Nutrition, Exercise, and Pharmaceutical Therapies for Sarcopenic Obesity

Abstract

Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and strength, with a risk of adverse outcomes such as physical disability, poor quality of life, and death. Sarcopenic obesity is defined as having both sarcopenia and obesity, a condition reported to be associated with a higher risk for adverse outcomes including functional disability, frailty, poor quality of life, longer hospitalization, and higher mortality rates. The definition and diagnostic criteria for sarcopenia have been described by several working groups on the disease; however, there is no standardized definition and diagnostic criteria for sarcopenic obesity. In this review, we summarize nutrition, exercise, and pharmaceutical therapies for counteracting sarcopenic obesity in humans. Although there are some pharmaceutical therapies for both sarcopenia (i.e., testosterone, growth hormone, ghrelin, and vitamin D) and obesity (orlistat, lorcaserin, phentermine-topiramate, and vitamin D), therapies combining nutrition and exercise remain the first-line choice for preventing and treating sarcopenic obesity. Resistance training combined with supplements containing amino acids are considered most effective for treating sarcopenia. Low-calorie, high-protein diets combined with aerobic exercise and resistance training are recommended for preventing and treating obesity. Therefore, nutrition therapies (low-calorie, high-protein diets, protein and amino acid supplementation) and exercise therapies (resistance training and aerobic exercise) would be expected to be the most effective option for preventing and treating sarcopenic obesity. In cases of severe sarcopenic obesity or failure to achieve muscle gain and weight loss through nutrition and exercise therapies, it is necessary to add pharmaceutical therapies to treat the condition.

Effects of Different Types of Exercise on Body Composition, Muscle Strength, and IGF‐1 in the Elderly with Sarcopenic Obesity

“…Sarcopenia refers to an age‐related reduction of muscle mass, strength, and function . The older adults experience problems with sarcopenia and high risk for obesity, causing sarcopenic obesity and vulnerability of the elderly . Older adults lose approximately 0.5% of their total skeletal muscle mass (SMM) in a day accompanied by a muscle strength reduction of 0.3–4.2% per day .…”

“…found that RT prevents loss of muscle mass and strength, making it considerably beneficial for preventing age‐induced sarcopenia. Particularly, highly intense RT can effectively facilitate increasing the muscle strength and mass of older adults . In addition, Sarsan et al .…”

“…1 The older adults experience problems with sarcopenia and high risk for obesity, causing sarcopenic obesity and vulnerability of the elderly. 2 Older adults lose approximately 0.5% of their total skeletal muscle mass (SMM) in a day accompanied by a muscle strength reduction of 0.3-4.2% per day. 3 Leg strength declines at a rate of 10-15% every 10 years until the age of 70 years followed by increased reduction rate around 25-40% every 10 years thereafter.…”

“…Particularly, highly intense RT can effectively facilitate increasing the muscle strength and mass of older adults. 2,10 In addition, Sarsan et al 11 indicated that both aerobic training (AT) and RT can effectively improve obesity factors. Previous studies have attested that AT exhibits a favorable effect on reducing obesity risk factors, whereas RT has resulted in increasing muscle mass and strength.…”

Negative effect of clenbuterol on physical capacities and neuromuscular control of muscle atrophy in adult rats

“…Some pharmaceutical therapies (e.g., testosterone, growth hormone, ghrelin, and vitamin D) and nutritional therapies (e.g., protein and amino acid supplementation) have been studied for prevention and treatment of muscle atrophy . So far, only resistance training and some therapies (e.g., protein, amino acids with large amounts of leucine, vitamin D, nutritional compound supplementation, and formoterol) have shown any real benefits for muscles and their function . Drug treatments, including non‐steroidal selective androgen receptor modulators and anti‐myostatin / anti‐activin type II receptor antibodies, are being developed.…”