title: Protein supplementation during resistance-type exercise training in the elderly. High-intensity functional exercise program and protein-enriched energy supplement for older persons dependent in activities of daily living: a randomised controlled trial. Effects of free leucine supplementation and resistance training on muscle strength and functional status in older adults: a randomized controlled trial Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: a randomised controlled trial Body composition in 70-year-old adults responds to dietary beta-hydroxy-beta-methylbutyrate similarly to that of young adults. The impact of nutritional supplementation and resistance training on the health functioning of free-living Chilean elders: results of 18 months of follow-up. The effects of exercise and protein-energy supplements on body composition and muscle function in frail elderly individuals: a long-term controlled randomised study. Four-month course of soluble milk proteins interacts with exercise to improve muscle strength and delay fatigue in elderly participants. Creatine supplementation post-exercise does not enhance training-induced adaptations in middle to older aged males Protein supplementation before and after exercise does not further augment skeletal muscle hypertrophy after resistance training in elderly men. The Boston FICSIT study: the effects of resistance training and nutritional supplementation on physical frailty in the oldest old. Effects of nutritional supplementation and resistance training on muscle strength in free living elders. Results of one year follow. Effects of vitamin D supplementation and exercise training on physical performance in Chilean vitamin D deficient elderly subjects Mail-Based Intervention for Sarcopenia Prevention Increased Anabolic Hormone and Skeletal Muscle Mass in Community-Dwelling Japanese Older Adults: The INE (Intervention by Nutrition and Exercise) Study. Long-term creatine supplementation improves muscular performance during resistance training in older women Creatine Monohydrate and Conjugated Linoleic Acid Improve Strength and Body Composition Following Resistance Exercise in Older Adults Effects of Exercise and Milk Fat Globule Membrane (MFGM) Supplementation on Body Composition, Physical Function, and Hematological Parameters in Community-Dwelling Frail Japanese Women: A Randomized Double Blind, Placebo-Controlled, Follow-Up Trial Periodized resistance training with and without supplementation improve body composition and performance in older men Effects of whey proteins and carbohydrates on the efficacy of resistance training in elderly people: double blind, randomised controlled trial Additive effects of isoflavones and exercise training on inflammatory cytokines and body composition in overweight and obese postmenopausal women: a randomized controlled trial Effects of macronutrient intake on thigh muscle mass during home-based walking training in middle-aged and older women. Oral amino-acid provision does not affect muscle strength or size gains in older men. Creatine supplementation and resistance training in vulnerable older women: A randomized double-blind placebo-controlled clinical trial Efficacy of whey protein supplementation on resistance exercise-induced changes in lean mass, muscle strength, and physical function in mobility-limited older adults. Effects of elastic band resistance training and nutritional supplementation on physical performance of institutionalised elderly — A randomized controlled trial Nutritional supplementation and resistance training in nutritionally at risk older adults following lower limb fracture: a randomized controlled trial Dietary supplements and physical exercise affecting bone and body composition in frail elderly persons. Effect of oral magnesium supplementation on physical performance in healthy elderly women involved in a weekly exercise program: a randomized controlled trial. Protein supplementation increases muscle mass gain during prolonged resistance-type exercise training in frail elderly people: a randomized, double-blind, placebo-controlled trial. Protein-enriched diet, with the use of lean red meat, combined with progressive resistance training enhances lean tissue mass and muscle strength and reduces circulating IL-6 concentrations in elderly women: a cluster randomized controlled trial. Effect of β-hydroxy-β-methylbutyrate (HMB) on lean body mass during 10 days of bed rest in older adults. Effects of exercise and amino acid supplementation on body composition and physical function in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial. Creatine supplementation enhances isometric strength and body composition improvements following strength exercise training in older adults. Effects of exercise and tea catechins on muscle mass, strength and walking ability in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial. Physical exercise and/or enriched foods for functional improvement in frail, independently living elderly: a randomized controlled trial. Exercise training and nutritional supplementation for physical frailty in very elderly people.
abstract: INTRODUCTION Resistance training has been well established as an effective treatment strategy to increase skeletal muscle mass and strength in the elderly . We assessed whether dietary protein supplementation can further augment the adaptive response to prolonged resistance-type exercise training in healthy elderly men and women . METHODS Healthy elderly men ( n = 31 , 70 ± 1 yr ) and women ( n = 29 , 70 ± 1 yr ) were r and omly assigned to a progressive , 24-wk resistance-type exercise training program with or without additional protein supplementation ( 15 g·d-1 ) . Muscle hypertrophy was assessed on a whole-body Dual-energy X-ray absorptiometry ( DXA ) , limb ( computed tomography ) , and muscle fiber ( biopsy ) level . Strength was assessed regularly by 1-repetition maximum ( RM ) strength testing . Functional capacity was assessed with a sit-to-st and and h and grip test . RESULTS One-RM strength increased by 45 % ± 6 % versus 40 % ± 3 % ( women ) and 41 % ± 4 % versus 44 % ± 3 % ( men ) in the placebo versus protein group , respectively ( P < 0.001 ) , with no differences between groups . Leg muscle mass ( women , 4 % ± 1 % vs 3 % ± 1 % ; men , 3 % ± 1 % vs 3 % ± 1 % ) and quadriceps cross-sectional area ( women , 9 % ± 1 % vs 9 % ± 1 % ; men , 9 % ± 1 % vs 10 % ± 1 % ) increased similarly in the placebo versus protein groups ( P < 0.001 ) . Type II muscle fiber size increased over time in both placebo and protein groups ( 25 % ± 13 % vs 30 % ± 9 % and 23 % ± 12 % vs 22 % ± 10 % in the women and men , respectively ) . Sit-to-st and improved by 18 % ± 2 % and 19 % ± 2 % in women and men , respectively ( P < 0.001 ) . CONCLUSION Prolonged resistance-type exercise training increases skeletal muscle mass and strength , augments functional capacity , improves glycemia and lipidemia , and reduces blood pressure in healthy elderly men and women .  Additional protein supplementation ( 15 g·d-1 ) does not further increase muscle mass , strength , and /or functional capacity The aims of this r and omised controlled trial were to determine if a high-intensity functional exercise program improves balance , gait ability , and lower-limb strength in older persons dependent in activities of daily living and if an intake of protein-enriched energy supplement immediately after the exercises increases the effects of the training . One hundred and ninety-one older persons dependent in activities of daily living , living in residential care facilities , and with a Mini-Mental State Examination ( MMSE ) score of ? 10 participated . They were r and omised to a high-intensity functional exercise program or a control activity , which included 29 sessions over 3 months , as well as to protein-enriched energy supplement or placebo .  