Ren Yuanyuan, Lu Aming, Wang Bingqing, Wang Cenyi
School of Physical Education and Sports Science, Soochow University, Suzhou 215006, China.
Life (Basel). 2023 Dec 31;14(1):70. doi: 10.3390/life14010070.
Nutritional supplements have been extensively used as health interventions for the elderly. However, with the spread of COVID-19, no consensus exists on whether nutritional interventions could improve muscle mass and physical activity in community-dwelling older adults. To conduct a systematic review and meta-analysis to explore the effects of different nutritional interventions on muscle mass and physical performance in the elderly, we searched , , , and databases from their founding dates to December 2023. The meta-analysis was performed using RevMan5.3 software. Only randomized controlled trials (RCTs) were considered, and the overall mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI) was calculated. There were 33 studies comprising 3579 elderly persons meeting the inclusion criteria. Comprehensive analysis suggested that the intervention effect of fat-free mass (FFM), appendix skeletal muscle mass (ASMM), handgrip strength (HGS), gait speed, and short physical performance battery (SPPB) score was higher in the nutritional supplement group than in the control group. The results of subgroup analysis demonstrated that protein supplementation (SMD = 0.82, < 0.0001) had an optimal effect on ASMM (SMD = 0.89, < 0.0001) and FFM (MD = 2.09, < 0.0001) in the elderly. Vitamin D supplementation (SMD = 0.52, < 0.0001) had a marginal effect on ASMM, and energy supplementation (SMD = 0.39, = 0.0005) had the lowest effect. Moreover, nutritional interventions had the most significant impact on HGS (MD = 1.06, < 0.0001) and TUG (MD = 0.14, < 0.0001) in individuals aged 65-75 years old, with positive effects on FFM (MD = 1.62, < 0.0001) and HGS (MD = 0.82, < 0.0001) when compared to healthy elderly individuals, and had greater effect on ASMM (SMD = 0.69, < 0.0001) than on the elderly with sarcopenia. Nutritional supplements can enhance muscle mass and physical performance in the elderly, while protein is recommended for muscle function. The golden period for implementing nutritional interventions to improve muscle function is before the age of 75 years. However, the impact of nutritional interventions varies with age and population. Given the limited evidence on nutritional interventions, more detailed and high-quality studies are highly warranted in the future.
营养补充剂已被广泛用作老年人的健康干预措施。然而，随着新冠疫情的蔓延，对于营养干预是否能改善社区居住老年人的肌肉量和身体活动，目前尚无共识。为了进行系统评价和荟萃分析，以探索不同营养干预对老年人肌肉量和身体机能的影响，我们检索了 、 、 和 数据库，检索时间从其创建日期至2023年12月。荟萃分析使用RevMan5.3软件进行。仅纳入随机对照试验（RCT），并计算总体平均差（MD）或标准化平均差（SMD）以及95%置信区间（CI）。共有33项研究，包括3579名符合纳入标准的老年人。综合分析表明，营养补充剂组在去脂体重（FFM）、附录骨骼肌量（ASMM）、握力（HGS）、步速和简短体能状况量表（SPPB）评分方面的干预效果高于对照组。亚组分析结果表明，补充蛋白质（SMD = 0.82，P < 0.0001）对老年人的ASMM（SMD = 0.89，P < 0.0001）和FFM（MD = 2.09，P < 0.0001）有最佳效果。补充维生素D（SMD = 0.52，P < 0.0001）对ASMM有边缘效应，补充能量（SMD = 0.39，P = 0.0005）效果最低。此外，营养干预对65 - 75岁个体的HGS（MD = 1.06，P < 0.0001）和定时起立行走测试（TUG）（MD = 0.14，P < 0.0001）影响最为显著，与健康老年人相比，对FFM（MD = 1.62，P < 0.0001）和HGS（MD = 0.82，P < 0.0001）有积极影响，对ASMM的影响（SMD = 0.69，P < 0.0001）比对肌少症老年人更大。营养补充剂可以增强老年人的肌肉量和身体机能，同时推荐补充蛋白质以改善肌肉功能。实施营养干预以改善肌肉功能的黄金时期是75岁之前。然而，营养干预的影响因年龄和人群而异。鉴于关于营养干预的证据有限，未来非常有必要开展更详细和高质量的研究。
