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Systematic review and meta-analysis of the effect of protein and amino acid supplements in older adults with acute or chronic conditions

  • Heilok Cheng (a1), Jielan Kong (a1), Catherine Underwood (a1), Peter Petocz (a2), Vasant Hirani (a1), Beryl Dawson (a3) and Fiona O’Leary (a1)...

The loss of lean body mass, muscle strength and physical function causes significant problems in older adults. Protein and amino acid supplements can preserve muscle strength but the effect on function is variable. We conducted a systematic literature review and meta-analysis to investigate the effect of protein and amino acid supplementation on fat-free mass, muscle strength and physical function in malnourished, frail, sarcopenic, dependent or elderly with acute or chronic conditions, with or without rehabilitation exercise. Databases searched included Medline, BIOSIS, CINAHL, Cochrane Library, EBM Reviews, Embase, Pre-Medline, ProQuest, PubMed and Scopus. Retrieved articles were assessed by two reviewers using the Cochrane Risk of Bias (ROB) Tool. In all, thirty nine randomised controlled trails (n 4274) were included. The studies used a range of protein or essential amino acid (EAA) supplements in a variety of settings, including hospital, community and long-term care. Only seven studies had low ROB and no effect of supplementation was found on any outcomes. Analysis of all thirty-nine studies suggest protein and EAA supplements may improve fat-free mass, muscle strength and physical function (standardised mean difference 0·21–0·27, all P<0·005), but significant heterogeneity and ROB was evident. Predetermined subgroup analysis found undernourished elderly benefitted most; EAA were the most effective supplements and small beneficial effects were seen without rehabilitation exercise. The high heterogeneity and few studies with low ROB limits the conclusions and more high quality studies are needed to determine the best nutritional strategies for the maintenance of strength and function with increasing age.

Corresponding author
* Corresponding author: F. O’Leary, email
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1. Cruz-Jentoft, AJ, Baeyens, JP, Bauer, JM, et al. (2010) Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing 39, 412423.
2. Cruz-Jentoft, AJ, Landi, F, Topinkova, E, et al. (2010) Understanding sarcopenia as a geriatric syndrome. Curr Opin Clin Nutr Metab Care 13, 17.
3. Janssen, I, Shepard, DS, Katzmarzyk, PT, et al. (2004) The healthcare costs of sarcopenia in the United States. J Am Geriatr Soc 52, 8085.
4. Morley, JE, Anker, SD & von Haehling, S (2014) Prevalence, incidence, and clinical impact of sarcopenia: facts, numbers, and epidemiology-update 2014. J Cachexia Sarcopenia Muscle 5, 253259.
5. National Institute on Aging, National Institutes of Health & US Department of Health and Human Services et al. (2011) Humanity’s Aging. Global Health and Aging. (accessed December 2015).
6. Paddon-Jones, D & van Loon, L (2012) Nutritional approaches to treating sarcopenia. In Sarcopenia, pp. 275295 [AJ Cruz-Jentoft and JE Morley, editors]. New York: John Wiley & Sons, Ltd.
7. Bauer, J, Biolo, G, Cederholm, T, et al. (2013) Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the prot-age study group. J Am Med Dir Assoc 14, 542559.
8. Fujita, S & Volpi, E (2004) Nutrition and sarcopenia of ageing. Nutr Res Rev 17, 6976.
9. Paddon-Jones, D & Rasmussen, BB (2009) Dietary protein recommendations and the prevention of sarcopenia. Curr Opin Clin Nutr Metab Care 12, 8690.
10. Nowson, C & O’Connell, S (2015) Protein requirements and recommendations for older people: a review. Nutrients 7, 68746899.
11. Rolland, Y, Dupuy, C, Abellan van Kan, G, et al. (2011) Treatment strategies for sarcopenia and frailty. Med Clin North Am 95, 427438.
12. Volpi, E, Kobayashi, H, Sheffield-Moore, M, et al. (2003) Essential amino acids are primarily responsible for the amino acid stimulation of muscle protein anabolism in healthy elderly adults. Am J Clin Nutr 78, 250258.
13. Katsanos, CS, Kobayashi, H, Sheffield-Moore, M, et al. (2006) A high proportion of leucine is required for optimal stimulation of the rate of muscle protein synthesis by essential amino acids in the elderly. Am J Physiol Endocrinol Metab 291, E381E387.
