Abstract
Most studies in older adults have utilized powdered protein supplements or oral nutrition solutions as a source of additional dietary protein, but whole foods may provide a greater anabolic stimulus than protein isolated from food matrices. Therefore, the present study investigated a concurrent aerobic and resistance exercise training program in older adults, in the absence or presence of a high protein whole food-based dietary intervention, for effects on strength, physical function, and body composition. Community-dwelling older adults (n = 56; M/F, 28/28; age, 69.3 ± 4.0 years; BMI, 26.6 ± 3.7 kg m−2) participated in a 12-week intervention after randomization to either nutrition only (NUTR; n = 16), exercise only (EX, n = 19), or nutrition plus exercise (NUTR + EX, n = 21) groups. NUTR and NUTR + EX followed a dietary intervention targeting an increase in protein-rich meals at breakfast, lunch, and dinner. Exercise training in EX and NUTR + EX consisted of 24 min sessions of concurrent aerobic and resistance exercise performed three times per week. Daily protein intake increased in NUTR and NUTR + EX, but not EX. The increase in 1RM leg press strength was greater (Interaction effect, P = 0.012) in NUTR + EX [29.6 (18.1, 41.0) kg] than increases observed in NUTR [11.1 (−1.3, 23.6) kg] and EX [12.3 (0.9, 23.8) kg]. The increase in 1RM chest press strength was greater (interaction effect, P = 0.031) in NUTR + EX [6.3 (4.0, 8.6) kg] than the increase observed in NUTR [2.9 (0.3, 5.5) kg], but not EX [6.3 (3.9, 8.7) kg]. Hand-grip strength and sit-to-stand performance were each improved in all three groups, with no differences observed between groups (interaction effect, P = 0.382 and P = 0.671, respectively). An increase in percentage body fat was observed in NUTR, but not in EX or NUTR + EX (interaction effect, P = 0.018). No between-group differences were observed for change in lean body mass (interaction effect, P = 0.402). Concurrent aerobic and resistance exercise training improves strength and physical function in older adults, but combining this training with an increase in daily protein intake through whole foods may be advantageous to increase lower limb strength.
Highlights
Age-related declines in skeletal muscle strength and physical function are a major threat to healthy aging by increasing the risks of adverse outcomes such as falls and fractures, frailty, loss of independence, and reduced quality of life (Wolfe, 2006; Cruz-Jentoft et al, 2019)
There was no change in dietary intake in exercise training only (EX) throughout the intervention period whereas the dietary intervention was successful in increasing daily protein intake, and daily energy intake, in nutrition only (NUTR) and NUTR+EX (Table 2)
The increase in 1RM leg press strength in NUTR+EX was greater than the increases observed in NUTR by 18.5 (1.9, 35.0) kg (P = 0.026; d = 0.95), and in EX by 17.3 (1.4, 33.1) kg (P = 0.030; d = 0.70) (Figure 1B)
Summary
Age-related declines in skeletal muscle strength and physical function are a major threat to healthy aging by increasing the risks of adverse outcomes such as falls and fractures, frailty, loss of independence, and reduced quality of life (Wolfe, 2006; Cruz-Jentoft et al, 2019). These declines are exacerbated by the loss of skeletal muscle mass, and when declines in physical function and muscle mass are advanced, this results in the diagnosis of sarcopenia (CruzJentoft et al, 2019). Little research has investigated strength, physical function, or body composition outcomes in older adults after undertaking concurrent aerobic and resistance exercise training when this training has been undertaken combined with a dietary intervention to increase daily protein intake
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