title: The effect of protein intake and resistance training on muscle mass in acutely ill old medical patients - A randomized controlled trial.
abstract: OBJECTIVE
  Stress metabolism is associated with accelerated loss of muscle that has large consequences for the old medical patient. The aim of this study was to investigate if an intervention combining protein and resistance training was more effective in counteracting loss of muscle than standard care. Secondary outcomes were changes in muscle strength, functional ability and body weight.
  
  
  METHODS
  29 acutely admitted old (>65 years) patients were randomly assigned to the intervention (n = 14) or to standard care (n = 15). The Intervention Group received 1.7 g protein/kg/day during admission and a daily protein supplement (18.8 g protein) and resistance training 3 times per week the 12 weeks following discharge. Muscle mass was assessed by Dual-energy X-ray Absorptiometry. Muscle strength was assessed by Hand Grip Strength and Chair Stand Test. Functional ability was assessed by the de Morton Mobility Index, the Functional Recovery Score and the New Mobility Score. Changes in outcomes from time of admission to three-months after discharge were analysed by linear regression analysis.
  
  
  RESULTS
  The intention-to-treat analysis showed no significant effect of the intervention on lean mass (unadjusted: β-coefficient = -1.28 P = 0.32, adjusted for gender: β-coefficient = -0.02 P = 0.99, adjusted for baseline lean mass: β-coefficient = -0.31 P = 0.80). The de Morton Mobility Index significantly increased in the Control Group (β-coefficient = -11.43 CI: 0.72-22.13, P = 0.04). No other differences were found.
  
  
  CONCLUSIONS
  No significant effect on muscle mass was observed in this group of acutely ill old medical patients. High compliance was achieved with the dietary intervention, but resistance training was challenging. Clinical trials identifier NCT02077491.
authors: Optimed, Clinical Research Centre (056), Amager Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958 Frederiksberg C, Denmark. Electronic address: sussiogbuhl@gmail.com.
authors: Sussi F
authors: SF
authors: Buhl
authors: Optimed, Clinical Research Centre (056), Amager Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958 Frederiksberg C, Denmark.
authors: Aino L
authors: AL
authors: Andersen
authors: Department of Nutrition, Exercise and Sports, University of Copenhagen, DK-1958 Frederiksberg C, Denmark; Nutrition Unit 5711, Rigshospitalet, DK-2100 Copenhagen Oe, Denmark.
authors: Jens R
authors: JR
authors: Andersen
authors: Optimed, Clinical Research Centre (056), Amager Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark.
authors: Ove
authors: O
authors: Andersen
authors: Department of Endocrinology (541), Amager Hvidovre Hospital, DK-2650 Hvidovre, Denmark.
authors: Jens-Erik B
authors: JB
authors: Jensen
authors: Department of Endocrinology (541), Amager Hvidovre Hospital, DK-2650 Hvidovre, Denmark.
authors: Anne Mette L
authors: AML
authors: Rasmussen
authors: Optimed, Clinical Research Centre (056), Amager Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark.
authors: Mette M
authors: MM
authors: Pedersen
authors: Department of Rehabilitation, Municipality of Copenhagen, DK-2200 Copenhagen N, Denmark.
authors: Lars
authors: L
authors: Damkjær
authors: Optimed, Clinical Research Centre (056), Amager Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark.
authors: Hanne
authors: H
authors: Gilkes
authors: Optimed, Clinical Research Centre (056), Amager Hvidovre Hospital, University of Copenhagen, DK-2650 Hvidovre, Denmark.
authors: Janne
authors: J
authors: Petersen
mesh_terms: D015502:Absorptiometry, Photon; D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D001835:Body Weight; D004044:Dietary Proteins / Q000008:administration & dosage*; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength; D006801:Humans; D008297:Male; D053580:Muscle Strength; D018482:Muscle, Skeletal / Q000502:physiology*; D055070:Resistance Training; D016037:Single-Blind Method; D016896:Treatment Outcome
chemical_list: D004044:Dietary Proteins
keywords: Geriatric; Muscle mass; Nutrition; Oral Nutritional Supplement; Resistance training; Systemic Inflammatory Response Syndrome