The Impact of Dietary Protein or Amino Acid Supplementation on Muscle Mass and Strength in Elderly People: Individual Participant Data and Meta-Analysis of RCT's.

OBJECTIVES: Increasing protein or amino acid intake has been promoted as a promising strategy to increase muscle mass and strength in elderly people, however, long-term intervention studies show inconsistent findings. Therefore, we aim to determine the impact of protein or amino acid supplementation compared to placebo on muscle mass and strength in older adults by combining the results from published trials in a meta-analysis and pooled individual participant data analysis. DESIGN: We searched Medline and Cochrane databases and performed a meta-analysis on eight available trials on the effect of protein or amino acid supplementation on muscle mass and strength in older adults. Furthermore, we pooled individual data of six of these randomized double-blind placebo-controlled trials. The main outcomes were change in lean body mass and change in muscle strength for both the meta-analysis and the pooled analysis. RESULTS: The meta-analysis of eight studies (n=557) showed no significant positive effects of protein or amino acid supplementation on lean body mass (mean difference: 0.014 kg: 95% CI -0.152; 0.18), leg press strength (mean difference: 2.26 kg: 95% CI -0.56; 5.08), leg extension strength (mean difference: 0.75 kg: 95% CI: -1.96, 3.47) or handgrip strength (mean difference: -0.002 kg: 95% CI -0.182; 0.179). Likewise, the pooled analysis showed no significant difference between protein and placebo treatment on lean body mass (n=412: p=0.78), leg press strength (n=121: p=0.50), leg extension strength (n=121: p=0.16) and handgrip strength (n=318: p=0.37). CONCLUSIONS: There is currently no evidence to suggest that protein or amino acid supplementation without concomitant nutritional or exercise interventions increases muscle mass or strength in predominantly healthy elderly people.

The impact of repetition mechanics on the adaptations resulting from strength-, hypertrophy- and cluster-type resistance training.

PURPOSE: The purpose of this study was to examine the acute and chronic training responses to strength-, hypertrophy- and cluster-type resistance training. METHODS: Thirty-four trained males were assigned to a strength [STR: 4 × 6 repetitions, 85 % of one repetition maximum, (1RM), 900 s total rest], hypertrophy (HYP: 5 × 10 repetitions, 70 % 1RM, 360 s total rest), cluster 1 (CL-1: 4 × 6/1 repetitions, 85 % 1RM, 1400 s total rest), and cluster 2 (CL-2: 4 × 6/1 repetitions, 90 % 1RM, 1400 s total rest) regimens which were performed twice weekly for a 6-week period. Measurements were taken before, during and following the four workouts to investigate the acute training stimulus, whilst similar measurements were employed to examine the training effects before and after the intervention. RESULTS: The improvements in 1RM strength were significantly greater for the STR (12.09 ± 2.75 %; p < 0.05, d = 1.106) and CL-2 (13.20 ± 2.18 %; p < 0.001, d = 0.816) regimens than the HYP regimen (8.13 ± 2.54 %, d = 0.453). In terms of the acute responses, the STR and CL-2 workouts resulted in greater time under tension (TUT) and impulse generation in individual repetitions than the HYP workout (p < 0.05). Furthermore, the STR (+3.65 ± 2.54 mmol/L(-1)) and HYP (+6.02 ± 2.97 mmol/L(-1)) workouts resulted in significantly greater elevations in blood lactate concentration (p < 0.001) than the CL-1 and CL-2 workouts. CONCLUSION: CL regimens produced similar strength improvements to STR regimens even when volume load was elevated (CL-2). The effectiveness of the STR and CL-2 regimens underlines the importance of high loads and impulse generation for strength development.

Double-blind, placebo-controlled pilot trial of L-Leucine-enriched amino-acid mixtures on body composition and physical performance in men and women aged 65-75 years.

BACKGROUND/OBJECTIVES: Adequate protein intake is essential to retaining muscle and maintaining physical function, especially in the elderly, and L-Leucine has received attention as an essential amino acid (EAA) that enhances protein retention. The study's aim was to compare the efficacy of EAA mixtures on lean tissue mass (LTM) and functional performance (FP) in a healthy elderly population. SUBJECTS/METHODS: Thirty-six subjects (65-75 years) volunteered to receive capsules with EAAs (Groups A and B containing 20% and 40% L-Leucine, respectively) or placebo (lactose containing 0% L-Leucine, Group C) for 12 weeks. The daily amount ranged from 11 to 21 g (0.21 g/ kg/day) and was taken in two equal dosages alongside food, morning and evening. Main outcomes measured before and after intervention were LTM and FP (30-s arm-curl test; 30-s chair-stand test (30-CST); 6-min walk test (6-WT); and handgrip strength). Secondary outcomes included dietary intakes and physical activity. RESULTS: Twenty-five subjects (11 male and 14 female) completed the study (Group A, n=8; Group B, n=8; Group C, n=9). Gains associated with medium effect sizes were noted in LTM (Group B, 1.1 ±1.1%, P=0.003) and FP (Group A in 30-CST (11.0±11.5%, P=0.02) and 6-WT (8.8±10.0%, P=0.02); Group B in 6-WT (5.8±6.6%, P=0.03) and a trend in 30-CST (13.2±16.0, P=0.06)). Significant differences between groups were not observed in secondary outcomes. CONCLUSIONS: Twice-daily supplementation of EAAs containing 20% or 40% L-Leucine improved aspects of functional status and at the higher level improved LTM. Further work to establish change in a larger sample and palatable supplemental format is now required.