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Protein interventions augment the effect of resistance exercise on appendicular lean mass and handgrip strength in older adults: a systematic review and meta-analysis of randomized controlled trials.

Kirwan, RP, Mazidi, M, García, CR, Lane, KE, Jafari, A, Butler, T, Pérez de Heredia, F and Davies, IG Protein interventions augment the effect of resistance exercise on appendicular lean mass and handgrip strength in older adults: a systematic review and meta-analysis of randomized controlled trials. American Journal of Clinical Nutrition. ISSN 1938-3207 (Accepted)

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Abstract

BACKGROUND: Increased protein intake is suggested as a strategy to slow or reverse the loss of muscle mass and strength observed in sarcopenia, but results from studies that directly tested this possibility have been inconsistent. OBJECTIVES: We assessed the evidence on the effects of whole protein supplementation or higher-protein diets, without the use of amino acids or supplements known to stimulate hypertrophy, alone or in combination with resistance exercise (RE) interventions, on lean body mass (LBM) and strength in older adults. DESIGN: A systematic search was conducted using PubMed, Medline, Web of Science and Cochrane CENTRAL databases from January 1990 up to July 2021. Randomized controlled trials that assessed the effects of protein supplementation and/or higher-protein dietary interventions in older adults (mean age ≥ 50 years), on total LBM, appendicular lean mass (ALM), handgrip (HG) and knee extension strength (KE) were included. RESULTS: 28 studies were identified. In pooled analysis, compared with lower protein controls, protein supplementation did not have a significant positive effect on total LBM [weighted mean difference in change (WMD):0.34, 95% CI: -0.21,0.89, I2:90.01%], ALM [WMD:0.4, 95% CI: -0.01,0.81, I2:90.38%], HG [WMD:0.69, 95% CI: -0.69,2.06, I2:94.52%] or KE [WMD:1.88, 95% CI: -0.6,4.35, I2:95.35%]. However, in interventions that used also RE, statistically significant positive effects of protein were observed for ALM [WMD:0.54, 95% CI:0.03,1.05, I2:89.76%] and HG [WMD:1.71, 95% CI:0.12,3.30, I2:88.71%]. Meta-regression revealed no significant association between age, per-meal protein dose, duration, and baseline protein intake with change in any outcome. Sub-group analysis revealed the statistically significant effects on ALM only occurred in sarcopenic/frail populations (WMD:0.88, 95% CI:0.51,1.25, I2:79.0%). Most studies (n = 22) had some risk of bias. CONCLUSIONS: In older adults performing RE, increased protein intake leads to greater ALM and HG, compared with lower protein controls. Without RE, protein has no additional benefit on changes in total LBM, ALM or HG.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in American Journal of Clinical Nutrition following peer review. The version of record Richard P Kirwan, Mohsen Mazidi, Carmen Rodríguez García, Katie E Lane, Alireza Jafari, Tom Butler, Fatima Perez de Heredia, Ian G Davies, Protein interventions augment the effect of resistance exercise on appendicular lean mass and handgrip strength in older adults: a systematic review and meta-analysis of randomized controlled trials, The American Journal of Clinical Nutrition, 2021;, nqab355, is available online at:https://doi.org/10.1093/ajcn/nqab355
Uncontrolled Keywords: 09 Engineering, 11 Medical and Health Sciences
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Biological & Environmental Sciences (new Sep 19)
Sport & Exercise Sciences
Publisher: Oxford University Press (OUP)
Related URLs:
Date Deposited: 01 Nov 2021 11:16
Last Modified: 01 Nov 2021 11:16
DOI or Identification number: 10.1093/ajcn/nqab355
URI: https://researchonline.ljmu.ac.uk/id/eprint/15718

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