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      The Impact of Dairy Protein Intake on Muscle Mass, Muscle Strength, and Physical Performance in Middle-Aged to Older Adults with or without Existing Sarcopenia: A Systematic Review and Meta-Analysis

      1 , 1 , 1
      Advances in Nutrition
      Oxford University Press (OUP)

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          Abstract

          Sarcopenia is an age-related condition associated with a progressive loss of muscle mass and strength. Insufficient protein intake is a risk factor for sarcopenia. Protein supplementation is suggested to improve muscle anabolism and function in younger and older adults. Dairy products are a good source of high-quality proteins. This review evaluates the effectiveness of dairy proteins on functions associated with sarcopenia in middle-aged and older adults. Randomized controlled trials were identified using PubMed, CINAHL/EBSCO, and Web of Science databases (last search: 10 May 2017) and were quality assessed. The results of appendicular muscle mass and muscle strength of handgrip and leg press were pooled using a random-effects model. The analysis of the Short Physical Performance Battery is presented in narrative form. Adverse events and tolerability of dairy protein supplementation were considered as secondary outcomes. Fourteen studies involving 1424 participants aged between 61 and 81 y met the inclusion criteria. Dairy protein significantly increased appendicular muscle mass (0.13 kg; 95% CI: 0.01, 0.26 kg; P  = 0.04); however, it had no effect on improvement in handgrip (0.84 kg; 95% CI: −0.24, 1.93 kg; P  = 0.13) or leg press (0.37 kg; 95% CI: −4.79, 5.53 kg; P  = 0.89). The effect of dairy protein on the Short Physical Performance Battery was inconclusive. Nine studies reported the dairy protein to be well tolerated with no serious adverse events. Although future high-quality research is required to establish the optimal type of dairy protein, the present systematic review provides evidence of the beneficial effect of dairy protein as a potential nutrition strategy to improve appendicular muscle mass in middle-aged and older adults.

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          Effectiveness of nutritional supplementation on muscle mass in treatment of sarcopenia in old age: a systematic review.

          Much interest has been focused on nutritional treatment of sarcopenia, loss of muscle mass and performance associated to aging; however, its benefits are unclear. To analyze the relevance of nutritional treatment of sarcopenia and assess the effects of supplementation on muscle mass and function within the aged population. 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. 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. 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. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.
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            A 3-year longitudinal study on body composition changes in the elderly: role of physical exercise.

            Cross-sectional data have shown that sarcopenia and fat accumulation are associated with aging and can be limited by structured physical training. However, it is often difficult to maintain a long-term compliance to training programs. It is not clear whether leisure-time physical activity is effective in preventing sarcopenia and fat accumulation. (i) To investigate longitudinal body composition changes in a population of elderly people in good apparent health. (ii) To evaluate the impact of leisure-time physical activity on muscle mass and characteristic as reflected by total body potassium per fat-free soft tissue (TBK/FFST), and on fat accumulation. Longitudinal evaluation over 3 years, of body composition changes in 74 healthy men and 66 women, over 65 years old. Body fat and FFST were analyzed by dual-energy X-ray absorptiometry and TBK by whole-body (40)K counter. Physical activity was analyzed by a specific questionnaire. Despite a stable total body weight, FFST and appendicular skeletal muscle mass slightly decreased (-0.3+/-1.4 and -0.2+/-2.2 kg, P<0.01, respectively) as well as the TBK/FFST (-4.1+/-6.3 mmol/kg, P<0.001), over the 3-year period. Body fat increased significantly (0.6+/-2.2 kg, P<0.0001), and it accumulated mainly in the abdomen (0.4+/-1.5 kg, P<0.01). Multiple regression analysis showed that body composition changes were related mainly to body weight changes. Nevertheless, positive linear correlations were observed between the degree of engagement in leisure-time physical activity and FFST (P<0.01), appendicular skeletal muscle mass (P<0.05), TBK/FFST (P<0.05), whereas negative correlation was observed with total and truncal fat (P<0.01). Mild but significant decline in muscle mass and its TBK content, and body fat accumulation were observed over a 3-year period in healthy elderly subject: leisure-time physical activity does not seem to prevent them. However, a higher level of physical activity is associated with higher muscle mass and TBK content, and less total and truncal fat.
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              Physical function and self-rated health status as predictors of mortality: results from longitudinal analysis in the ilSIRENTE study

              Background Physical function measures have been shown to predict negative health-related events in older persons, including mortality. These markers of functioning may interact with the self-rated health (SRH) in the prediction of events. Aim of the present study is to compare the predictive value for mortality of measures of physical function and SRH status, and test their possible interactions. Methods Data are from 335 older persons aged ≥ 80 years (mean age 85.6 years) enrolled in the "Invecchiamento e Longevità nel Sirente" (ilSIRENTE) study. The predictive values for mortality of 4-meter walk test, Short Physical Performance Battery (SPPB), hand grip strength, Activities of Daily Living (ADL) scale, Instrumental ADL (IADL) scale, and a SRH scale were compared using proportional hazard models. Kaplan-Meier survival curves for mortality and Receiver Operating Characteristic (ROC) curve analyses were also computed to estimate the predictive value of the independent variables of interest for mortality (alone and in combination). Results During the 24-month follow-up (mean 1.8 years), 71 (21.2%) events occurred in the study sample. All the tested variables were able to significantly predict mortality. No significant interaction was reported between physical function measures and SRH. The SPPB score was the strongest predictor of overall mortality after adjustment for potential confounders (per SD increase; HR 0.64; 95%CI 0.48–0.86). A similar predictive value was showed by the SRH (per SD increase; HR 0.76; 95%CI 0.59–0.97). The chair stand test was the SPPB subtask showing the highest prognostic value. Conclusion All the tested measures are able to predict mortality with different extents, but strongest results were obtained from the SPPB and the SRH. The chair stand test may be as useful as the complete SPPB in estimating the mortality risk.
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                Author and article information

                Journal
                Advances in Nutrition
                Oxford University Press (OUP)
                2161-8313
                2156-5376
                January 2019
                January 01 2019
                January 08 2019
                January 2019
                January 01 2019
                January 08 2019
                : 10
                : 1
                : 59-69
                Affiliations
                [1 ]Division of Nutritional Sciences, University of Nottingham, Leicestershire, United Kingdom
                Article
                10.1093/advances/nmy065
                6370271
                30624580
                d889391a-a0bb-453f-8f7e-e3054d4f7003
                © 2019

                https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model

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