Academic Journal of Medicine & Health Sciences, 2025, 6(9); doi: 10.25236/AJMHS.2025.060902.
Xixi Zhang1, Wenya Qiang2, Huan Xu1, Nina Xie1, Yichao Liu3, Danzen Cuomu3, Yulian Zhang4, Liang Shang5
1School of Nursing, Shaanxi University of Chinese Medicine, Xianyang, 712046, Shaanxi, China
2School of Nursing, Yan'an University, Yan'an, 716000, Shaanxi, China
3School of Medicine, Tibet Minzu University, Xianyang, 712082, Shaanxi, China
4Director's Office, Shaanxi Provincial People's Hospital, Xi'an, 710068, Shaanxi, China
5Department of Geriatrics, Shaanxi Provincial People's Hospital, Xi'an, 710068, Shaanxi, China
This scoping review aims to examine combined exercise-nutrition interventions for sarcopenic older adults, providing evidence to guide the design and implementation of future programs. We followed Arksey and O’Malley’s five-step scoping-review framework and the PRISMA-ScR guideline. PubMed, Web of Science, Embase, the Cochrane Library and CINAHL were searched frominception to June 2025. We descriptively analysed the composition and outcomes of combined interventions. A total of 673 studies met the screening criteria, and 25 were eligible for analysis; most were randomized controlled trials. Participants were older adults diagnosed with either primary or secondary sarcopenia. Resistance exercise was the predominant intervention (60%), and most studies provided protein-based nutritional supplementation (64%). Among individuals with sarcopenia, the combined intervention exerted a synergistic effect. Combined exercise and nutrition therapies enhance muscle mass, strength and physical function in sarcopenic older adults. Future research should include long-term follow-up and test adherence-enhancement strategies.
sarcopenia; exercise therapy; nutritional intervention; older adults; scoping review
Xixi Zhang, Wenya Qiang, Huan Xu, Nina Xie, Yichao Liu, Danzen Cuomu, Yulian Zhang, Liang Shang. Combined Exercise–Nutrition Intervention Strategies for Older Adults with Sarcopenia: A Scoping Review. Academic Journal of Medicine & Health Sciences (2025), Vol. 6, Issue 9: 8-13. https://doi.org/10.25236/AJMHS.2025.060902.
[1] Cruz-Jentoft, A.J., et al., Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing, 2019. 48(1): p. 16–31.
[2] Shafiee, G., et al., Prevalence of sarcopenia in the world: a systematic review and meta- analysis of general population studies. Journal of diabetes and metabolic disorders, 2017. 16(eCollection 2017): p. 21.
[3] Cho, M.A.-O., S.A.-O. Lee, and S.A.-O. Song, A Review of Sarcopenia Pathophysiology, Diagnosis, Treatment and Future Direction. Journal of Korean medical science, 2022. 37(18): p. e146.
[4] Arksey H and O.m. L., Scoping studies: towards a methodological framework. International journal of social research methodology, 2005: p. 19-32.
[5] Amir-Behghadami, M.A.-O. and A. Janati, Population, Intervention, Comparison, Outcomes and Study (PICOS) design as a framework to formulate eligibility criteria in systematic reviews. Emergency medicine journal, 2020. 37(6): p. 387.
[6] Chen, L.K., et al., Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. Journal of the American Medical Directors Association, 2020. 21(3): p. 300-307.e2.
[7] Bell, K., et al., A whey protein-based, multi-ingredient supplement independently stimulates gains in lean body mass and strength, and enhances exercise-induced adaptations in older men. FASEB journal, 2017. 31(1).
[8] Meza-Valderrama, D., et al., Supplementation with 13-hydroxy-13-methylbutyrate after resistance training in post-acute care patients with sarcopenia: A randomized, double-blind placebo-controlled trial. ARCHIVES OF GERONTOLOGY AND GERIATRICS, 2024. 119.
[9] Peng, L.-N., et al., Sarcojoint®, the branched-chain amino acid-based supplement, plus resistance exercise improved muscle mass in adults aged 50 years and older: A double-blinded randomized controlled trial. EXPERIMENTAL GERONTOLOGY, 2022. 157.
[10] Yamada, M., et al., Synergistic effect of bodyweight resistance exercise and protein supplementation on skeletal muscle in sarcopenic or dynapenic older adults. GERIATRICS & GERONTOLOGY INTERNATIONAL, 2019. 19(5): p. 429-437.
[11] Chang, K.-V., et al., Enhanced serum levels of tumor necrosis factor-α, interleukin-1β, and-6 in sarcopenia: alleviation through exercise and nutrition intervention. AGING-US, 2023. 15(22): p. 13471-13485.
[12] Daly, R.M., et al., Protein-enriched diet, with the use of lean red meat, combined with progressive resistance training enhances lean tissue mass and muscle strength and reduces circulating IL-6 concentrations in elderly women: a cluster randomized controlled trial. AMERICAN JOURNAL OF CLINICAL NUTRITION, 2014. 99(4): p. 899-910.
