Nutrition periodization for older adults -
After removing duplicate studies and two screening stages, 24 studies were identified for inclusion in the analysis. We present a detailed overview of the study selection procedure in Fig.
We placed no limitations on the number of sub-groups to which a study could be allocated, provided the criteria for inclusion were satisfied. We report details about the experimental design, sample size, population s , and baseline characteristics of the included studies in Table 1.
The mean ages of the study participants ranged from Twenty studies were randomized controlled, or crossover designs and 4 were quasi-experimental. Tables 2 , 3 , 4 , 5 detail each study's exercise protocols and relevant WL-related outcome measures.
Feasibility and tolerability information is provided if reported. Studies are grouped according to the four general categories of investigation present in the literature. Intervention lengths ranged from 8 weeks [ 14 ] to one year [ 11 ] at a frequency of either 2 or 3 training sessions per week in almost every case.
Low homogeneity in RT modality utilized across all studies was observed, with methods ranging from elastic tubing and bodyweight exercises [ 13 ] to maximum-intensity efforts on computerized resistance exercise machines. Numerous methods were used to monitor exercise intensity, including but not limited to: specified percentages of the one-repetition maximum 1RM , [ 15 ] ratings of perceived exertion, [ 16 ] number of repetitions completed before failure [ 8 ] and prescribed entirely in advance by the study protocol.
All studies except one [ 13 ] utilized selectorized resistance exercise machines, and common to all investigations was the recognition that WL alone is an inappropriate marker of RT effectiveness in this population and that RT interventions leading to reduced BM are only of value if researchers can demonstrate LBM was preserved in the process.
Accordingly, the gold standard for a RT protocol designed for healthy older adults is one that is oriented to changes in body composition , where FM decreases, LMM increases, and total BM might remain unchanged.
An investigation that appears to have most effectively reached this target is that of Gambassi et al. post: Similar to RT programming for healthy older adults discussed above, the guiding principle underlining the gold standard of RT programs designed for older women is not the attainment of BM losses as a sole end goal, but rather the achievement of reductions in FM while maintaining or increasing LBM [ 10 , 12 , 17 , 20 , 21 ].
The major distinction between the previous sub-group and the current population is the need to ensure, at minimum, the maintenance of LBM in structured exercise programs is elevated in older women compared to older men.
We evaluated 13 RT studies examining WL and body composition changes in older women Table 3. Heterogeneity concerning RT modality, intervention duration and frequency, body composition, feasibility, tolerance, and adherence mirrored those found in the total cohort.
One particular outcome of interest is the finding from Brochu et al. Their findings underscore the fundamental principle that diet and exercise must be considered in conjunction to create the most effective intervention for older women.
Older adults face both an elevated risk of developing sarcopenia as they age as well as developing obesity; a proportion of individuals will develop both conditions.
Rather than the overall health impact of sarcopenic obesity equaling the sum of the two contributing conditions combined, a synergistic negative effect can often occur, leading to an overall health impact greater than the individual sum of its parts.
As with the previous sub-groups, the objective of effective RT programming for obese and sarcopenic obese older adults is to maximize reductions in FM while maintaining or, if possible, increasing LBM. We present details of the 13 studies included in this sub-group analysis in Table 4.
Selectorized resistance exercise machines were the most common RT modality employed, and study durations lasted between 8 weeks [ 16 ] and 18 months. We reviewed eight studies involving RT in older adults and an element of dietary control or pharmaceutical application Table 5.
Two studies [ 16 , 28 ] investigated differences in body composition between individuals engaged in the Dietary Approaches to Stop Hypertension DASH diet and individuals engaged in the DASH diet plus RT.
Aguilar and colleagues [ 18 ] investigated the ergogenic effects of creatine phosphate supplementation on LBM responses to RT, while Kritchkevsky and Shea [ 34 ] evaluated the therapeutic impact of pioglitazone on FM losses when RT combined with a structured RT program.
Campbell et al. caloric restriction plus RT on measures of body composition. At the same time, Verrieijin and colleagues [ 31 ] evaluated the degree to which a high-protein diet can attenuate LBM losses in obese older adults participating in a structured RT program while following a hypocaloric diet.
The finding by Beavers et al. It demonstrates how all exercise-induced reductions in BM cannot be considered equal in terms of the overall benefit to health.
