{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T05:16:14Z","timestamp":1773206174105,"version":"3.50.1"},"reference-count":38,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,7,17]],"date-time":"2025-07-17T00:00:00Z","timestamp":1752710400000},"content-version":"unspecified","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"crossref","award":["CNPq 402305\/2023-0"],"award-info":[{"award-number":["CNPq 402305\/2023-0"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,6,27]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Sarcopenia, osteoporosis and osteosarcopenia are conditions prevalent in ageing that impair muscle strength and bone density, increasing the risks of fractures, falls, disability and mortality. Recent studies highlight the benefits of milk protein supplementation (MPS) combined with exercises to improve musculoskeletal health in the older population. This systematic review protocol will enable the production of a compilation of evidence that will elucidate the effects of MPS combined with aerobic exercise, resistance exercise or both on the musculoskeletal function of older individuals with these three conditions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods\/analysis<\/jats:title>\n                  <jats:p>Studies will be selected from electronic databases, including PubMed\/MEDLINE, EMBASE, Scopus, Web of Science and the Cochrane Library, without restrictions on language or publication date. The outcomes evaluated will include muscle mass, muscle strength, BMD and physical performance after combined interventions of MPS and physical exercise of any type. The risk of bias will be assessed using the Cochrane Risk of Bias 2 tool. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to classify the certainty of the evidence into four levels: high, moderate, low and very low. Meta-analysis will be performed given the homogeneity of the studies, using random effects methods in the face of the expected heterogeneity. The standardised mean difference (SMD) will be used for continuous data, and the I\u00b2 index will assess heterogeneity (I\u00b2 &gt; 50%). Sensitivity analysis, \u2018leave one out\u2019 and a strategy for dealing with missing data will be carried out. Statistical analysis will be conducted using the STATA 18 software with a 95% CI and p&lt;0.05. The searches will be carried out from inception until August 2025.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Formal ethical approval will not be required as primary data collection will not be performed. The results will be disseminated through peer-reviewed publications and presentations at conferences dedicated to the relevant field of study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>PROSPERO registration number<\/jats:title>\n                  <jats:p>CRD42024555933.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-094863","type":"journal-article","created":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T10:05:33Z","timestamp":1752833133000},"page":"e094863","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Interventions with milk proteins supplementation combined with exercise on musculoskeletal function in older adults with sarcopenia, osteoporosis and osteosarcopenia: a systematic review protocol of randomised controlled trials"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-2420-6068","authenticated-orcid":false,"given":"M\u00e1rio Duarte","family":"Brito","sequence":"first","affiliation":[{"name":"Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1564-328X","authenticated-orcid":false,"given":"Nailton Jos\u00e9","family":"Neto","sequence":"additional","affiliation":[{"name":"Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiano dos Santos","family":"Gomes","sequence":"additional","affiliation":[{"name":"Physical Therapy Department, University of Pernambuco, Petrolina, Pernambuco, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6553-6266","authenticated-orcid":false,"given":"Weslley","family":"Barbosa Sales","sequence":"additional","affiliation":[{"name":"Graduate Program in Physiotherapy, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerlane Coelho Bernardo","family":"Guerra","sequence":"additional","affiliation":[{"name":"Department of Biophysics and Pharmacology, Federal University of Rio Grande do Norte, Natal, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3824-3713","authenticated-orcid":false,"given":"Ricardo O","family":"Guerra","sequence":"additional","affiliation":[{"name":"Graduate Program in Health Sciences, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"},{"name":"Graduate Program in Physiotherapy, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,18]]},"reference":[{"key":"2025071803051798000_15.7.e094863.1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afq034"},{"key":"2025071803051798000_15.7.e094863.2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy169"},{"key":"2025071803051798000_15.7.e094863.3","doi-asserted-by":"crossref","first-page":"155638","DOI":"10.1016\/j.metabol.2023.155638","article-title":"Sarcopenia, osteoporosis and frailty","volume":"145","author":"Gielen","year":"2023","journal-title":"Metab Clin Exp"},{"key":"2025071803051798000_15.7.e094863.4","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1002\/jcsm.12783","article-title":"Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta\u2010analysis","volume":"13","author":"Petermann\u2010Rocha","year":"2022","journal-title":"J cachexia sarcopenia muscle"},{"key":"2025071803051798000_15.7.e094863.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2019.12.012"},{"key":"2025071803051798000_15.7.e094863.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2011.01.003"},{"key":"2025071803051798000_15.7.e094863.7","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glu010"},{"key":"2025071803051798000_15.7.e094863.8","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1093\/ageing\/afac220","article-title":"Sarcopenia definition, diagnosis and treatment: consensus is growing","volume":"51","author":"Sayer","year":"2022","journal-title":"Age Ageing"},{"key":"2025071803051798000_15.7.e094863.9","unstructured":"Varacallo MA , Seaman TJ , Jandu JS , et al . Osteopenia. In: StatPearls. 