| Sumario: | • This meta-analysis indicates that supplementation with branched-chain amino acid–enriched nutritional products in combination with resistance training significantly increases skeletal muscle mass index (SMI) in older adults with sarcopenia, whereas no improvements were observed in physical function or other body composition outcomes. • Compared with resistance training alone, BCAA-rich supplementation plus resistance training significantly improved skeletal muscle index (SMI) in older adults with sarcopenia, but showed no significant improvement in physical function or other body composition outcomes. • For older adults with sarcopenia, the clinical value of SMI improvement without functional gains remains uncertain. • This exploratory study suggests that variations in daily protein intake may influence the independent effects of BCAA; future studies should standardize protein intake to clarify this relationship. Sarcopenia impairs self-care ability in older adults. While branched-chain amino acids (BCAAs)/leucine enhance muscle protein synthesis and resistance training promotes muscle growth, the combined effect on sarcopenia remains unclear. This meta-analysis evaluates whether combining resistance training with BCAA-rich supplements synergistically improves body composition and function in sarcopenic elders. We systematically searched four databases and analyzed outcomes using Stata 18.0. Standardized mean differences (SMDs) were calculated via random-effects models. Twelve randomized trials (n = 459) were included. Only skeletal muscle index significantly improved with combined intervention vs. control (SMD = 0.337, 95 % CI [0.035,0.639], p = 0.029). No significant differences were found in: hand grip strength (SMD = 0.289, p = 0.080), 30-s chair stand (SMD = -0.794, p = 0.169), SPPB (SMD = -0.321, p = 0.124), walking speed (SMD = 0.344, p = 0.283), knee extension strength (SMD = 0.332, p = 0.328), total lean mass (SMD = 0.024, p = 0.908), or fat mass (SMD = -0.036, p = 0.866; all p > 0.05). BCAA supplementation post-resistance training only increased skeletal muscle index in older adults, without improving other functional or body composition outcomes.
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