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1.
Effects of Milk Protein in Resistance Training-Induced Lean Mass Gains for Older Adults Aged ≥ 60 y: A Systematic Review and Meta-Analysis.
Huang, LP, Condello, G, Kuo, CH
Nutrients. 2021;(8)
Abstract
This review evaluated the effects of milk-based protein supplementation on resistance training (RT)-induced gains in lean body mass or fat free mass (LBM/FFM) and muscle strength for older adults. A systematic search of PubMed, Scopus and EBSCOhost/SPORTDiscus was conducted. Eligibility criteria: Randomized controlled trials comparing all types of milk-based protein supplements with control supplements for the training older adults at mean age ≥ 60 y. Twenty studies were included in the qualitative synthesis, whilst seventeen studies were included in the quantitative synthesis. A dose of 10-15 g of milk protein supplementation was sufficient to augment RT-induced LBM/FFM. Intriguingly, four out of five studies show negative effect of whey protein supplementation at the same dose range (or even higher) compared with control supplementation (-0.49 kg, 95% CI: -0.69, -0.29, I2 = 14%, Z = 4.82, p < 0.001). For milk-based protein supplementation, RT-induced improvements in muscle strength were observed only when the protein doses ≥22 g (+0.66 kg, 95% CI: 0.07, 1.25, I2 = 0%, Z = 2.18, p = 0.03). Conclusion: Milk protein is superior to whey protein in enhancing RT-induced LBM/FFM gains for older adults. Optimal daily protein intake can dilute the protein supplementation effect.
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2.
Efficacy of Creatine Supplementation Combined with Resistance Training on Muscle Strength and Muscle Mass in Older Females: A Systematic Review and Meta-Analysis.
Dos Santos, EEP, de Araújo, RC, Candow, DG, Forbes, SC, Guijo, JA, de Almeida Santana, CC, Prado, WLD, Botero, JP
Nutrients. 2021;(11)
Abstract
Sarcopenia refers to the age-related loss of muscle strength and muscle mass, which is associated with a reduced quality of life, particularly in older females. Resistance training (RT) is well established to be an effective intervention to counter indices of sarcopenia. Accumulating research indicates that the addition of creatine supplementation (Cr) to RT augments gains in muscle strength and muscle mass, compared to RT alone. However, some evidence indicates that sex differences may alter the effectiveness of Cr. Therefore, we systematically reviewed randomized controlled trials (RCTs) investigating the efficacy of Cr + RT on measures of upper- and lower-body strength and muscle mass in older females. A systematic literature search was performed in nine electronic databases. Ten RCTs (N = 211 participants) were included the review. Overall, Cr significantly increased measures of upper-body strength (7 studies, n = 142, p = 0.04), with no effect on lower-body strength or measures of muscle mass. Sub-analyses revealed that both upper-body (4 studies, n = 97, p = 0.05) and lower-body strength (4 studies, n = 100, p = 0.03) were increased by Cr, compared to placebo in studies ≥ 24 weeks in duration. In conclusion, older females supplementing with Cr experience significant gains in muscle strength, especially when RT lasts for at least 24 weeks in duration. However, given the level of evidence, future high-quality studies are needed to confirm these findings.
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Prognostic value of skeletal muscle mass during tyrosine kinase inhibitor (TKI) therapy in cancer patients: a systematic review and meta-analysis.
Rinninella, E, Cintoni, M, Raoul, P, Ponziani, FR, Pompili, M, Pozzo, C, Strippoli, A, Bria, E, Tortora, G, Gasbarrini, A, et al
Internal and emergency medicine. 2021;(5):1341-1356
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Abstract
Low muscle mass has been associated with worse clinical outcomes in various cancers. This work investigated whether, during tyrosine kinases inhibitors (TKIs) therapy, low muscle mass was associated with treatment toxicity and survival outcomes. A systematic literature search was performed in Pubmed, Web of Science, and Scopus databases from inception to June 2020, based on fixed inclusion and exclusion criteria. Effect sizes were estimated with hazard ratios (HR) and odds ratios (OR) with 95% confidence interval (CI) and heterogeneity was assessed by measuring inconsistency (I2) based on the Chi squared test. A total of 24 retrospective studies were identified, enrolling patients treated with sorafenib (n = 12), sunitinib (n = 6), lenvatinib (n = 3), regorafenib (n = 2), gefitinib (n = 1), imatinib (n = 1), and pazopanib (n = 1). Thirteen studies were deemed eligible for pooled analyses. Meta-analyses found a significant effect of low muscle mass on dose-limiting toxicity (DLT) (OR 2.40, 95% CI 1.26-4.58, p = 0.008, I2 = 51%) in patients treated with TKI therapy. A subgroup analysis by treatment showed an association between DLT and low muscle during sorafenib or sunitinib, although not significant. A significant association between low skeletal muscle index and poorer overall survival was observed in HCC patients treated with sorafenib (HR 1.45, 95% CI 1.07-1.96, p = 0.02). For other TKIs, although some results showed an association between low muscle mass and worse outcomes, the number of studies for each TKI therapy was too small to reach conclusions. Skeletal muscle mass could influence the prognosis of some TKI-treated patients. This effect is demonstrated in sorafenib-treated HCC patients but remains almost unexplored in other cancer patients undergoing TKI therapy. Further prospective studies with large sample size and sufficient follow-up are needed to clarify the role of muscle mass in the metabolism of TKI-based cancer treatment, and its association with toxicity and survival.