Results of the caloric restriction plus RT studies [ 10 , 15 , 29 ] also highlight the existence of a ceiling-effect concerning the ability of RT-alone to facilitate healthy bodyweight changes. The finding that creatine supplementation led to significantly greater increases in LBM compared to the placebo in older adults after a period of RT [ 18 ] has apparent implications for future study in this population, given their susceptibility to developing sarcopenia and, in general, slowing the reductions in muscle mass and strength known to occur with age.
Pioglitazone increased visceral fat loss, while the RT element of the study was credited with facilitating the attenuated reductions in skeletal muscle mass.
This scoping review characterized the existing literature on RT and weight loss and body composition changes in healthy older adults, healthy older women, older adults with obesity and sarcopenic obesity and the effect of various dietary and therapeutic approaches.
The purpose of this study was to provide a survey of existing literature on the topic, particularly regarding the degree of similarity in methodological approaches used and outcomes reported. Given the limited high-quality evidence we found showing that resistance training RT coupled with a healthy diet results in substantial fat loss and lean muscle gain, it may be too early to label our findings as an evidence-based strategy for weight loss through RT in older adults.
The main findings and recommendations are summarized below. The main takeaway message from this review is that the true value of RT as it relates to WL is not that it leads to more significant reductions in total BM than other exercise approaches such as AT or circuit resistance training, but rather that it is an adjunct modality leading to the right kind of weight loss, namely reductions in FM only.
As explained throughout this review, older adults are already facing a decline in their skeletal muscle mass and strength, which is critical for these individuals to maintain as they age.
The pursuit of body weight reductions via exercise should undoubtedly be recommended to obese and sarcopenic obese older adults. However, consideration of the form said exercise should take is of critical importance lest individuals inadvertently trade reduction in one age-related chronic disease obesity for the accelerated onset of another sarcopenia.
Bodyweight reductions through exercise are undoubtedly an essential objective for obese older adults. Higher exercise intensities and training volumes facilitate more significant improvements in LBM.
Lower-intensity modalities such as body weight, resistance bands and hand weights may not facilitate the same level of improvement in muscular size and strength but have the benefit of being inexpensive, portable and easy to use. Women are at greater risk for age-related reductions in muscle mass and strength than men [ 21 , 22 ], meaning there is added importance to ensuring exercise modalities that they engage in and are recommended to them take into consideration the need to maintain LBM.
Studies reviewed indicate the existence of multiple suitable approaches in this regard [ 3 , 8 ] and the task of exercise professionals is to translate this knowledge out of academic journals and into the broader population. The impact of RT on positive changes in body composition in older women seems greatest at higher intensities and when selectorized exercise machines are used.
Exploring ways to make members of this population group comfortable with the idea of regularly attending an exercise facility for their RT exercise, rather than doing it at home with low-complexity modalities such as body weight and elastic bands, may be worthwhile.
In time, recommendations may expand to include using ergogenic aids such as creatine and pioglitazone. A consequence of a detailed analysis of RT and the most effective implementations to effect positive body composition changes is that it can be easy to lose sight of the fact that exercise is only one-half of the equation necessary to achieve maximum results in this domain.
Multiple studies in this review remind us that regardless of how effective particular RT approaches may be at facilitating healthy body composition changes, there is an upper limit to their effectiveness and that proper dietary habits must also be present to obtain the greatest possible result for changes in body weight.
Beavers et al. None of the studies retained for analysis directly commented on the feasibility or tolerability of their protocol.
However, several conclusions can be drawn from the studies reporting the highest dropout rates. In the study by Chen et al. Aside from a single sentence in which the authors indicate reasons for discontinuation included loss of motivation, family factors, and difficulty in time arrangement, no further discussion was provided, limiting the degree to which valuable lessons from their experience can be carried forward.
Reasonable speculation may be that the scheduled four-week interval between completion of the final exercise session and the first post-testing session reduced the ultimate number of participants who completed the study.
The authors indicated the rate may have been partially due to the higher median age of their participants The authors attributed the high observed dropout rate partly to their participants' advanced age and low health status and suggested that future studies should include strategies aimed at maximizing compliance, such as strengthening older adults' self-efficacy and motivation.
The authors also suggested that future research should also evaluate the effect of earlier implementation and the cost-effectiveness of implementing long-term RT in older adults' real-life settings. An additional key area of concern for the future is how the importance of WL with minimal FFM loss can become more widely known in medicine, public health, and in the general population.
We propose four possible ways this may be achieved: 1 Education and awareness: By educating healthcare professionals, public health advocates, and the general population about the dangers of losing muscle mass during weight loss, people can be made aware of the importance of preserving muscle mass while losing weight.
