Table 1.
Summary of included study characteristics
| First author (year), study location | Sample characteristics: n, mean age ± SD, sex (female ratio) | Intervention group | Control groupa | Follow-up period (weeks)b | Body composition assessment method | Muscle strength assessment method | Physical performance assessment method | |
|---|---|---|---|---|---|---|---|---|
| Exercise | Nutrition | |||||||
| Aguiar (2013) [28], Brazil |
Ic: 9, 64 ± 4, female Cd: 9, 65 ± 6, female |
Resistance training using machines, 60 min sessions, 3 times a week, for 24 weeks | 5 g Creatine monohydrate, once a day, for 12 weeks | Placebo: maltodextrin | 24 |
Body mass Fat free mass Muscle mass |
Bench press Biceps curl Knee extension |
Chair stand |
| Aoki (2018) [29], Japan |
I: 43, 68.8 ± 5.3, mixed (74.4%) C: 45, 71.2 ± 6.8, mixed (75.6%) |
Lower body resistance training, daily | 25mcg vitamin D3 (1000 IUe), divided into 3 times, daily | Usual diet | 24 |
BMIf Lower limb muscle mass |
Hip flexion Knee extension |
Chair stand Single leg stance Two step test Functional reach test |
| Arnarson (2013) [30], Iceland |
I: 83, 73.3 ± 6, mixed (unknown) C: 78, 74.6 ± 5.8, mixed (unknown) |
Resistance training using machines, 3 times a week | 20 g of whey protein 3 times a week | Placebo: 250 ml isocaloric carbohydrate drink | 12 |
ASMMg Lean body mass |
Grip strength Knee extension |
TUGh 6-min walk |
| Bermon (1998) [31], France |
I: 8, 71.0 ± 5.4, mixed (50%) C: 8, 69.3 ± 1.1, mixed (50%) |
Resistance training using machines, 3 times a week, for 7 weeks |
First 5 days: 5 g creatine monohydrate and 2 g glucose, 4 times a day Following 47 days: 3 g creatine monohydrate and 2 g glucose once a day |
Placebo: First 5 days:7 g glucose 4 times a day Following 47 days: 5 g glucose once a day |
8 |
Body mass BMI Lower limb muscle volume |
Leg press Chest press Knee extension |
– |
| Bjørnsen (2016) [32], Norway |
I: 17, 69 ± 7, male C: 17, 67 ± 5, male |
Free weight exercises, 3 times a week | 500 mg vitamin C and 117.5 mg vitamin E, twice a day | Placebo: cellulose and dicalsium phosphate | 12 |
Lean body mass Muscle thickness |
Biceps curl Knee extension Leg press |
– |
| Bobeuf (2011) [33], Canada |
I: 14, 64.3 ± 3.8, mixed (50%) C: 17, 67 ± 3.7, mixed (52.9%) |
Resistance training, 60 min sessions, 3 times a week | 1000 mg vitamin C ascorbate and vitamin E, once a day | Placebo: 100 mg lactose | 24 |
ASMM Muscle mass |
– | – |
| Brose (2003) [34], Canada |
I: 14, 69.6 ± 5.4, mixed (42.8%) C: 14, 69.1 ± 4.8, mixed (50%) |
Resistance training using machines, 3 times a week | 5 g creatine and 2 g dextrose, once a day |
Placebo: 7 g dextrose |
14 | Fat free mass |
Grip strength Knee extension Leg press |
– |
| Chrusch (2001) [35], Canada |
I:16, 70.4 ± 6.4, male C:14, 71.1 ± 6.7, male |
Resistance training using machines, 3 times a week | Creatine supplement: 0.3 g/kg/day for the first 5 days (loading phase) and 0.07 g/kg/day thereafter, once a day, for 11 weeks | Placebo: sucrose-flour mixture | 12 | Lean body mass |
Bench press Knee extension Leg press |
– |
| Cornish (2018) [36], Canada |
I:11, 71.4 ± 6.2, male C:12, 70.9 ± 5, male |
Resistance training, 60 min sessions, 3 times a week |
3.0 g omega-3 fatty acid combined 1.98 g EPAi and 0.99 g DHAj, once a day |
Placebo: 3.0 g omega 3–6-9 blend |