14. Aquilani, R, Opasich, C, Gualco, A, et al. (2008) Adequate energy-protein intake is not enough to improve nutritional and metabolic status in muscle-depleted patients with chronic heart failure. Eur J Heart Fail 10, 11271135.
15. Rondanelli, M, Opizzi, A, Antoniello, N, et al. (2011) Effect of essential amino acid supplementation on quality of life, amino acid profile and strength in institutionalized elderly patients. Clin Nutr 30, 571577.
16. Dal Negro, RW, Aquilani, R, Bertacco, S, et al. (2010) Comprehensive effects of supplemented essential amino acids in patients with severe COPD and sarcopenia. Monaldi Arch Chest Dis 73, 2533.
17. Symons, TB, Sheffield-Moore, M, Wolfe, RR, et al. (2009) A moderate serving of high-quality protein maximally stimulates skeletal muscle protein synthesis in young and elderly subjects. J Am Diet Assoc 109, 15821586.
18. Bouillanne, O, Neveux, N, Nicolis, I, et al. (2014) Long-lasting improved amino acid bioavailability associated with protein pulse feeding in hospitalized elderly patients: a randomized controlled trial. Nutrition 30, 544550.
19. Cawood, AL, Elia, M & Stratton, RJ (2012) Systematic review and meta-analysis of the effects of high protein oral nutritional supplements. Ageing Res Rev 11, 278296.
20. Malafarina, V, Uriz-Otano, F, Iniesta, R, et al. (2013) Effectiveness of nutritional supplementation on muscle mass in treatment of sarcopenia in old age: a systematic review. J Am Med Dir Assoc 14, 1017.
21. Cermak, NM, Res, PT, De Groot, LCPGM, et al. (2012) Protein supplementation augments the adaptive response of skeletal muscle to resistance-type exercise training: a meta-analysis. Am J Clin Nutr 96, 14541464.
22. Finger, D, Goltz, F, Umpierre, D, et al. (2015) Effects of protein supplementation in older adults undergoing resistance training: a systematic review and meta-analysis. Sports Med 45, 245255.
23. Moher, D, Liberati, A, Tetzlaff, J, et al. (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151, 264269, w264.
24. Rhea, MR, Alvar, BA, Burkett, LN, et al. (2003) A meta-analysis to determine the dose response for strength development. Med Sci Sports Exerc 35, 456464.
25. The Cochrane Collaboration (2011) The Cochrane Collaboration’s tool for assessing risk of bias. In Cochrane Handbook for Systematic Reviews of Interventions, chapter 5, section 8.
26. Baldi, S, Aquilani, R, Pinna, GD, et al. (2010) Fat-free mass change after nutritional rehabilitation in weight losing COPD: role of insulin, C-reactive protein and tissue hypoxia. Int J Chron Obstruct Pulmon Dis 5, 2939.
27. Feldblum, I, German, L, Castel, H, et al. (2011) Individualized nutritional intervention during and after hospitalization: the nutrition intervention study clinical trial. J Am Geriatr Soc 59, 1017.
28. Gray-Donald, K, Payette, H & Boutier, V (1995) Randomized clinical trial of nutritional supplementation shows little effect on functional status among free-living frail elderly. J Nutr 125, 29652971.
29. Hampson, G, Martin, FC, Moffat, K, et al. (2003) Effects of dietary improvement on bone metabolism in elderly underweight women with osteoporosis: a randomised controlled trial. Osteoporos Int 14, 750756.
30. Manders, M, De Groot, LC, Hoefnagels, WH, et al. (2009) The effect of a nutrient dense drink on mental and physical function in institutionalized elderly people. J Nutr Health Aging 13, 760767.
31. Neelemaat, F, Bosmans, JE, Thijs, A, et al. (2011) Post-discharge nutritional support in malnourished elderly individuals improves functional limitations. J Am Med Dir Assoc 12, 295301.
32. Price, R, Daly, F, Pennington, CR, et al. (2005) Nutritional supplementation of very old people at hospital discharge increases muscle strength: a randomised controlled trial. Gerontology 51, 179185.
