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

Osteoporosis International, Mar 2017

Summary 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.

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

Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review C. Beaudart 0 1 2 3 4 5 6 7 8 10 A. Dawson 0 1 2 3 4 5 6 7 8 10 S. C. Shaw 0 1 2 3 4 5 6 7 8 10 N. C. Harvey 0 1 2 3 4 5 6 7 8 10 J. A. Kanis 0 1 2 3 4 5 6 7 8 10 N. Binkley 0 1 2 3 4 5 6 7 8 10 J. Y. Reginster 0 1 2 3 4 5 6 7 8 10 R. Chapurlat 0 1 2 3 4 5 6 7 8 10 D. C. Chan 0 1 2 3 4 5 6 7 8 10 11 O. Bruyère 0 1 2 3 4 5 6 7 8 10 R. Rizzoli 0 1 2 3 4 5 6 7 8 9 10 C. Cooper 0 1 2 3 4 5 6 7 8 10 E. M. Dennison 0 1 2 3 4 5 6 7 8 10 the IOF-ESCEO Sarcopenia Working Group 0 1 2 3 4 5 6 7 8 10 0 Department of Public Health, Epidemiology and Health Economics, University of Liège , Liège , Belgium 1 NIHR Musculoskeletal Biomedical Research Unit, Institute of Musculoskeletal Sciences, University of Oxford , Oxford , UK 2 MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital , Southampton SO16 6YD , UK 3 University of Wisconsin Osteoporosis Clinical Center and Research Program , Madison, WI , USA 4 Department of Internal Medicine, National Taiwan University Hospital , Taipei , Taiwan 5 Department of Geriatrics and Gerontology, National Taiwan University Hospital , Taipei , Taiwan 6 INSERM UMR 1033, Université de Lyon, Hôpital E Herriot , Lyon , France 7 Department of Public Health, Epidemiology and Health Economics, University of Liège , Liège , Belgium 8 Institute for Health and Aging, Catholic University of Australia , Melbourne , Australia 9 Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine , Geneva , Switzerland 10 Centre for Metabolic Bone Disease, Medical School, University of Sheffield , Sheffield , UK 11 Superintendent's Office, National Taiwan University Hospital Chu-Tong Branch , Hsinchu City , Taiwan Summary 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 proThis paper has been endorsed by the Committee of Scientific Advisors of the IOF. - Introduction Methods Literature search Study selection Table 1 (continued) 1. Sarcopenia/ 2. Sarcopeni$.tw 3. Muscle atrophy/ 4. Muscle weakness/ 5. Fat free mass.tw 6. Lean body mass.tw 7. Muscle mass.tw 8. Exp hand strength/ 9. Grip strength.tw 10. Anthropometry/ 11. Body composition/ 12. Lean mass.tw 13. Or/1-12 14. Exp exercise/ 15. Exp Movement/ 16. Muscle contraction/ 17. Muscle Development/ 18. Physical exertion/ 19. Exp Physical endurance/ 20. Exp muscle strength/ 21. Physical fitness/ 22. Exp Exercise test/ 23. Exercise therapy.tw 24. Exp Exercise movement techniques/ 25. Exp Psychomotor performance/ 26. Muscle contraction/ 27. Resistance exercise.tw 28. Aerobic exercice.tw 29. Endurance.tw 30. Physical exercise.tw 31. Physical performance.tw 32. Physical training.tw 33. Exercise programme.tw 34. Exercise technique.tw 35. Muscle mass.tw 36. Or/14-35 37. Nutrition.tw 38. Exp nutrition therapy/ 39. Exp Nutritional physiological phenomena/ 40. Exp Diet/ 41. Exp Diet therapy/ 42. Exp Dietary fats/ 43. Exp Dietary proteins/ 44. Exp Food/ 45. Exp Food, fortified/ 46. Exp Micronutrients/ 47. Exp Dietary supplements/ 48. Energy intake/ 49. Nutrition.tw 50. Nutrition trial.tw 51. Dietary lipids.tw 52. Or/37-51 53. Randomized controlled trials/ 54. Randomised controlled trial.tw 55. Randomized controlled trial.tw 56. Controlled clinical trial/ 