12 |
Body mass Lean body mass |
Chest press Leg press |
TUG 6-min walk |
| Da Boit (2017) [37], UK |
I: 27, 70.1 ± 4, mixed (48.1%) C: 23, 70.9 ± 4.2, mixed (43.4%) |
Lower body resistance training, twice a week | 3.0 g omega–3 fatty acids containing 2.1 g EPA and 0.6 g DHA, once a day |
Placebo: 3.0 g safflower oil |
18 | Muscle anatomic cross-sectional area | Knee extension |
Chair stand SPPBk 4 m walk |
| Edholom (2017) [38], Sweden |
I: 20, 67.2 ± 1.3, female C: 17, 67.9 ± 2.1, female |
Resistance training, 60 min sessions, twice a week |
Healthy diet: following a dietary consultation and a diet plan with the current dietary guidelines in Europe and US |
Usual diet | 24 | Lean body mass |
Knee extension Leg press |
Chair stand Single leg stance Squat jump TUG |
| Holwerda (2018) [39], Netherlands |
I: 21, 69 ± 4.6, male C: 20, 71 ± 4.5, male |
Resistance exercise training, 3 times a week |
21 g leucine-enriched whey protein (3 g total leucine), once a day | Placebo | 12 |
ASMM BMI Body mass Lean body mass |
Knee extension Leg press |
Chair stand SPPB 4 m walk |
| Kawada (2013) [40], Japan |
Ia: 10, 65 ± 1, mixed (50%) Ib: 11, 67 ± 3, mixed (72.3%) C: 8, 70 ± 1, mixed (50%) |
Low-intensity resistance training, twice a week |
Ia: 3.0 g essential amino acid supplements with milk, twice a day Ib: 6.0 g essential amino acid supplements with milk, twice a day |
Placebo: 3 g dextrin-contained powder with milk, once a day |
24 | Cross sectional area of Psoas major muscle | – |
Gait speed Obstacle course walk 6-min walk |
| Leenders (2013) [41], Netherlands |
I: 27,70.9 ± 5.4, mixed (44.4%) C: 26, 69.5 ± 3.6, mixed (46.2%) |
Resistance training, 3 times a week | 15 g milk protein, once a day |
Placebo: 7.13 g lactose and 0.42 g calcium only |
24 |
BMI Lean body mass Lower limb lean mass |
Grip strength Leg press |
Chair stand |
| Mori (2018) [42], Japan |
I: 25, 70.6 ± 4.2, female C: 25, 70.6 ± 4.2, female |
Resistance training, twice a week | 25 g leucine enriched whey protein, once a day | Usual diet | 24 |
BMI Lower limb lean mass SMIl Upper limb lean mass |
Grip strength Knee extension |
Gait speed |
| Nabuco (2018) [43], Brazil |
Ia: 23, 66.2 ± 9.4, female Ib: 24, 67.5 ± 5.2, female C: 23, 66.5 ± 7.2, female |
Resistance training, 3 times a week |
Ia: 27.1 g whey protein after resistance training, 3 times a week Ib: 27.1 g whey protein before resistance training, 3 times a week |
Placebo: maltodextrin drink |
12 |
Lower limb lean mass Skeletal muscle mass Upper limb lean mass |
Biceps curl Chest press Knee extension |
Chair stand Gait speed |
| Nagai (2019) [44], Japan |
I: 17, 72.7 ± 1.4, mixed (64.7%) C: 19, 73.5 ± 2.3, mixed (68.4%) |
Latex band training, squat, and tai chi, 90 min sessions, once a week | 60 mg maslinic acid, once a day |
Placebo: jelly without maslinic acid |
12 |
BMI Body mass Fat free mass Skeletal muscle mass Segmental muscle mass |
Grip strength |
Chair stand Gait speed |
| Nakayama (2020) [45], Japan |
I: 61, 71.4 ± 6.2, mixed (74%) C: 61, 70.4 ± 5.5, mixed (77%) |
Body weight exercises and 5 medicine ball exercises, daily |
Low-dose milk protein: 10.1 g protein, once a day |
Placebo: Isocaloric carbohydrate |
24 |
Body mass Lean body mass |
Grip strength Knee extension Knee flexion Push up |
Chair stand Gait speed TUG |
| Nilsson (2020) [46], Canada |
