Prevention and optimal management of sarcopenia: a review of combined exercise and nutrition interventions to improve muscle outcomes in older people.
Prevention and optimal management of sarcopenia: a review of combined exercise and nutrition interventions to improve muscle outcomes in older people.
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DOI：
10.2147/cia.s55842
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发表时间：
2015
影响因子：
3.6
通讯作者：
Robinson SM
中科院分区：
文献类型：
--
作者：
Denison HJ;Cooper C;Sayer AA;Robinson SM
随着对骨骼肌减少症（骨骼肌质量和功能与年龄相关的丧失）的认识日益增强，人们需要更多地了解其病因。肌肉质量和力量的下降是衰老的预期方面，但在个体之间的损失速度有显著的差异。虽然其中一些差异可以用固定的因素来解释，比如性别，但其余的大部分差异是无法解释的。这导致人们越来越关注成人生活方式的影响，特别是身体活动和饮食等可改变因素的影响，以及确定预防和控制肌肉减少症的干预机会。许多试验已经研究了增加锻炼或补充膳食对老年人肌肉质量和身体表现的单独影响，但当这些干预措施结合起来时，运动训练的好处能在多大程度上得到增强，这一点尚不清楚。在对文献的全面回顾中，我们考虑了17项针对老年人（≥65岁）的研究，这些研究使用营养和运动相结合的干预措施来增加肌肉力量和/或质量，并实现身体表现的改善。这些研究在参与者（营养状况、身体虚弱程度）、补充策略（营养差异、剂量）、运动训练（类型、频率）以及设计（持续时间、环境）方面存在差异。主要的信息是，当运动训练与膳食补充相结合时，增强的益处已经在一些试验中显示出来——这表明了未来干预的潜力，但现有的证据并不一致。需要进一步的研究，特别是将运动训练与增加一系列营养素和生物活性非营养素摄入量的饮食策略相结合的研究，以便为公共卫生和临床建议提供依据。
The growing recognition of sarcopenia, the age-related loss of skeletal muscle mass and function, has highlighted the need to understand more about its etiology. Declines in muscle mass and strength are expected aspects of aging, but there is significant variability between individuals in rates of loss. Although some of these differences can be explained by fixed factors, such as sex, much of the remaining variation is unexplained. This has led to increasing interest in the influence of adult lifestyle, particularly in the effects of modifiable factors such as physical activity and diet, and in identifying intervention opportunities both to prevent and manage sarcopenia. A number of trials have examined the separate effects of increased exercise or dietary supplementation on muscle mass and physical performance of older adults, but less is known about the extent to which benefits of exercise training could be enhanced when these interventions are combined. In a comprehensive review of the literature, we consider 17 studies of older adults (≥65 years) in which combined nutrition and exercise interventions were used to increase muscle strength and/or mass, and achieve improvements in physical performance. The studies were diverse in terms of the participants included (nutritional status, degree of physical frailty), supplementation strategies (differences in nutrients, doses), exercise training (type, frequency), as well as design (duration, setting). The main message is that enhanced benefits of exercise training, when combined with dietary supplementation, have been shown in some trials – indicating potential for future interventions, but that existing evidence is inconsistent. Further studies are needed, particularly of exercise training combined with dietary strategies that increase intakes of a range of nutrients, as well as bioactive non-nutrients, to provide the evidence on which public health and clinical recommendations can be based.