human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: INTRODUCTION Resistance training has been well established as an effective treatment strategy to increase skeletal muscle mass and strength in the elderly . We assessed whether dietary protein supplementation can further augment the adaptive response to prolonged resistance-type exercise training in healthy elderly men and women . METHODS Healthy elderly men ( n = 31 , 70 ± 1 yr ) and women ( n = 29 , 70 ± 1 yr ) were r and omly assigned to a progressive , 24-wk resistance-type exercise training program with or without additional protein supplementation ( 15 g·d-1 ) . Muscle hypertrophy was assessed on a whole-body Dual-energy X-ray absorptiometry ( DXA ) , limb ( computed tomography ) , and muscle fiber ( biopsy ) level . Strength was assessed regularly by 1-repetition maximum ( RM ) strength testing . Functional capacity was assessed with a sit-to-st and and h and grip test . RESULTS One-RM strength increased by 45 % ± 6 % versus 40 % ± 3 % ( women ) and 41 % ± 4 % versus 44 % ± 3 % ( men ) in the placebo versus protein group , respectively ( P < 0.001 ) , with no differences between groups . Leg muscle mass ( women , 4 % ± 1 % vs 3 % ± 1 % ; men , 3 % ± 1 % vs 3 % ± 1 % ) and quadriceps cross-sectional area ( women , 9 % ± 1 % vs 9 % ± 1 % ; men , 9 % ± 1 % vs 10 % ± 1 % ) increased similarly in the placebo versus protein groups ( P < 0.001 ) . Type II muscle fiber size increased over time in both placebo and protein groups ( 25 % ± 13 % vs 30 % ± 9 % and 23 % ± 12 % vs 22 % ± 10 % in the women and men , respectively ) . Sit-to-st and improved by 18 % ± 2 % and 19 % ± 2 % in women and men , respectively ( P < 0.001 ) . CONCLUSION Prolonged resistance-type exercise training increases skeletal muscle mass and strength , augments functional capacity , improves glycemia and lipidemia , and reduces blood pressure in healthy elderly men and women .  Additional protein supplementation ( 15 g·d-1 ) does not further increase muscle mass , strength , and /or functional capacity The aims of this r and omised controlled trial were to determine if a high-intensity functional exercise program improves balance , gait ability , and lower-limb strength in older persons dependent in activities of daily living and if an intake of protein-enriched energy supplement immediately after the exercises increases the effects of the training . One hundred and ninety-one older persons dependent in activities of daily living , living in residential care facilities , and with a Mini-Mental State Examination ( MMSE ) score of ? 10 participated . They were r and omised to a high-intensity functional exercise program or a control activity , which included 29 sessions over 3 months , as well as to protein-enriched energy supplement or placebo .  Berg Balance Scale , self-paced and maximum gait speed , and one-repetition maximum in lower-limb strength were followed-up at three and six months and analysed by 2 x 2 factorial ANCOVA , using the intention-to-treat principle . At three months , the exercise group had improved significantly in self-paced gait speed compared with the control group ( mean difference 0.04 m/s , p = 0.02 ) . At six months , there were significant improvements favouring the exercise group for Berg Balance Scale ( 1.9 points , p = 0.05 ) , self-paced gait speed ( 0.05 m/s , p = 0.009 ) , and lower-limb strength ( 10.8 kg , p = 0.03 ) . No interaction effects were seen between the exercise and nutrition interventions . In conclusion , a high-intensity functional exercise program has positive long-term effects in balance , gait ability , and lower-limb strength for older persons dependent in activities of daily living . An intake of protein-enriched energy supplement immediately after the exercises does not appear to increase the effects of the training Objective To assess the effect of free leucine supplementation combined with resistance training versus resistance training only on muscle strength and functional status in older adults . Methods This was a r and omized , double-blind , placebo-controlled , parallel study with two intervention groups . Thirty older adults were r and omly assigned to receive either 10 g leucine/day ( leucine group [ LG ] , n=15 ) or a placebo ( control group [ CG ] , n=15 ) , plus resistance training over a 12-week period . Maximal overcoming isometric leg strength , functional status , nutritional