Berg Balance Scale , self-paced and maximum gait speed , and one-repetition maximum in lower-limb strength were followed-up at three and six months and analysed by 2 x 2 factorial ANCOVA , using the intention-to-treat principle . At three months , the exercise group had improved significantly in self-paced gait speed compared with the control group ( mean difference 0.04 m/s , p = 0.02 ) . At six months , there were significant improvements favouring the exercise group for Berg Balance Scale ( 1.9 points , p = 0.05 ) , self-paced gait speed ( 0.05 m/s , p = 0.009 ) , and lower-limb strength ( 10.8 kg , p = 0.03 ) . No interaction effects were seen between the exercise and nutrition interventions . In conclusion , a high-intensity functional exercise program has positive long-term effects in balance , gait ability , and lower-limb strength for older persons dependent in activities of daily living . An intake of protein-enriched energy supplement immediately after the exercises does not appear to increase the effects of the training Objective To assess the effect of free leucine supplementation combined with resistance training versus resistance training only on muscle strength and functional status in older adults . Methods This was a r and omized , double-blind , placebo-controlled , parallel study with two intervention groups . Thirty older adults were r and omly assigned to receive either 10 g leucine/day ( leucine group [ LG ] , n=15 ) or a placebo ( control group [ CG ] , n=15 ) , plus resistance training over a 12-week period . Maximal overcoming isometric leg strength , functional status , nutritional status , body composition , health-related quality of life , depression , and dietary intake were assessed at 4 and 12 weeks . Missing data at 12 weeks were h and led using mixed models for repeated measurements for data imputation . Results Twenty-four subjects completed the 4-week assessment and eleven completed the 12-week intervention . Clinical ly significant gains were found in isometric leg strength at both assessment time points . Analysis of the effect size also showed how participants in LG outperformed those in CG for chair st and s and the timed up and go test . No significant changes were observed for the rest of the outcomes . Conclusion Our combined analysis showed moderate changes in isometric leg muscle strength and certain components of functional status . The magnitude of changes found on these outcomes should be qualified as a positive effect of the concomitant intervention Protein supplementation in combination with resistance training may increase muscle mass and muscle strength in elderly subjects . The objective of this study was to assess the influence of post-exercise protein supplementation with collagen peptides v. placebo on muscle mass and muscle function following resistance training in elderly subjects with sarcopenia . A total of fifty-three male subjects ( 72·2 ( sd 4·68 ) years ) with sarcopenia ( class I or II ) completed this r and omised double-blind placebo-controlled study . All the participants underwent a 12-week guided resistance training programme ( three sessions per week ) and were supplemented with either collagen peptides ( treatment group ( TG ) ) ( 15 g/d ) or silica as placebo ( placebo group ( PG ) ) . Fat-free mass ( FFM ) , fat mass ( FM ) and bone mass ( BM ) were measured before and after the intervention using dual-energy X-ray absorptiometry . Isokinetic quadriceps strength ( IQS ) of the right leg was determined and sensory motor control ( SMC ) was investigated by a st and ardised one-leg stabilisation test . Following the training programme , all the subjects showed significantly higher ( P<0·01 ) levels for FFM , BM , IQS and SMC with significantly lower ( P<0·01 ) levels for FM . The effect was significantly more pronounced in subjects receiving collagen peptides : FFM ( TG + 4·2 ( sd 2·31 ) kg/PG + 2·9 ( sd 1·84 ) kg ; P<0·05 ) ; IQS ( TG + 16·5 ( sd 12·9 ) Nm/PG + 7·3 ( sd 13·2 ) Nm ; P<0·05 ) ; and FM ( TG –5·4 ( sd 3·17 ) kg/PG –3·5 ( sd 2·16 ) kg ; P<0·05 ) . Our data demonstrate that compared with placebo , collagen peptide supplementation in combination with resistance training further improved body composition by increasing FFM , muscle strength and the loss in FM Studies in young adults have demonstrated that beta-hydroxy-beta-methylbutyrate ( HMB ) can increase gains in strength and fat-free mass during a progressive resistance-training program . The purpose of this study was to determine whether HMB would similarly benefit 70-y-old adults undergoing a 5 d/wk exercise program . Thirty-one men ( n = 15 ) and women ( n = 16 ) ( 70 + /- 1 y ) were r and omly assigned in a double-blind study to receive either capsules containing a placebo or Ca-HMB ( 3 g/d ) for the 8-wk study . Skin fold estimations of body composition as well as computerized tomography ( CT ) and dual X-ray absorptiometry ( DXA ) scans were measured before the study and immediately after the 8-wk training program . HMB supplementation tended to increase fat-free mass gain ( HMB , 0.8 + /- 0.4 kg ; placebo , -0.2 + /- 0.3 kg ; treatment x time , P = 0.08 ) . Furthermore , HMB supplementation increased the percentage of body fat loss ( skin fold : HMB , -0.66 + /- 0.23 % ; placebo , -0.03 + /- 0.21 % ; P = 0.05 ) compared with the placebo group . CT scans also indicated a greater decrease in the percentage of body fat with HMB supplementation ( P < 0.05 ) . In conclusion , changes in body composition can be accomplished in 70-y-old adults participating in a strength training program , as previously demonstrated in young adults , when HMB is supplemented daily Body composition changes and loss of functionality in the elderly are related to subst and ard diets and progressive sedentariness . The aim of this study was to assess the impact of an 18-mo nutritional supplementation and resistance training program on health functioning of elders . Healthy elders aged > or = 70 y were studied . Half of the subjects received a nutritional supplement . Half of the supplemented and nonsupplemented subjects were r and omly assigned to a resistance exercise training program . Every 6 mo , a full assessment was performed . A total of 149 subjects were considered eligible for the study and 98 ( 31 supplemented and trained , 26 supplemented , 16 trained and 25 without supplementation or training ) completed 18 mo of follow-up .  Compliance with the supplement was 48 % , and trained subjects attended 56 % of programmed sessions . Activities of daily living remained constant in the supplemented subjects and decreased in the other groups . Body weight and fat-free mass did not change . Fat mass increased from 22.2 + /- 7.6 to 24.1 + /- 7.7 kg in all groups . Bone mineral density decreased less in both supplemented groups than in the nonsupplemented groups ( ANOVA , P < 0.01 ) . Serum cholesterol remained constant in both supplemented groups and in the trained groups , but it increased in the control group ( ANOVA , P < 0.05 ) . Upper and lower limb strength , walking capacity and maximal inspiratory pressure increased in trained subjects . In conclusion , patients who were receiving nutritional supplementation and resistance training  maintained functionality , bone mineral density and serum cholesterol levels and improved their muscle strength Fighting against inactivity and inadequate nutritional intake are of utmost importance in the elderly . To our knowledge , the few studies which have been performed were conducted for only a short period and the results do not permit formal conclusions to be drawn . We therefore tried to fill this gap in our knowledge by determining whether an intervention combining an acceptable progressive exercise programme and nutritional supplements would be feasible for a long-term period in the very frail elderly , and would bring about concomitant benefits in body composition and muscle power . Accordingly , this exercise and nutritional combination was assessed in the frail elderly in a 9-month r and omised trial with a factorial design . Fifty-seven elderly volunteers over 72 years , from sixteen retirement homes in Lyon , France participated in the study .  Dietary supplements were compared with placebo , and physical exercise was compared with memory training . Main outcome measures were fat-free mass ( FFM ) and muscle power . FFM was determined by labelled water , and muscle power was measured by a leg-extensor machine . At 9 months , the compliance was 63 % for exercise sessions , and 54 % for nutritional supplements . In patients with dietary supplements , muscle power increased by 57 % at 3 months ( P=0.03 ) , and showed only a tendency at 9 months ; although FFM increased by 2.7 % at 9 months , the difference was not significant ( P=0.10 ) . Exercise did not improve muscle power at 9 months , but improved functional tests ( five-time-chair rise , P=0.01 ) . BMI increased with supplements ( + 3.65 % ) , but decreased with placebo ( -0.5 % ) at 9 months ( P=0.007 ) . A long-term combined intervention is feasible in frail elderly individuals with a good rate of compliance . Nutritional supplements and exercise may improve muscle function . Despite no significant results on FFM , due to the limited number of volunteers , combined intervention should be suggested to counteract muscle weakness in the frail elderly BACKGROUND The benefit of protein supplementation on the adaptive response of muscle to exercise training in older people is controversial . OBJECTIVE To investigate the independent and combined effects of a multicomponent exercise program with and without a milk-based nutritional supplement on muscle strength and mass , lower-extremity fatigue , and metabolic markers . DESIGN A sample of 48 healthy sedentary men aged 60.8 ± 0.4 years were r and omly assigned to a 16-week multicomponent exercise training program with a milk-based supplement containing , besides proteins [ total milk proteins 4 or 10 g/day or soluble milk proteins rich in leucine ( PRO ) 10 g/day ] , carbohydrates and fat .  