Department of Nutrition, Exercise and Sports, Copenhagen University, 2200 Copenhagen, Denmark.
Dietetics and Clinical Nutrition Research Unit, Herlev and Gentofte Hospital, 2730 Herlev, Denmark.
Br J Nutr. 2019 Nov 14;122(9):1006-1020. doi: 10.1017/S0007114519001831.
Sarcopenia (loss of muscle mass/strength) burdens many older adults - hospitalised older adults being particularly vulnerable. Treating the condition, protein supplementation (PrS) and resistance training (RT) may act synergistically. Therefore, this block-randomised, double-blind, multicentre intervention study, recruiting geriatric patients > 70 years from three medical departments, investigated the effect of PrS combined with RT during hospitalisation and 12 weeks after discharge. Participants were randomly allocated (1:1) to receive PrS (totally 27·5 g whey protein/d, about 2000 kJ/d) or isoenergetic placebo-products (< 1·5 g protein/d) divided into two servings per d to supplement the habitual diet. Both groups were engaged in a standardised, progressive low-intensity RT programme for the lower extremities (hospital: supervised daily/after discharge: self-training 4×/week). From April 2016 to September 2017, 2351 patients were screened, 462 were eligible, and 165 included. Fourteen were excluded and ten dropped out, leaving 141 participants in the intention-to-treat analysis. The average total protein intake during hospitalisation/after discharge was 1·0 (interquartile range (IQR) 0·8, 1·3)/1·1 (IQR 0·9, 1·3) g/kg per d (protein-group) and 0·6 (IQR 0·5, 0·8)/0·9 (IQR 0·6, 1·0) g/kg per d (placebo group). Both groups improved significantly for the primary and secondary endpoints of muscle mass/strength, functional measurements and quality of life, but no additional effect of PrS was seen for the primary endpoint (30-s chair stand test, repetitions, median changes from baseline: (standard test: 0 (IQR 0, 5) (protein group) v. 2 (IQR 0, 6) (placebo group) and modified test: 2 (IQR 0, 5) (protein group) v. 2 (IQR -1, 5) (placebo group)) or any secondary endpoints (Mann-Whitney U tests, P > 0·05). In conclusion, PrS increasing the total protein intake by 0·4 and 0·2 g/kg per d during hospitalisation and after discharge, respectively, does not seem to increase the adaptive response to low-intensity RT in geriatric medical patients.
肌肉减少症（肌肉质量/力量丧失）困扰着许多老年人，住院老年人尤其脆弱。治疗这种疾病时，蛋白质补充（PrS）和抗阻训练（RT）可能具有协同作用。因此，这项随机分组、双盲、多中心干预研究招募了来自三个医学科的 70 岁以上的老年患者，研究了住院期间和出院后 12 周内 PrS 联合 RT 的效果。参与者按 1:1 随机分配（每天共接受 27.5 g 乳清蛋白，约 2000 kJ/d，相当于 0.4 g/kg 体重）或接受等能量安慰剂（<1.5 g 蛋白/d，每天 2 份，以补充常规饮食）。两组均接受标准化、渐进式下肢低强度 RT 方案（住院期间：每日监督/出院后：每周自我训练 4 次）。2016 年 4 月至 2017 年 9 月，共筛选 2351 例患者，462 例符合条件，165 例入选。14 例被排除，10 例退出，141 例参与者进行意向治疗分析。住院/出院后平均总蛋白摄入量为 1.0（IQR 0.8-1.3）/1.1（IQR 0.9-1.3）g/kg·d（蛋白组）和 0.6（IQR 0.5-0.8）/0.9（IQR 0.6-1.0）g/kg·d（安慰剂组）。两组肌肉质量/力量、功能测量和生活质量的主要和次要终点均显著改善，但 PrS 对主要终点（30 秒椅立试验，重复次数，从基线中位数变化：（标准试验：0（IQR 0-5）（蛋白组）比 2（IQR 0-6）（安慰剂组）和改良试验：2（IQR 0-5）（蛋白组）比 2（IQR-1-5）（安慰剂组））或任何次要终点（Mann-Whitney U 检验，P>0.05）均无额外作用。结论：住院和出院期间分别增加 0.4 和 0.2 g/kg·d 的蛋白质摄入，似乎不会增加老年医学患者对低强度 RT 的适应性反应。