2023. Available: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK499878\/ [accessed 18 Jun 2025]."},{"key":"2025071803051798000_15.7.e094863.10","first-page":"1","article-title":"The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis","volume":"16","author":"Salari","year":"2021","journal-title":"J Orthop Surg Res"},{"key":"2025071803051798000_15.7.e094863.11","doi-asserted-by":"publisher","DOI":"10.1007\/BF01622200"},{"key":"2025071803051798000_15.7.e094863.12","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-017-4151-8"},{"key":"2025071803051798000_15.7.e094863.13","doi-asserted-by":"publisher","DOI":"10.1186\/S12877-023-03772-X\/TABLES\/6"},{"key":"2025071803051798000_15.7.e094863.14","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1007\/s41999-020-00355-6","article-title":"Osteosarcopenia: beyond age-related muscle and bone loss","volume":"11","author":"Fagundes Belchior","year":"2020","journal-title":"Eur Geriatr Med"},{"key":"2025071803051798000_15.7.e094863.15","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa755"},{"key":"2025071803051798000_15.7.e094863.16","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1002\/jcsm.13392","article-title":"Global epidemiological features and impact of osteosarcopenia: A comprehensive meta\u2010analysis and systematic review","volume":"15","author":"Chen","year":"2024","journal-title":"J cachexia sarcopenia muscle"},{"key":"2025071803051798000_15.7.e094863.17","doi-asserted-by":"publisher","DOI":"10.3390\/nu12092757"},{"key":"2025071803051798000_15.7.e094863.18","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12981"},{"key":"2025071803051798000_15.7.e094863.19","doi-asserted-by":"crossref","first-page":"6","DOI":"10.3390\/foods9060750","article-title":"Whey for Sarcopenia; Can Whey Peptides, Hydrolysates or Proteins Play a Beneficial Role?","volume":"9","author":"Gilmartin","year":"2020","journal-title":"Foods"},{"key":"2025071803051798000_15.7.e094863.20","doi-asserted-by":"crossref","first-page":"2022","DOI":"10.1002\/jcsm.12805","article-title":"Leucine\u2010enriched whey protein supplementation, resistance\u2010based exercise, and cardiometabolic health in older adults: a randomized controlled trial","volume":"12","author":"Kirk","year":"2021","journal-title":"J cachexia sarcopenia muscle"},{"key":"2025071803051798000_15.7.e094863.21","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/50A.2.B97"},{"key":"2025071803051798000_15.7.e094863.22","doi-asserted-by":"crossref","first-page":"4390","DOI":"10.12659\/MSM.914031","article-title":"Nutrition, Physical Exercise, and the Prevalence of Sarcopenia in Elderly Residents in Nursing Homes in China","volume":"25","author":"Yang","year":"2019","journal-title":"Med Sci Monit"},{"key":"2025071803051798000_15.7.e094863.23","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.g7647","article-title":"Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation","volume":"349","author":"Shamseer","year":"2015","journal-title":"BMJ"},{"key":"2025071803051798000_15.7.e094863.24","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"2025071803051798000_15.7.e094863.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2017.06.010"},{"key":"2025071803051798000_15.7.e094863.26","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1002\/jcsm.12567","article-title":"Osteosarcopenia: epidemiology, diagnosis, and treatment-facts and numbers","volume":"11","author":"Kirk","year":"2020","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"2025071803051798000_15.7.e094863.27","doi-asserted-by":"publisher","DOI":"10.1016\/S8756-3282(01)00653-6"},{"key":"2025071803051798000_15.7.e094863.28","doi-asserted-by":"publisher","DOI":"10.1016\/S8756-3282(00)00381-1"},{"key":"2025071803051798000_15.7.e094863.29","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"2025071803051798000_15.7.e094863.30","unstructured":"PRISMA 2020 flow diagram \u2014 prisma statement. Available: https:\/\/www.prisma-statement.org\/prisma-2020-flow-diagram [Accessed 16 Aug 2024]."},{"key":"2025071803051798000_15.7.e094863.31","unstructured":"Cochrane handbook for systematic reviews of interventions. Cochrane, Available: https:\/\/www.cochrane.org\/authors\/handbooks-and-manuals\/handbook [accessed 19 Jun 2024]."},{"key":"2025071803051798000_15.7.e094863.32","unstructured":"RoB 2: a revised cochrane risk-of-bias tool for randomized trials. Cochrane bias. Available: https:\/\/methods.cochrane.org\/bias\/resources\/rob-2-revised-cochrane-risk-bias-tool-randomized-trials [Accessed 16 Aug 2024]."},{"key":"2025071803051798000_15.7.e094863.33","doi-asserted-by":"crossref","unstructured":"Harrer M , Cuijpers P , Furukawa TA , et al . Doing meta-analysis with r. In: Doing meta-analysis with R. Boca Raton, 2021. Available: https:\/\/www.taylorfrancis.com\/books\/9781003107347","DOI":"10.1201\/9781003107347"},{"key":"2025071803051798000_15.7.e094863.34","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.11.014"},{"key":"2025071803051798000_15.7.e094863.35","unstructured":"Statistical software for data science. Stata. Available: https:\/\/www.stata.com\/ [Accessed 18 Feb 2025]."},{"key":"2025071803051798000_15.7.e094863.36","doi-asserted-by":"publisher","DOI":"10.1002\/jrsm.11"},{"key":"2025071803051798000_15.7.e094863.37","unstructured":"Cochrane handbook for systematic reviews of interventions. Cochrane training. Available: https:\/\/training.cochrane.org\/handbook [Accessed 16 Aug 2024]."},{"key":"2025071803051798000_15.7.e094863.38","unstructured":"GRADE approach. Cochrane training; 2024. Available: https:\/\/training.cochrane.org\/grade-approach [Accessed 16 Aug 2024]."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2024-094863","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T10:05:37Z","timestamp":1752833137000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2024-094863"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7]]},"references-count":38,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,7,18]]},"published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1136\/bmjopen-2024-094863"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2024-094863","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7]]}}}