Body composition , muscle mass and strength , and time to task failure , an index of muscle fatigue , were measured . Blood lipid , fibrinogen , creatine phosphokinase , glucose , insulin , C-reactive protein , interleukin-6 , tumor necrosis factor-α soluble receptors , and endothelial markers were assessed . RESULTS Body fat mass was reduced after the 4-month training program in groups receiving 10 g/day of protein supplementation ( P < .01 ) . The training program sustained with the daily 10 g/day PRO was associated with a significant increase in dominant fat free mass ( + 5.4 % , P < .01 ) and in appendicular muscle mass ( + 4.5 % , P < .01 ) . Blood cholesterol was decreased in the trained group receiving 10 g/day PRO . The index of insulin resistance ( homeostasis model assessment -insulin resistance ) and blood creatine phosphokinase were reduced in the groups receiving 10 g/day PRO , irrespective of exercise . The inflammatory and endothelial markers were not different between the groups . Training caused a significant improvement ( + 10.6 % to 19.4 % , P < .01 ) in the maximal oxygen uptake . Increased maximum voluntary contraction force was seen in the trained groups receiving 10 g/day of proteins ( about 3 % , P < .05 ) . Time to task failure was improved in the trained participants receiving a 10 g/day supplementation with PRO ( P < .01 ) . CONCLUSIONS Soluble milk proteins rich in leucine improved time to muscle failure and increase in skeletal muscle mass and strength after prolonged multicomponent exercise training in healthy older men Abstract Purpose The present study evaluated the effects of creatine monohydrate ( CrM ) consumption post-exercise on body composition and muscle strength in middle to older males following a 12-week resistance training program  . Methods In a double-blind , r and omized trial , 20 males aged between 55 and 70 years were r and omly assigned to consume either CrM-carbohydrate ( CHO ) [ 20 g days−1 CrM + 5 g days−1 CHO × 7 days , then 0.1 g kg−1 CrM + 5 g CHO on training days ( average dosage of ~8.8 g ) ] or placebo CHO ( 20 g days−1 CHO × 7 days , then 5 g CHO on training days ) while participating in a high intensity resistance training program [ 3 sets × 10 repetitions at 75 % of 1 repetition maximum ( 1RM ) ] , 3 days weeks−1 for 12 weeks . Following the initial 7-day “ loading ” phase , participants were instructed to ingest their supplement within 60 min post-exercise . Body composition and muscle strength measurements , blood collection and vastus lateralis muscle biopsy were completed at 0 , 4 , 8 and 12 weeks of the supplement and resistance training program . Results A significant time effect was observed for 1RM bench press ( p = 0.016 ) , leg press ( p = 0.012 ) , body mass ( p = 0.03 ) , fat-free mass ( p = 0.005 ) and total myofibrillar protein ( p = 0.005 ) . A trend for larger muscle fiber cross-sectional area in the type II fibers compared to type I fibers was observed following the 12-week resistance training ( p = 0.08 ) . No supplement interaction effects were observed . Conclusion Post-exercise ingestion of creatine monohydrate does not provide greater enhancement of body composition and muscle strength compared to resistance training alone in middle to older males BACKGROUND Considerable discrepancy exists in the literature on the proposed benefits of protein supplementation on the adaptive response of skeletal muscle to resistance-type exercise training in the elderly . OBJECTIVE The objective was to assess the benefits of timed protein supplementation on the increase in muscle mass and strength during prolonged resistance-type exercise training in healthy elderly men who habitually consume adequate amounts of dietary protein . DESIGN Healthy elderly men ( n = 26 ) aged 72 + /- 2 y were r and omly assigned to a progressive , 12-wk resistance-type exercise training program with ( protein group ) or without ( placebo group ) protein provided before and immediately after each exercise session ( 3 sessions/wk , 20 g protein/session ) . One-repetition maximum ( 1RM ) tests were performed regularly to ensure a progressive workload during the intervention . Muscle hypertrophy was assessed at the whole-body ( dual-energy X-ray absorptiometry ) , limb ( computed tomography ) , and muscle fiber ( biopsy ) level . RESULTS The 1RM strength increased approximately 25 - 35 % in both groups ( P < 0.001 ) . Dual-energy X-ray absorptiometry and computed tomography scans showed similar increases in leg muscle mass ( 6 + /- 1 % in both groups ; P < 0.001 ) and in the quadriceps ( 9 + /- 1 % in both groups ) , from 75.9 + /- 3.7 and 73.8 + /- 3.2 to 82.4 + /- 3.9 and 80.0 + /- 3.0 cm2 in the placebo and protein groups , respectively ( P < 0.001 ) . Muscle fiber hypertrophy was greater in type II ( placebo : 28 + /- 6 % ; protein : 29 + /- 4 % ) than in type I ( placebo : 5 + /- 4 % ; protein : 13 + /- 6 % ) fibers , but the difference between groups was not significant . CONCLUSION Timed protein supplementation immediately before and after exercise does not further augment the increase in skeletal muscle mass and strength after prolonged resistance-type exercise training in healthy elderly men who habitually consume adequate amounts of dietary protein . This trial was registered at clinical trials.gov as NCT00744094 Research indicates that lower extremity muscle weakness in the elderly is consistently related to impaired mobility and fall risk . Reversible components of the muscle weakness of aging include underuse syndromes and undernutrition , both of which are prevalent in nursing home population s. The Boston FICSIT study is a nursing home-based intervention to improve muscle strength through progressive resistance training of the lower extremities and /or multi-nutrient supplementation in chronically institutionalized subjects aged 70 - 100 . Baseline measurements of falls , medical status , psychological variables , functional status , nutritional intake and status , body composition , muscle mass and morphology , muscle function , and gait and balance are taken . The nursing home residents are then r and omly assigned to one of four treatment groups for 10 weeks : ( 1 ) high intensity progressive resistance training of the hip and knee extensors 3 days per week ; ( 2 ) multi-nutrient supplementation with a 360-kcal high carbohydrate , low fat liquid supplement every day ; ( 3 ) a combination of groups ( 1 ) and ( 2 ) ; and ( 4 ) a control group . Both non-supplemented groups receive a liquid placebo every day , and both non-exercising groups attend three sessions of " leisure activities " every week in order to control for the attentional aspects of the exercise and nutritional interventions . At the end of the 10-week period , all baseline measurements are re-assessed PURPOSE To assess the effects of a one year nutritional supplementation and resistance training program on muscle strength and walking capacity in the elderly . MATERIAL AND METHODS Elderly subjects from two outpatient clinics received a nutritional supplement , that provided 400 Kcal , 15 g/protein and 50 % of vitamin DRVs per day . Half the subjects receiving and not receiving the supplement were r and omly assigned to a resistance exercise training program with two sessions per week . Every six months , body composition using DEXA , limb muscle strength , maximal inspiratory and expiratory pressures and walking capacity were assessed . RESULTS One hundred forty nine subjects were considered eligible and 101 ( 31 supplemented and trained , 28 supplemented , 16 trained and 26 without supplementation nor training ) completed the year of follow up . Overall compliance with the supplement was 48 22 % and trained subjects attended 56 21 % of programmed sessions . No changes in fat free mass were observed in any of the groups , but fat mass increased from 22.5 7.3 to 23.2 7.3 kg in all groups ( p < 0.001 ) . Upper and lower limb strength and walking capacity increased significantly in trained subjects whether supplemented or not . Maximal inspiratory pressure and right h and grip strength increased only in the supplemented and trained group . CONCLUSIONS Resistance training improved muscle strength and walking capacity The aim was to assess the effects of resistance training and vitamin D supplementation on physical performance of healthy elderly subjects . Ninety-six subjects , aged 70 years or more with 25 OH vitamin D levels of 16 ng/ml or less , were r and omized to a  resistance training or control group . Trained and control groups were further