The Effects of Very Low Energy Diets and Low Energy Diets with Exercise Training on Skeletal Muscle Mass: A Narrative Re
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REVIEW
The Effects of Very Low Energy Diets and Low Energy Diets with Exercise Training on Skeletal Muscle Mass: A Narrative Review Arash Ardavani . Hariz Aziz . Ken Smith . Philip J. Atherton . Bethan E. Phillips . Iskandar Idris
Received: September 10, 2020 / Accepted: November 4, 2020 Ó The Author(s) 2020
ABSTRACT In recent years, very-low-energy diets (VLEDs) have been recognised as a viable strategy for improving the extent of weight loss and cardiometabolic outcomes in people who are either overweight or obese. However, concerns exist regarding the reductions in lean body mass (LBM) during VLEDs, particularly in vulnerable demographic groups, such as middle-aged and older adults already prone to developing sarcopenia. Sarcopenia is itself associated with multiple adverse outcomes, including frailty, cardio-metabolic deterioration and increased
mortality. Therefore, a number of studies investigating strategies to ameliorate this detrimental effect of VLEDs have attempted to address this concern. This narrative review explores the potential benefits and limitations of exercise and/or protein supplementation for LBM retention during VLEDs based on the available evidence. Current studies suggest that both protein supplementation and exercise training may result in improved LBM retention (and skeletal muscle function) during VLEDs. However, uncertainty remains concerning the interactions between intervention types, based on discordant outcomes reported in the literature and the heterogeneity of exercise modalities in achieving this particular outcome.
Keywords: High-intensity interval training; Resistance exercise training; Sarcopenia; Skeletal muscle; Very-low-calorie diet A. Ardavani H. Aziz K. Smith P. J. Atherton B. E. Phillips I. Idris (&) Clinical, Metabolic and Molecular Physiology Research Group, MRC-Versus Arthritis Centre for Musculoskeletal Ageing Research, University of Nottingham, Royal Derby Hospital Centre, Derby, UK e-mail: [email protected] A. Ardavani H. Aziz K. Smith P. J. Atherton B. E. Phillips I. Idris National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
Adv Ther
VERY-LOW-ENERGY DIETS Key Summary Points An Introduction to Very-Low-Energy Diets What is already known? Very low-energy diets (VLEDs) have been implemented successfully primarily as a means of improving body composition, but also to improve metabolic parameters. However, as a consequence of profound energy restriction, VLEDs are associated with reductions in lean body mass (LBM). Theoretically, additional protein in LEDs will result in enhanced retention of LBM. Based on distinct physiological adaptation, differing forms of exercise will likely exert different effects on lean body mass retention during LEDs. What are the new findings? Resistance exercise training (RET) may significantly improve LBM retention during LEDs, although the precise effect and magnitude are unclear. The reported effects of aerobic exercise training (AET) on LBM preserva
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