Abstract
BackgroundHealth-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.MethodsRandomized 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.ResultsA 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.ConclusionsThis 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 registrationCRD42021224843.
Highlights
Health-promoting interventions are important for preventing frailty and sarcopenia in older adults
For the electronic search, MEDLINE (PubMed), Cochrane CENTRAL, and Embase were searched for articles published prior to July 2020 by entering the following combinations of keywords: (“nutrition” OR “food” OR “diet”) OR (“exercise” OR “resistance training”) AND “aged” AND (“muscle mass” or “skeletal muscle” OR “muscle strength” OR “physical performance” OR “physical functional performance” OR “walking speed” OR “gait speed”)
The experimental interventions included any form of resistance training and nutritional interventions that involved repeated practice during standardized programs for the purpose of enhancing muscle mass, muscle strength, and physical function
Summary
Health-promoting interventions are important for preventing frailty and sarcopenia in older adults. A growing research topic is the identification of factors that increase the risk of negative events and the development of preventive interventions against disability In this context, frailty and sarcopenia have increasingly emerged as research interests. The specific pathological pathway of frailty remains unclear, but frailty has a biological component resulting from inflammation and cumulative cellular damage over one’s lifetime It occurs independently of chronological age, frailty is more prevalent in people of an older age; females; those who are living alone; those with low educational and socioeconomic statuses, multimorbidity, malnourishment, depression, polypharmacy, cognitive impairment, and a low physical activity level; and those who smoke and drink alcohol regularly [6,7,8]
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