Effect of Protein Supplementation Combined with Resistance Training on Muscle Mass, Strength and Function in the Elderly: A Systematic Review and Meta-Analysis

Overview

Journal J Nutr Health Aging

Specialties Geriatrics
Nutritional Sciences

Date 2019 Apr 26

PMID 31021362

Citations 25

Authors

L Hou

Y Lei

X Li

C Huo

X Jia

J Yang

R Xu

X Wang

Affiliations

Soon will be listed here.

Abstract

Background: The loss of muscle mass, strength and function associated with increasing age has various health ramifications, including the elevated risk for falls, fractures, frailty, poor quality of life, and mortality. Several studies have confirmed the effects of protein supplementation and RT (resistance training) for this age-related change independently, but whether a combination of the two produces a stronger effect remains controversial.

Objective: This study aims to explore whether a combination of protein supplementation and RT leads to reduction of muscle mass, strength and function in the elderly.

Methods: We retrieved RCTs (randomized controlled trials) reporting the effects of protein supplementation combined with RT on muscle mass, strength and function in the elderly, published before May 2018 through PubMed, MEDLINE, Embase, and manual searches.

Results: Twenty-one RCTs were included, involving 1,249 participants. The results showed that protein supplementation combine with RT significantly enhances the muscle mass and strength of the older adults, where FFM (fat-free mass) increased by 0.23 kg (95% CI: 0.09, 0.38; P=0.002), ASMM (appendicular skeletal muscle mass) by 0.39 kg (95% CI: 0.14, 0.64; P=0.002), handgrip strength by 0.29 kg (95% CI: 0.08, 0.50; P=0.008), knee extension strength by 0.27 kg (95% CI: 0.06, 0.47; P=0.013), leg press strength by 0.33 kg (95% CI: 0.01, 0.64; P=0.04), but no significant effects were seen on muscle function.

Conclusion: Compared to simple RT, protein supplementation combine with RT is more effective in enhancing the muscle mass and strength in the elderly, and the findings do not support the benefit of combination treatment for muscle function.

Citing Articles

Sex differences in the associations of dietary protein intake with lean mass and grip strength in children and adolescents.

Wang Y, Sun D, Zhu Z J Int Soc Sports Nutr. 2025; 22(1):2471471.

PMID: 39994891 PMC: 11864004. DOI: 10.1080/15502783.2025.2471471.

Exercise with weight vest plus chicken protein supplementation delayed muscle and bone loss in older female adults.

Nithisup P, Manimmanakorn A, Hamlin M, Maneesai P, Manimmanakorn N, Khaengkhan C Phys Act Nutr. 2025; 28(4):15-23.

PMID: 39934626 PMC: 11811617. DOI: 10.20463/pan.2024.0028.

Sculpting Success: The Importance of Diet and Physical Activity to Support Skeletal Muscle Health during Weight Loss with New Generation Anti-Obesity Medications.

Grosicki G, Dhurandhar N, Unick J, Arent S, Thomas J, Lofton H Curr Dev Nutr. 2024; 8(11):104486.

PMID: 39624804 PMC: 11609469. DOI: 10.1016/j.cdnut.2024.104486.

Plant protein, fibre and physical activity solutions to address poor appetite and prevent undernutrition in older adults: study protocol for the APPETITE randomised controlled trial.

Horner K, Mullen B, Quinn A, Scheufele P, Gola S, Gonnelli F Br J Nutr. 2024; 132(6):823-834.

PMID: 39387205 PMC: 11557289. DOI: 10.1017/S0007114524002125.

Risk and determinants of sarcopenia in people with diabetes: a case-control study from Qatar Biobank cohort.

Shatila H, Ghazal N, Bukshaisha G, Al-Zeyara S, Khoury C, Bassil M BMC Endocr Disord. 2024; 24(1):205.

PMID: 39350192 PMC: 11440684. DOI: 10.1186/s12902-024-01722-1.

References

Greiwe J, Cheng B, Rubin D, Yarasheski K, Semenkovich C . Resistance exercise decreases skeletal muscle tumor necrosis factor alpha in frail elderly humans. FASEB J. 2001; 15(2):475-82. DOI: 10.1096/fj.00-0274com. View

Frontera W, Hughes V, Krivickas L, Kim S, Foldvari M, Roubenoff R . Strength training in older women: early and late changes in whole muscle and single cells. Muscle Nerve. 2003; 28(5):601-8. DOI: 10.1002/mus.10480. View

Bunout B, Barrera G, de la Maza P, Avendano M, Gattas V, Petermann M . Effects of nutritional supplementation and resistance training on muscle strength in free living elders. Results of one year follow. J Nutr Health Aging. 2004; 8(2):68-75. View