r and omized to receive in a double blind fashion , vitamin D 400 IU plus 800 mg of calcium per day or calcium alone . Subjects were followed for nine months . Serum 25 OH vitamin D increased from 12.4+/-2.2 to 25.8+/-6.5 ng/ml among subjects supplemented with vitamin D. Trained subjects had significant improvements in quadriceps muscle strength , the short physical performance test and timed up and go . The latter improved more in trained subjects supplemented with vitamin D. At the end of the follow up , gait speed was higher among subjects supplemented with vitamin ( whether trained or not ) than in non-supplemented subjects ( 838+/-147 and 768+/-127 m/12 min , respectively , p=0.02 ) . Romberg ratio was lower among supplemented controls than non-supplemented trained subjects ( 128+/-40 % and 144+/-37 % , respectively , p=0.05 ) . In conclusion , vitamin D supplementation improved gait speed and body sway , and training improved muscle strength OBJECTIVE The aim of the Intervention by Nutrition and Exercise ( INE ) study was to investigate the effects of a mail-based intervention for sarcopenia prevention on muscle mass and anabolic hormones in community-dwelling older adults . DESIGN A cluster-r and omized controlled trial . SETTING AND PARTICIPANTS This trial recruited community-dwelling adults aged 65 years and older in Japan . The 227 participants were cluster r and omized into a  walking and nutrition ( W/N ) group ( n = 79 ) , a  walking ( W ) group ( n = 71 ) , and a  control ( C ) group ( n = 77 ) . We analyzed the physical and biochemical measurements in this sub study . INTERVENTION Six months of mail-based intervention ( a pedometer-based walking program and nutritional supplementation ) . MEASUREMENTS The skeletal muscle mass index ( SMI ) using the bioelectrical impedance data acquisition system , biochemical measurements , such as those of insulinlike growth factor ( IGF-1 ) , dehydroepi and rosterone sulfate ( DHEA-S ) , and 25-hydroxy vitamin D ( 25[OH]D ) , as well as frailty , were assessed by the Cardiovascular Health Study criteria . RESULTS Participants in the W/N and W groups had significantly greater improvements in SMI , IGF-1 , and 25(OH)D ( P < .05 ) than those in the C group . Participants in the W/N group had significantly greater improvements in DHEA-S ( P < .05 ) than in the other groups . These effects were more pronounced in frail , older adults . CONCLUSION These results suggest that the mail-based walking intervention of the remote monitoring type for sarcopenia prevention can increase anabolic hormone levels and SMI in community-dwelling older adults , particularly in those who are frail This study examined the effects of long-term creatine supplementation combined with resistance training ( RT ) on the one-repetition maximum ( 1RM ) strength , motor functional performance ( e.g. , 30-s chair st and , arm curl , and getting up from lying on the floor tests ) and body composition ( e.g. , fat-free mass , muscle mass , and % body fat using DEXA scans ) in older women . Eighteen healthy women ( 64.9 ± 5.0 years ) were r and omly assigned in a double-blind fashion to either a creatine ( CR , N = 9 ) or placebo ( PL , N = 9 ) group . Both groups underwent a 12-week RT program ( 3 days week−1 ) , consuming an equivalent amount of either creatine ( 5.0 g day−1 ) or placebo ( maltodextrin ) . After 12 week , the CR group experienced a greater ( P < 0.05 ) increase ( Δ% ) in training volume ( + 164.2 ) , and 1RM bench press ( + 5.1 ) , knee extension ( + 3.9 ) and biceps curl ( + 8.8 ) performance than the PL group . Furthermore , CR group gained significantly more fat-free mass ( + 3.2 ) and muscle mass ( + 2.8 ) and were more efficient in performing submaximal-strength functional tests than the PL group . No changes ( P > 0.05 ) in body mass or % body fat were observed from pre- to post-test in either group . These results indicate that long-term creatine supplementation combined with RT  improves the ability to perform submaximal-strength functional tasks and promotes a greater increase in maximal strength , fat-free mass and muscle mass in older women Aging is associated with lower muscle mass and an increase in body fat . We examined whether creatine monohydrate ( CrM ) and conjugated linoleic acid ( CLA ) could enhance strength gains and improve body composition ( i.e. , increase fat-free mass ( FFM ) ; decrease body fat ) following  resistance exercise training in older adults ( > 65 y ) . Men ( N = 19 ) and women ( N = 20 ) completed six months of resistance exercise training with CrM (5g/d)+CLA ( 6g/d ) or placebo with r and omized , double blind , allocation . Outcomes included : strength and muscular endurance , functional tasks , body composition ( DEXA scan ) , blood tests ( lipids , liver function , CK , glucose , systemic inflammation markers ( IL-6 , C-reactive protein ) ) , urinary markers of compliance ( creatine/creatinine ) , oxidative stress ( 8-OH-2dG , 8-isoP ) and bone resorption ( Ν-telopeptides ) . Exercise training improved all measurements of functional capacity ( P<0.05 ) and strength ( P<0.001 ) , with greater improvement for the CrM+CLA group in most measurements of muscular endurance , isokinetic knee extension strength , FFM , and lower fat mass ( P<0.05 ) . Plasma creatinine ( P<0.05 ) , but not creatinine clearance , increased for CrM+CLA , with no changes in serum CK activity or liver function tests . Together , this data confirms that supervised resistance exercise training is safe and effective for increasing strength in older adults and that a combination of CrM and CLA can enhance some of the beneficial effects of training over a six-month period . Trial Registration . Clinical Trials.gov Objective To investigate the combined and separate effects of exercise and milk fat globule membrane ( MFGM ) supplementation on frailty , physical function , physical activity level , and hematological parameters in community-dwelling elderly Japanese women . Methods A total of 131 frail , elderly women over 75 years were r and omly assigned to one of four groups : exercise and MFGM supplementation ( Ex+MFGM ) , exercise and placebo ( Ex+Plac ) , MFGM supplementation , or the placebo group . The exercise group attended a 60-minute training program twice a week for three months , and the MFGM group ingested 1 g of the MFGM supplement in pill form , daily for 3 months . The primary outcome measure was change in frailty status based on Fried ’s frailty phenotype . Secondary outcome measures included body composition , physical function and hematological parameters , and interview survey components assessing lifestyle factors . Participants were followed for 4 months post-intervention . Results Significant group × time interactions were observed for usual walking speed ( P = 0.005 ) , timed up & go ( P<0.001 ) , and insulin-like growth factor-binding protein 3 / insulin-like growth factor 1 ratio ( P = 0.013 ) . The frailty components revealed that weight loss , exhaustion , low physical activity , and slow walking speed were reversed , but low muscle strength did not significantly changed . Frailty reversal rate was significantly higher in the Ex+MFGM ( 57.6 % ) than in the MFGM ( 28.1 % ) or placebo ( 30.3 % ) groups at post-intervention ( χ2 = 8.827 , P = 0.032 ) , and at the follow-up was also significantly greater in the Ex+MFGM ( 45.5 % ) and Ex+Plac ( 39.4 % ) groups compared with the placebo ( 15.2 % ) group ( χ2 = 8.607 , P = 0.035 ) . The exercise+MFGM group had the highest odds ratio ( OR ) for frailty reversal at post-intervention and follow-up ( OR = 3.12 , 95 % confidence interval ( CI ) = 1.13–8.60 ; and OR = 4.67 , 95 % CI = 1.45–15.08 , respectively ) . Conclusion This study suggests that interventions including exercise and nutrition can improve frailty status . Statistically significant additive effects of MFGM with exercise could not be confirmed in this population , and further investigation in larger sample s is necessary . Trial Registration The Japan Medical Association Clinical Trial Registry Purpose To examine the effects of 12 weeks of periodized resistance training ( RT ) with and without combined creatine and whey protein supplementation on changes in body composition , muscular strength , and functional performance . Methods Twenty-two male volunteers ( 68.1 ± 6.1 years ) were r and omly assigned to one of three groups : RT plus supplementation ( RTS , n = 7 ) ; RT only ( RT , n = 7 ) ; or control ( C , n = 8) . RTS consumed 0.3 g/kg/day of creatine for 5 days followed by 0.07 g/kg/day . RTS also consumed one 35 g liquid protein ready-to-drink daily . RT and RTS trained 3 days/week . Results Following 12 weeks of training , there were no significant differences in the main measured outcome variables between RT and RTS . RTS increased relative ( % change ) lean body mass ( LBM , 3.3 ± 3.1 % ) compared with C ( p = 0.01 ) . Compared to baseline , RT increased LBM at week 6 ( 60.2 ± 8.3 to 61.6 ± 9.4 kg ; p < 0.05 ) , and decreased fat mass ( 20.8 ± 4.2 to 19.0 ± 3.9 kg ; p = 0.05 ) and percentage body fat at week 12 ( 25.7 ± 3.8 to 23.8 ± 4.0 % ; p = 0.05 ) ; RTS increased LBM at week 6 ( p < 0.01 ) and week 12 ( 56.4 ± 4.3 to 58.2 ± 3.4 kg ; p < 0.01 ) , and decreased percentage body fat at week 12 ( 23.9 ± 4.4 to 22.0 ± 4.4 % ; p < 0.01 ) . In addition , compared to C , relative bench press 1-RM increased for RTS ( 72.4 ± 62.2 % ; p < 0.01 ) and RT ( 50.1 ± 21.5 % ; p = 0.05 ) ; relative leg press 1-RM increased for RTS ( 129.6 ± 39.4 % ; p < 0.0001 ) and RT ( 112.9 ± 22.7 % ; p < 0.0001 ) ; RTS increased relative Margaria stair-climbing power ( 38.3 ± 30.4 % ; p < 0.05 ) ; and , relative 400-m walk time decreased for RT ( −11 ± 9.2 % ; p < 0.05 ) and RTS ( −9.6 ± 9.4 % ; p = 0.05 ) . RT increased estimated VO2Max at week 6 ( p < 0.01 ) and 12 ( 34.6 ± 1.9 to 36.4 ± 2.7 ml/kg/min ; p = 0.01 ) compared to baseline . Lastly , RTS increased estimated VO2Max at week 12 ( 36.3 ± 2.7 to 37.5 ± 3.3 ml/kg/min ; p = 0.05 ) compared to baseline . Conclusion Creatine and whey protein supplementation may not provide additional benefits in older adults performing periodized RT to augment muscular and functional performance Background / objectives : A few previous studies indicate that protein supplementation increases gains in muscle mass and strength during a resistance exercise program . The purpose of this study was to investigate whether whey protein supplementation results in greater increases in lean body mass , muscle strength and physical function in elderly individuals during 12 weeks of resistance exercise when compared to isocaloric carbohydrate supplementation . Subjects/ Methods : A total of 161 men and women , 65–91 years old , participated in a r and omized , controlled , double-blind intervention study , involving dietary supplementation and a 12-week resistance exercise program , design ed to increase muscle mass and strength of all major muscle groups . Participants exercised three times a week and received either 20 g of whey protein ( n=83 ) or isocaloric carbohydrate ( n=78 ) in liquid form immediately after each workout . Data were obtained at baseline and end point . Results : The primary outcomes , lean body mass , strength and physical function increased significantly during the course of the study . Type of dietary supplementation did not influence gains in lean body mass ( P=0.365 ) , quadriceps strength ( P=0.776 ) or performance during a 6-min walk ( P=0.726 ) or a timed up- and -go test ( P=0.151 ) . Twenty participants discontinued the intervention . Conclusions : Ingestion of 20 g of whey protein immediately after resistance exercise three times per week , does not lead to greater gains in lean body mass , strength and physical function in elderly people with sufficient energy and protein intakes when compared to isocaloric carbohydrate Objective Isoflavones and exercise have been shown to affect C-reactive protein ( CRP ) and body composition and to act synergistically on trunk and total fat mass ( FM ) , glucose metabolism , and lean body mass in postmenopausal women with a body mass index higher than 25 kg/m2 . We hypothesized that exercise and isoflavone supplementation ( Ex + ISO ) could reduce inflammation in the same sub population of women . The objective of this study was to investigate if 6 months of mixed exercise combined with isoflavones could have greater effects on specific inflammatory markers than exercise alone in overweight or obese postmenopausal women . Methods Thirty-four postmenopausal women aged 50 to 70 years were r and omly assigned to exercise and placebo ( Ex + PLA ; n = 15 ) or Ex + ISO ( n = 19 ) . At baseline and after 6 months , waist circumference , hip circumference , total FM , trunk FM , leg FM , and muscle mass index ( MMI ; = total fat free mass [ kg ] / height2 [ m ] ) were assessed ( dual-energy x-ray absorptiometry ) . Inflammatory markers ( CRP , tumor necrosis factor-&agr ; [ TNF-&agr ; ] , and interleukin-6 ) were obtained by enzyme-linked immunosorbent assay . T tests were used to compare groups at baseline . Results The Ex + PLA group showed significant changes in MMI ( + 0.33 kg/m2 , P ⩽ 0.009 ) and FM compartments ( waist circumference , −5.13 cm ; % FM , −1.31 % ; P ⩽ 0.001 ) , whereas inflammation remained unchanged . However , the Ex + ISO group showed significant changes in total FM ( −1.70 kg , P < 0.0001 ) , FM compartments ( hip circumference [ −2.51 cm , P = 0.019 ] , leg FM [ −1.16 kg , P = 0.037 ] , and trunk FM [ −0.72 kg , P = 0.006 ] ) , MMI ( + 0.39 kg , P = 0.011 ) , and inflammation ( CRP , −1.14 mg/L , P = 0.029 ; TNF-&agr ; , + 0.29 pg/mL , P = 0.010 ) . Conclusions Despite an increase in TNF-&agr ; , the use of isoflavones — when body weight remains stable — seems to enhance the beneficial effects of mixed-exercise training on body composition and CRP in overweight or obese postmenopausal women We examined whether post-exercise macronutrient supplementation during a 5-month home-based interval walking training ( IWT ) accelerated exercise-induced increases in skeletal muscle mass and strength in healthy middle-aged and older women . Thirty-five women ( 41 - 78 years ) were r and omly divided into two groups : IWT alone ( CNT , n = 18 ) or IWT plus post-exercise macronutrient ( 7.6 g protein , 32.5 g carbohydrate , and 4.4 g fat ) supplementation ( NUT , n = 17 ) . For IWT , all subjects were instructed to repeat five or more sets of 3-min low-intensity walking at 40 % peak aerobic capacity ( Vo2 peak ) , followed by a 3-min high-intensity walking above 70 % Vo2 peak per day for 4 or more days per week . We determined Vo2 peak , thigh muscle tissue area by computer tomography , and thigh muscle strength in all subjects before and after IWT . We found that an increase in hamstring muscle tissue area was 2.8 ± 1.2 % in NUT vs -1.0 ± 0.7 % in CNT and that in isometric knee flexion force was 16.3 ± 3.7 % in NUT vs 6.5 ± 3.0 % in CNT ; both were significantly higher in NUT than in CNT ( both , P < 0.001 ) . Thus , post-exercise macronutrient supplementation enhanced the increases in thigh muscle mass and strength , although partially , in home-based IWT in middle-aged and older women PURPOSE The intent of this investigation was to examine the effects of a daily oral provision consisting of amino acids ( L-lysine , L-leucine , L-valine , L-phenylalanine , L-threonine , L-histidine , L-isoleucine , and L-methionine ) in combination with carbohydrates ( dextrose , sucrose , and fructose ) on whole muscle strength and size characteristics during a 12-wk progressive knee extensor resistance training ( PRT ) program in older men ( > 65 yr ) . METHODS Seventeen older men were r and omly assigned to either the experimental ( EX ) or control ( CN ) groups . The EX ( N = 8) and CN ( N = 9 ) groups had the following characteristics-EX : 70.8 + /- 1.5 yr , 91.0 + /- 4.9 kg , and 177.0 + /- 3.9 cm ; CN : 72.1 + /- 1.9 yr , 75.4 + /- 4.7 kg , and 176.1 + /- 3.0 . Pre and post PRT maximal unilateral isometric torque ( N.m ) , isokinetic torque ( 1.05 , 1.57 , 2.09 , 3.14 , 4.19 , and 5.24 rad.s-1 ) , work capacity ( 30 consecutive reps at 3.14 rad.s-1 ) torque , one repetition maximum ( 1RM ) bilateral isotonic strength , and whole muscle cross-sectional area ( CSA ) of the mid-thigh were performed by computed tomography on each subject . RESULTS All variables showed an improvement with training ( P < 0.05 ) ; however , there were no differences between the groups . Both groups increased in isometric strength by 21 % , and isokinetic torque by 24 % to 11 % with the varying velocities ( 1.05 - 5.24 rad.s-1 ) . Whole muscle 1RM strength and thigh CSA increased 50 % and 6.5 % , respectively . Additionally , voluntary torque/CSA increased 12 % in both the EX and CN groups ( P < 0.05 ) . CONCLUSIONS In conclusion , these data suggest that whole muscle strength and size are not enhanced with a postexercise daily provision of an oral amino-acid complex during 12 wk of PRT in older men This study aim ed to examine the efficacy of creatine supplementation , associated or not with resistance training , in vulnerable older women . A 24-week , double-blind , r and omized , placebo-controlled trial was performed . Sixty subjects were assigned to compose the following groups : placebo ( PL ) , creatine supplementation ( CR ) , placebo with resistance training ( PL+RT ) , and creatine supplementation with resistance training ( CR+RT ) . The subjects were assessed at baseline and after 24weeks . The primary outcome was muscle strength , as assessed by one-repetition maximum ( 1-RM ) tests . Secondary outcomes included appendicular lean