Nutritional advice

Objectives:
Do chair-based exercise programmes improve upper extremity and lower extremity function in older adults?

Study design:
This review article included 25 studies with a total of 1,388 participants.
19 studies were randomised controlled trials (RCTs).

The chair exercises included chair-based yoga, seated tai chi and rocking chair. The interventions lasted between 2 and 72 weeks, with the most common duration being 12 weeks, delivering 2 to 14 sessions per week. Sessions lasted between 15 and 110 minutes.

There was considerably heterogeneity in the age range of participants included.
The mean age of participants in studies ranges from 55 to 88 years.
17 studies had a low risk of bias and 5 had a high risk of bias.

Results and conclusions:
The investigators found that chair-based exercise programmes significantly improved upper extremity [handgrip strength: MD = 2.10, 95% CI = 0.76 to 3.43, I2 = 42% and 30 s arm curl test: MD = 2.82, 95% CI = 1.34 to 4.31, I2 = 71%] and lower extremity function [30 s chair stand: MD = 2.25, 95% CI = 0.64 to 3.86, I2 = 62%].

The investigators found no significant differences in the Berg balance scale, timed up and go test or gait speed between the intervention and control groups. Similarly, no significant differences were observed for self-reported activities of daily living or for falls efficacy, which were analyzed using standardised mean difference between the intervention and control groups as there were different instruments used to measure each outcome.

The investigators concluded that chair-based exercise programmes improve upper extremity (handgrip strength and 30 s arm curl test) and lower extremity (30 s chair stand) function in older adults. These changes are observed in short (12 weeks) and medium term (12 weeks to 6 months) interventions.

Original title:
The Effect of Chair-Based Exercise on Physical Function in Older Adults: A Systematic Review and Meta-Analysis by Klempel N, Blackburn NE, […], Tully MA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920319/

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Upper extremity is part of the body that includes the arm, wrist and hand.
Lower extremity refers to the part of the body from the hip to the toes.

Objectives:
The efficacy and safety of L‐arginine supplements and their effect on maximal oxygen uptake (VO2 max) remained unclear. Therefore, this review article has been conducted.

Does supplementation with arginine increase VO2 max in healthy people?

Study design:
This review article included 11 RCTs.
The different types of arginine supplements were L‐arginine, arginine aspartate, arginine alpha‐ketoglutarate and arginine in combination with antioxidants.
There was no publication bias.

Results and conclusions:
The investigators found subgroup analysis showed that arginine in the form of L‐arginine significantly increased VO2 max compared to the other forms [weighted mean difference = 0.11 L/min, I2 = 0.0%, p = 0.485].

The investigators concluded that supplementation with L‐arginine alone increases VO2 max compared to the other types of arginine or combined with other metabolites or supplements. Future homogeneous and well‐designed randomized clinical trials are needed to a deep understand of the effects of L‐arginine on VO2 max in healthy human subjects.

Original title:
The effect of L-arginine supplementation on maximal oxygen uptake: A systematic review and meta-analysis by Rezaei S, Gholamalizadeh M, […], Doaei S.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883807/

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VO2 max is the maximum amount of oxygen your body can utilize during exercise. The more oxygen your body can use, the more your muscles can work.

Objectives:
Does prenatal alcohol exposure have adverse effects on pregnancy and birth outcomes?

Study design:
This review article included 33 studies.
The quality assessment identified that 61% of studies were high quality, 30% were average quality and 9% were low quality.

Results and conclusions:
The investigators found that prenatal alcohol exposure significantly increased the likelihood of placental abruption with 48% [odds ratio = 1.48, 95% CI = 1.37 to 1.60].

The investigators found no association between prenatal alcohol exposure and placenta previa [odds ratio = 1.14, 95% CI = 0.84 to 1.34].

The investigators found that prenatal alcohol exposure significantly reduced placental weight with 51g [95% CI = -82.8g to -19.3g].

The investigators found reports of altered placental vasculature, placental DNA methylation, and gene expression following prenatal alcohol exposure.

