2.4. Interventions
The trial was conducted in Tokyo, Japan, from 22 January 2022 to 24 April 2022. Participants assigned to the test group were instructed to replace two meals with the test meals and continue their usual diet at other times. The 33 types of nutrition for all test meals were adjusted within the range shown in Participants assigned to both the control and test groups underwent the exercise program. All participants were required to join the group lesson of resistant exercise, as instructed by an exercise therapist, at weeks 1, 4, 8, and 10. In all exercise lessons, an exercise therapist was on site to supervise and guide the participants’ exercise. They were instructed to perform the same 20 min resistance exercise at home 3–5 times per week, as taught in the lecture and documented in the provided textbook. An exercise movie was also prepared, and the participants were instructed to watch it while exercising at home. Details of the exercise program are described in the 