Regular Multicomponent Exercise Increases Physical Fitness and Muscle Protein Anabolism in Frail, Obese, Older Adults

Abstract

Aging is associated with a decline in strength, endurance, balance, and mobility. Obesity worsens the age‐related impairment in physical function and often leads to frailty. The American College of Sports Medicine recommends a multicomponent (strength, endurance, flexibility, and balance) exercise program to maintain physical fitness. However, the effect of such an exercise program on physical fitness in frail, obese older adults is not known. We therefore determined the effect of a 3‐month long multicomponent exercise training program, on endurance (peak aerobic capacity (VO2 peak)), muscle strength, muscle mass, and the rate of muscle protein synthesis (basal rate and anabolic response to feeding) in nine 65‐ to 80‐year‐old, moderately frail, obese older adults. After 3 months of training, fat mass decreased (P < 0.05) whereas fat‐free mass (FFM), appendicular lean body mass, strength, and VO2 peak increased (all P < 0.05). Regular strength and endurance exercise increased the mixed muscle protein fractional synthesis rate (FSR) but had no effect on the feeding‐induced increase in muscle protein FSR (∼0.02%/h increase from basal values both before and after exercise training; effect of feeding: P = 0.02; effect of training: P = 0.047; no interaction: P = 0.84). We conclude that: (i) a multicomponent exercise training program has beneficial effects on muscle mass and physical function and should therefore be recommended to frail, obese older adults, and (ii) regular multicomponent exercise increases the basal rate of muscle protein synthesis without affecting the magnitude of the muscle protein anabolic response to feeding.

Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians

“…Due to the physical domains that are related to frailty, physical activity is one of the most important components in the prevention and treatment of this syndrome. Indeed, the benefits of physical exercise in improving the functional capacity of frail older adults have been the focus of considerable recent research (Fiatarone et al 1994;Hauer et al 2001;Barnett et al 2003;Lord et al 2003;Serra-Rexach et al 2011;Villareal et al 2011;Clemson et al 2012;Freiberger et al 2012;Kim et al 2012). In a recent systematic review that investigated the effectiveness of different exercise interventions on the incidence of falls, gait ability, balance, and strength, 70 % of the studies included showed a reduction in the incidence of falls, 54 % showed enhancements of gait ability, 80 % showed improvements in balance, and 70 % reported increases in muscle strength .…”

Usefulness of combining intermittent hypoxia and physical exercise in the treatment of obesity

“…They also favour low appetite by stimulating the corticotrophin-releasing hormone [115]. The most effective treatment to improve health parameters as well as body composition appears to be strength training or strength training combined with aerobic endurance training, which seem to improve both health biomarkers and to reduce fat content [135,142,145].…”

“…They also favour low appetite by stimulating the corticotrophin-releasing hormone [115]. The most effective treatment to improve health parameters as well as body composition appears to be strength training or strength training combined with aerobic endurance training, which seem to improve both health biomarkers and to reduce fat content [135,142,145].Since the energy cost of all exercise modes except walking seems to be beneficial, priority should be given to the obese preferences to promote long-term activity behavioral change [137].Moreover, it is known that physical exercise increases the secretion of endorphins [74], improving mood, and helping the patient to maintain motivation increasing adherence to the treatment.Strength-resistance training (SRT) is associated with great energy expenditure during the exercise session [30]. Some studies have reported that regular SRT is effective in promoting weight loss in obese subjects, decreasing fat mass and increasing lean body mass and thus has little influence or no effective change in total body weight [59,120,132].…”

Challenges in Treatment of Obesity in the Elderly

“…Standard hypocaloric diets are usually indicated, together with an exercise programme and a series of behavioural changes that are aimed at motivating patients and helping them comply with hygienic-dietary measures. However, although this therapeutic approach has certain logic for obese young and middle-aged patients, these measures might further reduce muscle mass in obese, elderly patients and exacerbate deficits in physical function [44]. It is estimated that 75% of the weight reduction achieved through diet corresponds to fat tissue and 25% to lean tissue.…”