33. Stange, I, Bartram, M, Liao, Y, et al. (2013) Effects of a low-volume, nutrient- and energy-dense oral nutritional supplement on nutritional and functional status: a randomized, controlled trial in nursing home residents. J Am Med Dir Assoc 14, 628.e621–628.
34. Stow, R, Ives, N, Smith, C, et al. (2015) A cluster randomised feasibility trial evaluating nutritional interventions in the treatment of malnutrition in care home adult residents. Trials 16, 433.
35. Tidermark, J, Ponzer, S, Carlsson, P, et al. (2004) Effects of protein-rich supplementation and nandrolone in lean elderly women with femoral neck fractures. Clin Nutr 23, 587596.
36. Woo, J, Ho, SC, Mak, YT, et al. (1994) Nutritional status of elderly patients during recovery from chest infection and the role of nutritional supplementation assessed by a prospective randomized single-blind trial. Age Ageing 23, 4048.
37. Wouters-Wesseling, W, Slump, E, Kleijer, CN, et al. (2006) Early nutritional supplementation immediately after diagnosis of infectious disease improves body weight in psychogeriatric nursing home residents. Aging Clin Exp Res 18, 7074.
38. Wouters-Wesseling, W, Van Hooijdonk, C, Wagenaar, L, et al. (2003) The effect of a liquid nutrition supplement on body composition and physical functioning in elderly people. Clin Nutr 22, 371377.
39. Wouters-Wesseling, W, Wouters, AE, Kleijer, CN, et al. (2002) Study of the effect of a liquid nutrition supplement on the nutritional status of psycho-geriatric nursing home patients. Eur J Clin Nutr 56, 245251.
40. Boreinstein, M, Hedges, LV, Higgins, JPT, et al. (2009) Introduction to Meta-Analysis. Chichester: John Wiley and Sons, Ltd.
41. Kim, CO & Lee, KR (2013) Preventive effect of protein-energy supplementation on the functional decline of frail older adults with low socioeconomic status: a community-based randomized controlled study. J Gerontol A Biol Sci Med Sci 68, 309316.
42. Tieland, M, Borgonjen-Van Den Berg, KJ, Van Loon, LJC, et al. (2012) Dietary protein intake in community-dwelling, frail, and institutionalized elderly people: scope for improvement. Eur J Nutr 51, 173179.
43. Zak, M, Swine, C & Grodzicki, T (2009) Combined effects of functionally-oriented exercise regimens and nutritional supplementation on both the institutionalised and free-living frail elderly (double-blind, randomised clinical trial). BMC Public Health 9, 39.
44. Fiatarone, MA, O’Neill, EF, Ryan, ND, et al. (1994) Exercise training and nutritional supplementation for physical frailty in very elderly people. N Engl J Med 330, 17691775.
45. Kim, HK, Suzuki, T, Saito, K, et al. (2012) Effects of exercise and amino acid supplementation on body composition and physical function in community-dwelling elderly Japanese sarcopenic women: a randomized controlled trial. J Am Geriatr Soc 60, 1623.
46. Rosendahl, E, Lindelof, N, Littbrand, H, et al. (2006) High-intensity functional exercise program and protein-enriched energy supplement for older persons dependent in activities of daily living: a randomised controlled trial. Aust J Physiother 52, 105113.
47. Milne, AC, Potter, J, Vivanti, A, et al. (2009) Protein and energy supplementation in elderly people at risk from malnutrition. Cochrane Database Syst Rev, issue 2, CD003288.
48. Deeks, JJ, Higgins, JPT & Altman, DG (2011) Analysing data and undertaking meta-analyses. In Cochrane Handbook for Systematic Reviews of Interventions , 5.0.1 [JJ Deeks and JPT Higgins, editors]. The Cochrane Collaboration.
49. Durlak, JA (2009) How to select, calculate, and interpret effect sizes. J Pediatr Psychol 34, 917928.
50. Bouillanne, O, Curis, E, Hamon-Vilcot, B, et al. (2013) Impact of protein pulse feeding on lean mass in malnourished and at-risk hospitalized elderly patients: a randomized controlled trial. Clin Nutr 32, 186192.
51. Payette, H, Boutier, V, Coulombe, C, et al. (2002) Benefits of nutritional supplementation in free-living, frail, undernourished elderly people: a prospective randomized community trial. J Am Diet Assoc 102, 10881095.