This can be done through health seminars, workshops, and public health campaigns; 2 Promoting healthy weight loss strategies: Encouraging the use of healthy weight loss strategies, such as a balanced diet and regular exercise, can help to minimize muscle loss during weight loss.
This can be done through partnerships between public health organizations and nutrition and fitness experts; 3 Media coverage: Encouraging media outlets to report on the importance of weight loss with minimal muscle loss can help to raise awareness of this issue.
This can include articles in health and fitness magazines and news segments on television and radio; 4 Government involvement: Governments can promote weight loss with minimal muscle loss by funding research and public health initiatives focused on this issue.
They can also encourage health insurance companies to cover treatments and interventions that prioritize the preservation of muscle mass during weight loss.
This review highlights the need for more comprehensive research on the combined effects of resistance training RT and a healthy diet for significant fat loss and lean body mass gain in older adults.
Ideal future studies should incorporate systematic integration of RT and dietary interventions and include rigorous monitoring of participants' dietary adherence and exercise regimens. It is essential to emphasize a well-rounded evaluation of body composition changes, extending focus beyond weight loss to include preservation and enhancement of lean body mass.
Addressing the high attrition rates observed in some studies, the development of feasible and tolerable RT protocols for older adults is crucial. Potential strategies could involve tailored exercise programs, motivational support, and addressing logistical issues that could hinder adherence.
Future ideal studies also should focus on reducing heterogeneity in RT methods and body composition evaluation measures, though we acknowledge the challenging practicalities of standardizing practices across this research field. Two promising areas for future research, illuminated by this review, include the development of RT protocols that effectively increase lean body mass while reducing fat mass in obese and sarcopenic obese older adults.
Additionally, there is potential merit in exploring the use of supplements, such as creatine monohydrate, as an ergogenic aid for older adults participating in RT. This is based on sound theoretical rationale and a significant body of preliminary research, providing a robust foundation for future exploration.
The purpose of this scoping review was to identify and characterize existing research on the use of RT exercise interventions as a modality to promote weight loss in older adults with the end goal of knowledge translation and recommendation to further areas of study.
While it is clear that changes in body composition are a crucial outcome measure for this population, the current literature provides limited evidence demonstrating that RT, alongside a healthy diet, results in significant fat loss and lean body mass gain.
Furthermore, high attrition rates in some of the analyzed studies highlight the need for well-structured and feasible protocols. Thus, the endorsement of a specific 'evidence-based approach' is premature at this stage. Our findings underline the need for more rigorous, adequately powered studies to explore these relationships further.
We aimed to describe populations that have been studied, how RT has been applied, what can be deduced about the feasibility and tolerability of RT used in said manner, what primary outcomes have been addressed and what gaps in the current knowledge have become evident.
The two most important takeaway messages we hope to convey from this review are an understanding of why WL changes alone are an incomplete and problematic outcome measure to use with an older population and why changes in body composition ratio of fat mass to lean body mass are the appropriate measure to consider for these individuals.
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Sodium nitrate supplementation alters mitochondrial H2O2 emission but does not improve mitochondrial oxidative metabolism in the heart of healthy rats. American Journal of Physiology - Regulatory Integrative and Comparative Physiology. The effect of acute and 7-days dietary nitrate on mechanical efficiency, exercise performance and cardiac biomarkers in patients with chronic obstructive pulmonary disease Beijers, Rosanne J.
and Schols, Annemie M. The effect of acute and 7-days dietary nitrate on mechanical efficiency, exercise performance and cardiac biomarkers in patients with chronic obstructive pulmonary disease.
Repeated-sprint performance and plasma responses following beetroot juice supplementation do not differ between recreational, competitive and elite sprint athletes Jonvik, Kristin L. Repeated-sprint performance and plasma responses following beetroot juice supplementation do not differ between recreational, competitive and elite sprint athletes.
Dietary nitrate does not reduce oxygen cost of exercise or improve muscle mitochondrial function in patients with mitochondrial myopathy Nabben, Miranda, Schmitz, Joep P. and Prompers, Jeanine J..
Dietary nitrate does not reduce oxygen cost of exercise or improve muscle mitochondrial function in patients with mitochondrial myopathy. Detection of localized hepatocellular amino acid kinetics by using mass spectrometry imaging of stable isotopes Arts, Martijn, Soons, Zita, Ellis, Shane R.
and Damink, Steven W. Detection of localized hepatocellular amino acid kinetics by using mass spectrometry imaging of stable isotopes. Angewandte Chemie. Post-exercise muscle glycogen resynthesis in humans Burke, Louise M.
