The effects of exercise and milk-fat globule membrane (MFGM) on walking parameters in community-dwelling elderly Japanese women with declines in walking ability: A randomized placebo controlled trial.

OBJECTIVE: To investigate the effects of exercise and milk fat globule membrane (MFGM) supplementation on walking ability and walking parameters in community-dwelling elderly Japanese women with declined walking ability. METHODS: A randomized placebo controlled trial was performed on 126 elderly community-dwelling women over 79 years old. Participants were randomly assigned to one of four three-month interventions: exercise and MFGM (Ex + MFGM), exercise and placebo (Ex + P), MFGM, and placebo interventions. The exercise intervention group performed one-hour progressive exercise classes twice a week. The MFGM supplementation included ingesting 1 g of MFGM per day. Medical history, physical function measurements included grip strength, knee extension strength, walking speed, as well as walking parameters, and blood components were analyzed. RESULTS: Significant group × time interactions were observed in usual walking speed, stride, and foot progression angle between the groups. Walking speed improved in both exercise groups (P < 0.001). Similarly, stride significantly increased in the exercise groups compared to the MFGM and placebo groups (P < 0.001). Foot progression angle decreased in the exercise groups (P = 0.023) but not in MFGM or placebo groups. Participants with decreased or unchanged walking speed had significantly lower knee extension strength at baseline (P = 0.016), and a higher prevalence of knee OA (P = 0.033, P = 0.010, respectively). CONCLUSION: The exercise interventions alone or combined with nutrition were effective in improving walking speed as well as other walking parameters. Improvement in stride and foot progression angle may have contributed to the increase in walking speed. However, augmented effects of MFGM with exercise could not be confirmed.

Association between exercise type and the decline in instrumental activities of daily living in community-dwelling older women: A 4-year prospective study.

Exercise can delay the decline of instrumental activities of daily living (IADL), although it remains unclear which specific exercise types are associated with such a delay. This 4-year prospective cohort study in Japan aimed to identify the longitudinal associations between exercise types and the onset of IADL decline in older women. Between 2008 and 2012, 1082 community-dwelling older women aged ≥75 years participated in this study. Participations in 16 exercise types based on a face-to-face interview at baseline were used as independent variables. The primary study outcome was a decline in IADL as assessed using the instrumental self-maintenance subscale of the Tokyo Metropolitan Institute of Gerontology index of competence. An IADL decline was defined as a decrease of ≥1 point over the 4-year follow-up period and was used as the dependent variable. Adjusted odds ratios (ORs) and 95% confident intervals (CIs) for IADL decline based on participation or non-participation in each exercise type were obtained using logistic regression analyses. An IADL decline was observed in 151 participants (13.9%) over the 4-year follow-up period. After adjustment for potential confounders, participation in calisthenics had a significantly lower OR (0.62; 95% CI 0.42-0.90) for IADL decline. There were no significant associations between other specific exercise types and IADL decline. In conclusion, participation in calisthenics was significantly and independently associated with delayed IADL decline in older women aged ≥75 years. Thus, calisthenics may be a useful exercise to slow IADL decline in this age group.

Exercise and Nutritional Supplementation on Community-Dwelling Elderly Japanese Women With Sarcopenic Obesity: A Randomized Controlled Trial.

OBJECTIVES: To investigate the effects of exercise and/or nutritional supplementation on body composition, blood components, and physical function in community-dwelling elderly Japanese women with sarcopenic obesity. DESIGN: Randomized controlled trial. SETTING: Urban community in Tokyo, Japan. PARTICIPANTS: Among 1213 community-dwelling elderly women over 70 years of age, 307 were defined with sarcopenic obesity, and 139 women participated in the study. INTERVENTION: Participants were randomly assigned to one of four intervention groups. The exercise and nutrition (Ex + N) and exercise only (Ex) groups attended 60-minute exercise classes twice a week for 3 months. The Ex + N and nutrition only (N) groups were provided with essential amino acid supplementation and tea fortified with catechins to be taken daily for 3 months. Health education classes were provided to the control (HE) group every 2 weeks. MEASUREMENTS: Bioelectric impedance analysis was used to measure body composition. Skeletal muscle mass index was calculated using measures of muscle mass and height. Physical function measures included grip strength, knee extension strength, usual walking speed, and walking parameters (stride, step length, width, walking angles). Blood samples were obtained to analyze levels of albumin, triglycerides, cholesterol, hemoglobin A1c, leptin, cystatin C, vitamin D, interleukin-6, and high-sensitivity C-reactive protein. RESULTS: Significant between-group × time interactions were observed in usual walking speed (P = .012), stride (P = .004), right step length (P = .003), average number of steps (P = .029), and vitamin D (P < .001). Compared to the HE group, the Ex + N intervention significantly decreased total body fat mass (P = .036) and increased stride (P = .038) and vitamin D (P < .001). Significant reductions in trunk fat were observed in the Ex group compared with HE (P = .014). The Ex + N and Ex interventions were over four times as likely (odds ratio [95% confidence interval]) to reduce body fat mass than the HE group (4.42 [1.21-16.19]; 4.50 [1.13-17.9], respectively). Significant odds ratios of the Ex + N intervention improving walking speed (3.05 [1.01-9.19]), vitamin D (14.22 [1.64-123.02]), and leptin (3.86 [1.19-12.47]) were also observed. CONCLUSION: Although exercise and nutrition have beneficial effects on individual variables of body composition, blood components, and physical function, improvements in muscle mass and variable combinations such as percent fat + skeletal muscle mass index or percent fat + physical functions were not observed in this population. Further large-scale and long-term investigation is necessary.