Rachel J Reid-McCann, Sarah F Brennan, Nicola A Ward, Danielle Logan, Michelle C McKinley, Claire T McEvoy
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The effects of protein on muscle health may depend on protein quality.</p><p><strong>Objective: </strong>The aim was to synthesize randomized controlled trial (RCT) data comparing plant with animal protein for muscle health.</p><p><strong>Data sources: </strong>Forty-three eligible RCTs were sourced from Medline, Embase, Scopus, Web of Science, and CENTRAL databases.</p><p><strong>Data extraction: </strong>Four reviewers (R.J.R.-M., S.F.B., N.A.W., D.L.) extracted data from RCTs (study setting, population, intervention characteristics, outcomes, summary statistics) and conducted quality assessment using the Cochrane Risk of Bias 2.0.</p><p><strong>Data analysis: </strong>Standardized mean differences (SMDs) (95% CIs) were combined using a random-effects meta-analysis and forest plots were generated. I2 statistics were calculated to test for statistical heterogeneity.</p><p><strong>Conclusion: </strong>Thirty RCTs (70%) were eligible for meta-analysis and all examined muscle mass outcomes. Compared with animal protein, plant protein resulted in lower muscle mass following the intervention (SMD = -0.20; 95% CI: -0.37, -0.03; P = .02), with stronger effects in younger (<60 years; SMD = -0.20; 95% CI: -0.37, -0.03; P = .02) than in older (≥60 years; SMD = -0.05; 95% CI: -0.32, 0.23; P = .74) adults. There was no pooled effect difference between soy and milk protein for muscle mass (SMD = -0.02; 95% CI: -0.20, 0.16; P = .80) (n = 17 RCTs), yet animal protein improved muscle mass compared with non-soy plant proteins (rice, chia, oat, and potato; SMD = -0.58; 95% CI: -1.06, -0.09; P = .02) (n = 5 RCTs) and plant-based diets (SMD = -0.51; 95% CI: -0.91, -0.11; P = .01) (n = 7 RCTs). 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引用次数: 0
摘要
背景：膳食蛋白质被推荐用于肌肉减少症——一种与年龄相关的肌肉质量和力量减少的衰弱状态，影响27%的老年人。蛋白质对肌肉健康的影响可能取决于蛋白质的质量。目的：综合比较植物蛋白与动物蛋白对肌肉健康的作用的随机对照试验（RCT）数据。数据来源：43项符合条件的随机对照试验来自Medline、Embase、Scopus、Web of Science和CENTRAL数据库。数据提取：四名审稿人(R.J.R.-M。， S.F.B， N.A.W， D.L.)从随机对照试验（RCTs）中提取数据（研究环境、人群、干预特征、结局、汇总统计），并使用Cochrane Risk of Bias 2.0进行质量评估。数据分析：采用随机效应荟萃分析合并标准化平均差异（SMDs） （95% ci），并生成森林图。计算I2统计量以检验统计异质性。结论：30项随机对照试验（70%）符合荟萃分析的条件，并且都检查了肌肉质量的结果。与动物蛋白相比，植物蛋白导致干预后肌肉量减少(SMD = -0.20；95% ci: -0.37, -0.03；P = .02)，对年轻人的影响更强(系统评价注册号：PROSPERO注册号；CRD42020188658。
Effect of Plant Versus Animal Protein on Muscle Mass, Strength, Physical Performance, and Sarcopenia: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Context: Dietary protein is recommended for sarcopenia-a debilitating condition of age-related loss of muscle mass and strength that affects 27% of older adults. The effects of protein on muscle health may depend on protein quality.
Objective: The aim was to synthesize randomized controlled trial (RCT) data comparing plant with animal protein for muscle health.
Data sources: Forty-three eligible RCTs were sourced from Medline, Embase, Scopus, Web of Science, and CENTRAL databases.
Data extraction: Four reviewers (R.J.R.-M., S.F.B., N.A.W., D.L.) extracted data from RCTs (study setting, population, intervention characteristics, outcomes, summary statistics) and conducted quality assessment using the Cochrane Risk of Bias 2.0.
Data analysis: Standardized mean differences (SMDs) (95% CIs) were combined using a random-effects meta-analysis and forest plots were generated. I2 statistics were calculated to test for statistical heterogeneity.
Conclusion: Thirty RCTs (70%) were eligible for meta-analysis and all examined muscle mass outcomes. Compared with animal protein, plant protein resulted in lower muscle mass following the intervention (SMD = -0.20; 95% CI: -0.37, -0.03; P = .02), with stronger effects in younger (<60 years; SMD = -0.20; 95% CI: -0.37, -0.03; P = .02) than in older (≥60 years; SMD = -0.05; 95% CI: -0.32, 0.23; P = .74) adults. There was no pooled effect difference between soy and milk protein for muscle mass (SMD = -0.02; 95% CI: -0.20, 0.16; P = .80) (n = 17 RCTs), yet animal protein improved muscle mass compared with non-soy plant proteins (rice, chia, oat, and potato; SMD = -0.58; 95% CI: -1.06, -0.09; P = .02) (n = 5 RCTs) and plant-based diets (SMD = -0.51; 95% CI: -0.91, -0.11; P = .01) (n = 7 RCTs). No significant difference was found between plant or animal protein for muscle strength (n = 14 RCTs) or physical performance (n = 5 RCTs). No trials examined sarcopenia as an outcome. Animal protein may have a small beneficial effect over non-soy plant protein for muscle mass; however, research into a wider range of plant proteins and diets is needed.
期刊介绍：
Nutrition Reviews is a highly cited, monthly, international, peer-reviewed journal that specializes in the publication of authoritative and critical literature reviews on current and emerging topics in nutrition science, food science, clinical nutrition, and nutrition policy. Readers of Nutrition Reviews include nutrition scientists, biomedical researchers, clinical and dietetic practitioners, and advanced students of nutrition.
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