The Impact of Nutritional Supplementation and Resistance Training on the Health Functioning of Free-Living Chilean Elders: Results of 18 Months of Follow-up

Abstract

Body composition changes and loss of functionality in the elderly are related to substandard 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 randomly 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.

Nutritional interventions in sarcopenia: a critical review

“…A recent systematic review (10) identified five protein supplement studies (11)(12)(13)(14)(15) , which are summarised in Table 1; Cruz-Jentoft et al concluded that there was no consistent effect on muscle mass, strength or function. A closer examination of the studies reveal why this may be so.…”

“…To further confuse the issue, in another Tieland et al study protein supplementation for 6 months without exercise did improve physical performance but did not show gains in muscle mass or strength (15) . The populations were also inconsistent, including older adults (mean age range 68-83 years) who were free living (12)(13)(14)(15) or in residential care (11) . Three studies specifically identified frail or pre-frail people (11,14,15) .…”

“…In two trials the protein was delivered with additional energy and micronutrients (11,12) , but these trials scored lowest in terms of quality on the PEDro scale. Bunout et al do not describe the exact content of the supplement since it was apparently incorporated into either soup or porridge and it is not stated what additional nutrients these foods added.…”

“…Bunout et al do not describe the exact content of the supplement since it was apparently incorporated into either soup or porridge and it is not stated what additional nutrients these foods added. The protein content is relatively low at 13 g/d, but a range of vitamins and minerals are also included to provide a more complete supplement (12) . Bonnefoy et al also aimed to provide a nutritionally complete supplement containing vitamins and minerals in addition to protein and energy.…”

“…If food intake is not measured, then it is impossible to assess what has produced any positive effect, or explain why no effect is apparent. The two lower quality studies did not aim to measure usual food intake (11,12) ; the other three studies used 3 d diet diaries at least at the start and end of the study (13)(14)(15) .…”