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Coingestion of Carbohydrate and Protein on Muscle Glycogen Synthesis after Exercise: A Meta-analysis.
Margolis, LM, Allen, JT, Hatch-McChesney, A, Pasiakos, SM
Medicine and science in sports and exercise. 2021;(2):384-393
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Abstract
INTRODUCTION/PURPOSE Evidence suggests that carbohydrate and protein (CHO-PRO) ingestion after exercise enhances muscle glycogen repletion to a greater extent than carbohydrate (CHO) alone. However, there is no consensus at this point, and results across studies are mixed, which may be attributable to differences in energy content and carbohydrate intake relative to body mass consumed after exercise. The purpose of this study was determine the overall effects of CHO-PRO and the independent effects of energy and relative carbohydrate content of CHO-PRO supplementation on postexercise muscle glycogen synthesis compared with CHO alone. METHODS Meta-analysis was conducted on crossover studies assessing the influence of CHO-PRO compared with CHO alone on postexercise muscle glycogen synthesis. Studies were identified in a systematic review from PubMed and Cochrane Library databases. Data are presented as effect size (95% confidence interval [CI]) using Hedges' g. Subgroup analyses were conducted to evaluate effects of isocaloric and nonisocaloric energy content and dichotomized by median relative carbohydrate (high, ≥0.8 g·kg-1⋅h-1; low, <0.8 g·kg-1⋅h-1) content on glycogen synthesis. RESULTS Twenty studies were included in the analysis. CHO-PRO had no overall effect on glycogen synthesis (0.13, 95% CI = -0.04 to 0.29) compared with CHO. Subgroup analysis found that CHO-PRO had a positive effect (0.26, 95% CI = 0.04-0.49) on glycogen synthesis when the combined intervention provided more energy than CHO. Glycogen synthesis was not significant (-0.05, 95% CI = -0.23 to 0.13) in CHO-PRO compared with CON when matched for energy content. There was no statistical difference of CHO-PRO on glycogen synthesis in high (0.07, 95% CI = -0.11 to 0.22) or low (0.21, 95% CI = -0.08 to 0.50) carbohydrate content compared with CHO. CONCLUSION Glycogen synthesis rates are enhanced when CHO-PRO are coingested after exercise compared with CHO only when the added energy of protein is consumed in addition to, not in place of, carbohydrate.
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Effects of Vitamin D in Post-Exercise Muscle Recovery. A Systematic Review and Meta-Analysis.
Bello, HJ, Caballero-García, A, Pérez-Valdecantos, D, Roche, E, Noriega, DC, Córdova-Martínez, A
Nutrients. 2021;(11)
Abstract
Vitamin D is a key micronutrient modulating function and health in skeletal muscle. Therefore, we sought to systematically review the role of vitamin D in muscle recovery. A search in different databases (PubMed/MEDLINE, WOS, Google Scholar, and Scopus) was carried out following PRISMA® and PICOS. The search period was from inception to April 2020. Changes in post-exercise muscle damage were quantified comparing experimental group vs. placebo in each study by using number of participants, standardized mean difference (SMD), and standard error of the SMD. Hedges's g was used to calculate the SMDs for each study group and biased by the inverse of variance that allows calculating an overall effect and the 95% confidence interval (CI). The net vitamin D supplementation effect was calculated by subtracting the placebo SMD from SMD of the experimental group. The DerSimonian and Laird method was used as a random effect model, taking into account that the effect of vitamin D on muscular damage may vary according to the dose administered and additional moderators. Six studies were selected. In conclusion, regarding circulating levels of muscle biomarkers and additional limitations of the studies, it cannot be concluded that vitamin D supplementation exerts an effect in post-exercise muscle recovery. Likely, the anti-inflammatory action of vitamin D is quicker than the recovery of tissue structure and function. This aspect is pending verification in future research.
