title: Effects of exercise and milk fat globule membrane (MFGM) supplementation on body composition, physical function, and hematological parameters in community-dwelling frail Japanese women: a randomized double blind, placebo-controlled, follow-up trial.
abstract: OBJECTIVE
  To investigate the combined and separate effects of exercise and milk fat globule membrane (MFGM) supplementation on frailty, physical function, physical activity level, and hematological parameters in community-dwelling elderly Japanese women.
  
  
  METHODS
  A total of 131 frail, elderly women over 75 years were randomly assigned to one of four groups: exercise and MFGM supplementation (Ex+MFGM), exercise and placebo (Ex+Plac), MFGM supplementation, or the placebo group. The exercise group attended a 60-minute training program twice a week for three months, and the MFGM group ingested 1g of the MFGM supplement in pill form, daily for 3 months. The primary outcome measure was change in frailty status based on Fried's frailty phenotype. Secondary outcome measures included body composition, physical function and hematological parameters, and interview survey components assessing lifestyle factors. Participants were followed for 4 months post-intervention.
  
  
  RESULTS
  Significant group × time interactions were observed for usual walking speed (P = 0.005), timed up & go (P<0.001), and insulin-like growth factor-binding protein 3/insulin-like growth factor 1 ratio (P = 0.013). The frailty components revealed that weight loss, exhaustion, low physical activity, and slow walking speed were reversed, but low muscle strength did not significantly changed. Frailty reversal rate was significantly higher in the Ex+MFGM (57.6%) than in the MFGM (28.1%) or placebo (30.3%) groups at post-intervention (χ2 = 8.827, P = 0.032), and at the follow-up was also significantly greater in the Ex+MFGM (45.5%) and Ex+Plac (39.4%) groups compared with the placebo (15.2%) group (χ2 = 8.607, P = 0.035). The exercise+MFGM group had the highest odds ratio (OR) for frailty reversal at post-intervention and follow-up (OR = 3.12, 95% confidence interval (CI) = 1.13-8.60; and OR = 4.67, 95% CI = 1.45-15.08, respectively).
  
  
  CONCLUSIONS
  This study suggests that interventions including exercise and nutrition can improve frailty status. Statistically significant additive effects of MFGM with exercise could not be confirmed in this population, and further investigation in larger samples is necessary.
  
  
  BACKGROUND
  The Japan Medical Association Clinical Trial Registry (JMACCT)JMA-IIA00069.
authors: Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors: Hunkyung
authors: H
authors: Kim
authors: National Institute for Longevity Sciences, Aichi, Japan.
authors: Takao
authors: T
authors: Suzuki
authors: Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors: Miji
authors: M
authors: Kim
authors: Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors: Narumi
authors: N
authors: Kojima
authors: Biological Science Laboratories, Health Science, Kao Corporation, Tochigi, Japan.
authors: Noriyasu
authors: N
authors: Ota
authors: Biological Science Laboratories, Health Science, Kao Corporation, Tochigi, Japan.
authors: Akira
authors: A
authors: Shimotoyodome
authors: Biological Science Laboratories, Health Science, Kao Corporation, Tochigi, Japan.
authors: Tadashi
authors: T
authors: Hase
authors: Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors: Erika
authors: E
authors: Hosoi
authors: Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
authors: Hideyo
authors: H
authors: Yoshida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition / Q000187:drug effects*; D019587:Dietary Supplements; D004311:Double-Blind Method; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006017:Glycolipids / Q000008:administration & dosage*; D006023:Glycoproteins / Q000008:administration & dosage*; D006801:Humans; D066292:Lipid Droplets; D013997:Time Factors; D015431:Weight Loss / Q000187:drug effects*
chemical_list: D006017:Glycolipids; D006023:Glycoproteins; C110367:milk fat globule