Cited by 193Nutrition and Health in AgingMuscle metabolism and nutritionFrailty in Older Adults

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Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects: a randomized, double-blind, placebo-controlled trial

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Park, Yongsoon, Choi, Jeong-Eun, Hwang, Hwan-Sik·2018·The American Journal of Clinical Nutrition

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Abstract

Background Age-related loss of muscle mass and function is a major component of frailty. Nutrition supplementation with exercise is an effective strategy to decrease frailty by preventing sarcopenia, but the effect of protein alone is controversial.Objective The present study was performed to investigate a dose-dependent effect of protein supplementation on muscle mass and frailty in prefrail or frail malnourished elderly people.Design A 12-wk double-blind randomized controlled trial was conducted in elderly subjects aged 70-85 y with ≥1 of the Cardiovascular Health Study frailty criteria and a Mini Nutritional Assessment score ≤23.5 (n = 120). Participants were randomly assigned to 1 of 3 groups: 0.8, 1.2, or 1.5 g protein · kg-1 · d-1, with concealed allocation and intention-to-treat analysis. Primary outcomes were appendicular skeletal muscle mass (ASM) and skeletal muscle mass index (SMI) measured by dual-energy X-ray absorptiometry.Results After the 12-wk intervention, the 1.5-g protein · kg-1 · d-1 group had higher ASM (mean ± SD: 0.52 ± 0.64 compared with 0.08 ± 0.68 kg, P = 0.036) and SMI (ASM/weight: 0.87% ± 0.69% compared with 0.15% ± 0.89%, P = 0.039; ASM/BMI: 0.02 ± 0.03 compared with 0.00 ± 0.04, P = 0.033; ASM:fat ratio: 0.04 ± 0.11 compared with -0.02 ± 0.10, P = 0.025) than the 0.8-g protein · kg-1 · d-1 group. In addition, gait speed was improved in the 1.5-g protein · kg-1 · d-1 group compared with the 0.8-g protein · kg-1 · d-1 group (0.09 ± 0.07 compared with 0.04 ± 0.07 m/s, P = 0.039). There were no significant differences between the 1.2- and 0.8-g protein · kg-1 · d-1 groups in muscle mass and physical performance. No harmful adverse effects were observed.Conclusions The present study indicates that protein intake of 1.5 g · kg-1 · d-1 has the most beneficial effects in regard to preventing sarcopenia and frailty compared with protein intakes of 0.8 and 1.2 g · kg-1 · d-1 in prefrail or frail elderly subjects at risk of malnutrition. This trial was registered at cris.nih.go.kr as KCT0001923.

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Authors: Park, Y., Choi, J.-E., & Hwang, H.-S.
Affiliations: Hanyang University (KR)
Corresponding author: Park, Yongsoon
ORCID: Park, Yongsoon
Hwang, Hwan-Sik
Venue: The American Journal of Clinical Nutrition
Publisher: Elsevier BV
Published: 2018-11
Volume: 108
Issue: 5
Pages: 1026-1033
ISSN: 0002-9165 (ISSN-L)
DOI: 10.1093/ajcn/nqy214
OpenAlex: W2900982893
Cited by: 193
References: 33
Citations by year: 2026: 18 · 2025: 29 · 2024: 30 · 2023: 29 · 2022: 25 · 2021: 28 · 2020: 26 · 2019: 6 · 2018: 2
FWCI: 10.70
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 1556 d)
Locations: American Journal of Clinical Nutrition (publishedVersion)
PubMed (publishedVersion)
Funders: Ministry of Health & Welfare, Republic of Korea (HI15C3207)
Topics: Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Keywords: protein supplementation, frailty, pre-frailty, sarcopenia, muscle mass, skeletal muscle index, malnutrition, older adults, walking speed, physical performance, dose-response relationship, appendicular skeletal muscle mass, Mini Nutritional Assessment, dietary intervention, exercise training, functional capacity, quality of life, body composition
MeSH terms: Frailty, Physical Functional Performance, Aged, Aged, 80 and over, Body Composition, Dietary Proteins, Dose-Response Relationship, Drug, Double-Blind Method, Female, Humans, Male, Nutritional Status, Nutrition Assessment, Frail Elderly, Muscle, Skeletal, Dietary Supplements, Malnutrition, Sarcopenia

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Protein supplementation improves muscle mass and physical performance in undernourished prefrail and frail elderly subjects: a randomized, double-blind, placebo-controlled trial

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