status , body composition , health-related quality of life , depression , and dietary intake were assessed at 4 and 12 weeks . Missing data at 12 weeks were h and led using mixed models for repeated measurements for data imputation . Results Twenty-four subjects completed the 4-week assessment and eleven completed the 12-week intervention . Clinical ly significant gains were found in isometric leg strength at both assessment time points . Analysis of the effect size also showed how participants in LG outperformed those in CG for chair st and s and the timed up and go test . No significant changes were observed for the rest of the outcomes . Conclusion Our combined analysis showed moderate changes in isometric leg muscle strength and certain components of functional status . The magnitude of changes found on these outcomes should be qualified as a positive effect of the concomitant intervention Protein supplementation in combination with resistance training may increase muscle mass and muscle strength in elderly subjects . The objective of this study was to assess the influence of post-exercise protein supplementation with collagen peptides v. placebo on muscle mass and muscle function following resistance training in elderly subjects with sarcopenia . A total of fifty-three male subjects ( 72·2 ( sd 4·68 ) years ) with sarcopenia ( class I or II ) completed this r and omised double-blind placebo-controlled study . All the participants underwent a 12-week guided resistance training programme ( three sessions per week ) and were supplemented with either collagen peptides ( treatment group ( TG ) ) ( 15 g/d ) or silica as placebo ( placebo group ( PG ) ) . Fat-free mass ( FFM ) , fat mass ( FM ) and bone mass ( BM ) were measured before and after the intervention using dual-energy X-ray absorptiometry . Isokinetic quadriceps strength ( IQS ) of the right leg was determined and sensory motor control ( SMC ) was investigated by a st and ardised one-leg stabilisation test . Following the training programme , all the subjects showed significantly higher ( P<0·01 ) levels for FFM , BM , IQS and SMC with significantly lower ( P<0·01 ) levels for FM . The effect was significantly more pronounced in subjects receiving collagen peptides : FFM ( TG + 4·2 ( sd 2·31 ) kg/PG + 2·9 ( sd 1·84 ) kg ; P<0·05 ) ; IQS ( TG + 16·5 ( sd 12·9 ) Nm/PG + 7·3 ( sd 13·2 ) Nm ; P<0·05 ) ; and FM ( TG –5·4 ( sd 3·17 ) kg/PG –3·5 ( sd 2·16 ) kg ; P<0·05 ) . Our data demonstrate that compared with placebo , collagen peptide supplementation in combination with resistance training further improved body composition by increasing FFM , muscle strength and the loss in FM Studies in young adults have demonstrated that beta-hydroxy-beta-methylbutyrate ( HMB ) can increase gains in strength and fat-free mass during a progressive resistance-training program . The purpose of this study was to determine whether HMB would similarly benefit 70-y-old adults undergoing a 5 d/wk exercise program . Thirty-one men ( n = 15 ) and women ( n = 16 ) ( 70 + /- 1 y ) were r and omly assigned in a double-blind study to receive either capsules containing a placebo or Ca-HMB ( 3 g/d ) for the 8-wk study . Skin fold estimations of body composition as well as computerized tomography ( CT ) and dual X-ray absorptiometry ( DXA ) scans were measured before the study and immediately after the 8-wk training program . HMB supplementation tended to increase fat-free mass gain ( HMB , 0.8 + /- 0.4 kg ; placebo , -0.2 + /- 0.3 kg ; treatment x time , P = 0.08 ) . Furthermore , HMB supplementation increased the percentage of body fat loss ( skin fold : HMB , -0.66 + /- 0.23 % ; placebo , -0.03 + /- 0.21 % ; P = 0.05 ) compared with the placebo group . CT scans also indicated a greater decrease in the percentage of body fat with HMB supplementation ( P < 0.05 ) . In conclusion , changes in body composition can be accomplished in 70-y-old adults participating in a strength training program , as previously demonstrated in young adults , when HMB is supplemented daily Body composition changes and loss of functionality in the elderly are related to subst and ard diets and progressive sedentariness . The aim of this study was to assess the impact of an 18-mo nutritional supplementation and resistance training program on health functioning of elders . Healthy elders aged > or = 70 y were studied . Half of the subjects received a nutritional supplement . Half of the supplemented and nonsupplemented subjects were r and omly assigned to a resistance exercise training program . Every 6 mo , a full assessment was performed . A total of 149 subjects were considered eligible for the study and 98 ( 31 supplemented and trained , 26 supplemented , 16 trained and 25 without supplementation or training ) completed 18 mo of follow-up .  