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Nutritional interventions to improve muscle mass, muscle strength, and physical performance in older people: an umbrella review of systematic reviews and meta-analyses.
Open accessAbstract
Context: Sarcopenia is a progressive and generalized skeletal muscle disorder associated with an increased risk of adverse outcomes such as falls, disability, and death. The Belgian Society of Gerontology and Geriatrics has developed evidence-based guidelines for the prevention and treatment of sarcopenia. This umbrella review presents the results of the Working Group on Nutritional Interventions. Objective: The aim of this umbrella review was to provide an evidence-based overview of nutritional interventions targeting sarcopenia or at least 1 of the 3 sarcopenia criteria (ie, muscle mass, muscle strength, or physical performance) in persons aged ≥ 65 years. Data sources: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed and Web of Science databases were searched for systematic reviews and meta-analyses reporting the effect of nutritional supplementation on sarcopenia or muscle mass, strength, or physical performance. Data extraction: Two authors extracted data on the key characteristics of the reviews, including participants, treatment, and outcomes. Methodological quality of the reviews was assessed using the product A Measurement Tool to Assess Systematic Reviews. Three authors synthesized the extracted data and generated recommendations on the basis of an overall synthesis of the effects of each intervention. Quality of evidence was rated with the Grading of Recommendations Assessment, Development and Evaluation approach. Data analysis: A total of 15 systematic reviews were included. The following supplements were examined: proteins, essential amino acids, leucine, β-hydroxy-β-methylbutyrate, creatine, and multinutrient supplementation (with or without physical exercise). Because of both the low amount and the low to moderate quality of the reviews, the level of evidence supporting most recommendations was low to moderate. Conclusions: Best evidence is available to recommend leucine, because it has a significant effect on muscle mass in elderly people with sarcopenia. Protein supplementation on top of resistance training is recommended to increase muscle mass and strength, in particular for obese persons and for ≥ 24 weeks. Effects on sarcopenia as a construct were not reported in the included reviews.
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“The methodological quality of each included review was assessed independently by two reviewers using the AMSTAR (A Measurement Tool to Assess Systematic Reviews) tool, which yields a score ranging from 1 to 11 that incorporates assessment of publication bias (Supplemental Appendix 4, Supplemental Digital Content, https://links.lww.com/MSS/D323) (18,19).”
From American College of Sports Medicine Position Stand. Resistance Training Prescription for Muscle Function, Hypertrophy, and Physical Performance in Healthy Adults: An Overview of Reviews (2026) · cites this paper as [18]
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Rayyan-a web and mobile app for systematic reviews.
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Liberati, A., Altman, D. G., Tetzlaff, J., Mulrow, C., Gotzsche, P. C., Ioannidis, J. P. A., Clarke, M., Devereaux, P. J., Kleijnen, J., & Moher, D. (2009) · BMJ · doi:10.1136/bmj.b2700 · Cited by 17,648
Sarcopenia: revised European consensus on definition and diagnosis
Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., Cooper, C., Landi, F., Rolland, Y., Sayer, A. A., et al. (2019) · Age and Ageing · doi:10.1093/ageing/afy169 · Cited by 13,818
Self-citationSarcopenia: European consensus on definition and diagnosis
Cruz-Jentoft, A. J., Baeyens, J. P., Bauer, J. M., Boirie, Y., Cederholm, T., Landi, F., Martin, F. C., Michel, J.-P., Rolland, Y., Schneider, S. M., et al. (2010) · Age and Ageing · doi:10.1093/ageing/afq034 · Cited by 11,601
Self-citationDevelopment of AMSTAR: A measurement tool to assess the methodological quality of systematic reviews
Shea, B. J., Grimshaw, J. M., Wells, G. A., Boers, M., Andersson, N., Hamel, C., Porter, A. C., Tugwell, P., Moher, D., & Bouter, L. M. (2007) · BMC Medical Research Methodology · doi:10.1186/1471-2288-7-10 · Cited by 4,374
Sarcopenia in Asia: Consensus Report of the Asian Working Group for Sarcopenia
Chen, L.-K., Liu, L.-K., Woo, J., Assantachai, P., Auyeung, T.-W., Bahyah, K. S., Chou, M.-Y., Chen, L.-Y., Hsu, P.-S., Krairit, O., et al. (2014) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2013.11.025 · Cited by 4,051
Fielding, R. A., Vellas, B., Evans, W. J., Bhasin, S., Morley, J. E., Newman, A. B., Abellan van Kan, G., Andrieu, S., Bauer, J., Breuille, D., et al. (2011) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2011.01.003 · Cited by 3,256
Bauer, J., Biolo, G., Cederholm, T., Cesari, M., Cruz-Jentoft, A. J., Morley, J. E., Phillips, S., Sieber, C., Stehle, P., Teta, D., et al. (2013) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2013.05.021 · Cited by 2,553
Studenski, S. A., Peters, K. W., Alley, D. E., Cawthon, P. M., McLean, R. R., Harris, T. B., Ferrucci, L., Guralnik, J. M., Fragala, M. S., Kenny, A. M., et al. (2014) · The Journals of Gerontology: Series A · doi:10.1093/gerona/glu010 · Cited by 2,545
Deutz, N. E. P., Bauer, J. M., Barazzoni, R., Biolo, G., Boirie, Y., Bosy-Westphal, A., Cederholm, T., Cruz-Jentoft, A., Krznariç, Z., Nair, K. S., et al. (2014) · Clinical Nutrition · doi:10.1016/j.clnu.2014.04.007 · Cited by 1,738
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Lai, J. C., Tandon, P., Bernal, W., Tapper, E. B., Ekong, U., Dasarathy, S., & Carey, E. J. (2021) · Hepatology · doi:10.1002/hep.32049 · Cited by 742
“These include ß- hydroxy- ß-methylbutyrate (a metabolite of leucine), (230,231) acetyl- L-carnitine (an amino acid that has been shown to reduce blood ammonia levels), (193) and L-ornithine L-aspartate (a combination of two endogenous amino acids that reduces blood ammonia levels).”
