Nutritional supplementation showed overall benefits for ASMI, grip strength, and gait speed in older adults with or at high risk of sarcopenia, while formulation-specific effects varied across outcomes; given the sparse network and low to very low certainty of evidence, these findings should be regarded as candidate signals rather than evidence of a definitive treatment hierarchy.
The review included 20 RCTs with 2160 participants, forming a network of 17 nodes comparing nutritional strategies in older adults with sarcopenia or at high risk of sarcopenia.
Pooled across all nutritional interventions, supplementation improved appendicular skeletal muscle mass index (ASMI), grip strength, and gait speed, but not five-times sit-to-stand (5STS) performance.
Whey protein + vitamin D + leucine improved ASMI, grip strength, and 5STS completion time in the network meta-analysis.
Omega-3 fatty acids + leucine + Lactobacillus paracasei PS23 improved ASMI and grip strength, but this node was supported by only a single RCT.
Leucine + vitamin D + medium-chain triglycerides improved gait speed, but this node was also supported by only a single RCT.
Sensitivity analyses showed that some formulation-specific estimates were not robust.
The certainty of evidence for the principal comparisons was low to very low, and the network was sparse.
Effects of formulations varied across outcomes, with whey protein + vitamin D + leucine showing favorable effects across several outcomes.
This study combined results from 20 randomized trials involving 2160 older adults who had sarcopenia (age-related loss of muscle) or were at high risk of it. It compared different nutritional supplement strategies, such as protein combined with vitamin D and leucine (an amino acid), for effects on muscle mass, grip strength, and physical performance. Overall, nutritional supplements were linked to better muscle mass, grip strength, and walking speed, but not to a clear improvement in the sit-to-stand test. Of the specific formulations, whey protein plus vitamin D plus leucine showed benefits across several measures: muscle mass, grip strength, and sit-to-stand time. Two other combinations (omega-3 plus leucine plus a probiotic, and leucine plus vitamin D plus medium-chain fats) showed promising results for particular outcomes, but each rested on just one trial, so those results are less reliable. The authors stress that the evidence is of low to very low certainty, the network of comparisons was sparse, and results changed in some sensitivity checks. This research suggests that nutritional support may help older adults with sarcopenia, but it does not establish which specific formulation is best; larger, better-designed trials directly comparing formulations are needed.
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Upload Your LabsZhang X, Fan S, Zan J, Chen M, Chen X. (2026). Comparative Effectiveness of Nutritional Strategies for Sarcopenia-Related Outcomes in Older Adults: A Systematic Review and Network Meta-Analysis.. Nutrients. https://doi.org/10.3390/nu18203368