{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T03:56:22Z","timestamp":1789617382246,"version":"build-2803163510"},"reference-count":111,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Pusan National University Hospital","award":["20250028"],"award-info":[{"award-number":["20250028"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Sarcopenia, a progressive loss of muscle mass and strength, is a major health concern primarily affecting older adults worldwide. With no pharmaceutical cure for sarcopenia, dietary protein, probiotic supplementation, and physical exercise have gained increasing attention as lifestyle-based interventions. Dietary protein has shown promising effects in preventing the loss of skeletal muscle and physical strength by favorably influencing muscle protein synthesis in sarcopenic individuals. Probiotic supplementation has been associated with muscle regeneration, increased muscle protein synthesis among adults with sarcopenia, and improved exercise performance based on preliminary and emerging evidence. Multimodal or hybrid exercise programs have been shown to improve muscle strength, mobility, and overall physical function in individuals with sarcopenia. This paper reviews how combining protein, probiotics, and multimodal exercise may offer complementary strategies for sarcopenia management. Evidence from preclinical and mechanistic studies suggests that these interventions may support muscle health by activating shared intracellular pathways such as mTOR signaling, the suppression of FOXO3a, and the enhancement of mitochondrial biogenesis.<\/jats:p>","DOI":"10.3390\/cells14171375","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T15:15:57Z","timestamp":1756912557000},"page":"1375","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Combined Protein, Probiotics, and Exercise Therapy for Sarcopenia: A Comprehensive Review"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7757-7412","authenticated-orcid":false,"given":"Ryuk Jun","family":"Kwon","sequence":"first","affiliation":[{"name":"Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"},{"name":"Family Medicine Clinic, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"},{"name":"Department of Family Medicine, School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Al","family":"Mijan","sequence":"additional","affiliation":[{"name":"Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0165-7480","authenticated-orcid":false,"given":"Soo Min","family":"Son","sequence":"additional","affiliation":[{"name":"Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"},{"name":"Family Medicine Clinic, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea"},{"name":"Department of Family Medicine, School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanho","family":"Yoo","sequence":"additional","affiliation":[{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea"},{"name":"Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Pusan National University Hospital, Busan 49241, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3722-0261","authenticated-orcid":false,"given":"Taehwa","family":"Kim","sequence":"additional","affiliation":[{"name":"Biomedical Research Institute, Pusan National University Hospital, Busan 49241, Republic of Korea"},{"name":"Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Pusan National University Hospital, Busan 49241, Republic of Korea"},{"name":"Department of Internal Medicine, School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1093\/ageing\/afy169","article-title":"Sarcopenia: Revised European consensus on definition and diagnosis","volume":"48","author":"Bahat","year":"2019","journal-title":"Age Ageing"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment","volume":"21","author":"Chen","year":"2020","journal-title":"J. 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