEDLINE and EMBASE, we identified RCTs which assessed the combined effect of exercise training and nutritional supplementation on muscle strength, muscle mass, or physical performance in subjects aged 60 years and over. Study selection and data extraction were performed by two independent reviewers.

RESULTS: The search strategy identified 21 additional RCTs giving a total of 37 RCTs. Studies were heterogeneous in terms of protocols for physical exercise and dietary supplementation (proteins, essential amino acids, creatine, β-hydroxy-β-methylbuthyrate, vitamin D, multi-nutrients, or other). In 79% of the studies (27/34 RCTs), muscle mass increased with exercise but an additional effect of nutrition was only found in 8 RCTs (23.5%). Muscle strength increased in 82.8% of the studies (29/35 RCTs) following exercise intervention, and dietary supplementation showed additional benefits in only a small number of studies (8/35 RCTS, 22.8%). Finally, the majority of studies showed an increase of physical performance following exercise intervention (26/28 RCTs, 92.8%) but interaction with nutrition supplementation was only found in 14.3% of these studies (4/28 RCTs).

CONCLUSION: Physical exercise has a positive impact on muscle mass and muscle function in healthy subjects aged 60 years and older. The biggest effect of exercise intervention, of any type, has been seen on physical performance (gait speed, chair rising test, balance, SPPB test, etc.). We observed huge variations in regard to the dietary supplementation protocols. Based on the included studies, mainly performed on well-nourished subjects, the interactive effect of dietary supplementation on muscle function appears limited.

Key numbers

27 of 34 RCTs

Increase in Muscle Mass

Percentage of studies showing muscle mass increase with exercise intervention.

29 of 35 RCTs

Increase in Muscle Strength

Percentage of studies showing muscle strength increase with exercise intervention.

26 of 28 RCTs

Improvement in Physical Performance

Percentage of studies reporting improved physical performance with exercise intervention.

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Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review

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