mass , bone mass , biochemical bone markers , and physical function tests . The changes in 1-RM leg press were significantly greater in the CR+RT group ( + 19.9 % ) than in the PL ( + 2.4 % ) and the CR groups ( + 3.7 % ) , but not than in the PL+RT group ( + 15 % ) ( p=0.002 , p=0.002 , and p=0.357 , respectively ) . The CR+RT group showed superior gains in 1-RM bench press ( + 10 % ) when compared with all the other groups ( p≤0.05 ) . The CR+RT group ( + 1.31 % ) showed greater appendicular lean mass accrual than the PL ( -1.2 % ) , the CR ( + 0.3 % ) , and the PL+RT groups ( -0.2 % ) ( p≤0.05 ) . The CR and the PL+RT groups experienced comparable gains in appendicular lean mass ( p=0.62 ) , but superior to those seen in the PL group . Changes in fat mass , bone mass and serum bone markers did not significantly differ between the groups ( p>0.05 ) . In conclusion , creatine supplementation combined with resistance training improved appendicular lean mass and muscle function , but not bone mass , in older vulnerable women . Clinical trials.gov : NCT01472393 BACKGROUND Whey protein supplementation may augment resistance exercise-induced increases in muscle strength and mass . Further studies are required to determine whether this effect extends to mobility-limited older adults . The objectives of the study were to compare the effects of whey protein concentrate ( WPC ) supplementation to an isocaloric control on changes in whole-body lean mass , mid-thigh muscle cross-sectional area , muscle strength , and stair-climbing performance in older mobility-limited adults in response to 6 months of resistance training ( RT ) . METHODS Eighty mobility-limited adults aged 70 - 85 years were r and omized to receive WPC ( 40g/day ) or an isocaloric control for 6 months . All participants also completed a progressive high-intensity RT intervention . Sample sizes were calculated based on the primary outcome of change in whole-body lean mass to give 80 % power for a 0.05-level , two-sided test . RESULTS Lean mass increased 1.3 % and 0.6 % in the WPC and control groups , respectively . Muscle cross-sectional area was increased 4.6 % and 2.9 % in the WPC and control groups , respectively , and muscle strength increased 16%-50 % in WPC and control groups . Stair-climbing performance also improved in both groups . However , there were no statistically significant differences in the change in any of these variables between groups . CONCLUSIONS These data suggest that WPC supplementation at this dose does not offer additional benefit to the effects of RT in mobility-limited older adults OBJECTIVES To evaluate the effects of elastic b and resistance training in combination with nutrient supplementation on muscular strength and the ability to perform mobility-related activities of daily living in older adults living in retirement care facilities . DESIGN R and omized controlled trial , with a 6-month intervention period . SETTING A retirement care facility , Vienna , Austria . PARTICIPANTS One hundred and seventeen older adults ( 14 males ( 12 % ) and 103 females ( 88 % ) ) , aged 65 to 97 years ( mean age : 82.8 ± 6.0 ) , having a mini-mental state examination score ≥ 23 and no chronic diseases posing a medical contraindication to training therapy . INTERVENTION Participants were r and omly assigned , but stratified by sex , to one of three intervention groups : supervised resistance exercise training ( RT ) , RT in combination with nutrient supplementation ( RTS ) , or cognitive training group ( CT ) . All interventions were performed two times a week for 6 months . RT was design ed to train all major muscle groups using elastic b and s. The nutrient supplement ( rich in proteins , vitamin D , B2 , B12 ) was distributed every morning as well as after each RT session . MEASUREMENTS A battery of motor ability tests and functional test were performed prior to as well as following 3 months and finally after 6 months of intervention . These tests included isokinetic torque measurements of the knee extensors and flexors in concentric mode at 60 and 120 ° /s , isometric h and grip strength , senior arm-lifting test , chair st and test , maximum walking speed and a 6-minute walking test ( 6 MWT ) . RESULTS A repeated- measures ANOVA analysis revealed significant improvements in physical function of lower ( p=0.002 ) and upper extremities ( p=0.006 ) for RT and /or RTS in comparison to CT . For isokinetic measurements , 6 MWT , and gait speed time effects ( p<0.05 ) were detected without any group × time interaction effects . Dropouts showed lower performance in chair st and test ( p=0.012 ) , 6 MWT ( p=0.003 ) , and gait speed ( p=0.013 ) at baseline than that of the finishers of the study . CONCLUSION Six months of a low intensity resistance exercise using elastic b and s and own body weight is safe and beneficial in improving functional performance of institutionalised older people . Multinutrient supplementation did not offer additional benefits to the effects of RT in improving muscular performance Objective : To describe the independent and combined effects of oral nutrition supplementation and resistance training on health outcomes in nutritionally at risk older adults following lower limb fracture . Design : R and omized controlled trial with 12-week masked outcome assessment . Setting : Teaching hospital . Participants : One hundred nutritionally at risk older adults hospitalized following a fall-related lower limb fracture . Intervention : Commenced seven days after injury . Consisted of daily multinutrient energy-dense oral supplement ( 6.3 kJ/mL ) individually prescribed for six weeks ( n = 25 ) , tri-weekly resistance training for 12 weeks ( n = 25 ) , combined treatment ( n = 24 ) or attention control plus usual care and general nutrition and exercise advice ( n = 26 ) . Measurements : Weight change , quadriceps strength , gait speed , quality of life and health care utilization at completion of the 12-week intervention . Results : At 12 weeks , all groups lost weight :  nutrition -6.2 % ( -8.4 , -4.0 ) ; resistance training -6.3 % ( -8.3 , -4.3 ) ; nutrition and resistance training -4.7 % ( -7.4 , -2.0 ) ; attention control -5.2 % ( -9.0 , -1.5 ) . Those receiving resistance training alone lost more weight than those receiving the combined treatment ( P = 0.029 ) . Significant weight loss was prevented if supplement was consumed for at least 35 days . Groups were no different at 12 weeks for any other outcome . Conclusion : Frail , undernourished older adults with a fall-related lower limb fracture experience clinical ly significant weight loss that is unable to be reversed with oral nutritional supplements . Those receiving a programme of resistance training without concurrent nutrition support are at increased risk of weight loss compared with those who receive a combined nutrition and resistance training intervention . In this high-risk patient group it is possible to prevent further decline in nutritional status using oral nutritional supplements if strategies are implemented to ensure prescription is adequate to meet energy requirements and levels of adherence are high OBJECTIVES This study determined the effect of enriched foods and all-around physical exercise on bone and body composition in frail elderly persons . METHODS A 17-week r and omized , controlled intervention trial , following a 2 x 2 factorial design --(1 ) enriched foods , ( 2 ) exercise , ( 3 ) both , or ( 4 ) neither -- was performed in 143 frail elderly persons ( aged 78.6 + /- 5.6 years ) .  