Effectiveness of Nutrition and Exercise Interventions Among Community-Dwelling Older Vietnamese Adults with Sarcopenia: A Cluster-Randomized Controlled Trial.

BACKGROUND/OBJECTIVES: Exercise and nutrition are central to sarcopenia management, but Vietnamese evidence is limited. We compared exercise intervention (Ex) alone and Ex plus nutritional support against health education. METHODS: In this study, a three-arm, parallel-group cluster-randomized controlled trial, three communities in Can Gio District were randomly selected and assigned 1:1:1 (one per arm) to health-education control, Ex, or combined intervention. Before allocation, 30 adults aged 60-70 years with AWGS 2019-defined sarcopenia were randomly selected from screening lists within each community (n = 90). Both active arms underwent 24 weeks of aerobic and resistance exercise, with weekly supervised sessions during weeks 1-12 and less-supervised home exercise thereafter. The combined arm also received weekly individualized nutrition counseling and a daily multinutrient oral supplement (270 kcal; 11 g protein) during weeks 1-12. Outcomes at baseline, 12 weeks, and 24 weeks were analyzed using sex-adjusted participant-level linear mixed-effects models. RESULTS: At 24 weeks, adjusted differences in change (95% CIs) for Ex versus control and combined versus control were, respectively, 0.12 (0.02-0.22) and 0.01 (-0.09-0.11) kg/m2 for the skeletal muscle index; 2.49 (1.57-3.42) and 2.23 (1.30-3.15) kg for handgrip strength; and 0.206 (0.132-0.279) and 0.053 (-0.017-0.123) m/s for gait speed. CONCLUSIONS: Both active communities showed better handgrip strength than control; only the Ex community showed a gait-speed advantage, while muscle-mass changes were modest. With one cluster per arm, treatment and community were confounded; definitive treatment effects and the independent contribution of nutrition cannot be determined. TRIAL REGISTRATION: ClinicalTrials.gov NCT07761091 (retrospectively registered on 12 August 2026).