title: Effects of high-intensity exercise and protein supplement on muscle mass in ADL dependent older people with and without malnutrition: a randomized controlled trial.
abstract: BACKGROUND
  Loss of muscle mass is common among old people living in institutions but trials that evaluate interventions aimed at increasing the muscle mass are lacking. Objective, participants and intervention: This randomized controlled trial was performed to evaluate the effect of a high-intensity functional exercise program and a timed protein-enriched drink on muscle mass in 177 people aged 65 to 99 with severe physical or cognitive impairments, and living in residential care facilities.
  
  
  METHODS
  Three-month high-intensity exercise was compared with a control activity and a protein-enriched drink was compared with a placebo drink. A bioelectrical impedance spectrometer (BIS) was used in the evaluation. The amount of muscle mass and body weight (BW) were followed-up at three and six months and analyzed in a 2 x 2 factorial ANCOVA, using the intention to treat principle, and controlling for baseline values.
  
  
  RESULTS
  At 3-month follow-up there were no differences in muscle mass and BW between the exercise and the control group or between the protein and the placebo group. No interaction effects were seen between the exercise and nutritional intervention. Long-term negative effects on muscle mass and BW was seen in the exercise group at the 6-month follow-up.
  
  
  CONCLUSIONS
  A three month high-intensity functional exercise program did not increase the amount of muscle mass and an intake of a protein-enriched drink immediately after the exercise did not induce any additional effect on muscle mass. There were negative long-term effects on muscle mass and BW, indicating that it is probably necessary to compensate for an increased energy demand when offering a high-intensity exercise program.
authors.affiliation: Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umea University, Sweden. maine.carlsson@germed.umu.se
authors.forename: M
authors.initials: M
authors.lastname: Carlsson
authors.forename: H
authors.initials: H
authors.lastname: Littbrand
authors.forename: Y
authors.initials: Y
authors.lastname: Gustafson
authors.forename: L
authors.initials: L
authors.lastname: Lundin-Olsson
authors.forename: N
authors.initials: N
authors.lastname: Lindelöf
authors.forename: E
authors.initials: E
authors.lastname: Rosendahl
authors.forename: L
authors.initials: L
authors.lastname: Håglin
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001835:Body Weight; D004044:Dietary Proteins / Q000494:pharmacology*; D019587:Dietary Supplements; D006233:Persons with Disabilities; D015444:Exercise; D005081:Exercise Therapy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D016852:Housing for the Elderly; D006801:Humans; D057194:Intention to Treat Analysis; D008297:Male; D044342:Malnutrition; D018482:Muscle, Skeletal / Q000187:drug effects / Q000473:pathology*; D005082:Physical Exertion; D055948:Sarcopenia / Q000517:prevention & control*
chemical_list: D004044:Dietary Proteins