Effectiveness of whey protein supplementation on muscle strength and physical performance of older adults: A systematic review and meta-analysis of randomized clinical trials

IF 6.6 2区 医学 Q1 NUTRITION & DIETETICS Clinical nutrition Pub Date : 2024-09-05 DOI:10.1016/j.clnu.2024.08.033
Alaa H. Al-Rawhani , Siti Nur’Asyura Adznam , Zalina Abu Zaid , Nor Baizura Md. Yusop , Hakimah M. Sallehuddin , Mohammed A. Alshawsh
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Abstract

Background

The efficacy of whey protein supplement (WPS) in improving muscle strength, physical performance, and body composition in older adults has been widely promoted. However, the results of randomized clinical trials in this regard have been inconsistent. We aimed to determine the impact of WPS, compared to a placebo, during or without training on muscle strength, physical function, and body composition in older adults.

Methods

Randomized controlled trials were thoroughly searched using PubMed, EMBASE, the Cochrane Library Database, and Scopus databases up to June 2024. The analysis focused on key parameters such as handgrip strength (HS), leg press, knee extension, gait speed (GS), 6-min walking test (6MWT), Timed-up and go test (TUG), lean body mass (LBM), fat mass (FM), and appendicular skeletal muscle mass (ASM). A pooled effect size was calculated using a random-effects model based on standardized mean differences (SMD).

Results

Thirty studies involving 2105 participants aged 60 and older met the inclusion criteria. The meta-analysis of 26 RCTs showed no significant positive effect of WPS on HS (n = 11, SMD: 0.18; 95% CI: −0.13, 0.49; I2 = 69%), 6MWT (n = 5, SMD: −0.08; 95%CI: −0.31, 0.16; I2 = 0%), GS test (n = 4, SMD: −0.08; 95%CI: −0.43, 0.28; I2 = 36%), TUG test (n = 9, SMD: 0.0, 95% CI -0.15, 0.14; I2 = 0%), LBM (n = 11, SMD: 0.02; 95%CI: −0.13, 0.17; I2 = 0%), FM (n = 15, SMD: −0.04; 95%CI: −0.18, 0.10; I2 = 0%). However, ASM significantly improved after WPS consumption but with high heterogeneity (n = 2, SMD: 0.39; 95%CI: 0.28, 0.51; I2 = 69%). In interventions incorporating RE, statistically significant positive effects of WPS on lower body strength were observed (n = 11, SMD: 0.25; 95%CI: 0.05, 0.45; I2 = 0%).

Conclusion

The present meta-analysis indicates that WPS, when combined with resistance training (RT), can enhance lower body strength but does not seem to have a significant beneficial effect on handgrip strength, physical performance, or body composition. Further large-scale studies are necessary to confirm these findings and elucidate the potential benefits of WPS in this population.

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补充乳清蛋白对老年人肌肉力量和身体表现的效果:随机临床试验的系统回顾和荟萃分析
背景乳清蛋白补充剂(WPS)在改善老年人肌肉力量、体能表现和身体成分方面的功效已被广泛推广。然而,这方面的随机临床试验结果并不一致。我们旨在确定与安慰剂相比,WPS 在训练期间或不训练期间对老年人肌肉力量、身体机能和身体成分的影响。方法使用 PubMed、EMBASE、Cochrane 图书馆数据库和 Scopus 数据库对截至 2024 年 6 月的随机对照试验进行了全面检索。分析的重点是手握力(HS)、压腿、伸膝、步态速度(GS)、6 分钟步行测试(6MWT)、定时上下楼测试(TUG)、瘦体重(LBM)、脂肪量(FM)和附着骨骼肌量(ASM)等关键参数。采用基于标准化均值差异(SMD)的随机效应模型计算了汇总效应大小。结果有 30 项研究符合纳入标准,涉及 2105 名 60 岁及以上的参与者。对 26 项研究的荟萃分析表明,WPS 对 HS(n = 11,SMD:0.18;95%CI:-0.13,0.49;I2 = 69%)、6MWT(n = 5,SMD:-0.08;95%CI:-0.31,0.16;I2 = 0%)、GS 测试(n = 4,SMD:-0.08;95%CI:-0.43,0.28;I2 = 36%)、TUG 测试(n = 9,SMD:0.0,95%CI -0.15,0.14;I2 = 0%)、LBM(n = 11,SMD:0.02;95%CI:-0.13,0.17;I2 = 0%)、FM(n = 15,SMD:-0.04;95%CI:-0.18,0.10;I2 = 0%)。然而,服用 WPS 后 ASM 有明显改善,但异质性较高(n = 2,SMD:0.39;95%CI:0.28,0.51;I2 = 69%)。结论本荟萃分析表明,WPS 与阻力训练(RT)相结合可增强下半身力量,但似乎对手握力量、体能表现或身体成分没有显著的有益影响。有必要进一步开展大规模研究,以证实这些发现,并阐明 WPS 对这一人群的潜在益处。
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来源期刊
Clinical nutrition
Clinical nutrition 医学-营养学
CiteScore
14.10
自引率
6.30%
发文量
356
审稿时长
28 days
期刊介绍: Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.
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