57. Controlled study.tw 58. Random allocation/ 59. Random$.tw 60. Randomly allocated.tw 61. Double blind method/ 62. Single blind method/ 63. Clinical trials.tw 64. Clinical trial/ 65. Trial$.tw 66. Intervention studies/ Data extraction Methodology quality assessment Inclusion criteria Participants Exposure Outcome Language Randomized controlled trials Studies which include at least two groups of comparison: a control group with only exercise intervention and a treated group with combined exercise intervention and nutritional intervention. Exercise intervention can be resistance exercise, aerobic exercise, or other. Nutrition intervention involves the provision of nutrients supplied with either a supplement or food Outcomes on muscle mass, on muscle strength, or on physical performance English only Studies published between April 2013 and end of October 2015 Presentation of results Results Included studies Fig. 1 Flow chart of literature search Types of nutritional intervention Protein supplementation least one outcome, in 9/9 RCTs with no additional effect of protein. d u k k n n e a lam tirc tirc tex n its t e e o a to m m ee ix w o o n le : : is is k f M M + e ed d .iitittrsacapnonP i:)(rsnp5gouo ,iiir)(seececxbo tiiirffrseceox+ tiiirffrseceeox+ itiifrfrseceeod+ trseeenwm lilendbubdo .iittitrsacapnonP :it(r)supoogw ,iil)(feeaxvoon ttrrseeeaenwm illednubob itreenvn iizednm ilseap+ ,iii()eo i()evno ,()eevx .treeaT ittrsaed tireenvn iizednm iisseand .laecboT itrseedd k o c eb , in in in h o c p in e d r c lk c c t d r e n e a i u m n n e d m -w ra x l m le leu ad o a x n d e p r e a a a y s p r ie ic ta i n d t e u r d t a e s p s rs d y D y a h e e d S tl y d a tu ± e .4 h 0 in sg ag .53 ± fo itn an e .7 m .y g bo ro iu . g ad 51 e n lca tse m m re s g lac ie c h iu 0 s 0 e 3 p in 3 P to g ca s ta .1 .m rp 2 )s n o um reeaevg secgon ,tfag7 licacu itanno ,.seo04 ieoxd lraagm itndng isaegn 5 g n t m o o lb0m reaevb .,i0n .420 sceo lacg iseun /fod rrsep leabm .ien25 tireon trfepo ,tsceo reeavg ,.t713 (ragm 0gm iecdo ilaav t P o la b fa eh 90 ox ibo ro t P O y n d a a e d ip ifn 0 lo c n 1 tr tir co fro on a ts t /c p lu se rs rs y D d r a a d S ra ed ey ey tu ± e b .4 .7 s e w n r n g o e y iso in d p ingp tceud lifad ssee tiran tsan irsce .fseoU leadkw itrrseen reubom tnh .reghT tisacen lreadu ceeenx ram -sab sw en om iinn rsee lrdo laab g r t a ropg teeom iitacnp tseaeh each trecn irssevg tfeodp ifono k ep aP ircn 10% is r d e in d r ta o a ss l s p a s a e e r e d e g r e tsanw :i()s liakn t leb tsew i() irsece iitrsen iitrcp rpuo ,ii)(w teanm todu iitcapn :spuo ii)(ex aedm aP eg ino re on ra rg ,e re .iteonn tirehn titrun .ltronT sanow .itnonP tinow liceun tsenw n ( leu ,ly o re li ap :s n e T b ic p b o an .l le ti u lo e r o b ra ro g is b tr u .nP rguo tlfak rcex emm ,con edod io f i e e n r ten in m ii) lu ito tse v d nd ,(e lo c n b a i r u i e ze a tin im ise ran tag ed dm b f h a t e o th ty n th kn rp d -ec iap in iev gn ise tsan itrca eek ay rsse iian rcex is P w d g tr e e ro R P o .ttreahy tisacennod iittrscaapn ,tlrseeehu .l)aaceybP iilacn /adggn3y ilrsandnk ,lcak02g0 ltebuyh lseacup ;pBM rsacpu /(dg3y tireend iirdovp ititrouN iirndvo -m tn -aH fo ad e ,e .t (p β e C ed r w cn r n ) - 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Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review, Osteoporosis International, 2017, DOI: 10.1007/s00198-017-3980-9