Nutritional Support With Or Without Exercise for Older Adults With GLIM-Compatible Malnutrition: A Meta-Analysis of...

Area of Science:

• Gerontology
• Nutritional Science
• Exercise Physiology

Background:

• Malnutrition is prevalent in older adults, leading to decreased physical function.
• The Global Leadership Initiative on Malnutrition (GLIM) 2025 framework provides updated criteria for diagnosing malnutrition.
• Nutritional support (NS) is a common intervention, but its efficacy may be enhanced by exercise.

Purpose of the Study:

• To evaluate if combining exercise with NS improves physical function in older adults with malnutrition compared to NS alone.
• To assess the impact on specific physical function outcomes like upper and lower limb strength, muscle mass, and mobility.

Main Methods:

• A systematic meta-analysis of 17 randomized controlled trials (RCTs) was conducted.
• Participants met GLIM-defined malnutrition criteria.
• Data were analyzed using random-effects models, focusing on physical function and nutritional outcomes.

Main Results:

• Combined exercise and NS significantly improved lower limb strength (SMD 0.35) and usual walking speed (UWS) (SMD 0.38).
• No significant improvements were observed in upper limb strength, muscle mass, or lean body mass (LBM).
• GRADE certainty was moderate for lower limb strength but low to very low for other outcomes.

Conclusions:

• Exercise combined with NS offers benefits for lower limb strength and UWS in malnourished older adults.
• This combined approach optimizes specific functional outcomes but lacks demonstrated benefits for body composition or upper limb strength.
• Further research with higher GRADE certainty is needed to confirm effects on mobility and body composition.