Effects of Physical Exercise with and Without Nutritional Supplementation on Serum Albumin in Older People: A Systematic Review and Meta-Analysis

Background: This comprehensive review with meta-analysis was to evaluate the effects of physical exercise interventions alone, as well as in combination with nutritional supplementation, on serum albumin levels in older people. Methods: A systematic literature review was performed across eight general electronic databases from inception to March 2026. The risk of bias was evaluated with the RoB 2 tool, and the certainty of evidence was determined using GRADE. The protocol has been registered in PROSPERO with registration number CRD420251072030. Results: A total of six randomized controlled trials were included, involving 330 older people (mean age: 72.1 ± 5.4 years, 61% female). Physical exercise interventions alone significantly improved serum albumin levels in older people, whereas combined interventions including nutritional supplementation did not show additional significant effects. The majority of the studies assessed were deemed to have a significant risk of bias, resulting in a low overall certainty of evidence. Conclusions: Physical exercise treatments elevated blood albumin levels in older people; however, the combination of physical exercise and nutritional supplementation did not have a meaningful effect. Due to the limited reliability of the evidence, more extensive, high-caliber research are required.