Compliance with the supplement was 48 % , and trained subjects attended 56 % of programmed sessions . Activities of daily living remained constant in the supplemented subjects and decreased in the other groups . Body weight and fat-free mass did not change . Fat mass increased from 22.2 + /- 7.6 to 24.1 + /- 7.7 kg in all groups . Bone mineral density decreased less in both supplemented groups than in the nonsupplemented groups ( ANOVA , P < 0.01 ) . Serum cholesterol remained constant in both supplemented groups and in the trained groups , but it increased in the control group ( ANOVA , P < 0.05 ) . Upper and lower limb strength , walking capacity and maximal inspiratory pressure increased in trained subjects . In conclusion , patients who were receiving nutritional supplementation and resistance training  maintained functionality , bone mineral density and serum cholesterol levels and improved their muscle strength Fighting against inactivity and inadequate nutritional intake are of utmost importance in the elderly . To our knowledge , the few studies which have been performed were conducted for only a short period and the results do not permit formal conclusions to be drawn . We therefore tried to fill this gap in our knowledge by determining whether an intervention combining an acceptable progressive exercise programme and nutritional supplements would be feasible for a long-term period in the very frail elderly , and would bring about concomitant benefits in body composition and muscle power . Accordingly , this exercise and nutritional combination was assessed in the frail elderly in a 9-month r and omised trial with a factorial design . Fifty-seven elderly volunteers over 72 years , from sixteen retirement homes in Lyon , France participated in the study .  Dietary supplements were compared with placebo , and physical exercise was compared with memory training . Main outcome measures were fat-free mass ( FFM ) and muscle power . FFM was determined by labelled water , and muscle power was measured by a leg-extensor machine . At 9 months , the compliance was 63 % for exercise sessions , and 54 % for nutritional supplements . In patients with dietary supplements , muscle power increased by 57 % at 3 months ( P=0.03 ) , and showed only a tendency at 9 months ; although FFM increased by 2.7 % at 9 months , the difference was not significant ( P=0.10 ) . Exercise did not improve muscle power at 9 months , but improved functional tests ( five-time-chair rise , P=0.01 ) . BMI increased with supplements ( + 3.65 % ) , but decreased with placebo ( -0.5 % ) at 9 months ( P=0.007 ) . A long-term combined intervention is feasible in frail elderly individuals with a good rate of compliance . Nutritional supplements and exercise may improve muscle function . Despite no significant results on FFM , due to the limited number of volunteers , combined intervention should be suggested to counteract muscle weakness in the frail elderly BACKGROUND The benefit of protein supplementation on the adaptive response of muscle to exercise training in older people is controversial . OBJECTIVE To investigate the independent and combined effects of a multicomponent exercise program with and without a milk-based nutritional supplement on muscle strength and mass , lower-extremity fatigue , and metabolic markers . DESIGN A sample of 48 healthy sedentary men aged 60.8 ± 0.4 years were r and omly assigned to a 16-week multicomponent exercise training program with a milk-based supplement containing , besides proteins [ total milk proteins 4 or 10 g/day or soluble milk proteins rich in leucine ( PRO ) 10 g/day ] , carbohydrates and fat .  Body composition , muscle mass and strength , and time to task failure , an index of muscle fatigue , were 
    Output:
    
agent
Results indicate that physical exercise has a positive impact on muscle mass and muscle function in subjects aged 65 years and older .
Conclusion Physical exercise has a positive impact on muscle mass and muscle function in healthy subjects aged 60 years and older .
