Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review.
Nutrition and physical activity in the prevention and treatment of sarcopenia: systematic review.
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DOI：
10.1007/s00198-017-3980-9
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发表时间：
2017-06
期刊：
影响因子：
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通讯作者：
IOF-ESCEO Sarcopenia Working Group
中科院分区：
文献类型：
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作者：
Beaudart C;Dawson A;Shaw SC;Harvey NC;Kanis JA;Binkley N;Reginster JY;Chapurlat R;Chan DC;Bruyère O;Rizzoli R;Cooper C;Dennison EM;IOF-ESCEO Sarcopenia Working Group
本系统综述总结了运动和营养联合干预对肌肉质量和肌肉功能的影响。共确定了37项RCT。结果表明，体育锻炼对65岁及以上受试者的肌肉质量和肌肉功能有积极影响。然而，膳食补充剂的任何相互作用似乎是有限的。2013年，Denison等人进行了一项系统性综述，包括17项随机对照试验（RCT），以探索运动和营养干预联合治疗对改善老年人肌肉质量、肌肉力量或身体表现的影响。他们的结论是，需要进一步的研究来提供公共卫生和临床建议的证据。本工作的目的是更新之前的系统性综述，并纳入截至2015年10月发表的研究。使用MEDLINE和EMBASE电子数据库，我们确定了评估运动训练和营养补充对60岁及以上受试者的肌肉力量、肌肉质量或体能的综合影响的RCT。研究选择和数据提取由两名独立的评审员进行。检索策略确定了21项额外RCT，共计37项RCT。研究在体育锻炼和膳食补充（蛋白质、必需氨基酸、肌酸、β-羟基-β-甲基丁酸、维生素D、多种营养素或其他）方案方面存在差异。在79%的研究（27/34）中，肌肉质量随着运动而增加，但仅在8项RCT（23.5%）中发现了营养的额外作用。82.8%的研究（29/35 RCT）在运动干预后肌肉力量增加，只有少数研究（8/35 RCTS，22.8%）显示膳食补充剂有额外的益处。最后，大多数研究显示，运动干预后体能有所提高（26/28项RCT，92.8%），但仅在14.3%的研究中发现了与营养补充的相互作用（4/28项RCT）。体育锻炼对60岁及以上的健康受试者的肌肉质量和肌肉功能有积极的影响。任何类型的运动干预的最大效果都是对身体表现（步态速度，椅子上升测试，平衡，SPPB测试等）的影响。我们观察到饮食补充方案存在巨大差异。根据纳入的研究，主要是在营养良好的受试者中进行的，膳食补充剂对肌肉功能的相互作用似乎有限。
This systematic review summarizes the effect of combined exercise and nutrition intervention on muscle mass and muscle function. A total of 37 RCTs were identified. Results indicate that physical exercise has a positive impact on muscle mass and muscle function in subjects aged 65 years and older. However, any interactive effect of dietary supplementation appears to be limited. In 2013, Denison et al. conducted a systematic review including 17 randomized controlled trials (RCTs) to explore the effect of combined exercise and nutrition intervention to improve muscle mass, muscle strength, or physical performance in older people. They concluded that further studies were needed to provide evidence upon which public health and clinical recommendations could be based. The purpose of the present work was to update the prior systematic review and include studies published up to October 2015. Using the electronic databases MEDLINE and EMBASE, we identified RCTs which assessed the combined effect of exercise training and nutritional supplementation on muscle strength, muscle mass, or physical performance in subjects aged 60 years and over. Study selection and data extraction were performed by two independent reviewers. The search strategy identified 21 additional RCTs giving a total of 37 RCTs. Studies were heterogeneous in terms of protocols for physical exercise and dietary supplementation (proteins, essential amino acids, creatine, β-hydroxy-β-methylbuthyrate, vitamin D, multi-nutrients, or other). In 79% of the studies (27/34 RCTs), muscle mass increased with exercise but an additional effect of nutrition was only found in 8 RCTs (23.5%). Muscle strength increased in 82.8% of the studies (29/35 RCTs) following exercise intervention, and dietary supplementation showed additional benefits in only a small number of studies (8/35 RCTS, 22.8%). Finally, the majority of studies showed an increase of physical performance following exercise intervention (26/28 RCTs, 92.8%) but interaction with nutrition supplementation was only found in 14.3% of these studies (4/28 RCTs). Physical exercise has a positive impact on muscle mass and muscle function in healthy subjects aged 60 years and older. The biggest effect of exercise intervention, of any type, has been seen on physical performance (gait speed, chair rising test, balance, SPPB test, etc.). We observed huge variations in regard to the dietary supplementation protocols. Based on the included studies, mainly performed on well-nourished subjects, the interactive effect of dietary supplementation on muscle function appears limited.