- Design
- Systematic review and network meta-analysis of randomised trials
- Population
- 2,160 older adults with or at risk of sarcopenia, 20 trials
- Primary outcome
- Muscle mass, grip strength and physical performance
- Effect
- Whey + vitamin D + leucine: ASMI SMD 0.29 (0.06–0.52); grip SMD 0.82 (0.13–1.50)
A systematic review and network meta-analysis included 20 randomised trials of nutritional strategies in 2,160 older adults with, or at high risk of, sarcopenia, forming 17 comparison nodes.
Taken together, supplements improved appendicular muscle mass, grip strength and gait speed, but not the five-times sit-to-stand test. Whey protein plus vitamin D plus leucine was the most consistent: it improved muscle mass (SMD 0.29, 95% CI 0.06–0.52), grip (SMD 0.82) and sit-to-stand time. Larger effects for other combinations came from single trials.
The network was sparse and certainty was low to very low, so the authors present these as signals rather than a ranking. Most trials studied supplements alongside usual activity, and resistance exercise remains the core treatment for sarcopenia; protein supplementation is best seen as an addition to it.
- Combine adequate protein intake with resistance exercise as the base of sarcopenia management.
- Consider whey protein with vitamin D and leucine where dietary protein is inadequate.
- Check vitamin D status in older adults with low muscle strength.
- Do not rely on single-trial combinations; certainty was low to very low.
Why it matters
Supplements are widely sold to older adults, and this shows which combinations have even modest evidence.
Don't overread it
Sparse network, low to very low certainty — not a definitive ranking of supplements.
The statistics, in plain English
A standardised mean difference of 0.29 for muscle mass is a small effect; 0.82 for grip strength is larger. With low to very low certainty, the true effects could be meaningfully different.
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