Merchant Reshma Aziz, Chan Yiong Huak, Anbarasan Denishkrshna, Seetharaman Santhosh, Au Lydia, Nachammai Vidhya, Lai Alexa, Ho Vanda, Wong Beatrix Ling Ling, Pang Eunice, Bhaskaran Kalpana
Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore.
Department of Medicine, National University Singapore, Singapore, Singapore.
Front Med (Lausanne). 2023 Aug 14;10:1204198. doi: 10.3389/fmed.2023.1204198. eCollection 2023.
Exercise and a protein-enriched diet are essential for muscle protein synthesis, cellular growth, mitochondrial function, and immune function. The U.S. Food and Nutrition Board's current guideline on recommended dietary allowance for protein in older adults is 0.8 g/kg per day, which may not be sufficient in vulnerable pre-frail older adults.
This study aimed to evaluate the impact of leucine-enriched protein supplementation with or without exercise over 3 months in pre-frail older adults who consumed ≤1 g/kg/day of protein on improving (i) physical function, (ii) body composition measures, and (iii) inflammatory biomarkers such as interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α).
A non-randomized cluster quasi-experimental study guided by the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist of 178 pre-frail older adults [112 control, 44 nutrition (Nu), and 22 in the nutrition with exercise (Nu+Ex) group] comparing the effect of Nu+Ex and Nu on physical function, body composition, and inflammation. At 0, 3, and 6 months, questionnaires on demographics, depression, perceived health, and cognition were administered. Physical function assessment (short physical performance battery [SPPB] test, gait speed, handgrip strength, 5× sit-to-stand [STS]) was conducted, and body composition analysis was performed using a bioelectrical impedance analysis machine. IL-6 and TNF-α were measured at 0 and 3 months.
At 3 months, there were significant improvements in gait speed, 5× STS, SPPB scores, depression, perceived health, fat-free mass, and appendicular skeletal muscle mass indices in the Nu+Ex group. Both Nu+Ex and Nu groups had improvements in body cell mass and reductions in IL-6 and TNF-α. The improvements were not sustained after 6 months.
Our study results need to be validated in future longitudinal randomized studies with a larger sample size focusing on populations at risk.
运动和富含蛋白质的饮食对于肌肉蛋白质合成、细胞生长、线粒体功能及免疫功能至关重要。美国食品营养委员会目前针对老年人蛋白质推荐膳食摄入量的指南为每日0.8克/千克，但这对于脆弱的准衰弱老年人可能并不充足。
本研究旨在评估在3个月时间里，对于每日蛋白质摄入量≤1克/千克的准衰弱老年人，补充富含亮氨酸的蛋白质并结合或不结合运动，在改善（i）身体功能、（ii）身体成分指标以及（iii）诸如白细胞介素-6（IL-6）和肿瘤坏死因子α（TNF-α）等炎症生物标志物方面的影响。
一项非随机整群准实验研究，以178名准衰弱老年人（112名对照组、44名营养组[Nu]以及22名营养加运动组[Nu+Ex]）为研究对象，遵循加强流行病学观察性研究报告（STROBE）清单，比较Nu+Ex组和Nu组在身体功能、身体成分及炎症方面的效果。在第0、3和6个月，发放关于人口统计学、抑郁、健康感知及认知的问卷。进行身体功能评估（简短身体性能量表[SPPB]测试、步速、握力、5次坐立试验[STS]），并使用生物电阻抗分析仪进行身体成分分析。在第0和3个月测量IL-6和TNF-α。
在第3个月时，Nu+Ex组的步速、5次STS、SPPB评分、抑郁、健康感知、去脂体重及四肢骨骼肌质量指数均有显著改善。Nu+Ex组和Nu组的身体细胞质量均有所改善，IL-6和TNF-α均有所降低。这些改善在6个月后未持续。
我们的研究结果需要在未来更大样本量的纵向随机研究中针对高危人群进行验证。