52. Dreyer, HC, Strycker, LA, Senesac, HA, et al. (2013) Essential amino acid supplementation in patients following total knee arthroplasty. J Clin Invest 123, 46544666.
53. Smoliner, C, Norman, K, Scheufele, R, et al. (2008) Effects of food fortification on nutritional and functional status in frail elderly nursing home residents at risk of malnutrition. Nutrition 24, 11391144.
54. Aleman-Mateo, H, Macias, L, Esparza-Romero, J, et al. (2012) Physiological effects beyond the significant gain in muscle mass in sarcopenic elderly men: evidence from a randomized clinical trial using a protein-rich food. Clin Interv Aging 7, 225234.
55. Bakhtiari, A, Yassin, Z, Hanachi, P, et al. (2012) Effects of soy on body composition: a 12-week randomized controlled trial among Iranian elderly women with metabolic syndrome. Iran J Public Health 41, 918.
56. Bauer, JM, Verlaan, S, Bautmans, I, et al. (2015) Effects of a vitamin d and leucine-enriched whey protein nutritional supplement on measures of sarcopenia in older adults, the provide study: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc 16, 740747.
57. Björkman, MP, Finne-Soveri, H & Tilvis, RS (2012) Whey protein supplementation in nursing home residents. A randomized controlled trial. Eur Geriatr Med 3, 161166.
58. Bonnefoy, M, Cornu, C, Normand, S, et al. (2003) The effects of exercise and protein-energy supplements on body composition and muscle function in frail elderly individuals: a long-term controlled randomised study. Br J Nutr 89, 731739.
59. Cameron, ID, Kurrle, SE, Uy, C, et al. (2011) Effectiveness of oral nutritional supplementation for older women after a fracture: rationale, design and study of the feasibility of a randomized controlled study. BMC Geriatr 11, 32.
60. Chapman, IM, Visvanathan, R, Hammond, AJ, et al. (2009) Effect of testosterone and a nutritional supplement, alone and in combination, on hospital admissions in undernourished older men and women. Am J Clin Nutr 89, 880889.
61. Collins, CE, Kershaw, J & Brockington, S (2005) Effect of nutritional supplements on wound healing in home-nursed elderly: a randomized trial. Nutrition 21, 147155.
62. Dangour, AD, Albala, C, Allen, E, et al. (2011) Effect of a nutrition supplement and physical activity program on pneumonia and walking capacity in Chilean older people: a factorial cluster randomized trial. PLoS Med 8, e1001023.
63. Espaulella, J, Guyer, H, Diaz-Escriu, F, et al. (2000) Nutritional supplementation of elderly hip fracture patients. A randomized, double-blind, placebo-controlled trial. Age Ageing 29, 425431.
64. Gariballa, S & Forster, S (2007) Effects of dietary supplements on depressive symptoms in older patients: a randomised double-blind placebo-controlled trial. Clin Nutr 26, 545551.
65. Lauque, S, Arnaud-Battandier, F, Gillette, S, et al. (2004) Improvement of weight and fat-free mass with oral nutritional supplementation in patients with Alzheimer’s disease at risk of malnutrition: a prospective randomized study. J Am Geriatr Soc 52, 17021707.
66. Lauque, S, Arnaud-Battandier, F, Mansourian, R, et al. (2000) Protein-energy oral supplementation in malnourished nursing-home residents. A controlled trial. Age Ageing 29, 5156.
67. McMurdo, ME, Price, RJ, Shields, M, et al. (2009) Should oral nutritional supplementation be given to undernourished older people upon hospital discharge? A controlled trial. J Am Geriatr Soc 57, 22392245.
68. Miller, MD, Crotty, M, Whitehead, C, et al. (2006) Nutritional supplementation and resistance training in nutritionally at risk older adults following lower limb fracture: a randomized controlled trial. Clin Rehabil 20, 311323.
69. Myint, MWW, Wu, J, Wong, E, et al. (2013) Clinical benefits of oral nutritional supplementation for elderly hip fracture patients: a single blind randomised controlled trial. Age Ageing 42, 3945.
