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Effects of protein supplementation on lean body mass, muscle strength, and physical performance in nonfrail community-dwelling older adults: a systematic review and meta-analysis
Open accessAbstract
Background Increasing protein intake has been suggested as an effective strategy to ameliorate age-related loss of muscle mass and strength. Current reviews assessing the effect of protein supplementation are strongly influenced by the inclusion of studies with frail older adults.Objectives We assessed the effect of protein supplementation on lean body mass, muscle strength, and physical performance in exclusively nonfrail community-dwelling older adults. Moreover, we assessed the superior effects of protein supplementation during concomitant resistance exercise training on muscle characteristics.Design A systematic literature search was conducted on PubMed, Embase, and Web of Science up to 15 May 2018. We included randomized controlled trials that assessed the effect of protein supplementation on lean body mass, muscle thigh cross-sectional area, muscle strength, gait speed, and chair-rise ability and performed random-effects meta-analyses.Results Data from 36 studies with 1682 participants showed no significant effects of protein supplementation on changes in lean body mass [standardized mean difference (SMD): 0.11; 95% CI: -0.06, 0.28], handgrip strength (SMD: 0.58; 95% CI: -0.08, 1.24), lower extremity muscle strength (SMD: 0.03; 95% CI: -0.20, 0.27), gait speed (SMD: 0.41; 95% CI: -0.04, 0.85), or chair-rise ability (SMD: 0.10; 95%: CI -0.08, 0.28) compared with a control condition in nonfrail community-dwelling older adults. Moreover, no superior effects of protein supplementation were found during concomitant resistance exercise training on muscle characteristics.Conclusions Protein supplementation in nonfrail community-dwelling older adults does not lead to increases in lean body mass, muscle cross-sectional area, muscle strength, or physical performance compared with control conditions; nor does it exert superior effects when added to resistance exercise training. Habitual protein intakes of most study participants were already sufficient, and protein interventions differed in terms of type of protein, amount, and timing. Future research should clarify what specific protein supplementation protocol is beneficial for nonfrail community-dwelling older adults with low habitual protein intake.
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“However, the effects of protein ingestion independent of RE are not commonly explored.”
From Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults (2022) · cites this paper as [22]
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“This question is relevant as protein supplementation rarely substantially affects strength outcomes, 14 , 21 , 22 , 23 which highlights that the extra LBM gain stimulated by protein supplementation may not be muscle, 111 or at least not sufficient muscle that is contributing to increases in strength.”
From Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults (2022) · cites this paper as [22]
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“The insertion of clinical trials testing multi‐ingredient supplements, 106 including energy‐restricted weight‐loss diets, 13 or using different cut‐off points for age sub‐groups likely explain the differences in main effects and conclusions when comparing studies. 14 , 21 , 22 , 23”
From Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults (2022) · cites this paper as [22]
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“However, some particularities in the inclusion criteria in these two meta‐analyses (i.e. aerobic exercise training or the cut‐off point during age subgroup analysis) might cause such contrast compared with our findings.”
From Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults (2022) · cites this paper as [22]
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“According to previous meta‐analyses from our group and others, the effects of increasing daily protein ingestion on muscle strength are highly variable. 14 , 21 , 22 , 23”
From Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults (2022) · cites this paper as [22]
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“Conversely, Haaf et al. 22 found no effect of additional protein supplementation in LBM in non‐frail community‐dwelling older adults (>50 years old), even when combined with resistance exercise (≥4 weeks).”
From Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults (2022) · cites this paper as [22]
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“In contrast, Wirth et al. 21 and Haaf et al. 22 found no effect of additional protein ingestion and exercise on lower‐body strength.”
From Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults (2022) · cites this paper as [22]
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“Our results are in line with a previous meta‐analysis 22 showing no significant effect of protein ingestion added to RE on gait speed or chair‐rise time in healthy subjects.”
From Systematic review and meta-analysis of protein intake to support muscle mass and function in healthy adults (2022) · cites this paper as [22]
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Barazzoni, R., Jensen, G. L., Correia, M. I. T. D., Gonzalez, M. C., Higashiguchi, T., Shi, H. P., Bischoff, S. C., Boirie, Y., Carrasco, F., Cruz-Jentoft, A., et al. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.02.001 · Cited by 406
Nunes, E. A., Colenso‐Semple, L., McKellar, S. R., Yau, T., Ali, M. U., Fitzpatrick‐Lewis, D., Sherifali, D., Gaudichon, C., Tomé, D., Atherton, P. J., et al. (2022) · Journal of Cachexia, Sarcopenia and Muscle · doi:10.1002/jcsm.12922 · Cited by 280
Morin, S. N., Feldman, S., Funnell, L., Giangregorio, L., Kim, S. S. Y., McDonald-Blumer, H., Santesso, N. A., Ridout, R., Ward, W. E., Ashe, M. C., et al. (2023) · Canadian Medical Association Journal · doi:10.1503/cmaj.221647 · Cited by 212
Strategies to Prevent Sarcopenia in the Aging Process: Role of Protein Intake and Exercise
Rogeri, P. S., Zanella, R., Martins, G. L., Garcia, M. D. A., Leite, G., Lugaresi, R., Gasparini, S. O., Sperandio, G. A., Ferreira, L. H. B., Souza-Junior, T. P., et al. (2021) · Nutrients · doi:10.3390/nu14010052 · Cited by 181
“Additionally, two meta-analyses corroborate the findings of these two studies, suggesting that protein supplementation alone may not be enough to promote positive changes in skeletal muscle mass in older adults [130,131].”
ResultWu, P.-Y., Huang, K.-S., Chen, K.-M., Chou, C.-P., & Tu, Y.-K. (2021) · Maturitas · doi:10.1016/j.maturitas.2020.12.009 · Cited by 168
Metadata
- Authors
- ten Haaf, D. S. M., Nuijten, M. A. H., Maessen, M. F. H., Horstman, A. M. H., Eijsvogels, T. M. H., & Hopman, M. T.
- Affiliations
- Radboud University Medical Center (NL)
- FrieslandCampina (Netherlands) (NL)
- Corresponding author
- Hopman, Maria TE
- ORCID
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2018-11
- Volume
- 108
- Issue
- 5
- Pages
- 1043-1059
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2901144022
- Cited by
- 152
- References
- 94
- Citations by year
- 2026: 11 · 2025: 9 · 2024: 24 · 2023: 18 · 2022: 40 · 2021: 19 · 2020: 24 · 2019: 7
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Socio-Environmental Systems Modeling (acceptedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- protein supplementation, lean body mass, muscle strength, physical performance, community-dwelling older adults, resistance training, grip strength, walking speed, muscle cross-sectional area, sarcopenia
- MeSH terms
- Physical Functional Performance, Aged, Aged, 80 and over, Body Fluid Compartments, Dietary Proteins, Female, Gait, Humans, Male, Middle Aged, Movement, Exercise, Geriatric Assessment, Muscle, Skeletal, Dietary Supplements, Muscle Strength, Resistance Training, Independent Living
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