Abstract
ObjectiveTo investigate the combined and separate effects of exercise and milk fat globule membrane (MFGM) supplementation on frailty, physical function, physical activity level, and hematological parameters in community-dwelling elderly Japanese women.MethodsA total of 131 frail, elderly women over 75 years were randomly assigned to one of four groups: exercise and MFGM supplementation (Ex+MFGM), exercise and placebo (Ex+Plac), MFGM supplementation, or the placebo group. The exercise group attended a 60-minute training program twice a week for three months, and the MFGM group ingested 1g of the MFGM supplement in pill form, daily for 3 months. The primary outcome measure was change in frailty status based on Fried’s frailty phenotype. Secondary outcome measures included body composition, physical function and hematological parameters, and interview survey components assessing lifestyle factors. Participants were followed for 4 months post-intervention.ResultsSignificant group×time interactions were observed for usual walking speed (P = 0.005), timed up & go (P<0.001), and insulin-like growth factor-binding protein 3 / insulin-like growth factor 1 ratio (P = 0.013). The frailty components revealed that weight loss, exhaustion, low physical activity, and slow walking speed were reversed, but low muscle strength did not significantly changed. Frailty reversal rate was significantly higher in the Ex+MFGM (57.6%) than in the MFGM (28.1%) or placebo (30.3%) groups at post-intervention (χ2 = 8.827, P = 0.032), and at the follow-up was also significantly greater in the Ex+MFGM (45.5%) and Ex+Plac (39.4%) groups compared with the placebo (15.2%) group (χ2 = 8.607, P = 0.035). The exercise+MFGM group had the highest odds ratio (OR) for frailty reversal at post-intervention and follow-up (OR = 3.12, 95% confidence interval (CI) = 1.13–8.60; and OR = 4.67, 95% CI = 1.45–15.08, respectively).ConclusionThis study suggests that interventions including exercise and nutrition can improve frailty status. Statistically significant additive effects of MFGM with exercise could not be confirmed in this population, and further investigation in larger samples is necessary.Trial RegistrationThe Japan Medical Association Clinical Trial Registry (JMACCT)JMA-IIA00069
Highlights
Frailty has been a focus in the aging literature in the past decade
Significant group×time interactions were observed for usual walking speed (P = 0.005), timed up & go (P
This study suggests that interventions including exercise and nutrition can improve frailty status
Summary
Frailty has been a focus in the aging literature in the past decade. There are several risk factors related to frailty such as aging, chronic disease, skeletal muscle disuse and cognitive function decline, the mechanisms are still unclear [1,2]. Exercise has been a focus in the prevention of frailty, as research has shown that it is beneficial for the enhancement of skeletal muscle mass and strength, and can improve muscle function, physical activity participants and functional ability in frail older adults [5]. Several studies have investigated the effects of milk ingestion on body composition and protein synthesis as well as muscle mass [6,7,8]. The results of these studies showed that the consumption of milk with resistance training may have increased muscle protein synthesis promoting muscle mass maintenance and gains, and even increased strength gains These studies were performed on young adults, and the results of milk consumption with exercise on the elderly population are unknown. The effects of MFGM supplementation alone and combined with exercise in frail elderly people, remains to be confirmed
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