The biggest effect of exercise intervention , of any type , has been seen on physical performance ( gait speed , chair rising test , balance , SPPB test , etc . )
.
We observed huge variations in regard to the dietary supplementation protocol s. Based on the included studies , mainly performed on well-nourished subjects , the interactive effect of dietary supplementation on muscle function appears limited
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: INTRODUCTION Resistance training has been well established as an effective treatment strategy to increase skeletal muscle mass and strength in the elderly . We assessed whether dietary protein supplementation can further augment the adaptive response to prolonged resistance-type exercise training in healthy elderly men and women . METHODS Healthy elderly men ( n = 31 , 70 ± 1 yr ) and women ( n = 29 , 70 ± 1 yr ) were r and omly assigned to a progressive , 24-wk resistance-type exercise training program with or without additional protein supplementation ( 15 g·d-1 ) . Muscle hypertrophy was assessed on a whole-body Dual-energy X-ray absorptiometry ( DXA ) , limb ( computed tomography ) , and muscle fiber ( biopsy ) level . Strength was assessed regularly by 1-repetition maximum ( RM ) strength testing . Functional capacity was assessed with a sit-to-st and and h and grip test . RESULTS One-RM strength increased by 45 % ± 6 % versus 40 % ± 3 % ( women ) and 41 % ± 4 % versus 44 % ± 3 % ( men ) in the placebo versus protein group , respectively ( P < 0.001 ) , with no differences between groups . Leg muscle mass ( women , 4 % ± 1 % vs 3 % ± 1 % ; men , 3 % ± 1 % vs 3 % ± 1 % ) and quadriceps cross-sectional area ( women , 9 % ± 1 % vs 9 % ± 1 % ; men , 9 % ± 1 % vs 10 % ± 1 % ) increased similarly in the placebo versus protein groups ( P < 0.001 ) . Type II muscle fiber size increased over time in both placebo and protein groups ( 25 % ± 13 % vs 30 % ± 9 % and 23 % ± 12 % vs 22 % ± 10 % in the women and men , respectively ) . Sit-to-st and improved by 18 % ± 2 % and 19 % ± 2 % in women and men , respectively ( P < 0.001 ) . CONCLUSION Prolonged resistance-type exercise training increases skeletal muscle mass and strength , augments functional capacity , improves glycemia and lipidemia , and reduces blood pressure in healthy elderly men and women .  Additional protein supplementation ( 15 g·d-1 ) does not further increase muscle mass , strength , and /or functional capacity The aims of this r and omised controlled trial were to determine if a high-intensity functional exercise program improves balance , gait ability , and lower-limb strength in older persons dependent in activities of daily living and if an intake of protein-enriched energy supplement immediately after the exercises increases the effects of the training . One hundred and ninety-one older persons dependent in activities of daily living , living in residential care facilities , and with a Mini-Mental State Examination ( MMSE ) score of ? 10 participated . They were r and omised to a high-intensity functional exercise program or a control activity , which included 29 sessions over 3 months , as well as to protein-enriched energy supplement or placebo .  Berg Balance Scale , self-paced and maximum gait speed , and one-repetition maximum in lower-limb strength were followed-up at three and six months and analysed by 2 x 2 factorial ANCOVA , using the intention-to-treat principle . At three months , the exercise group had improved significantly in self-paced gait speed compared with the control group ( mean difference 0.04 m/s , p = 0.02 ) . At six months , there were significant improvements favouring the exercise group for Berg Balance Scale ( 1.9 points , p = 0.05 ) , self-paced gait speed ( 0.05 m/s , p = 0.009 ) , and lower-limb strength ( 10.8 kg , p = 0.03 ) . No interaction effects were seen between the exercise and nutrition interventions . In conclusion , a high-intensity functional exercise program has positive long-term effects in balance , gait ability , and lower-limb strength for older persons dependent in activities of daily living . An intake of protein-enriched energy supplement immediately after the exercises does not appear to increase the effects of the training Objective To assess the effect of free leucine supplementation combined with resistance training versus resistance training only on muscle strength and functional status in older adults . Methods This was a r and omized , double-blind , placebo-controlled , parallel study with two intervention groups . Thirty older adults were r and omly assigned to receive either 10 g leucine/day ( leucine group [ LG ] , n=15 ) or a placebo ( control group [ CG ] , n=15 ) , plus resistance training over a 12-week period . Maximal overcoming isometric leg strength , functional status , nutritional status , body composition , health-related quality of life , depression , and dietary intake were assessed at 4 and 12 weeks . Missing data at 12 weeks were h and led using mixed models for repeated measurements for data imputation . Results Twenty-four subjects completed the 4-week assessment and eleven completed the 12-week intervention . Clinical ly significant gains were found in isometric leg strength at both assessment time points . Analysis of the effect size also showed how participants in LG outperformed those in CG for chair st and s and the timed up and go test . No significant changes were observed for the rest of the outcomes . Conclusion Our combined analysis showed moderate changes in isometric leg muscle strength and certain components of functional status . The magnitude of changes found on these outcomes should be qualified as a positive effect of the concomitant intervention Protein supplementation in combination with resistance training may increase muscle mass and muscle strength in elderly subjects . The objective of this study was to assess the influence of post-exercise protein supplementation with collagen peptides v. placebo on muscle mass and muscle function following resistance training in elderly subjects with sarcopenia . A total of fifty-three male subjects ( 72·2 ( sd 4·68 ) years ) with sarcopenia ( class I or II ) completed this r and omised double-blind placebo-controlled study . All the participants underwent a 12-week guided resistance training programme ( three sessions per week ) and were supplemented with either collagen peptides ( treatment group ( TG ) ) ( 15 g/d ) or silica as placebo ( placebo group ( PG ) ) . Fat-free mass ( FFM ) , fat mass ( FM ) and bone mass ( BM ) were measured before and after the intervention using dual-energy X-ray absorptiometry . Isokinetic quadriceps strength ( IQS ) of the right leg was determined and sensory motor control ( SMC ) was investigated by a st and ardised one-leg stabilisation test . Following the training programme , all the subjects showed significantly higher ( P<0·01 ) levels for FFM , BM , IQS and SMC with significantly lower ( P<0·01 ) levels for FM . The effect was significantly more pronounced in subjects receiving collagen peptides : FFM ( TG + 4·2 ( sd 2·31 ) kg/PG + 2·9 ( sd 1·84 ) kg ; P<0·05 ) ; IQS ( TG + 16·5 ( sd 12·9 ) Nm/PG + 7·3 ( sd 13·2 ) Nm ; P<0·05 ) ; and FM ( TG –5·4 ( sd 3·17 ) kg/PG –3·5 ( sd 2·16 ) kg ; P<0·05 ) . Our data demonstrate that compared with placebo , collagen peptide supplementation in combination with resistance training further improved body composition by increasing FFM , muscle strength and the loss in FM Studies in young adults have demonstrated that beta-hydroxy-beta-methylbutyrate ( HMB ) can increase gains in strength and fat-free mass during a progressive resistance-training program . The purpose of this study was to determine whether HMB would similarly benefit 70-y-old adults undergoing a 5 d/wk exercise program . Thirty-one men ( n = 15 ) and women ( n = 16 ) ( 70 + /- 1 y ) were r and omly assigned in a double-blind study to receive either capsules containing a placebo or Ca-HMB ( 3 g/d ) for the 8-wk study . Skin fold estimations of body composition as well as computerized tomography ( CT ) and dual X-ray absorptiometry ( DXA ) scans were measured before the study and immediately after the 8-wk training program . HMB supplementation tended to increase fat-free mass gain ( HMB , 0.8 + /- 0.4 kg ; placebo , -0.2 + /- 0.3 kg ; treatment x time , P = 0.08 ) . Furthermore , HMB supplementation increased the percentage of body fat loss ( skin fold : HMB , -0.66 + /- 0.23 % ; placebo , -0.03 + /- 0.21 % ; P = 0.05 ) compared with the placebo group . CT scans also indicated a greater decrease in the percentage of body fat with HMB supplementation ( P < 0.05 ) . In conclusion , changes in body composition can be accomplished in 70-y-old adults participating in a strength training program , as previously demonstrated in young adults , when HMB is supplemented daily Body composition changes and loss of functionality in the elderly