70. Ng, TP, Feng, L, Nyunt, MSZ, et al. (2015) Nutritional, physical, cognitive, and combination interventions and frailty reversal among older adults: a randomized controlled trial. Am J Med 128, 12251236.
71. Persson, M, Hytter-Landahl, A, Brismar, K, et al. (2007) Nutritional supplementation and dietary advice in geriatric patients at risk of malnutrition. Clin Nutr 26, 216224.
72. Schurch, MA, Rizzoli, R, Slosman, D, et al. (1998) Protein supplements increase serum insulin-like growth factor-I levels and attenuate proximal femur bone loss in patients with recent hip fracture. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 128, 801809.
73. Sugawara, K, Takahashi, H, Kashiwagura, T, et al. (2012) Effect of anti-inflammatory supplementation with whey peptide and exercise therapy in patients with COPD. Respir Med 106, 15261534.
74. Tieland, M, van de Rest, O, Dirks, ML, et al. (2012) Protein supplementation improves physical performance in frail elderly people: a randomized, double-blind, placebo-controlled trial. J Am Med Dir Assoc 13, 720726.
75. Volkert, D, Hubsch, S, Oster, P, et al. (1996) Nutritional support and functional status in undernourished geriatric patients during hospitalization and 6-month follow-up. Aging (Milano) 8, 386395.
76. Yamada, M, Nishiguchi, S, Fukutani, N, et al. (2015) Mail-based intervention for sarcopenia prevention increased anabolic hormone and skeletal muscle mass in community-dwelling Japanese older adults: The INE (Intervention by Nutrition and Exercise) Study. J Am Med Dir Assoc 16, 654660.
77. Bonnefoy, M, Laville, M, Ecochard, R, et al. (2010) Effects of branched amino acids supplementation in malnourished elderly with catabolic status. J Nutr Health Aging 14, 579584.
78. Dal Negro, RW, Testa, A, Aquilani, R, et al. (2012) Essential amino acid supplementation in patients with severe COPD: a step towards home rehabilitation. Monaldi Arch Chest Dis 77, 6775.
79. Abe, S, Ezaki, O & Suzuki, M (2016) Medium-chain triglycerides in combination with leucine and vitamin d increase muscle strength and function in frail elderly adults in a randomized controlled trial. J Nutr 146, 10171026.
80. Leenders, M, Verdijk, LB, van der Hoeven, L, et al. (2011) Prolonged leucine supplementation does not augment muscle mass or affect glycemic control in elderly type 2 diabetic men. J Nutr 141, 10701076.
81. Gariballa, S & Forster, S (2007) Dietary supplementation and quality of life of older patients: a randomized, double-blind, placebo-controlled trial. J Am Geriatr Soc 55, 20302034.
82. The Cochrane Collaboration (2011) Summary assessments of risk of bias. In Cochrane Handbook for Systematic Reviews of Interventions, 5.1.0 ed. [JPT Higgins and S Green, editors]. The Cochrane Collaboration.
83. Higgins, JPT (2012) Incorporating ‘risk of bias’ assessments into meta-analyses. (accessed November 2016).
84. Breen, L & Phillips, SM (2011) Skeletal muscle protein metabolism in the elderly: Interventions to counteract the ‘anabolic resistance’ of ageing. Nutr Metab 8, 68.
85. Paddon-Jones, D, Campbell, WW, Jacques, PF, et al. (2015) Protein and healthy aging. Am J Clin Nutr 101, 1339S1345S.
86. Xu, ZR, Tan, ZJ, Zhang, Q, et al. (2015) The effectiveness of leucine on muscle protein synthesis, lean body mass and leg lean mass accretion in older people: a systematic review and meta-analysis. Br J Nutr 113, 2534.
87. Ham, DJ, Caldow, MK, Lynch, GS, et al. (2014) Leucine as a treatment for muscle wasting: a critical review. Clin Nutr 33, 937945.
88. Deutz, NE, Bauer, JM, Barazzoni, R, et al. (2014) Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin Nutr 33, 929936.
89. Walrand, S, Gryson, C, Salles, J, et al. (2016) Fast-digestive protein supplement for ten days overcomes muscle anabolic resistance in healthy elderly men. Clin Nutr 35, 660668.
90. Phillips, SM, Chevalier, S & Leidy, HJ (2016) Protein ‘requirements’ beyond the RDA: implications for optimizing health. Appl Physiol Nutr Metab 41, 565572.
