Comparative efficacy of combined exercise and nutritional interventions for sarcopenia: A systematic review and network meta-analysis incorporating remote delivery models.
Level 1 - systematic review of randomized trials
Systematic review and network meta-analysis of randomized controlled trials
PubMed 41996930 · doi:10.1016/j.archger.2026.106239
What was done
A systematic review and network meta-analysis evaluated 115 randomized controlled trials comprising 10,967 participants (average age 74.85 years) to compare the comparative efficacy of 27 pharmacological and non-pharmacological interventions for sarcopenia, including in-person exercise modalities, nutritional strategies, and remote delivery models.
What was found
Endurance training followed by resistance training yielded the highest effect on muscle strength (standardized mean difference [SMD] 2.59, 95% CI 1.50 to 3.69). General remote training was most effective for lean mass (SMD 1.35, 95% CI 0.41 to 2.29) and physical performance (SMD 2.39, 95% CI 1.26 to 3.53). The combination of nutrition with aerobic and resistance training significantly improved muscle strength (SMD 1.25, 95% CI 0.64 to 1.87) and physical performance (SMD 1.73, 95% CI 1.09 to 2.37). Resistance training alone improved body fat mass (SMD -0.57, 95% CI -0.75 to -0.40), inflammatory markers (SMD -1.69, 95% CI -1.95 to -1.43), and knee extension strength (SMD 0.55, 95% CI 0.33 to 0.76). Aerobic exercise reduced body fat (SMD -0.48, 95% CI -0.87 to -0.09) and inflammation (SMD -1.98, 95% CI -2.31 to -1.66), and improved quality of life (SMD 0.71, 95% CI 0.53 to 1.03). Sample size, age, and intervention duration were significant moderators of treatment effects.
Why it matters
This review establishes that combining resistance training, aerobic exercise, and targeted nutrition is the most comprehensive strategy for managing sarcopenia, while demonstrating that remote intervention delivery is a viable, highly effective approach for improving lean mass and physical function in older adults.
Limits
Specific types and dosages of nutritional supplements or pharmacological agents were not detailed in the abstract. Interventions spanned 27 distinct nodes, introducing potential heterogeneity across protocols. Study duration, participant age, and sample size significantly moderated outcomes, and long-term sustainability or compliance beyond the intervention periods was not reported.
Cited by
- partial Two to three sessions per week of resistance training is the only intervention that reverses sarcopenia.