Foods were enriched with multiple micronutrients ; exercises focused on skill training , including strength , endurance , coordination , and flexibility . Main outcome parameters were bone and body composition . RESULTS Exercise preserved lean mass ( mean difference between exercisers and non-exercisers : 0.5 kg + /- 1.2 kg ; P < .02 ) . Groups receiving enriched food had slightly increased bone mineral density ( + 0.4 % ) , bone mass ( + 0.6 % ) , and bone calcium ( + 0.6 % ) compared with groups receiving non-enriched foods , in whom small decreases of 0.1 % , 0.2 % , and 0.4 % , respectively , were found . These groups differed in bone mineral density ( 0.006 + /- 0.020 g/cm2 ; P = .08 ) , total bone mass ( 19 + /- g ; P = .04 ) , and bone calcium ( 8 + /- 21 g ; P = .03 ) . CONCLUSIONS Foods containing a physiologic dose of micronutrients slightly increased bone density , mass , and calcium , whereas moderately intense exercise preserved lean body mass in frail elderly persons BACKGROUND Magnesium deficiency is associated with poor physical performance , but no trials are available on how magnesium supplementation affects elderly people 's physical performance . OBJECTIVE The aim of our study was to investigate whether 12 wk of oral magnesium supplementation can improve physical performance in healthy elderly women . DESIGN In a parallel-group , r and omized controlled trial , 139 healthy women ( mean ± SD age : 71.5 ± 5.2 y ) attending a mild fitness program were r and omly allocated to a treatment group ( 300 mg Mg/d ; n = 62 ) or a control group ( no placebo or intervention ; n = 77 ) by using a computer-generated r and omization sequence , and research ers were blinded to their grouping . After assessment at baseline and again after 12 wk , the primary outcome was a change in the Short Physical Performance Battery ( SPPB ) ; secondary outcomes were changes in peak torque isometric and isokinetic strength of the lower limbs and h and grip strength . RESULTS A total of 124 participants allocated to the treatment ( n = 53 ) or control ( n = 71 ) group were considered in the final analysis . At baseline , the SPPB scores did not differ between the 2 groups . After 12 wk , the treated group had a significantly better total SPPB score ( Δ = 0.41 ± 0.24 points ; P = 0.03 ) , chair st and times ( Δ = -1.31 ± 0.33 s ; P < 0.0001 ) , and 4-m walking speeds ( Δ = 0.14 ± 0.03 m/s ; P = 0.006 ) than did the control group . These findings were more evident in participants with a magnesium dietary intake lower than the Recommended Dietary Allowance . No significant differences emerged for the secondary outcomes investigated , and no serious adverse effects were reported . CONCLUSIONS Daily magnesium oxide supplementation for 12 wk seems to improve physical performance in healthy elderly women . These findings suggest a role for magnesium supplementation in preventing or delaying the age-related decline in physical performance OBJECTIVES Protein supplementation has been proposed as an effective dietary strategy to augment the skeletal muscle adaptive response to prolonged resistance-type exercise training in elderly people . Our objective was to assess the impact of protein supplementation on muscle mass , strength , and physical performance during prolonged resistance-type exercise training in frail elderly men and women . DESIGN / SETTING / PARTICIPANTS A r and omized , double-blind , placebo-controlled trial with 2 arms in parallel among 62 frail elderly subjects ( 78 ± 1 year ) . These elderly subjects participated in a progressive resistance-type exercise training program ( 2 sessions per week for 24 weeks ) during which they were supplemented twice daily with either protein ( 2 * 15 g ) or a placebo .  MEASUREMENTS Lean body mass ( DXA ) , strength ( 1-RM ) , and physical performance ( SPPB ) were assessed at baseline , and after 12 and 24 weeks of intervention . RESULTS Lean body mass increased from 47.2 kg ( 95 % CI , 43.5 - 50.9 ) to 48.5 kg ( 95 % CI , 44.8 - 52.1 ) in the protein group and did not change in the placebo group ( from 45.7 kg , 95 % CI , 42.1 - 49.2 to 45.4 kg , 95 % CI , 41.8 - 48.9 ) following the intervention ( P value for treatment × time interaction = .006 ) . Strength and physical performance improved significantly in both groups ( P = .000 ) with no interaction effect of dietary protein supplementation . CONCLUSIONS Prolonged resistance-type exercise training represents an effective strategy to improve strength and physical performance in frail elderly people  . Dietary protein supplementation is required to allow muscle mass gain during exercise training in frail elderly people . TRIAL REGISTRATION clinical trials.gov identifier : NCT01110369 BACKGROUND Physical inactivity , inadequate dietary protein , and low- grade systemic inflammation contribute to age-related muscle loss , impaired function , and disability . OBJECTIVE We assessed the effects of progressive resistance training ( PRT ) combined with a protein-enriched diet facilitated through lean red meat on lean tissue mass ( LTM ) , muscle size , strength and function , circulating inflammatory markers , blood pressure , and lipids in elderly women . DESIGN In a 4-mo cluster r and omized controlled trial , 100 women aged 60 - 90 y who were residing in 15 retirement villages were allocated to receive PRT with lean red meat ( ∼160 g cooked ) to be consumed 6 d/wk [ resistance training plus lean red meat ( RT+Meat ) group ; n = 53 ] or control PRT [ 1 serving pasta or rice/d ; control resistance training ( CRT ) group ; n = 47 ) ] . All women undertook PRT 2 times/wk and received 1000 IU vitamin D3/d . RESULTS The mean ( ± SD ) protein intake was greater in the RT+Meat group than in the CRT group throughout the study ( 1.3 ± 0.3 compared with 1.1 ± 0.3 g · kg⁻¹ · d⁻¹ , respectively ; P < 0.05 ) . The RT+Meat group experienced greater gains in total body LTM ( 0.45 kg ; 95 % CI : 0.07 , 0.84 kg ) , leg LTM ( 0.22 kg ; 95 % CI : 0.02 , 0.42 kg ) , and muscle strength ( 18 % ; 95 % CI : 0.03 , 0.34 ) than did the CRT group ( all P < 0.05 ) . The RT+Meat group also experienced a 10 % greater increase in serum insulin-like growth factor I ( P < 0.05 ) and a 16 % greater reduction in the proinflammatory marker interleukin-6 ( IL-6 ) ( P < 0.05 ) after 4 mo . There were no between-group differences for the change in blood lipids or blood pressure . CONCLUSION A protein-enriched diet equivalent to ∼1.3 g · kg⁻¹ · d⁻¹ achieved through lean red meat is safe and effective for enhancing the effects of PRT on LTM and muscle strength and reducing circulating IL-6 concentrations in elderly women . This trial was registered at the Australian Clinical Trials Registry as ACTRN12609000223235 BACKGROUND Loss of muscle mass due to prolonged bed rest decreases functional capacity and increases hospital morbidity and mortality in older adults . OBJECTIVE To determine if HMB , a leucine metabolite , is capable of attenuating muscle decline in healthy older adults during complete bed rest . DESIGN A r and omized , controlled , double-blinded , parallel-group design study was carried out in 24 healthy ( SPPB ≥ 9 ) older adult subjects ( 20 women , 4 men ) , confined to complete bed rest for ten days , followed by resistance training rehabilitation for eight weeks . Subjects in the experimental group were treated with HMB ( calcium salt , 1.5 g twice daily - total 3 g/day ) . Control subjects were treated with an inactive placebo powder . Treatments were provided starting 5 days prior to bed rest till the end rehabilitation phase . DXA was used to measure body composition . RESULTS Nineteen eligible older adults ( BMI : 21 - 33 ; age : 60 - 76 year ) were evaluable at the end of the bed rest period ( Control n = 8 ; Ca-HMB n = 11 ) . Bed rest caused a significant decrease in total lean body mass ( LBM ) ( 2.05 ± 0.66 kg ; p = 0.02 , paired t-test ) in the Control group . With the exclusion of one subject , treatment with HMB prevented the decline in LBM over bed rest -0.17 ± 0.19 kg ; p = 0.23 , paired t-test ) . There was a statistically significant difference between treatment groups for change in LBM over bed rest ( p = 0.02 , ANOVA ) . Sub- analysis on female subjects ( Control = 7 , HMB = 8) also revealed a significant difference in change in LBM over bed rest between treatment groups ( p = 0.04 , ANOVA ) . However , differences in function parameters could not be observed , probably due to the sample size of the study . CONCLUSIONS In healthy older adults  , HMB supplementation preserves muscle mass during 10 days of bed rest . These results need to be confirmed in a larger trial OBJECTIVES To evaluate the effectiveness of exercise and amino acid supplementation in enhancing muscle mass and strength in community-dwelling elderly sarcopenic women . DESIGN R and omized controlled trial . SETTING Urban community in Tokyo , Japan . PARTICIPANTS One hundred fifty-five women aged 75 and older were defined as sarcopenic and r and omly assigned to one of four groups : exercise and amino acid supplementation ( exercise + AAS ; n = 38 ) , exercise ( n = 39 ) , amino acid supplementation ( AAS ; n = 39 ) , or health education ( HE ; n = 39 ) . INTERVENTION The exercise group attended a 60-minute comprehensive training program twice a week , and the AAS group ingested 3 g of a leucine-rich essential amino acid mixture twice a day for 3 months . MEASUREMENTS Body composition was determined using bioelectrical impedance analysis . Data from interviews and functional fitness parameters such as muscle strength and walking ability were collected at baseline and after the 3-month intervention . RESULTS A significant group × time interaction was seen in leg muscle mass ( P = .007 ) , usual walking speed ( P = .007 ) , and knee extension strength ( P = .017 ) . The within-group analysis showed that walking speed significantly increased in all three intervention groups , leg muscle mass in the exercise + AAS and exercise  groups , and knee extension strength only in the exercise + AAS group ( 9.3 % increase , P = .01 ) . The odds ratio for leg muscle mass and knee extension