Effect of exercise alone or combined with dietary supplements on anthropometric and physical performance measures in community-dwelling elderly people with sarcopenic obesity: A meta-analysis of randomized controlled trials

Hita‐Contreras, Fidel; Bueno-Notivol, Juan; Martínez‐Amat, Antonio; Cruz‐Díaz, David; Hernandez, Adrián V.; Pérez‐López, Faustino R.

doi:10.1016/j.maturitas.2018.07.007

Cited by 60 publications

(78 citation statements)

References 38 publications

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“…First, the inclusion criteria in this meta-analysis were relatively rigid; we included only older individuals with a definite diagnosis of sarcopenia. Second, 1041 participants were enrolled in the present meta-analysis, which is twice as large as the previous reviews of sarcopenia treated by exercise [48]. Finally, we provided an integrated overview (three aspects with six outcomes) to evaluate the general effectiveness of exercise programs.…”

Section: Discussionmentioning

confidence: 99%

Exercise Programs for Muscle Mass, Muscle Strength and Physical Performance in Older Adults with Sarcopenia: A Systematic Review and Meta-Analysis

Bao¹,

Sun²,

Zhang³

et al. 2020

Aging and disease

103

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Sarcopenia is an age-related condition that is characterized by progressive and generalized loss of muscle mass and function. Exercise treatment has been the most commonly used intervention among elderly populations. We performed a systematic review and meta-analysis to evaluate the available literature related to the effects of exercise interventions/programs on muscle mass, muscle strength and physical performance in older adults with sarcopenia. We searched PubMed, EMBASE, MEDLINE and the Web of Science for randomized controlled trials and controlled clinical trials exploring exercise in older adults with sarcopenia published through July 2019 without any language restrictions. Pooled analyses were conducted using Review Manager 5.3, with standardized mean differences (SMDs) and fixed-effect models. A total of 3898 titles and abstracts were initially identified, and 22 studies (1041 individuals, 80.75% females, mean age ranged from 60.51 to 85.90 years) were included in the meta-analysis. The exercise programs in the studies consisted of 30 to 80 min of training, with 1 to 5 training sessions weekly for 6 to 36 weeks. Muscle strength (grip strength [SMD 0.57, 95 % CI 0.42 to 0.73, P <0.00001] and timed five chair stands [SMD-0.56, 95 % CI-0.85 to-0.28, P < 0.0001]) and physical performance (gait speed [SMD 0.44, 95 % CI 0.26 to 0.61, P < 0.00001] and the timed up and go test [SMD-0.97, 95 % CI-1.22 to-0.72, P < 0.00001]) showed significant improvement following exercise treatment, while no differences in muscle mass (ASM [SMD 0.15, 95 % CI-0.05 to 0.36, P = 0.15] and ASM/height 2 [SMD 0.21, 95 % CI-0.05 to 0.48, P = 0.12]) were detected. Exercise programs showed overall significant positive effects on muscle strength and physical performance but not on muscle mass in sarcopenic older adults.

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Section: Discussionmentioning

confidence: 99%

Exercise Programs for Muscle Mass, Muscle Strength and Physical Performance in Older Adults with Sarcopenia: A Systematic Review and Meta-Analysis

Bao¹,

Sun²,

Zhang³

et al. 2020

Aging and disease

103

View full text Add to dashboard Cite

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“…From an interventional and biometrical point of view, addressing "osteosarcopenia" [46], "sarcopenic obesity" [47] or even "osteosarcopenic obesity" [44], with their inherent combination of at least three different conditions, is a daunting task. In general, exercise or more dedicated resistance exercise-ideally supported by dietary supplements-might be the most promising strategy to positively affect all physiologic and functional outcomes related to the osteopenia/sarcopenia/obesity complex [48,49]. However, due to the gynocentrism of osteoporosis research, there is a lack of exercise studies [50] confirming the positive effects on BMD demonstrated for female cohorts [8,51] in older men.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, our protein approach focused predominately on the muscular aspect of osteosarcopenia; but there is some evidence for a significant superior effect of high versus low protein intake on BMD at the LS [81,83]. On the other hand, the additional effect of protein supplementation to resistance exercise on muscle mass and/or function in older people with [49,84,85] or without sarcopenia/SO [69,85] is still under discussion. In general, FrOST did not address the research issue of different contributions of HIT-RT vs. whey protein supplementation on osteosarcopenia.…”