Post-exercise muscle glycogen resynthesis in humans. 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 Tieland, Michael, Franssen, Rinske, Dullemeijer, C. 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.
Neuromuscular electrical stimulation prior to presleep protein feeding stimulates the use of protein-derived amino acids for overnight muscle protein synthesis Dirks, Marlou L. Neuromuscular electrical stimulation prior to presleep protein feeding stimulates the use of protein-derived amino acids for overnight muscle protein synthesis.
Muscle fiber capillarization as determining factor on indices of insulin sensitivity in humans Snijders, Tim, Nederveen, Joshua P. Muscle fiber capillarization as determining factor on indices of insulin sensitivity in humans.
Physiological Reports. Postexercise muscle glycogen resynthesis in humans Burke, Louise, Van Loon, Luc and Hawley, John. Postexercise muscle glycogen resynthesis in humans.
Consideration of insects as a source of dietary protein for human consumption Churchward-Venne, T. Consideration of insects as a source of dietary protein for human consumption. Protein supplementation augments muscle fiber hypertrophy but does not modulate satellite cell content during prolonged resistance-type exercise training in frail elderly Dirks, Marlou L.
Protein supplementation augments muscle fiber hypertrophy but does not modulate satellite cell content during prolonged resistance-type exercise training in frail elderly. Journal of the American Medical Directors Association JAMDA : long-term care: management, applied research and clinical issues.
Glucose plus fructose ingestion for post exercise recovery greater than the sum of its parts? Gonzalez, Javier T. Twenty-four-hour biological variation profiles of cardiac troponin I in individuals with or without chronic kidney disease Van Der Linden, Noreen, Hilderink, Judith M.
and Meex, Steven J. Twenty-four-hour biological variation profiles of cardiac troponin I in individuals with or without chronic kidney disease. Clinical Chemistry Washington, DC : international journal of molecular diagnostics and laboratory medicine. Dietary protein intake and distribution patterns of well-trained Dutch athletes Gillen, Jenna B.
Dietary protein intake and distribution patterns of well-trained Dutch athletes. Differential effects of leucine and leucine-enriched whey protein on skeletal muscle protein synthesis in aged mice Dijk, Francina J. Differential effects of leucine and leucine-enriched whey protein on skeletal muscle protein synthesis in aged mice.
Clinical Nutrition ESPEN. Extensive type ii muscle fiber atrophy in elderly female hip fracture patients Kramer, Irene F. Extensive type ii muscle fiber atrophy in elderly female hip fracture patients.
The Journals of Gerontology: Series A. Fructose and sucrose intake increase exogenous carbohydrate oxidation during exercise Trommelen, Jorn, Fuchs, Cas J.
Fructose and sucrose intake increase exogenous carbohydrate oxidation during exercise. Protein ingestion before sleep increases overnight muscle protein synthesis rates in healthy older men: A randomized controlled trial Kouw, Imre W.
Protein ingestion before sleep increases overnight muscle protein synthesis rates in healthy older men: A randomized controlled trial. Sodium nitrate ingestion increases skeletal muscle nitrate content in humans Nyakayiru, Jean, Kouw, Imre W.
Sodium nitrate ingestion increases skeletal muscle nitrate content in humans. Intramyocellular lipid content and lipogenic gene expression responses following a single bout of resistance type exercise differ between young and older men Tsintzas, Kostas, Stephens, F.
Intramyocellular lipid content and lipogenic gene expression responses following a single bout of resistance type exercise differ between young and older men.
Commentaries on Viewpoint: A time for exercise: the exercise window Boule, Normand G. Commentaries on Viewpoint: A time for exercise: the exercise window. No effect of acute and 6-day nitrate supplementation on VO2 and time-trial performance in highly trained cyclists Nyakayiru, Jean, Jonvik, Kristin L.
No effect of acute and 6-day nitrate supplementation on VO2 and time-trial performance in highly trained cyclists. Food ingestion in an upright sitting position increases postprandial amino acid availability when compared with food ingestion in a lying down position Holwerda, Andrew M.
Food ingestion in an upright sitting position increases postprandial amino acid availability when compared with food ingestion in a lying down position. Beetroot juice supplementation improves high-intensity intermittent type exercise performance in trained soccer players Nyakayiru, Jean, Jonvik, Kristin L.