strength improvement was more than four times as great in the exercise + AAS group ( odds ratio = 4.89 , 95 % confidence interval = 1.89 - 11.27 ) as in the HE group . CONCLUSION The data suggest that exercise and AAS together may be effective in enhancing not only muscle strength , but also combined variables of muscle mass and walking speed and of muscle mass and strength in sarcopenic women We sought to determine whether creatine monohydrate ( CrM ) supplementation would enhance the increases in strength and fat-free mass that develop during resistance exercise training in older adults . Twenty-eight healthy men and women over the age of 65 years participated in a whole-body resistance exercise program 3 days per week for 14 weeks . The study participants were r and omly allocated , in a double-blind fashion , to receive either CrM ( 5 g/d + 2 g of dextrose ; n = 14 ) or placebo ( 7 g of dextrose ; n = 14 ) . The primary outcome measurements included the following : total body mass , fat-free mass , one-repetition maximum strength for each body part , isometric knee extension , h and grip , and dorsiflexion strength , chair st and performance , 30-m walk test , 14-stair climb performance , muscle fiber type and area , and intramuscular total creatine . Fourteen weeks of resistance exercise training result ed in significant increases in all measurements of strength and functional tasks and muscle fiber area for both groups ( p < .05 ) . CrM supplementation result ed in significantly greater increases in fat-free mass and total body mass , as compared with placebo ( p < .05 ) . The CrM group also showed a greater increase in isometric knee extension strength in men and women , as compared with placebo ( p < .05 ) , and also greater gains in isometric dorsiflexion strength ( p < .05 ) , but in men only . There was a significant increase in intramuscular total creatine in the CrM group ( p < .05 ) . Finally , there were no significant side effects of treatment or exercise training . This study confirms that supervised heavy resistance exercise training can safely increase muscle strength and functional capacity in older adults . The addition of CrM supplementation to the exercise stimulus enhanced the increase in total and fat-free mass , and gains in several indices of isometric muscle strength AIM To investigate the effects of exercise and /or tea catechin supplementation on muscle mass , strength and walking ability in elderly Japanese women with sarcopenia . METHODS A total of 128 women aged over 75 years were defined as sarcopenic and r and omly assigned into four groups : exercise and tea catechin supplementation ( n = 32 ) , exercise ( n = 32 ) , tea catechin supplementation ( n = 32 ) or health education ( n = 32 ) . The exercise group attended a 60-min comprehensive training program twice a week and the tea catechin supplementation group ingested 350 mL of a tea beverage fortified with catechin daily for 3 months . Body composition was determined by bioelectrical impedance analysis . Interview data and functional fitness measurements , such as muscle strength , balance and walking ability , were collected at baseline and after the 3-month intervention . RESULTS There were significant group × time interactions observed in timed up & go ( P < 0.001 ) , usual walking speed ( P = 0.007 ) and maximum walking speed ( P < 0.001 ) . The exercise + catechin group showed a significant effect ( odds ratio 3.61 , 95 % confidence interval 1.05 - 13.66 ) for changes in the combined variables of leg muscle mass and usual walking speed compared with the health education group . CONCLUSIONS The combination of exercise and tea catechin supplementation had a beneficial effect on physical function measured by walking ability and muscle mass OBJECTIVE To examine the effects of an exercise program and an enriched food regimen on physical functioning of frail elderly persons . DESIGN A 17-week r and omized , placebo-controlled trial . SETTING Community . PARTICIPANTS One hundred fifty-seven independently living frail elderly ( mean age , 78.7 + /- 5.6yr ) . INTERVENTION Thirty-nine subjects participated in a twice weekly group exercise design ed to improve daily functioning ; 39 subjects daily ate foods enriched with vitamins and minerals ( at 25%-100 % of the recommended daily allowances ) ; 42 subjects exercised and ate enriched foods ; and 37 subjects served as controls . Nonexercising groups followed a social program ; nonsupplement groups received the same food products without the micronutrients . MAIN OUTCOME MEASURES Functional performance based on 6 performance tests , physical fitness based on 7 fitness tests , and disabilities based on the self-reported ability to perform 16 daily activities . RESULTS Performance sum scores were significantly enhanced in trained ( + 8 % ) compared with nontrained subjects ( -8 % ) ( difference in change : 1.9 points , p < .001 , adjusted for baseline scores ) . Fitness sum scores were significantly enhanced as well ( + 3 % in trained vs -2 % in nontrained ) ( difference in change : 0.9 points , p = .05 , adjusted for baseline scores ) . No exercise effects on the disability score were observed . Consumption of enriched products did not affect performance , fitness , or disability scores . CONCLUSION Our comprehensive exercise program , design ed for widespread applicability , enhanced physical performance and fitness in a population of frail elderly . Daily consumption of micronutrient enriched foods showed no functional benefits within 17 weeks BACKGROUND Although disuse of skeletal muscle and undernutrition are often cited as potentially reversible causes of frailty in elderly people , the efficacy of interventions targeted specifically at these deficits has not been carefully studied . METHODS We conducted a r and omized , placebo-controlled trial comparing progressive resistance exercise training , multinutrient supplementation , both interventions , and neither in 100 frail nursing home residents over a 10-week period . RESULTS The mean ( + /- SE ) age of the 63 women and 37 men enrolled in the study was 87.1 + /- 0.6 years ( range , 72 to 98 ) ; 94 percent of the subjects completed the study .  Muscle strength increased by 113 + /- 8 percent in the subjects who underwent exercise training , as compared with 3 + /- 9 percent in the nonexercising subjects ( P < 0.001 ) . Gait velocity increased by 11.8 + /- 3.8 percent in the exercisers but declined by 1.0 + /- 3.8 percent in the nonexercisers ( P = 0.02 ) . Stair-climbing power also improved in the exercisers as compared with the nonexercisers ( by 28.4 + /- 6.6 percent vs. 3.6 + /- 6.7 percent , P = 0.01 ) , as did the level of spontaneous physical activity . Cross-sectional thigh-muscle area increased by 2.7 + /- 1.8 percent in the exercisers but declined by 1.8 + /- 2.0 percent in the nonexercisers ( P = 0.11 ) . The nutritional supplement had no effect on any primary outcome measure . Total energy intake was significantly increased only in the exercising subjects who also received nutritional supplementation . CONCLUSIONS High-intensity resistance exercise training is a feasible and effective means of counteracting muscle weakness and physical frailty in very elderly people . In contrast , multi-nutrient supplementation without concomitant exercise does not reduce muscle weakness or physical frailty
target: Results indicate that physical exercise has a positive impact on muscle mass and muscle function in subjects aged 65 years and older .
  Conclusion Physical exercise has a positive impact on muscle mass and muscle function in healthy subjects aged 60 years and older .
  The biggest effect of exercise intervention , of any type , has been seen on physical performance ( gait speed , chair rising test , balance , SPPB test , etc . )
  .
  We observed huge variations in regard to the dietary supplementation protocol s. Based on the included studies , mainly performed on well-nourished subjects , the interactive effect of dietary supplementation on muscle function appears limited
background: Summary This systematic review summarizes the effect of combined exercise and nutrition intervention on muscle mass and muscle function .
  However , any interactive effect of dietary supplementation appears to be limited .
  Introduction In 2013 , Denison et al. conducted a systematic review including 17 r and omized controlled trials ( RCTs ) to explore the effect of combined exercise and nutrition intervention to improve muscle mass , muscle strength , or physical performance in older people .
  They concluded that further studies were needed to provide evidence upon which public health and clinical recommendations could be based .
  The purpose of the present work was to up date the prior systematic review and include studies published up to October 2015 .