Comparative Efficacy of Different Protein Supplements on Muscle Mass, Strength, and Physical Indices of Sarcopenia among Community-Dwelling, Hospitalized or Institutionalized Older Adults Undergoing Resistance Training: A Network Meta-Analysis of Randomized Controlled Trials.

2024-03-25
Nutrients 16(7)
- Chun-De Liao
- Shih-Wei Huang
- Hung-Chou Chen
- Mao-Hua Huang
- Tsan-Hon Liou
- Che-Li Lin

PubMed: 38612975
DOI: 10.3390/nu16070941

Study Design

Type: Systematic Review
Sample size: n = 5,272
Population: middle-aged and older individuals undergoing RT, untrained community-dwelling adults, hospitalized, or institutionalized residents who suffered acute or chronic health conditions
Methods: Network meta-analysis (NMA) of RCTs examining the efficacy of protein supplement plus RT

Rigorous Journal

Aging-related sarcopenia exerts harmful impacts on muscle mass, strength, and physical mobility. Protein supplementation has been demonstrated to augment efficacy of resistance training (RT) in elderly. This study compared the relative effects of different protein supplements on muscle mass, strength, and mobility outcomes in middle-aged and older individuals undergoing RT. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) examining the efficacy of protein supplement plus RT in untrained community-dwelling adults, hospitalized, or institutionalized residents who suffered acute or chronic health conditions. Network meta-analysis (NMA) was performed using a frequentist method for all analyses. Treatment effects for main outcomes were expressed as standard mean difference (SMD) with 95% confidence interval (CI). We used the surface-under-the cumulative-ranking (SUCRA) scores to rank probabilities of effect estimation among all identified treatments. Meta-regression analyses were performed to identify any relevant moderator of the treatment efficacy and results were expressed as β with 95% credible interval (CrI). We finally included 78 RCTs (5272 participants) for analyses. Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on muscle mass (SMD = 1.29, 95% CI: 0.96, 1.62; SUCRA = 0.86), handgrip strength (SMD = 1.46, 95% CI: 0.92, 2.00; SUCRA = 0.85), and walking speed (SMD = 0.73, 95% CI: 0.39, 1.07; SUCRA = 0.84). Participant's health condition, sex, and supplementation dose were significant factors moderating the treatment efficacy on muscle mass (β = 0.74; 95% CrI: 0.22, 1.25), handgrip strength (β = -1.72; 95% CrI: -2.68, -0.77), and leg strength (β = 0.76; 95% CrI: 0.06, 1.47), respectively. Our findings suggest whey protein yields the optimal supplements to counter sarcopenia in older individuals undergoing RT.

Research Insights

Casein Protein→Improved Handgrip Strength
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on ... handgrip strength
Effect
Beneficial
Effect size
Moderate
Casein Protein→Improved Leg Strength
Participant's health condition, sex, and supplementation dose were significant factors moderating the treatment efficacy on ... leg strength (β = 0.76; 95% CrI: 0.06, 1.47)
Effect
Beneficial
Effect size
Moderate
Casein Protein→Improved Physical Mobility
This study compared the relative effects of different protein supplements on muscle mass, strength, and mobility outcomes in middle-aged and older individuals undergoing RT.
Effect
Beneficial
Effect size
Moderate
Casein Protein→Improved Walking Speed
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on ... walking speed
Effect
Beneficial
Effect size
Moderate
Casein Protein→Increased Handgrip Strength
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Casein Protein→Increased Muscle Mass
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Casein Protein→Increased Walking Speed
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Milk Protein→Improved Handgrip Strength
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on ... handgrip strength
Effect
Beneficial
Effect size
Moderate
Milk Protein→Improved Leg Strength
Participant's health condition, sex, and supplementation dose were significant factors moderating the treatment efficacy on ... leg strength (β = 0.76; 95% CrI: 0.06, 1.47)
Effect
Beneficial
Effect size
Moderate
Milk Protein→Improved Physical Mobility
This study compared the relative effects of different protein supplements on muscle mass, strength, and mobility outcomes in middle-aged and older individuals undergoing RT.
Effect
Beneficial
Effect size
Moderate
Milk Protein→Improved Walking Speed
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on ... walking speed
Effect
Beneficial
Effect size
Moderate
Milk Protein→Increased Handgrip Strength
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Milk Protein→Increased Muscle Mass
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Milk Protein→Increased Walking Speed
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Peanut Protein→Improved Handgrip Strength
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on ... handgrip strength
Effect
Beneficial
Effect size
Moderate
Peanut Protein→Improved Leg Strength
Participant's health condition, sex, and supplementation dose were significant factors moderating the treatment efficacy on ... leg strength (β = 0.76; 95% CrI: 0.06, 1.47)
Effect
Beneficial
Effect size
Moderate
Peanut Protein→Improved Physical Mobility
This study compared the relative effects of different protein supplements on muscle mass, strength, and mobility outcomes in middle-aged and older individuals undergoing RT.
Effect
Beneficial
Effect size
Moderate
Peanut Protein→Improved Walking Speed
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on ... walking speed
Effect
Beneficial
Effect size
Moderate
Peanut Protein→Increased Handgrip Strength
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Peanut Protein→Increased Muscle Mass
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Peanut Protein→Increased Walking Speed
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Soy Protein→Improved Handgrip Strength
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on ... handgrip strength
Effect
Beneficial
Effect size
Moderate
Soy Protein→Improved Leg Strength
Participant's health condition, sex, and supplementation dose were significant factors moderating the treatment efficacy on ... leg strength (β = 0.76; 95% CrI: 0.06, 1.47)
Effect
Beneficial
Effect size
Moderate
Soy Protein→Improved Physical Mobility
This study compared the relative effects of different protein supplements on muscle mass, strength, and mobility outcomes in middle-aged and older individuals undergoing RT.
Effect
Beneficial
Effect size
Moderate
Soy Protein→Improved Walking Speed
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on ... walking speed
Effect
Beneficial
Effect size
Moderate
Soy Protein→Increased Handgrip Strength
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Soy Protein→Increased Muscle Mass
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Soy Protein→Increased Walking Speed
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Whey Protein→Improved Handgrip Strength
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on ... handgrip strength
Effect
Beneficial
Effect size
Moderate
Whey Protein→Improved Leg Strength
Participant's health condition, sex, and supplementation dose were significant factors moderating the treatment efficacy on ... leg strength (β = 0.76; 95% CrI: 0.06, 1.47)
Effect
Beneficial
Effect size
Moderate
Whey Protein→Improved Physical Mobility
This study compared the relative effects of different protein supplements on muscle mass, strength, and mobility outcomes in middle-aged and older individuals undergoing RT.
Effect
Beneficial
Effect size
Moderate
Whey Protein→Improved Walking Speed
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut, whey supplement yielded the most effective treatments augmenting efficacy of RT on ... walking speed
Effect
Beneficial
Effect size
Moderate
Whey Protein→Increased Handgrip Strength
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Whey Protein→Increased Muscle Mass
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small
Whey Protein→Increased Walking Speed
Among the six protein sources identified in this NMA, namely whey, milk, casein, meat, soy, and peanut... whey supplement yielded the most effective treatments
Effect
Neutral
Effect size
Small