Beetroot juice supplementation improves high-intensity intermittent type exercise performance in trained soccer players. Seasonal variation in vitamin d status in elite athletes: a longitudinal study Backx, E. and Mensink, M.. Seasonal variation in vitamin d status in elite athletes: a longitudinal study.
Glycemic control during consecutive days with prolongedwalking exercise in individuals with type 1 diabetes mellitus van Dijk, Jan Willem, Eijsvogels, Thijs M. and Van Loon, Lucas. Glycemic control during consecutive days with prolongedwalking exercise in individuals with type 1 diabetes mellitus.
Diabetes Research and Clinical Practice. May bed rest cause greater muscle loss than limb immobilization? Dirks, M. and van Loon, L.. Hyperoxia increases arterial oxygen pressure during exercise in type 2 diabetes patients: A feasibility study Rozenberg, Robert, Mankowski, Robert T.
and Praet, Stephan F. Hyperoxia increases arterial oxygen pressure during exercise in type 2 diabetes patients: A feasibility study. European Journal of Medical Research. Cardiac Troponin T and i Release after a km Run Klinkenberg, Lieke J.
Meex, Steven J. Cardiac Troponin T and i Release after a km Run. American Journal of Cardiology. Prognostic value of basal high-sensitive cardiac troponin levels on mortality in the general population van der Linden, Noreen, Klinkenberg, Lieke J.
Prognostic value of basal high-sensitive cardiac troponin levels on mortality in the general population. Short-term muscle disuse lowers myofibrillar protein synthesis rates and induces anabolic resistance to protein ingestion Wall, Benjamin T.
Short-term muscle disuse lowers myofibrillar protein synthesis rates and induces anabolic resistance to protein ingestion. Impact of diet composition on blood glucose regulation Russell, Wendy R.
Impact of diet composition on blood glucose regulation. Critical Reviews in Food Science and Nutrition. The Martin Vigorimeter Represents a Reliable and More Practical Tool Than the Jamar Dynamometer to Assess Handgrip Strength in the Geriatric Patient Sipers, Walther M.
The Martin Vigorimeter Represents a Reliable and More Practical Tool Than the Jamar Dynamometer to Assess Handgrip Strength in the Geriatric Patient.
Journal of the American Medical Directors Association. Resistance training increases skeletal muscle capillarization in healthy older men Verdijk, Lex B. Resistance training increases skeletal muscle capillarization in healthy older men.
Habitual Dietary Nitrate Intake in Highly Trained Athletes Jonvik, Kristin L. Habitual Dietary Nitrate Intake in Highly Trained Athletes. Protein intake and lean body mass preservation during energy intake restriction in overweight older adults Backx, E.
Protein intake and lean body mass preservation during energy intake restriction in overweight older adults. International Journal of Obesity. Changes in myonuclear domain size do not precede muscle hypertrophy during prolonged resistance-type exercise training Snijders, Tim, Smeets, Joey S.
Changes in myonuclear domain size do not precede muscle hypertrophy during prolonged resistance-type exercise training. Resistance exercise augments postprandial overnight muscle protein synthesis rates Trommelen, Jorn, Holwerda, Andrew M.
The present study aimed at investigating the effects Nutgition two periodizwtion resistance periodizzation protocols Ginseng supplements nonperiodized NP Nutrltion daily undulating periodization DUP - on hemodynamic, morphofunctional Recharge with healthy snacks cognitive parameters of robust older women. Periodizatiob Forty-two older women were randomized allocated into one of the three experimental groups: NP, DUP, and control group CG. Evaluations of the hemodynamic, morphofunctional and cognitive parameters occurred before, during and after six months. The exercise groups performed the program of exercise twice a week over 22 weeks. In NP, the two weekly sessions were based on 3 sets of repetitions at a difficult intensity. Effect of Nutritional Intervention and Exercise Patterns on the Nutriion of Ginseng supplements Aduts Nutrition periodization for older adults A Review. Efecto de la Flaxseeds for hair growth nutricional y los patrones peroidization ejercicio en la funcionalidad de las personas mayores obesas: una revisión. Universitas Medicavol. Abstract: Elderly people are susceptible to obesity-associated cardiovascular diseases, which are risk factors for frail elderly. The purpose of this study is to determine exercise and nutrition regimens for obese elderly to improve functionality.
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