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What influence does resistance exercise order have on muscular strength gains and muscle hypertrophy? A systematic review and meta-analysis.
Nunes, JP, Grgic, J, Cunha, PM, Ribeiro, AS, Schoenfeld, BJ, de Salles, BF, Cyrino, ES
European journal of sport science. 2021;(2):149-157
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The objectives of this paper were to: (a) systematically review studies that explored the effects of exercise order (EO) on muscular strength and/or hypertrophy; (b) pool their results using a meta-analysis; and (c) provide recommendations for the prescription of EO in resistance training (RT) programmes. A literature search was performed in four databases. Studies were included if they explored the effects of EO on dynamic muscular strength and/or muscle hypertrophy. The meta-analysis was performed using a random-effects model with Hedges' g effect size (ES). The methodological quality of studies was appraised using the TESTEX checklist. Eleven good-to-excellent methodological quality studies were included in the review. When all strength tests, that is, both in multi-joint (MJ) and single-joint (SJ) exercises were considered, there was no difference between the EOs (ES = -0.11; p = 0.306). However, there was a difference between the MJ-to-SJ and SJ-to-MJ orders for strength gains in the MJ exercises, favouring starting the exercise session with MJ exercises (ES = 0.32; p = 0.034), and the strength gains in the SJ exercises, favouring starting the exercise session with SJ exercises (ES = -0.58; p = 0.032). No significant effect of EO was observed for hypertrophy combining site-specific and indirect measures (ES = 0.03; p = 0.862). In conclusion, increases in muscular strength are the largest in the exercises performed at the beginning of an exercise session. For muscle hypertrophy, our meta-analysis indicated that both MJ-to-SJ and SJ-to-MJ EOs may produce similar results.
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Fruit supplementation reduces indices of exercise-induced muscle damage: a systematic review and meta-analysis.
Doma, K, Gahreman, D, Connor, J
European journal of sport science. 2021;(4):562-579
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This systematic review and meta-analysis examined the effects of fruit supplements on indices of muscle damage and physical performance measures following muscle-damaging exercise protocols. The PEDro scale and Cochrane's risk of bias tool was used to critically appraise each study, whilst forest plots were generated to report on standardised mean differences (SMD) and p-values. The studies employed a crossover-randomised design, or a randomised controlled placebo design, with measures compared between the supplement (SUPP) and placebo (PLA) conditions at 24 and 48 h following the muscle-damaging exercise protocols. Compared to the PLA condition, the SUPP condition exhibited significantly lower levels of indirect muscle damage markers (p = 0.02; I2 = 44%), inflammatory markers (p = 0.03; I2 = 45%) and oxidative stress (p < 0.001; I2 = 58%), whilst antioxidant capacity was significantly increased (p = 0.04; I2 = 82%) at 24 h post-exercise. The maximal isometric voluntary contraction was significantly greater for the SUPP condition than the PLA at 24 h (p < 0.001; I2 = 81%) and 48 h (p < 0.001; 84%) post-exercise. Only a few studies reported on functional outcome measures (i.e. countermovement jump, cycling, sprint and running maximal oxygen uptake), and the findings appeared conflicting according to qualitative analyses. Fruit supplementation minimised the level of several biomarkers of muscle damage, inflammation and oxidative stress, whilst improved muscular contractility during periods of EIMD. These findings demonstrate that fruit supplements could be used as recovery strategies from strenuous exercise sessions.
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The effect of leaf extract supplementation on exercise-induced muscle damage and muscular performance: A systematic review and meta-analysis.
