Effects of progressive resistance training combined with a protein-enriched lean red meat diet on health-related quality of life in elderly women: secondary analysis of a 4-month cluster randomised controlled trial

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Human and Clinical Nutrition

Most people strive to maintain their independence and quality of life (QoL) into old age, in the face of increasing life expectancy. QoL comprises broad concepts that affect global life satisfaction, including good health, adequate housing, employment, personal and family safety, interpersonal relationships, education and leisure pursuits⁽¹⁾. QoL has been applied specifically to those life concerns that are most affected by health or illness, hence the term 'health-related quality of life' (HR-QoL)⁽²⁾. Sarcopenia, the age-related loss in muscle mass, strength and function, has been associated with multiple adverse clinical outcomes, including impaired mobility, increased risk of falls and fractures, physical disability, loss of independence, increased hospitalisation and all-cause mortality^(3-7). There is also evidence that a loss in muscle mass and strength is associated with major comorbidities, including osteoporosis, type 2 diabetes, obesity, the metabolic syndrome and CVD⁽⁸⁾. More recent studies have reported that sarcopenia and its determinants (losses of muscle mass, strength or function) are associated with reduced HR-QoL, particularly in terms of impaired physical function^(9-11). Indeed, the findings from a 3-year prospective study in older adults showed that declines in muscle mass and physical performance were associated with a deterioration in the physical QoL domain⁽¹²⁾. Therefore, it is likely that strategies which improve muscle strength and function may improve overall HR-QoL for older people.

Current international consensus guidelines recommend progressive resistance training (PRT) in combination with an adequate intake of dietary protein (or protein (amino acid) supplementation) as a strategy to optimise muscle mass, strength and function in older adults^(13-16). However, there have been few studies which have examined the combined effects of PRT and dietary protein on HR-QoL in community-dwelling older adults. The SF-36 Health Survey (SF-36) is a valid and reliable tool for measuring HR-QoL and health perceptions of many populations including the elderly⁽¹⁷⁾. This multi-item scale, which is designed for self-administration, contains thirty-six questions that forms eight specific health concepts (physical functioning; role limitations because of physical...