are related to subst and ard diets and progressive sedentariness . The aim of this study was to assess the impact of an 18-mo nutritional supplementation and resistance training program on health functioning of elders . Healthy elders aged > or = 70 y were studied . Half of the subjects received a nutritional supplement . Half of the supplemented and nonsupplemented subjects were r and omly assigned to a resistance exercise training program . Every 6 mo , a full assessment was performed . A total of 149 subjects were considered eligible for the study and 98 ( 31 supplemented and trained , 26 supplemented , 16 trained and 25 without supplementation or training ) completed 18 mo of follow-up .  Compliance with the supplement was 48 % , and trained subjects attended 56 % of programmed sessions . Activities of daily living remained constant in the supplemented subjects and decreased in the other groups . Body weight and fat-free mass did not change . Fat mass increased from 22.2 + /- 7.6 to 24.1 + /- 7.7 kg in all groups . Bone mineral density decreased less in both supplemented groups than in the nonsupplemented groups ( ANOVA , P < 0.01 ) . Serum cholesterol remained constant in both supplemented groups and in the trained groups , but it increased in the control group ( ANOVA , P < 0.05 ) . Upper and lower limb strength , walking capacity and maximal inspiratory pressure increased in trained subjects . In conclusion , patients who were receiving nutritional supplementation and resistance training  maintained functionality , bone mineral density and serum cholesterol levels and improved their muscle strength Fighting against inactivity and inadequate nutritional intake are of utmost importance in the elderly . To our knowledge , the few studies which have been performed were conducted for only a short period and the results do not permit formal conclusions to be drawn . We therefore tried to fill this gap in our knowledge by determining whether an intervention combining an acceptable progressive exercise programme and nutritional supplements would be feasible for a long-term period in the very frail elderly , and would bring about concomitant benefits in body composition and muscle power . Accordingly , this exercise and nutritional combination was assessed in the frail elderly in a 9-month r and omised trial with a factorial design . Fifty-seven elderly volunteers over 72 years , from sixteen retirement homes in Lyon , France participated in the study .  Dietary supplements were compared with placebo , and physical exercise was compared with memory training . Main outcome measures were fat-free mass ( FFM ) and muscle power . FFM was determined by labelled water , and muscle power was measured by a leg-extensor machine . At 9 months , the compliance was 63 % for exercise sessions , and 54 % for nutritional supplements . In patients with dietary supplements , muscle power increased by 57 % at 3 months ( P=0.03 ) , and showed only a tendency at 9 months ; although FFM increased by 2.7 % at 9 months , the difference was not significant ( P=0.10 ) . Exercise did not improve muscle power at 9 months , but improved functional tests ( five-time-chair rise , P=0.01 ) . BMI increased with supplements ( + 3.65 % ) , but decreased with placebo ( -0.5 % ) at 9 months ( P=0.007 ) . A long-term combined intervention is feasible in frail elderly individuals with a good rate of compliance . Nutritional supplements and exercise may improve muscle function . Despite no significant results on FFM , due to the limited number of volunteers , combined intervention should be suggested to counteract muscle weakness in the frail elderly BACKGROUND The benefit of protein supplementation on the adaptive response of muscle to exercise training in older people is controversial . OBJECTIVE To investigate the independent and combined effects of a multicomponent exercise program with and without a milk-based nutritional supplement on muscle strength and mass , lower-extremity fatigue , and metabolic markers . DESIGN A sample of 48 healthy sedentary men aged 60.8 ± 0.4 years were r and omly assigned to a 16-week multicomponent exercise training program with a milk-based supplement containing , besides proteins [ total milk proteins 4 or 10 g/day or soluble milk proteins rich in leucine ( PRO ) 10 g/day ] , carbohydrates and fat .  Body composition , muscle mass and strength , and time to task failure , an index of muscle fatigue , were 
    Output:
    