The investigators concluded prenatal alcohol exposure increases the likelihood of placental abruption and is associated with decreased placental weight, altered placental vasculature, DNA methylation and molecular pathways. Given the critical role of the placenta in determining pregnancy outcomes, further studies investigating the molecular mechanisms underlying alcohol-induced placental dysfunction are required. Sex-specific placental adaptations to adverse conditions in utero have been well documented; thus, future studies should examine prenatal alcohol exposure-associated placental outcomes separately by sex.

Original title:
Prenatal alcohol consumption and placental outcomes: a systematic review and meta-analysis of clinical studies by Steane SE, Young SL, […], Moritz KM.

Link:
https://pubmed.ncbi.nlm.nih.gov/34181895/

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Objectives:
Essential amino acids (EAAs) promote the process of regulating muscle synthesis. Thus, whey protein that contains higher amounts of essential amino acids can have a considerable effect on modifying muscle synthesis. However, there is insufficient evidence regarding the effect of soya and whey protein supplementation on body composition. Therefore, this review article has been conducted.

Does whey protein or soya protein supplementation improve body composition parameters (like lean body mass, body mass, fat mass and body fat percentage) in adults?

Study design:
This review article included 10 RCTs with 596 participants.

Results and conclusions:
The investigators found a significant increase in lean body mass after whey protein supplementation [WMD = 0.91, 95% CI = 0.15 to 1.67, p = 0.019].
This significant increase was not found for soya protein supplementation.

The investigators found no significant change between whey protein supplementation and body mass, fat mass and body fat percentage.

The investigators found no significant change between soya protein supplementation and body mass, fat mass and body fat percentage.

The investigators concluded that whey protein supplementation improves body composition via increases in lean body mass, without influencing fat mass, body mass and body fat percentage in adults.

Original title:
Comparison of the effect of soya protein and whey protein on body composition: a meta-analysis of randomised clinical trials by Damaghi MP, Mirzababaei A, […], Mirzaei K.

Link:
https://pubmed.ncbi.nlm.nih.gov/33971994/

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Objectives:
There is much debate regarding the source/quality of dietary proteins in supporting indices of skeletal muscle anabolism. Therefore, this review article has been conducted.

What is the effect of protein source/quality on acute muscle protein synthesis (MPS) and changes in lean body mass (LBM) and strength, when combined with resistance exercise (RE)?  

Study design:
This review article included 27 studies that compared the effects of ≥2 dose-matched, predominantly isolated protein sources of varying "quality”, in young (18-35 y) and older (≥60 y) adults.

3 separate models were employed as follows: 1) protein feeding alone on muscle protein synthesis, 2) protein feeding combined with a bout of resistance exercise on muscle protein synthesis and 3) protein feeding combined with longer-term resistance exercise training (RET) on lean body mass and strength.  

The mean age for the young groups across all 3 models ranged between 20 and 29 y and the older groups were between 61 and 75 y.

Results and conclusions:
The investigators found analysis revealed an effect favoring higher-quality protein for postprandial muscle protein synthesis at rest [mean difference (MD) = 0.014%/h, 95% CI = 0.006 to 0.021, p 0.001] and following resistance exercise [MD = 0.022%/h, 95% CI = 0.014 to 0.030, p 0.00001] in young [model 1 = 0.016%/h, 95% CI = -0.004 to 0.036, p = 0.12. Model 2 = 0.030%/h, 95% CI = 0.015 to 0.045, p 0.0001] and older [model 1 = 0.012%/h, 95% CI = 0.006 to 0.018, p 0.001. Model 2 = 0.014%/h, 95% CI = 0.007 to 0.021, p 0.001] adults.  

The investigators found, however, although higher protein quality was significantly associated with superior strength gains with resistance exercise training [standardized mean difference (SMD) = 0.24 kg, 95% CI = 0.02 to 0.45, p = 0.03], no effect was observed on changes to lean body mass [SMD = 0.05 kg, 95% CI = -0.16 to 0.25, p = 0.65].

The investigators concluded that protein quality provides a small but significant impact on indices of muscle protein anabolism in young and older adults. However, further research is warranted to elucidate the importance of protein source/quality on musculoskeletal aging, particularly in situations of low protein intake.

