Review
Effectiveness of Nutritional Supplementation on Muscle Mass in Treatment of Sarcopenia in Old Age: A Systematic Review

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Abstract

Background

Much interest has been focused on nutritional treatment of sarcopenia, loss of muscle mass and performance associated to aging; however, its benefits are unclear.

Objective

To analyze the relevance of nutritional treatment of sarcopenia and assess the effects of supplementation on muscle mass and function within the aged population.

Methods

We searched Medline and the Cochrane Library for controlled trials published between 1991 and 2012. We have assessed the quality, type of intervention, the cohort used, the way muscle mass was measured, and the outcomes of the various studies.

Results

We have included 17 studies, with a total of 1287 patients, aged between 65 and 85 on average. An improvement in muscle mass was proven, whether measured with bioelectrical impedance analysis or dual energy x-ray absorptiometry, and an improvement in strength was also proven.

Conclusion

Nutritional supplementation is effective in the treatment of sarcopenia in old age, and its positive effects increase when associated with physical exercise. The main limitation of this treatment is lack of long-term adherence. A healthy diet associated with a physically active lifestyle and possibly with aerobic exercise are the basis of healthy aging, which is the aim of all doctors treating aged people must seek.

Section snippets

Methods

We performed this systematic review in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines for systematic reviews.23 The protocol of this systematic review was registered at PROSPERO, as CRD42012002546, which is an international database of prospectively registered systematic reviews in health and social care. PROSPERO is funded by the UK National Institute for Health Research (available at: //www.crd.york.ac.uk/PROSPERO/display_record.asp%3FID=CRD42012002546

Results

Figure 1 shows the flow chart of the articles we found, the ones we discarded, and the ones we included in the review. One hundred sixty-eight citations came from MEDLINE, 20 came from the search in the Cochrane Library, and 12 from the references of the included articles, from all of which, after removing duplicates, we were left with 176 papers resulted. One hundred fifty-two were discarded because they did not fulfill the inclusion criteria set by the design of this review. The full text of

Discussion

All the papers reviewed refer to sarcopenia in their introduction and mention sarcopenia often in the discussion but only three of the trials included sarcopenic patients. In one of them, the criteria used to define sarcopenia differ from those accepted by international consensus and the other two do not specify the criteria used.

Patients with a BMI higher than 20 kg/m2 were included in 53% of the trials and 30% included patients with a BMI above 27 kg/m2. Despite the severe limitations the

Conclusion

We found two papers assessing the effects of nutritional supplementation on muscle mass and function in patients with hip fractures that were published in the “Journal” last month.53, 54 These further support our conclusions. Some of the papers reviewed did not achieve positive results, but showed negative effects on untreated groups, which may be an indirect indication of the protective effect of nutritional supplementation in terms of the consequences of ageing.

The right kind of diet and a

References (57)

  • D. Bunout et al.

    The impact of nutritional supplementation and resistance training on the health functioning of free-living Chilean elders: Results of 18 months of follow-up

    J Nutr

    (2001)
  • W. Wouters-Wesseling et al.

    The effect of a liquid nutrition supplement on body composition and physical functioning in elderly people

    Clin Nutr

    (2003)
  • F. Neelemaat et al.

    Post-discharge nutritional support in malnourished elderly individuals improves functional limitations

    J Am Med Dir Assoc

    (2011)
  • H.K. Kim et al.

    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

    (2012)
  • L.B. Verdijk et al.

    Protein supplementation before and after exercise does not further augment skeletal muscle hypertrophy after resistance training in elderly men

    Am J Clin Nutr

    (2009)
  • P. Flakoll et al.

    Effect of beta-hydroxy-beta-methylbutyrate, arginine, and lysine supplementation on strength, functionality, body composition, and protein metabolism in elderly women

    Nutrition

    (2004)
  • C.R. Van Wetering et al.

    Efficacy and costs of nutritional rehabilitation in muscle-wasted patients with chronic obstructive pulmonary disease in a community-based setting: A prespecified subgroup analysis of the INTERCOM Trial

    J Am Med Dir Assoc

    (2010)
  • I. Janssen

    The epidemiology of sarcopenia

    Clin Geriatr Med

    (2011)
  • U.G. Kyle et al.

    Bioelectrical impedance analysis–Part I: Review of principles and methods

    Clin Nutr

    (2004)
  • J.E. Morley

    Anorexia of aging: Physiologic and pathologic

    Am J Clin Nutr

    (1997)
  • J.E. Morley et al.

    Anorexia in the elderly

    Neurobiol Aging

    (1988)
  • M. Tieland et al.

    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)
  • M. Tieland et al.

    Protein supplementation improves physical performance in frail elderly people: A randomized, double-blind, placebo-controlled trial

    J Am Med Dir Assoc

    (2012)
  • T.E. Jones et al.

    Sarcopenia–Mechanisms and treatments

    J Geriatr Phys Ther

    (2009)
  • M. Visser et al.

    Relationship of interleukin-6 and tumor necrosis factor-alpha with muscle mass and muscle strength in elderly men and women: The Health ABC Study

    J Gerontol A Biol Sci Med Sci

    (2002)
  • I.M. Chapman et al.

    The anorexia of ageing

    Biogerontology

    (2002)
  • H. Alemán et al.

    Longitudinal evidence on the association between interleukin-6 and C-reactive protein with the loss of total appendicular skeletal muscle in free-living older men and women

    Age Ageing

    (2011)
  • H. Klitgaard et al.

    Function, morphology and protein expression of ageing skeletal muscle: A cross-sectional study of elderly men with different training backgrounds

    Acta Physiol Scand

    (1990)
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    The authors have no financial or any other kind of personal conflicts with this paper.

    This review was registered at www.crd.york.ac.uk/prospero/prospero.asp (PROSPERO), as CRD42012002546.

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