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Effects of branched-chain amino acid-rich supplementation on EWGSOP2 criteria for sarcopenia in older adults: a systematic review and meta-analysis

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Abstract

Purpose

According to criteria recommended by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), we analyzed the effects of branched-chain amino acid (BCAA)-rich supplements on muscle strength, muscle mass, and physical performance in older people.

Methods

We searched PubMed, Embase, Cochrane Library, and CINAHL from inception until March 2021. Randomized controlled trials that examined the effect of BCAA-rich supplements on older people were included. Random-effects meta-analyses and sensitivity analyses were performed. Subgroup analyses were stratified by participant and supplementation characteristics. Meta-regression analyses were performed to examine the effect of continuous variables.

Results

Thirty-five studies were included in this meta-analysis. Quality assessment revealed that 14 of 35 RCTs had some potential bias. The overall standardized mean difference (SMD) in muscle strength, muscle mass, and physical performance between the supplement and control groups was 0.35 (95% CI = [0.15, 0.55], P = 0.0007), 0.25 (95% CI = [0.10, 0.40], P = 0.0008), and 0.29 (95% CI = [0.00, 0.57], P = 0.05), respectively. Subgroup analysis revealed that essential amino acid supplementation improved handgrip strength more significantly than whey protein supplementation in older people. Meta-regression analysis revealed a significant linear relationship between improvements in handgrip strength and body mass index.

Conclusions

BCAA-rich supplementation by older people may have beneficial effects on muscle mass and strength. However, the included studies had high heterogeneity, and the results must be interpreted with caution.

Prospero registration number

CRD42020206674.

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Availability of data, material, and code

Data described in the manuscript, the code book, and the analytic code will not be made available, because this study is a secondary data analysis of 35 previously published RCTs.

Abbreviations

BCAA:

Branched-chain amino acid

EAA:

Essential amino acid

EWGSOP2:

European Working Group on Sarcopenia in Older People 2

ASMM:

Appendicular skeletal muscle mass

CSA:

Cross-sectional area

CST:

Chair stand test

TUG:

Timed Up and Go

SPPB:

Short physical performance battery

SMD:

Standardized mean difference

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Acknowledgements

Authors’ responsibilities: GHB, MCT, and WHH designed the research; GHB and MCT conducted the research; GHB and MCT analyzed the data; GHB, MCT, and WHH wrote the manuscript; GHB, MCT, and WHH had primary responsibility for final content. Wallace Academic Editing edited this manuscript

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No funding, grants, or equipment were provided for the project from any source. The authors have received no financial benefits associated with this work. This work has not been presented previously.

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  1. Geng-Hao Bai and Meng-Chen Tsai have contributed equally to this paper.

Authors and Affiliations

  1. School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC

    Geng-Hao Bai & Meng-Chen Tsai

  2. Center of Evidence-Based Medicine, Department of Education, Taipei Medical University Hospital, 252 Wu-Xing Street, Taipei, Taiwan, ROC

    Geng-Hao Bai, Meng-Chen Tsai, Han-Wei Tsai & Wen-Hsuan Hou

  3. Master Program in Long-Term Care and School of Gerontology Health Management, College of Nursing, Taipei Medical University, Taipei, Taiwan, ROC

    Han-Wei Tsai & Wen-Hsuan Hou

  4. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei, Taiwan, ROC

    Chun-Chao Chang

  5. Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan, ROC

    Chun-Chao Chang

  6. Department of Geriatric Medicine, Taipei Medical University Hospital, Taipei, Taiwan, ROC

    Wen-Hsuan Hou

  7. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan, ROC

    Wen-Hsuan Hou

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Contributions

GHB, MCT, and WHH designed the research; GHB and MCT conducted the research; GHB and MCT analyzed the data; GHB, MCT, and WHH wrote the manuscript; GHB, MCT, and WHH had primary responsibility for final content.

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Bai, GH., Tsai, MC., Tsai, HW. et al. Effects of branched-chain amino acid-rich supplementation on EWGSOP2 criteria for sarcopenia in older adults: a systematic review and meta-analysis. Eur J Nutr 61, 637–651 (2022). https://doi.org/10.1007/s00394-021-02710-0

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