Original title:
Protein Source and Quality for Skeletal Muscle Anabolism in Young and Older Adults: A Systematic Review and Meta-Analysis by Morgan PT, Harris DO, […], Breen L.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8245874/

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Objectives:
Does tart cherry (TC) supplementation improve recovery following strenuous exercise?

Study design:
This review article included 14 studies.

Results and conclusions:
The investigators found tart cherry supplementation had a small significant beneficial effect in reducing muscle soreness [effect size (ES) = -0.44, 95% CI = -0.87 to -0.02].

The investigators found a moderate significant beneficial effect was observed for recovery of muscular strength [ES = -0.78, 95% CI = -1.11 to -0.46] for tart cherry supplementation.

The investigators found a moderate significant effect was observed for muscular power [ES = -0.53, 95% CI = -0.77 to -0.29] for tart cherry supplementation.
A further subgroup analysis on this variable indicated a large significant effect of tart cherry supplementation on recovery of jump height [ES = -0.82, 95% CI = -1.18 to -0.45] and a small significant effect of tart cherry supplementation on sprint time [ES = -0.32, 95% CI = -0.60 to -0.04]. 

The investigators found a small significant effect was observed for both C-reactive protein [ES = -0.46, 95% CI = -0.93 to -0.00] and Interleukin-6 [ES = -0.35, 95% CI = -0.68 to -0.02] for tart cherry supplementation.

The investigators found no significant effects were observed for creatine kinase and tumor necrosis factor alpha (TNF-α) for tart cherry supplementation. 

The investigators concluded that tart cherry supplementation improves aspects of recovery from strenuous exercise.

Original title:
Tart Cherry Supplementation and Recovery From Strenuous Exercise: A Systematic Review and Meta-Analysis by Hill JA, Keane KM, […], Howatson G.

Link:
https://pubmed.ncbi.nlm.nih.gov/33440334/

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Objectives:
Visceral adipose tissue (VAT) are deleterious fat deposits in the human body and can be effectively reduced by exercise intervention. Despite well-established exercise prescriptions are available, the effective dosage of exercise for reducing VAT requires verification. Therefore, this review article has been conducted.

What is the most effective exercise dosage (modality, intensity, duration and amount) for decreasing visceral adipose tissue (VAT)?

Study design:
This review article included 32 RCTs with a total of 1,900 participants.

Results and conclusions:
The investigators found that 30-60 min of high-intensity interval training, 3 times per week for 12 to 16 weeks [SMD = -0.39, 95% CI = -0.60 to -0.18] and 30-60 min of aerobic exercise of at least moderate intensity, 3 times per week for 12 to 16 weeks [SMD = -0.26, 95% CI = -0.38 to -0.13] were beneficial for reducing visceral adipose tissue.

The investigators found, by contrast, resistance exercise, aerobic exercise combined with resistance exercise and sprint interval training had no significant effects on reducing visceral adipose tissue.

The investigators found no difference in visceral adipose tissue reduction was observed between exercising more or less than 150 minutes per week.

The investigators found meta-regression revealed that the effect of visceral adipose tissue reduction was not significantly influenced by an increase in the duration of or amount of exercise in an exercise program.

The investigators concluded that 30-60 min of high-intensity interval training, 3 times per week for 12 to 16 weeks and 30-60 min of aerobic exercise of at least moderate intensity, 3 times per week for 12 to 16 weeks causally reduce visceral adipose tissue.

Original title:
Effect of exercise intervention dosage on reducing visceral adipose tissue: a systematic review and network meta-analysis of randomized controlled trials by Chang YH, Yang HY and Shun SC.

Link:
https://pubmed.ncbi.nlm.nih.gov/33558643/

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A causal relationship can be found in RCTs.

High intensity interval trainings are:
-using a stationary bike, pedal as hard and fast as possible for 30 seconds.
-after jogging to warm up, sprint as fast as you can for 15 seconds.
-perform squat jumps as quickly as possible for 30 to 90 seconds.