Abstract
BACKGROUND: Sarcopenia is characterized by progressive loss of muscle strength, mass, and function, representing a major public health concern, particularly in aging populations. According to incomplete statistics, approximately 10-30% of older adults worldwide are affected by sarcopenia, this health issue has imposed substantial impacts on global public health systems and economic burdens. Due to the disease’s multifactorial pathogenesis, no targeted pharmacotherapies currently exist. Research indicates that nutritional intervention, as a complementary alternative therapy, promotes muscle protein synthesis and maintains musculoskeletal health. However, the efficacy of nutritional therapy remains controversial due to sarcopenia’s multifactorial etiology. OBJECTIVE: This study systematically evaluates the therapeutic efficacy of protein-based multinutritional interventions for sarcopenia through a high-quality meta-analysis. METHODS: We systematically searched electronic databases from inception to January 6, 2025, including PubMed, EMBASE, Web of Science, Scopus, Ovid/MEDLINE, and ProQuest. Randomized controlled trials (RCTs) meeting the inclusion criteria were subjected to meta-analysis using STATA 17.0 for statistical computations. RESULTS: A total of 10 studies involving 1,359 participants with intervention durations ranging from 12 to 48 weeks were included. The meta-analysis demonstrated significant improvements with nutritional therapy: handgrip strength (HGS) (MD = 0.33 kg, 95% CI: 0.07 to 0.60), gait speed (GS) (MD = 0.15 m/s, 95% CI: 0.03 to 0.28), and Insulin-like Growth Factor-1 (IGF-1) levels (MD = 0.49 ng/mL, 95% CI: 0.33 to 0.65). Compared to placebo, no statistically significant differences were observed for Short Physical Performance Battery (SPPB) (SMD = 0.06, 95% CI: -0.12 to 0.23), chair-stand time (MD = -0.15 s, 95% CI: -0.37 to 0.07), or Skeletal Muscle Index (SMI) (MD = 0.61 kg/m², 95% CI: -0.41 to 1.64). CONCLUSIONS: Protein-based multinutrient therapy significantly improved HGS, GS, and IGF-1 levels in patients with sarcopenia, but showed no significant effects on SPPB scores, chair-stand time, or SMI. The included studies were generally of high quality, and the results are relatively reliable, however, more high-quality RCTs are needed for further validation. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40520-025-03114-4.