[13] Ji, S., et al., Effect of Exercise and Nutrition Intervention for Older Adults with Impaired Physical Function with Preserved Muscle Mass (Functional Sarcopenia): a Randomized Controlled Trial. Clinical interventions in aging, 2025. 20: p. 161‐170.
[14] Kim, H.K., et al., Effects of Exercise and Amino Acid Supplementation on Body Composition and Physical Function in Community-Dwelling Elderly Japanese Sarcopenic Women: A Randomized Controlled Trial. JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2012. 60(1): p. 16-23.
[15] Li, W., et al., Impact of nutrition intervention and physical exercise on muscle mass and body fat among community elderly with sarcopenia: a randomized controlled study. Chinese journal of clinical nutrition, 2022. 30(1): p. 1‐8.
[16] Rondanelli, M., et al., Whey protein, amino acids, and vitamin D supplementation with physical activity increases fat-free mass and strength, functionality, and quality of life and decreases inflammation in sarcopenic elderly. AMERICAN JOURNAL OF CLINICAL NUTRITION, 2016. 103(3): p. 830-840.
[17] Wang, B., et al., Preliminary study on nutritional and exercise strategies to prevent and reverse sarcopenia in aging: an open-label single-arm trial. ASIA PACIFIC JOURNAL OF CLINICAL NUTRITION, 2025. 34(2): p. 249-261.
[18] Zdzieblik, D., et al., Collagen peptide supplementation in combination with resistance training improves body composition and increases muscle strength in elderly sarcopenic men: a randomised controlled trial. BRITISH JOURNAL OF NUTRITION, 2015. 114(8): p. 1237-1245.
[19] da Cruz Alves, N.M., et al., Randomised Controlled Trial of Fish Oil Supplementation on Responsiveness to Resistance Exercise Training in Sarcopenic Older Women. NUTRIENTS, 2022. 14(14).
[20] Mori, H. and Y. Tokuda, De-Training Effects Following Leucine-Enriched Whey Protein Supplementation and Resistance Training in Older Adults with Sarcopenia: A Randomized Controlled Trial with 24 Weeks of Follow-Up. JOURNAL OF NUTRITION HEALTH & AGING, 2022. 26(11): p. 994-1002.
[21] Gade, J., et al., Protein supplementation combined with low-intensity resistance training in geriatric medical patients during and after hospitalisation: a randomised, double-blind, multicentre trial. BRITISH JOURNAL OF NUTRITION, 2019. 122(9): p. 1006-1020.
[22] Osuka, Y., et al., β-Hydroxy-β-Methylbutyrate Supplementation May Not Enhance Additional Effects of Exercise on Muscle Quality in Older Women. MEDICINE & SCIENCE IN SPORTS & EXERCISE, 2022. 54(4): p. 543-550.
[23] Bjorkman, M.P., et al., Effect of Protein Supplementation on Physical Performance in Older People With SarcopeniaA Randomized Controlled Trial. JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION, 2020. 21(2): p. 226-232.e1.
[24] Yamamoto, K., et al., Effectiveness of a preoperative exercise and nutritional support program for elderly sarcopenic patients with gastric cancer. Gastric Cancer, 2017. 20(5): p. 913-918.
[25] Kemmler, W., et al., Effects of Combined Whole-Body Electromyostimulation and Protein Supplementation on Local and Overall Muscle/Fat Distribution in Older Men with Sarcopenic Obesity: The Randomized Controlled Franconia Sarcopenic Obesity (FranSO) Study. CALCIFIED TISSUE INTERNATIONAL, 2018. 103(3): p. 266-277.
[26] Nabuco, H.C.G., et al., Effect of whey protein supplementation combined with resistance training on body composition, muscular strength, functional capacity, and plasma-metabolism biomarkers in older women with sarcopenic obesity: A randomized, double-blind, placebo-controlled trial. Clinical nutrition ESPEN, 2019. 32: p. 88-95.
[27] Kemmler, W., et al., Effects of High Intensity Dynamic Resistance Exercise and Whey Protein Supplements on Osteosarcopenia in Older Men with Low Bone and Muscle Mass. Final Results of the Randomized Controlled FrOST Study. NUTRIENTS, 2020. 12(8).
[28] Xiang, Q., et al., Walking exercise through smartphone application plus branched-chain amino acid supplementation benefits skeletal muscle mass and strength in liver cirrhosis: A prospective control trial. ZEITSCHRIFT FUR GASTROENTEROLOGIE, 2024. 62(02): p. 183-192.
[29] Guan, Y., et al., Efficacy of nutritional intervention and exercise rehabilitation therapy on sarcopenia in elderly patients with type 2 diabetes mellitus. Chinese Journal of Health Management, 2023. 17(3): p. 194-199.
[30] Hu, H., et al., Efficacy of nutrition intervention combined with rehabilitation exercise in elderly patients with chronic heart failure complicated by sarcopenia. Chinese Journal of Health Management, 2023. 17(11): p. 811-815.
[31] Nie, N., et al., Clinical Efficacy of Nutritional Intervention Combined with Muscle Exercise on Sarcopenia Patients with Femoral Fracture: A Pilot Randomized Controlled Trial. BIOMED RESEARCH INTERNATIONAL, 2023. 2023: p. 3222686.