A multicomponent intervention consisting of exercise, proteins and omega-3 supplementation to improve sarcopenia in community-dwelling older adults: Lessons learned from a 5-armed randomized controlled feasibility trial.

BACKGROUND

Anabolic interventions, including physical exercise, proteins and omega-3 polyunsaturated fatty acids (PUFAs) supplementation, have shown effectiveness in improving sarcopenia outcomes. However, data on their combined effects in older adults with sarcopenia remain limited.

OBJECTIVES

To assess feasibility, acceptability, and preliminary effects of a multicomponent intervention combining individualized home-based exercise, proteins, and/or omega-3 supplementation.

DESIGN

Parallel five-armed randomized assessor-blinded controlled feasibility trial with triple-blinded supplementation.

PARTICIPANTS AND

SETTING

Community-dwelling older adults (≥65 years) diagnosed with sarcopenia (EWGSOP2-criteria) from the Exercise and Nutrition for Healthy Ageing (ENHANce) study. The ENHANce study was registered on ClinicalTrials.gov (NCT03649698).

INTERVENTION: Participants were randomized into 5 groups: 1) Exercise, 2) Proteins, 3) Exercise+Protein, 4) Exercise+Protein+Omega-3, and 5) Control group.

MEASUREMENTS: Feasibility was assessed via eligibility, recruitment, retention, and data completion rates. Acceptability was evaluated through participants' feedback, adherence, and safety. Effects were measured by changes in sarcopenia outcomes after 12 weeks.

RESULTS

Fifty-eight participants (76.2±6.6years,♀:65.5%) were included (Exercise,n=9;Protein,n=12; Exercise+Protein,n=13;Exercise+Protein+Omega-3;n=12;Control,n=12). Feasibility was low, with a recruitment rate of 2%. Acceptability was moderate, with most participants completing the planned assessments and reporting positive experiences such as feeling stronger and more aware of the importance of physical activity and nutrition. However, many found the study procedures demanding, and many experienced difficulties with the protein supplements. Adherence varied widely across interventions. Safety was high, with no significant adverse effects reported. The interventions showed potential to improve chair stand test (CST), Short Physical Performance Battery (SPPB), muscle mass and quadriceps strength.

CONCLUSION

A multicomponent intervention to treat sarcopenia showed low feasibility, moderate acceptability, and high safety. Preliminary efficacy results showed that exercise with protein supplementation may improve physical function. Adding omega-3 PUFA might offer further benefits for muscle strength and mass, but should be confirmed in larger studies. The insights and the practical challenges in the ENHANce study inform future sarcopenia intervention designs.