Effects of combined nutritional supplementation and exercise on proxy measures of muscle mass, strength, and function in older adults with sarcopenia: a 12-week multicentre RCT.

The intervention group showed significant increases in BIA-derived appendicular lean tissue compared to the control group.

• Mean change of +0.60 kg in appendicular lean tissue (95% CI 0.33 to 0.88)
• Skeletal muscle index increased by +0.20 kg/m² (95% CI 0.11 to 0.29)
• Muscle mass was assessed via bioelectrical impedance analysis (BIA), not direct measurement
• Assessed at baseline and post-intervention at 12 weeks

Handgrip strength improved significantly in the intervention group compared to the control group.

• Mean change of +2.22 kg in handgrip strength (95% CI 1.35 to 3.09)
• Improvement was measured over the 12-week intervention period
• Handgrip strength is a proxy measure of muscle strength

Physical function measures improved in the intervention group, including walking speed, chair-stand performance, and Short Physical Performance Battery (SPPB) scores.

• Improvements were observed in walking speed, chair-stand performance, and SPPB scores
• These are recognized functional outcome measures for sarcopenia
• Outcomes were assessed at baseline and after 12 weeks of intervention

Serum vitamin D levels and quality of life as measured by EQ-5D improved in the intervention group.

• Improvements were observed in serum vitamin D concentrations
• EQ-5D measures of quality of life showed improvement in the intervention group
• The intervention supplementation included 200 IU vitamin D3 per sachet, with 2 sachets per day (400 IU/day total)

The trial enrolled 110 older adults with sarcopenia or possible sarcopenia and randomly allocated them to intervention or control groups.

• 110 participants aged ≥65 years were enrolled across multiple centres
• Participants were randomly allocated 1:1: intervention group (n=55) and control group (n=55)
• Participants had sarcopenia or possible sarcopenia
• Trial was registered on Chinese Clinical Trial Registry (ChiCTR2300077187) on 1 November 2023
• The study was a 12-week multicentre randomized controlled trial

The intervention consisted of daily muscle-targeted oral nutritional supplementation combined with a structured exercise program.

• MT-ONS provided as 2 × 10 g sachets per day, each containing 8.4 g protein, 0.5 g calcium β-hydroxy-β-methylbutyrate (HMB), and 200 IU vitamin D3
• Exercise program included twice-weekly resistance training (20 min/session), alternate-day chair-based exercises (10 min/session), and home-based activity recommendations
• Control group maintained habitual dietary and physical activity patterns without intervention

The study was unable to determine the relative contributions of exercise and nutritional supplementation to the observed improvements.

• The study did not employ a factorial design, preventing isolation of individual intervention components
• Muscle mass was not directly measured; BIA-derived proxies were used
• Authors noted that combined interventions 'may help attenuate, rather than reverse, sarcopenia-related decline'