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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
Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review
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.
0937-941X
1817–1833
Beaudart, C.
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Dawson, A.
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Shaw, S.C.
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Harvey, N.C.
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Kanis, J.A.
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Binkley, N.
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Reginster, J.Y.
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Chapulat, R.
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Chan, D.C.
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Bruyere, O.
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Rizzoli, R.
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Cooper, C.
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Dennison, E.M.
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Beaudart, C.
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Dawson, A.
3938e4c8-8d40-45db-88fa-72a3431df4fe
Shaw, S.C.
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Harvey, N.C.
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Kanis, J.A.
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Binkley, N.
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Reginster, J.Y.
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Chapulat, R.
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Chan, D.C.
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Bruyere, O.
9c455ea4-7f77-407f-ab5a-ecb571db8245
Rizzoli, R.
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Cooper, C.
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Dennison, E.M.
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Beaudart, C., Dawson, A., Shaw, S.C., Harvey, N.C., Kanis, J.A., Binkley, N., Reginster, J.Y., Chapulat, R., Chan, D.C., Bruyere, O., Rizzoli, R., Cooper, C. and Dennison, E.M. (2017) Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review. Osteoporosis International, 28 (6), 1817–1833. (doi:10.1007/s00198-017-3980-9).

Record type: Article

Abstract

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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More information

Accepted/In Press date: 31 January 2017
e-pub ahead of print date: 1 March 2017
Published date: June 2017
Organisations: MRC Life-Course Epidemiology Unit

Identifiers

Local EPrints ID: 405415
URI: http://eprints.soton.ac.uk/id/eprint/405415
ISSN: 0937-941X
PURE UUID: 95bd7272-7de4-4ded-b56d-992c4868a131
ORCID for N.C. Harvey: ORCID iD orcid.org/0000-0002-8194-2512
ORCID for C. Cooper: ORCID iD orcid.org/0000-0003-3510-0709
ORCID for E.M. Dennison: ORCID iD orcid.org/0000-0002-3048-4961

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Date deposited: 03 Feb 2017 13:59
Last modified: 17 Dec 2019 06:24

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Contributors

Author: C. Beaudart
Author: A. Dawson
Author: S.C. Shaw
Author: N.C. Harvey ORCID iD
Author: J.A. Kanis
Author: N. Binkley
Author: J.Y. Reginster
Author: R. Chapulat
Author: D.C. Chan
Author: O. Bruyere
Author: R. Rizzoli
Author: C. Cooper ORCID iD
Author: E.M. Dennison ORCID iD

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