Doma, K, Gahreman, D, Ramachandran, AK, Singh, U, Connor, J
Journal of sports sciences. 2021;(17):1952-1968
Abstract
This systematic review and meta-analysis investigated the effects of leaf-plant extracts typically used for tea beverages on the level of exercise-induced muscle damage. The meta-analysis was conducted by comparing measures between the leaf-extract supplements (SUPP) and placebo (PLA) conditions at 24 h and 48 h following the muscle-damaging protocols from 19 studies with 416 participants. The results showed that the SUPP condition exhibited significantly lower indirect muscle damage markers than the PLA condition at 24- and 48-h post-exercise (p < 0.05). Furthermore, oxidative stress markers were significantly lower for the SUPP condition than the PLA condition at 24-h post-exercise (p < 0.05), although not at 48-h post-exercise (p > 0.05). In addition, no differences were found for anti-oxidant status at 24- and 48-h post-exercise (p > 0.05) between conditions. Muscle performance measures significantly increased for the SUPP condition than the PLA condition at 24-h post-exercise (p < 0.05), but not at 48-h post-exercise (p > 0.05). These results demonstrate that leaf plant extracts reduces the level of various biomarkers indicative of exercise-induced stress, although its effect on anti-oxidant status remains equivocal. Nonetheless, leaf-plant extracts typically ingested as a tea beverage may be an effective recovery strategy following strenuous exercises.
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Nutritional interventions to improve muscle mass, muscle strength, and physical performance in older people: an umbrella review of systematic reviews and meta-analyses.
Gielen, E, Beckwée, D, Delaere, A, De Breucker, S, Vandewoude, M, Bautmans, I, ,
Nutrition reviews. 2021;(2):121-147
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CONTEXT Sarcopenia is a progressive and generalized skeletal muscle disorder associated with an increased risk of adverse outcomes such as falls, disability, and death. The Belgian Society of Gerontology and Geriatrics has developed evidence-based guidelines for the prevention and treatment of sarcopenia. This umbrella review presents the results of the Working Group on Nutritional Interventions. OBJECTIVE The aim of this umbrella review was to provide an evidence-based overview of nutritional interventions targeting sarcopenia or at least 1 of the 3 sarcopenia criteria (ie, muscle mass, muscle strength, or physical performance) in persons aged ≥ 65 years. DATA SOURCES Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the PubMed and Web of Science databases were searched for systematic reviews and meta-analyses reporting the effect of nutritional supplementation on sarcopenia or muscle mass, strength, or physical performance. DATA EXTRACTION Two authors extracted data on the key characteristics of the reviews, including participants, treatment, and outcomes. Methodological quality of the reviews was assessed using the product A Measurement Tool to Assess Systematic Reviews. Three authors synthesized the extracted data and generated recommendations on the basis of an overall synthesis of the effects of each intervention. Quality of evidence was rated with the Grading of Recommendations Assessment, Development and Evaluation approach. DATA ANALYSIS A total of 15 systematic reviews were included. The following supplements were examined: proteins, essential amino acids, leucine, β-hydroxy-β-methylbutyrate, creatine, and multinutrient supplementation (with or without physical exercise). Because of both the low amount and the low to moderate quality of the reviews, the level of evidence supporting most recommendations was low to moderate. CONCLUSIONS Best evidence is available to recommend leucine, because it has a significant effect on muscle mass in elderly people with sarcopenia. Protein supplementation on top of resistance training is recommended to increase muscle mass and strength, in particular for obese persons and for ≥ 24 weeks. Effects on sarcopenia as a construct were not reported in the included reviews.
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Does Branched-Chain Amino Acids (BCAAs) Supplementation Attenuate Muscle Damage Markers and Soreness after Resistance Exercise in Trained Males? A Meta-Analysis of Randomized Controlled Trials.
Khemtong, C, Kuo, CH, Chen, CY, Jaime, SJ, Condello, G
Nutrients. 2021;(6)
Abstract
Previous studies have reported the positive effects of branched-chain amino acids (BCAAs) supplementation on lowering plasma markers of muscle damage and subjective soreness after resistance exercise. However, a variety of factors can potentially moderate its efficacy. This meta-analysis aimed to summarize the evidence regarding the effect of BCAAs supplementation on plasma muscle damage markers and soreness after resistance exercise in only trained males, by considering the plasma lactate dehydrogenase (LDH) and creatine kinase (CK). Randomized controlled trials were identified through a computerized literature search for the period 2010-2020. The pooled data were analyzed with the random-effects model and heterogeneity using I2. Cochrane Collaboration tools was used for the assessment of risk of bias. Nine studies met the inclusion criteria. A positive effect was found for CK at <24, 24, and 48 h after exercise and for muscle soreness at <24 h only. However, the positive effect was not evident for plasma LDH at any follow-up time. Different outcomes for post-exercise responses may suggest that BCAAs supplementation can attenuate muscle damage and ameliorate muscle soreness after resistance exercise in trained males.