I: 16, 77.4 ± 11.2, male C: 16, 74.4 ± 5.2, male |
Home based resistance training with elastic bands, 3 times a week | Multi nutrients: 24 g whey protein, 16 g micellar casein contained 416 mg calcium, 3 g creatine, vitamin D 1000 IU, and omega-3 fish-oil containing 1.51 g EPA and 0.95 g DHA, once a day | Placebo: collagen and sunflower oil | 12 |
ASMM Body mass BMI Lean body mass |
Grip strength Knee extension Leg press |
Chair stand SPPB Stair climb TUG 4 m walk |
| Pinto (2016) [47], Brazil |
I: 13, 67.4 ± 4.7, mixed (unknown) C: 14, 67.1 ± 6.3, mixed (unknown) |
Resistance training, 3 times a week | 5 g Creatine monohydrate, once a day | Placebo: 5 g maltodextrin | 12 |
Body mass Lean body mass SMI |
Bench press Leg press |
– |
| Seino (2018) [48], Japan |
I: 40, 73.4 ± 4.3, mixed (85%) C: 40, 73.7 ± 4.3, mixed (82.5%) |
Weight-bearing exercise and exercises using a resistance band and Pilates ball, 60 min sessions, twice a week | Fortified milk containing 10.5 g total milk protein, 3.9 g fat, 9.3 g carbohydrate, and 337 mg calcium at lunch and micronutrient beverage at breakfast, daily | Usual diet | 12 |
Body mass Lean body mass Lower limb lean mass SMI |
Grip strength Knee extension |
Chair stand Gait speed One leg standing with eyes open TUG |
| Stout (2013) [49], USA |
I: 24, 73 ± 4.9, mixed (54.2%) C: 24, 73 ± 4.9, mixed (54.2%) |
Resistance exercise, 3 times a week for 21 weeks | 1.5 g calcium and 4 g carbohydrate, twice a day | Placebo: 200 mg calcium and 4 g carbohydrate | 24 |
Lean body mass Lower limb lean mass Upper limb lean mass |
Grip strength | Chair stand |
| Sugihara Junior (2018) [50], Brazil |
I: 15, 67.4 ± 4.1, female C: 16, 67.8 ± 4.1, female |
Resistance training using a combination of free weights and machines, 45 ~ 50 min sessions, 3 times a week | 35 g whey protein, immediately after each resistance training |
Placebo: 35 g maltodextrin |
12 |
Body mass BMI Lower limb lean mass SMI Upper limb lean mass |
Biceps curl Chest press Knee extension |
– |
| Tarnopolsky (2007) [51], Canada |
I: 21,70.7 ± 4.5, mixed (47.6%) C: 18, 71.1 ± 5.5, mixed (55.6%) |
Resistance exercise using machines, twice a week | 5 g creatine monohydrate and 6 g conjugated linoleic acid, once a day | Placebo: dextrose and safflower oil | 24 |
Body mass BMI Fat free mass |
Biceps curl Chest press Knee extension Leg press |
Chair stand Gait speed Stair climb Standing balance |
| Villanueva (2014) [52], USA |
I: 7, 68.7 ± 6.8, male C: 7, 68.7 ± 6.6, male |
Progressive overload, total body periodized resistance program, 3 times a week |
First 5 days: 0.1 g/kg body weight of creatine 3 times a day and 35 g whey protein once a day Following days: 0.07 g/kg body weight of creatine and 35 g whey protein, once a day |
Usual diet | 12 | Lean body mass |
Bench press Leg press |
Stair climb 400 m walk |
aThe resistance exercise of the control group applied in the same manner as in the experimental group
b The duration of intervention in most studies were the same as the follow-up period
c I, intervention group d C, control group e IU, international unit f BMI, body mass index g ASMM, appendicular skeletal muscle mass, h TUG, timed up and go i EPA, eicosapentaenoic acid j DHA, docosahexaenoic acid k SPPB, short physical performance battery l SMI, skeletal muscle mass index