Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada; Laboratory of Investigation of Chronic Diseases, Department of Physiological Sciences, Federal University of Santa Catarina, Florianópolis, Brazil.
Adv Nutr. 2023 Jul;14(4):762-773. doi: 10.1016/j.advnut.2023.05.011. Epub 2023 May 15.
The effects of supplementation with whey protein alone or with vitamin D on sarcopenia-related outcomes in older adults are unclear. We aimed to assess the effect of whey protein supplementation alone or with vitamin D on lean mass (LM), strength, and function in older adults with or without sarcopenia or frailty. We searched PubMed, Web of Science, and SCOPUS databases. Randomized controlled trials (RCT) that investigated the effect of whey protein supplementation with or without vitamin D on sarcopenia outcomes in healthy and sarcopenic or frail older adults were included. Standardized mean differences (SMDs) were calculated for LM, muscle strength, and physical function data. The analysis showed that whey protein supplementation had no effect on LM and muscle strength; nevertheless, a significant improvement was found in physical function (SMD = 0.561; 95% confidence interval [CIs]: 0.256, 0.865, n = 33), particularly gait speed (GS). On the contrary, whey protein supplementation significantly improved LM (SMD = 0.982; 95% CI: 0.228, 1.736; n = 11), appendicular lean mass and physical function (SMD = 1.211; 95% CI: 0.588, 1.834; n = 16), and GS in sarcopenic/frail older adults. By contrast, co-supplementation with vitamin D enhanced LM gains (SMD =0.993; 95% CI: 0.112, 1.874; n = 11), muscle strength (SMD =2.005; 95% CI: 0.975, 3.035; n = 11), and physical function (SMD = 3.038; 95% CI: 2.196, 3.879; n = 18) significantly. Muscle strength and physical function improvements after whey protein supplementation plus vitamin D were observed without resistance exercise (RE) and short study duration subgroups. Moreover, the combination of whey protein and vitamin D with RE did not enhance the effect of RE. Whey protein supplementation improved LM and function in sarcopenic/frail older adults but had no positive effect in healthy older persons. By contrast, our meta-analysis showed that co-supplementation with whey protein and vitamin D is effective, particularly in healthy older adults, which is likely owing, we propose, to the correction of vitamin D insufficiency or deficiency. The trial was registered at https://inplasy.com as INPLASY202240167.
单独补充乳清蛋白或同时补充乳清蛋白和维生素 D 对老年人与肌肉减少症相关结局的影响尚不清楚。我们旨在评估单独补充乳清蛋白或同时补充乳清蛋白和维生素 D 对有或无肌肉减少症或虚弱的老年人的瘦体重(LM)、力量和功能的影响。我们检索了 PubMed、Web of Science 和 SCOPUS 数据库。纳入了研究单独补充乳清蛋白或同时补充乳清蛋白和维生素 D 对健康和肌肉减少症或虚弱的老年人肌肉减少症结局影响的随机对照试验(RCT)。计算了 LM、肌肉力量和身体功能数据的标准化均数差(SMD)。分析结果显示,乳清蛋白补充对 LM 和肌肉力量没有影响;然而,身体功能显著改善(SMD=0.561;95%置信区间[CI]:0.256,0.865,n=33),尤其是步态速度(GS)。相反,乳清蛋白补充显著改善了 LM(SMD=0.982;95%CI:0.228,1.736;n=11)、四肢瘦体重和身体功能(SMD=1.211;95%CI:0.588,1.834;n=16)和 GS 在肌肉减少症/虚弱的老年人中。相比之下,同时补充维生素 D 可增加 LM 增加(SMD=0.993;95%CI:0.112,1.874;n=11)、肌肉力量(SMD=2.005;95%CI:0.975,3.035;n=11)和身体功能(SMD=3.038;95%CI:2.196,3.879;n=18)。在不进行抗阻运动(RE)和短期研究持续时间亚组中,观察到补充乳清蛋白加维生素 D 后肌肉力量和身体功能的改善。此外,补充乳清蛋白和维生素 D 联合 RE 并不能增强 RE 的效果。乳清蛋白补充可改善肌肉减少症/虚弱老年人的 LM 和功能,但对健康老年人没有积极影响。相比之下,我们的荟萃分析表明,同时补充乳清蛋白和维生素 D 是有效的,特别是在健康的老年人中,我们提出,这可能是由于纠正了维生素 D 不足或缺乏。该试验在 https://inplasy.com 上注册为 INPLASY202240167。