1.
Elastic-band resistance exercise or vibration treatment in combination with hydroxymethylbutyrate (HMB) supplement for management of sarcopenia in older people: a study protocol for a single-blinded randomised controlled trial in Hong Kong.
Chow, SK, Chim, YN, Cheng, KY, Ho, CY, Ho, WT, Cheng, KC, Wong, RM, Cheung, WH
BMJ open. 2020;(6):e034921
Abstract
INTRODUCTION Sarcopenia is a geriatric syndrome characterised by progressive loss of skeletal muscle mass and function with risks of adverse outcomes and becomes more prevalent due to ageing population. Elastic-band exercise, vibration treatment and hydroxymethylbutyrate (HMB) supplementation were previously proven to have positive effects on the control of sarcopenia. The purpose of this study is to evaluate the effectiveness of elastic-band exercise or vibration treatment with HMB supplementation in managing sarcopenia. Our findings will provide a safe and efficient strategy to mitigate the progression of sarcopenia in older people and contribute to higher quality of life as well as improved long-term health outcomes of elderly people. METHODS AND ANALYSIS In this single-blinded, randomised controlled trial (RCT), subjects will be screened for sarcopenia based on the Asian Working Group for Sarcopenia (AWGS) definition and 144 sarcopenic subjects aged 65 or above will be recruited. This RCT will have three groups evaluated at two time points to measure changes over 3 months-the control and the groups with combined HMB supplement and elastic-band resistance exercise or vibration treatment. Changes in muscle strength in lower extremity will be the primary outcome. Muscle strength in the upper extremity, gait speed, muscle mass (based on AWGS definition), functional performance in terms of balancing ability and time-up-and-go test and quality of life will be taken as secondary outcomes. In addition, each participant's daily activity will be monitored by a wrist-worn activity tracker. Repeated-measures analysis of variance will be performed to compare within-subject changes between control and treatment groups at two time points of pretreatments and post-treatments. ETHICS AND DISSEMINATION The procedures have been approved by the Joint CUHK-NTEC Clinical Research Management Office (Ref. CREC 2018.602) and conformed to the Declaration of Helsinki. Results will be disseminated through peer-reviewed publications, conferences and workshops. TRIAL REGISTRATION NUMBER NCT04028206.
2.
Effect of whey protein supplementation after resistance exercise on the muscle mass and physical function of healthy older women: A randomized controlled trial.
Mori, H, Tokuda, Y
Geriatrics & gerontology international. 2018;(9):1398-1404
Abstract
AIM: To evaluate the effectiveness of a 24-week program of nutritional supplementation using whey protein, ingested after resistance exercise, in increasing muscle mass and physical function among community-dwelling healthy older Japanese women. METHODS We carried out a randomized controlled trial, with 81 healthy women, aged 65-80 years, allocated to three groups of 27 participants each: the exercise and protein supplementation group, the exercise only group, and the protein supplementation only group. A 24-week program of resistance exercise, carried out twice per week, was combined with whey protein supplementation, containing 22.3 g of protein. The total protein intake for participants in all three experimental groups was adjusted to a level of at least 1.2 g/kg bodyweight/day, and more during the intervention period. Between-group differences in the pre- to post-intervention change in skeletal muscle mass and physical function were evaluated using an analysis of variance. RESULTS The pre- to post-intervention increase in the skeletal muscle mass index was significantly higher for the exercise only group than for the protein supplementation only group (P =0.008), and significantly higher for the exercise and protein supplementation group than for either the exercise only (P =0.007) or protein supplementation only (P <0.001) groups. Similarly, the increase in grip strength and gait speed was significantly greater for the exercise and protein supplementation group than for the protein supplementation only group (grip strength P =0.014, gait speed P =0.026). CONCLUSIONS Whey protein supplementation, ingested after resistance exercise, could be effective for the prevention of sarcopenia among healthy community-dwelling older Japanese women. Geriatr Gerontol Int 2018; 18: 1398-1404.
3.
Sarcopenic obesity: A probable risk factor for dose limiting toxicity during neo-adjuvant chemotherapy in oesophageal cancer patients.
Anandavadivelan, P, Brismar, TB, Nilsson, M, Johar, AM, Martin, L
Clinical nutrition (Edinburgh, Scotland). 2016;(3):724-30
Abstract
BACKGROUND & AIMS Profound weight loss and malnutrition subsequent to severe dysphagia and cancer cachexia are cardinal symptoms in oesophageal cancer (OC). Low muscle mass/sarcopenia has been linked to toxicity during neo-adjuvant therapy in other cancers, with worser effects in sarcopenic obesity. In this study the association between sarcopenia and/or sarcopenic obesity and dose limiting toxicity (DLT) during cycle one chemotherapy in resectable OC patients was evaluated. METHODS Body composition was assessed from computed tomography scans of 72 consecutively diagnosed OC patients. Lean body mass and body fat mass were estimated. Patients were grouped as sarcopenic or non-sarcopenic based on pre-defined gender-specific cut-offs for sarcopenia, and as underweight/normal (BMI < 25) or overweight/obese (BMI ≥ 25). Sarcopenic obesity was defined as sarcopenia combined with overweight and obesity. DLT was defined as temporary reduction/delay or permanent discontinuation of drugs due to adverse effects. Odds ratios for developing toxicity were ascertained using multiple logistic regression. RESULTS Of 72 patients, 85% (n = 61) were males. Sarcopenia and sarcopenic obesity were present in 31 (43%) and 10 (14%), respectively, prior to chemotherapy. Sarcopenic patients had significantly lower adipose tissue index (p = 0.02) compared to non-sarcopenic patients. Patients with DLT (n = 24) had lower skeletal muscle mass (p = 0.04) than those without DLT. Sarcopenic patients (OR = 2.47; 95% CI: 0.88-6.93) showed a trend towards increased DLT risk (p < 0.10). Logistic regression with BMI as an interaction term indicated higher DLT risk in sarcopenic patients with normal BMI (OR = 1.60; 95% CI 0.30-8.40), but was non-significant. In the sarcopenic obese, risk of DLT increased significantly (OR = 5.54; 95% CI 1.12-27.44). CONCLUSIONS Sarcopenic and sarcopenic obese OC patients may be at a higher risk for developing DLT during chemotherapy compared to non-sarcopenic OC patients.