Section: Discussionmentioning

confidence: 99%

Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study

et al. 2020

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The present study aimed to evaluate the effect of high intensity dynamic resistance exercise (HIT-DRT) and whey protein supplementation (WPS) on bone mineral density (BMD) and sarcopenia parameters in osteosarcopenic men. Men ≥ 72 years with osteosarcopenia (n = 43) were randomly assigned to a HIT-RT (HIT-RT: n = 21) or a non-training control group (n = 22). Supervised HIT-RT twice/week was applied for 18 months, while the control group maintained their habitual lifestyle. Supplying WPS, total protein intake amounted to 1.5–1.6 (HIT-RT) and 1.2 g/kg/body mass/d (control). Both groups were supplied with calcium and vitamin D. Primary study outcomes were BMD and the sarcopenia Z-score. After adjusting for multiplicity, we observed significant positive effects for sarcopenia Z-score (standardized mean difference (SMD): 1.40), BMD at lumbar spine (SMD: 0.72) and total hip (SMD: 0.72). In detail, effect sizes for skeletal muscle mass changes were very pronounced (1.97, p < 0.001), while effects for functional sarcopenia parameters were moderate (0.87, p = 0.008; handgrip strength) or low (0.39, p = 0.209; gait velocity). Apart from one man who reported short periods of temporary worsening of existing joint pain, no HIT-RT/WPS-related adverse effects or injuries were reported. We consider HIT-RT supported by whey protein supplementation as a feasible, attractive, safe and highly effective option to fight osteosarcopenia in older men.

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“…Thus, although our cohort with adequate dietary intakes (Table 1) might benefit less from additional protein supplementation (Dalle et al, 2017), the higher total protein intake of the HIT-RT group might have contributed to our results. Nevertheless, evidence for an additional effect of protein to DRT on muscle mass or strength in older people with sarcopenia or SO is limited (Liao et al, 2017a;Hita-Contreras et al, 2018;Martinez-Amat et al, 2018;Vlietstra et al, 2018;Beckwee et al, 2019;Hsu et al, 2019); (2) our eligibility criteria for sarcopenia focus on skeletal muscle mass index; functional aspects were not considered. We determined "skeletal muscle mass" (or more precisely "soft lean body mass") by DXA technique.…”

Section: Discussionmentioning

confidence: 99%

Effects of High-Intensity Resistance Training on Fitness and Fatness in Older Men With Osteosarcopenia

et al. 2020

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To date, there has been no study on the long-term effects of resistance exercise on sarcopenia and obesity indices for people with sarcopenia. The present study thus aimed to determine the effect of 18 months of periodized, high-velocity/intensity/effort progressive resistance training (HIT-RT) on body composition and strength in older men with osteosarcopenia. Using a single-blind, two-group parallel design, 43 community-dwelling men, 72 years and older, with osteopenia and sarcopenia in Erlangen-Nürnberg, Germany, were randomly assigned to two study arms by drawing lots: (1) an exercise group that conducted a consistently supervised periodized high-velocity/intensity/effort protocol (HIT-RT; n = 21) on machines twice a week for 18 months or (2) a control group (CG; n = 22) that maintained their physical activity/exercise habits. Both groups were supplied with protein, cholecalciferol, and calcium according to current recommendations. The study outcomes were lean body mass (LBM), total and abdominal body fat as determined by dual-energy X-ray absorptiometry and maximum hip/leg extensor strength as assessed on an isokinetic leg press at baseline and after 8, 12, and 18 months of follow-up. The intention-to-treat principle and multiple imputation were applied to calculated study outcomes. After 18 months of HIT-RT, altogether five participants were lost to follow up (HIT-RT: n = 2, CG: n = 3). The attendance rates (95%) for HIT-RT were high; relevant adverse effects were not observed. Significant effects (i.e., differences between HIT-RT vs. CG) in favor of HIT-RT were determined for LBM (+1.73 kg, 95% CI: +1.13 to +2.32 kg), total body fat mass (−2.44 kg, 95% CI: −1.28 to 3.60 kg), abdominal body fat percentage (−2.68, 95% CI: −1.70 to −3.66), and maximum hip/leg extensor strength (+533 N, 95% CI: +397 to +670 N; all p < 0.001). Even after adjusting for multiple testing, all effects remained significant. Of note, after 8 months of HIT-RT, only slight (LBM and fat indices) to moderate (maximum strength) ongoing effects were observed. Carefully introduced, continuously supervised HIT-RT is an effective, attractive, feasible, and safe method to improve body composition and muscle strength in older community-dwelling men with sarcopenia. However, even when consequently applying principles of exercise intensity progression within the RT protocol, only slight further positive changes were observed after 8 months of exercise.

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Effect of exercise alone or combined with dietary supplements on anthropometric and physical performance measures in community-dwelling elderly people with sarcopenic obesity: A meta-analysis of randomized controlled trials

Abstract: EXE alone and EXE-SUPPL improved muscle-related outcomes and reduced fat-related outcomes in subjects with sarcopenic obesity. There is a need for better-designed RCTs with systematic assessment of both different exercise regimes and dietary supplements in sarcopenic obese subjects.

Cited by 60 publications

References 38 publications

Exercise Programs for Muscle Mass, Muscle Strength and Physical Performance in Older Adults with Sarcopenia: A Systematic Review and Meta-Analysis

Exercise Programs for Muscle Mass, Muscle Strength and Physical Performance in Older Adults with Sarcopenia: A Systematic Review and Meta-Analysis

Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study

Effects of High-Intensity Resistance Training on Fitness and Fatness in Older Men With Osteosarcopenia

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