Dietary supplements and physical exercise affecting bone and body composition in frail elderly persons

Abstract

OBJECTIVES: This study determined the effect of enriched foods and all-around physical exercise on bone and body composition in frail elderly persons. METHODS: A 17-week randomized, controlled intervention trial, following a 2 x 2 factorial design--(1) enriched foods, (2) exercise, (3) both, or (4) neither--was performed in 143 frail elderly persons (aged 78.6 +/- 5.6 years). Foods were enriched with multiple micronutrients; exercises focused on skill training, including strength, endurance, coordination, and flexibility. Main outcome parameters were bone and body composition. RESULTS: Exercise preserved lean mass (mean difference between exercisers and non-exercisers: 0.5 kg +/- 1.2 kg; P < .02). Groups receiving enriched food had slightly increased bone mineral density (+0.4%), bone mass (+0.6%), and bone calcium (+0.6%) compared with groups receiving non-enriched foods, in whom small decreases of 0.1%, 0.2%, and 0.4%, respectively, were found. These groups differed in bone mineral density (0.006 +/- 0.020 g/cm2; P = .08), total bone mass (19 +/- g; P = .04), and bone calcium (8 +/- 21 g; P = .03). CONCLUSIONS: Foods containing a physiologic dose of micronutrients slightly increased bone density, mass, and calcium, whereas moderately intense exercise preserved lean body mass in frail elderly persons.

Effects of multi-domain interventions in (pre)frail elderly on frailty, functional, and cognitive status: a systematic review

“…First, Tieland et al found that adding a protein and mineral supplementation to an exercise intervention significantly improved appendicular and total muscle mass post-intervention 50. Chin A Paw et al found a significantly improved muscle mass by an exercise intervention combined with a protein, vitamin, and mineral supplementation intervention compared to protein, vitamin, and mineral supplementation 36. Kenny et al found that adding a hormonal dehydroepiandrosterone intervention to an exercise and vitamin and mineral supplementation increased total (but not appendicular) lean mass post-intervention 42.…”

Prevention and optimal management of sarcopenia: a review of combined exercise and nutrition interventions to improve muscle outcomes in older people

“…Seventeen studies met the inclusion criteria for the review; details of these studies are shown in Table 1 . Of these, six studies 19 – 23 , 27 , 34 , 35 were based in Europe, six were from the USA or Canada, 24 , 26 , 28 , 29 , 36 , 38 , 39 two from South America, 32 , 33 , 37 one from Australia, 30 and two from Japan. 25 , 31 The studies ranged in size from 17 participants 24 to 217 34 , 35 and varied in duration between 8 weeks 26 , 36 and 18 months.…”

“…Of these, six studies 19 – 23 , 27 , 34 , 35 were based in Europe, six were from the USA or Canada, 24 , 26 , 28 , 29 , 36 , 38 , 39 two from South America, 32 , 33 , 37 one from Australia, 30 and two from Japan. 25 , 31 The studies ranged in size from 17 participants 24 to 217 34 , 35 and varied in duration between 8 weeks 26 , 36 and 18 months. 32 , 33 Half of the reviewed studies included two comparison groups (exercise, exercise + nutritional supplement); 19 , 22 – 24 , 26 , 31 , 36 , 38 , 39 the remaining studies had a factorial design with four groups (exercise, nutritional supplement, both interventions, neither intervention).…”

“… 32 , 33 Half of the reviewed studies included two comparison groups (exercise, exercise + nutritional supplement); 19 , 22 – 24 , 26 , 31 , 36 , 38 , 39 the remaining studies had a factorial design with four groups (exercise, nutritional supplement, both interventions, neither intervention). 20 , 21 , 25 , 27 – 30 , 32 – 35 , 37 Study populations varied considerably, from community-dwelling older adults, 19 , 23 , 24 , 26 , 32 , 33 , 37 – 39 to older adults with comorbidities such as frailty, 22 , 34 , 35 chronic obstructive pulmonary disease (COPD) 31 and sarcopenia 25 and older adults in residential care 20 , 21 , 27 – 29 , 36 or who were hospitalized. 30 …”

“…The nature of the nutritional supplement used varied between studies in terms of the type of supplement, which additional nutrients were provided, the dose of additional nutrients, the timing of supplementation (at same time as exercise or not), and frequency of consumption. However, whilst acknowledging these differences in study design, overall the 17 studies could be considered within one of four broad groups of nutritional supplements: protein or amino acid supplementation (including β-hydroxy-β-methylbutyrate [HMB]) (seven studies), 19 – 26 vitamin D supplementation (two studies), 36 , 37 multinutrient supplementation (six studies) 27 – 35 or creatine supplementation (two studies). 38 , 39 The multinutrient supplements used in the interventions were diverse, ranging from a nutritional porridge to fortified food products and milk-based drinks.…”