Hozo S, Djulbegovic B, Hozo I . Estimating the mean and variance from the median, range, and the size of a sample. BMC Med Res Methodol. 2005; 5:13. PMC: 1097734. DOI: 10.1186/1471-2288-5-13. View

Visser M, Goodpaster B, Kritchevsky S, Newman A, Nevitt M, Rubin S . Muscle mass, muscle strength, and muscle fat infiltration as predictors of incident mobility limitations in well-functioning older persons. J Gerontol A Biol Sci Med Sci. 2005; 60(3):324-33. DOI: 10.1093/gerona/60.3.324. View

Abrams K, Gillies C, Lambert P . Meta-analysis of heterogeneously reported trials assessing change from baseline. Stat Med. 2005; 24(24):3823-44. DOI: 10.1002/sim.2423. View

Shimomura Y, Yamamoto Y, Bajotto G, Sato J, Murakami T, Shimomura N . Nutraceutical effects of branched-chain amino acids on skeletal muscle. J Nutr. 2006; 136(2):529S-532S. DOI: 10.1093/jn/136.2.529S. View

Candow D, Chilibeck P, Facci M, Abeysekara S, A Zello G . Protein supplementation before and after resistance training in older men. Eur J Appl Physiol. 2006; 97(5):548-56. DOI: 10.1007/s00421-006-0223-8. View

Solerte S, Gazzaruso C, Bonacasa R, Rondanelli M, Zamboni M, Basso C . Nutritional supplements with oral amino acid mixtures increases whole-body lean mass and insulin sensitivity in elderly subjects with sarcopenia. Am J Cardiol. 2008; 101(11A):69E-77E. DOI: 10.1016/j.amjcard.2008.03.004. View

10.

Martin H, Syddall H, Dennison E, Cooper C, Aihie Sayer A . Physical performance and physical activity in older people: are developmental influences important?. Gerontology. 2008; 55(2):186-93. DOI: 10.1159/000174823. View

11.

Liberati A, Altman D, Tetzlaff J, Mulrow C, Gotzsche P, Ioannidis J . The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. J Clin Epidemiol. 2009; 62(10):e1-34. DOI: 10.1016/j.jclinepi.2009.06.006. View

12.

Kukuljan S, Nowson C, Sanders K, Daly R . Effects of resistance exercise and fortified milk on skeletal muscle mass, muscle size, and functional performance in middle-aged and older men: an 18-mo randomized controlled trial. J Appl Physiol (1985). 2009; 107(6):1864-73. DOI: 10.1152/japplphysiol.00392.2009. View

13.

Cruz-Jentoft A, Baeyens J, Bauer J, Boirie Y, Cederholm T, Landi F . Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010; 39(4):412-23. PMC: 2886201. DOI: 10.1093/ageing/afq034. View

14.

Woods J, Iuliano-Burns S, King S, Strauss B, Walker K . Poor physical function in elderly women in low-level aged care is related to muscle strength rather than to measures of sarcopenia. Clin Interv Aging. 2011; 6:67-76. PMC: 3066255. DOI: 10.2147/CIA.S16979. View

15.

Koster A, Ding J, Stenholm S, Caserotti P, Houston D, Nicklas B . Does the amount of fat mass predict age-related loss of lean mass, muscle strength, and muscle quality in older adults?. J Gerontol A Biol Sci Med Sci. 2011; 66(8):888-95. PMC: 3184893. DOI: 10.1093/gerona/glr070. View

16.

Kim H, Suzuki T, Saito K, Yoshida H, Kobayashi H, Kato H . Effects of exercise and amino acid supplementation on body composition and physical function in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial. J Am Geriatr Soc. 2011; 60(1):16-23. DOI: 10.1111/j.1532-5415.2011.03776.x. View

17.

Morley J . Sarcopenia in the elderly. Fam Pract. 2012; 29 Suppl 1:i44-i48. DOI: 10.1093/fampra/cmr063. View

18.

Tieland M, Dirks M, van der Zwaluw N, Verdijk L, van de Rest O, de Groot L . Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc. 2012; 13(8):713-9. DOI: 10.1016/j.jamda.2012.05.020. View

19.

Leenders M, Verdijk L, van der Hoeven L, van Kranenburg J, Nilwik R, Wodzig W . Protein supplementation during resistance-type exercise training in the elderly. Med Sci Sports Exerc. 2012; 45(3):542-52. DOI: 10.1249/MSS.0b013e318272fcdb. View

20.

DiGirolamo D, Clemens T, Kousteni S . The skeleton as an endocrine organ. Nat Rev Rheumatol. 2012; 8(11):674-83. DOI: 10.1038/nrrheum.2012.157. View