BackgroundSarcopenia in chronic kidney disease: what have we learned so far?
Sabatino, A., Cuppari, L., Stenvinkel, P., Lindholm, B., & Avesani, C. M. (2020) · Journal of Nephrology · doi:10.1007/s40620-020-00840-y · Cited by 549
Metabolic changes in aging humans: current evidence and therapeutic strategies
Palmer, A. K., & Jensen, M. D. (2022) · Journal of Clinical Investigation · doi:10.1172/jci158451 · Cited by 383
“The beneficial effects of resistance exercise on skeletal muscle mass and strength are enhanced by provision of adequate protein intake (109).”
BackgroundBernabei, R., Landi, F., Calvani, R., Cesari, M., Del Signore, S., Anker, S. D., Bejuit, R., Bordes, P., Cherubini, A., Cruz-Jentoft, A. J., et al. (2022) · BMJ · doi:10.1136/bmj-2021-068788 · Cited by 318
Sarcopenia, osteoporosis and frailty
Gielen, E., Dupont, J., Dejaeger, M., & Laurent, M. R. (2023) · Metabolism · doi:10.1016/j.metabol.2023.155638 · Cited by 282
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Metadata
- Authors
- Gielen, E., Beckwée, D., Delaere, A., De Breucker, S., Vandewoude, M., Bautmans, I., the Sarcopenia Guidelines Development Group of the Belgian Society of Gerontology and Geriatrics (BSGG), Bautmans, I., Beaudart, C., Beckwée, D., Beyer, I., Bruyère, O., De Breucker, S., De Cock, A.-M., Delaere, A., de Saint-Hubert, M., De Spiegeleer, A., Gielen, E., Perkisas, S., & Vandewoude, M.
- Affiliations
- Department of Geriatrics, UZ Leuven, Leuven, Belgium
- Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Geriatrics, Erasme Hospital, Brussels, Belgium
- University of Antwerp (BE)
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
- Vrije Universiteit Brussel (BE)
- Erasmus Hospital (BE)
- Venue
- Nutrition Reviews
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-01-07
- Volume
- 79
- Issue
- 2
- Pages
- 121-147
- ISSN
- 0029-6643 (ISSN-L)
- 1753-4887
- OpenAlex
- W3030753538
- Cited by
- 269
- References
- 62
- Citations by year
- 2026: 32 · 2025: 60 · 2024: 47 · 2023: 52 · 2022: 44 · 2021: 25
- FWCI
- 4.10
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Nutrition Reviews (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion, other-oa)
- Lirias (submittedVersion, other-oa)
- Ghent University Academic Bibliography (Ghent University) (submittedVersion)
- Digital Access to Libraries (Université catholique de Louvain (UCL), l'Université de Namur (UNamur) and the Université Saint-Louis (USL-B)) (submittedVersion, other-oa)
- ORBi (University of Liège) (submittedVersion, other-oa)
- VUBIR (Vrije Universiteit Brussel) (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
- sarcopenia, dietary intervention, older adults, muscle mass, muscle strength, physical performance, protein supplementation, leucine, essential amino acids, creatine, beta-hydroxy-beta-methylbutyrate, resistance training, obesity
- MeSH terms
- Physical Functional Performance, Aged, Aged, 80 and over, Amino Acids, Essential, Creatine, Humans, Leucine, Valerates, Exercise, Muscle, Skeletal, Dietary Supplements, Muscle Strength, Sarcopenia
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