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).