91. Phillips, SM, Tang, JE & Moore, DR (2009) The role of milk- and soy-based protein in support of muscle protein synthesis and muscle protein accretion in young and elderly persons. J Am Coll Nutr 28, 343354.
92. Paddon-Jones, D, Sheffield-Moore, M, Katsanos, CS, et al. (2006) Differential stimulation of muscle protein synthesis in elderly humans following isocaloric ingestion of amino acids or whey protein. Exp Gerontol 41, 215219.
93. Tang, JE & Phillips, SM (2009) Maximizing muscle protein anabolism: the role of protein quality. Curr Opin Clin Nutr Metab Care 12, 6671.
94. Jonker, R, Deutz, NE, Erbland, ML, et al. (2017) Effectiveness of essential amino acid supplementation in stimulating whole body net protein anabolism is comparable between COPD patients and healthy older adults. Metabolism 69, 120129.
95. Boirie, Y, Dangin, M, Gachon, P, et al. (1997) Slow and fast dietary proteins differently modulate postprandial protein accretion. Proc Natl Acad Sci 94, 1493014935.
96. Witard, OC, Wardle, SL, Macnaughton, LS, et al. (2016) Protein considerations for optimising skeletal muscle mass in healthy young and older adults. Nutrients 8, 181.
97. Conley, TB, Apolzan, JW, Leidy, HJ, et al. (2011) Effect of food form on postprandial plasma amino acid concentrations in older adults. Br J Nutr 106, 203207.
98. Pennings, B, Groen, BB, van Dijk, JW, et al. (2013) Minced beef is more rapidly digested and absorbed than beef steak, resulting in greater postprandial protein retention in older men. Am J Clin Nutr 98, 121128.
99. Phillips, SM (2017) Current concepts and unresolved questions in dietary protein requirements and supplements in adults. Front Nutr 4, 13.
100. Correa-de-Araujo, R, Harris-Love, MO, Miljkovic, I, et al. (2017) The need for standardized assessment of muscle quality in skeletal muscle function deficit and other aging-related muscle dysfunctions: a symposium report. Front Physiol 8, 87.
101. Beyer, KS, Fukuda, DH, Boone, CH, et al. (2016) Short-term unilateral resistance training results in cross education of strength without changes in muscle size, activation, or endocrine response. J Strength Cond Res 30, 12131223.
102. Reid, KF & Fielding, RA (2012) Skeletal muscle power: a critical determinant of physical functioning in older adults. Exerc Sport Sci Rev 40, 412.
103. Clark, BC & Manini, TM (2010) Functional consequences of sarcopenia and dynapenia in the elderly. Curr Opin Clin Nutr Metab Care 13, 271276.
104. Beaudart, C, Buckinx, F, Rabenda, V, et al. (2014) The effects of vitamin D on skeletal muscle strength, muscle mass, and muscle power: a systematic review and meta-analysis of randomized controlled trials. J Clin Endocrinol Metab 99, 43364345.
105. Murphy, CH, Churchward-Venne, TA, Mitchell, CJ, et al. (2015) Hypoenergetic diet-induced reductions in myofibrillar protein synthesis are restored with resistance training and balanced daily protein ingestion in older men. Am J Physiol Endocrinol Metab 308, E734e743.
106. Stratton, RJ, Hebuterne, X & Elia, M (2013) A systematic review and meta-analysis of the impact of oral nutritional supplements on hospital readmissions. Ageing Res Rev 12, 884897.
107. Creutzberg, EC, Wouters, EFM, Mostert, R, et al. (2003) Efficacy of nutritional supplementation therapy in depleted patients with chronic obstructive pulmonary disease. Nutrition 19, 120127.
108. Gaffney-Stomberg, E, Insogna, KL, Rodriguez, NR, et al. (2009) Increasing dietary protein requirements in elderly people for optimal muscle and bone health. J Am Geriatr Soc 57, 10731079.
109. Ikizler, TA, Cano, NJ, Franch, H, et al. (2013) Prevention and treatment of protein energy wasting in chronic kidney disease patients: a consensus statement by the International Society of Renal Nutrition and Metabolism. Kidney Int 84, 10961107.
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