Sarcopenia Exacerbates Obesity-Associated Insulin Resistance and Dysglycemia: Findings from the National Health and Nutrition Examination Survey III

Srikanthan, Preethi; Hevener, Andrea L.; Karlamangla, Arun S.

doi:10.1371/journal.pone.0010805

Cited by 480 publications

(402 citation statements)

References 22 publications

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“…Similar findings were reported in a community-dwelling sample of Taiwanese older adults; sarcopenic obesity (defined by BIA-measured muscle mass and BMI) was associated with the highest risk of metabolic syndrome (56) . In a large cross-sectional analysis of over 14 000 adults from the National Health and Nutrition Examination Survey III, the sarcopenic obese group (defined by BIA-measured muscle mass and BMI) had the highest risk of insulin resistance and dysglycaemia (57) . However, not all studies have shown sarcopenic obese individuals to have the worst profile and some cross-sectional studies have suggested that obese older adults may have higher cardiovascular risk factors than sarcopenic obese subjects (58)(59)(60) .…”

Section: Sarcopenic Obesity and Cardiovascular Risk Factorsmentioning

confidence: 99%

Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity

2015

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Conference on 'Nutrition and age-related muscle loss, sarcopenia and cachexia' Symposium 4: Sarcopenia and cachexia and social, clinical and public health dimensionsMuscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity S. Goya Wannamethee* and Janice L. AtkinsDepartment of Primary Care and Population Health, University College London, Royal Free Campus, London NW3 2PF, UK This paper reviews the health implications of obesity, sarcopenia and sarcopenic obesity on CVD and mortality in older adults and discusses the obesity paradox seen in patients with CVD. Obesity is a major public health problem with increasing prevalence worldwide. It is an established risk factor for cardiovascular morbidity and mortality in adult populations. However, there is controversy surrounding the effects of obesity as measured by BMI in older people, and overweight and obesity (BMI ⩾ 25 kg/m 2 ) are apparently associated with increased survival in those with CVD (obesity paradox). Ageing is associated with an increase in visceral fat and a progressive loss of muscle mass which have opposing effects on mortality. Thus BMI is not a good indicator of obesity in older adults. Sarcopenia, the age-associated loss of skeletal muscle mass, is a major concern in ageing populations and has been associated with metabolic impairment, CVD risk factors, physical disability and mortality. Sarcopenia often coexists with obesity. Sarcopenic obesity is a new category of obesity in older adults who have high adiposity coupled with low muscle mass. To fully understand the effect of obesity on mortality in the elderly it is important to take muscle mass into account. The evidence suggests that sarcopenia with obesity may be associated with higher levels of metabolic disorders and an increased risk of mortality than obesity or sarcopenia alone. Efforts to promote healthy ageing should focus on both preventing obesity and maintaining or increasing muscle mass.Obesity: Muscle: Sarcopenia: CVD: Mortality: Older adults Obesity, i.e. excess body fat usually defined as BMI ⩾ 30 kg/m 2 , is a major public health problem and is well recognised as a risk factor for cardiovascular morbidity and mortality in adult populations. Obesity prevalence in middle-aged and older adults continues to increase worldwide and has doubled since 1980 (1,2) . However, there is controversy surrounding the effects of overweight and obesity in older people, with many studies showing that being overweight, as defined by BMI of 25-29 kg/m 2 , does not appear to be as harmful in the elderly as in middle-aged populations and may even be associated with lower, rather than higher, mortality (3)(4)(5) . In addition, a large body of evidence indicates that overweight and obesity (BMI ⩾ 25 kg/m 2 ) are associated with increased survival in patients with CVD and in particular those with heart failure, an unexpected finding termed the obesity paradox (6)(7)(8)(9)(10) . The mechanisms of these paradoxical association remain largely unexplained but a number of explana...

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Section: Sarcopenic Obesity and Cardiovascular Risk Factorsmentioning

confidence: 99%

Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity

2015

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“…Similarly, nutritional patterns entailing large caloric reductions and only-moderate protein consumption can result in the loss of lean body mass and appear inadequate for preserving or increasing lean body mass with resistance training (RT), which is a central part of exercise guidelines [16]. Reduced lean body mass is associated with insulin resistance and prediabetes [17][18][19]. In the Look Ahead protocol, for example, only 1,200 to 1,500 kcal/day with a minimum of 15 % calories from protein was recommended during the initial weight loss phase for people weighing <114 kg.…”

Section: Policymentioning

confidence: 99%

Developing a new treatment paradigm for disease prevention and healthy aging

Winett

Davy

Marinik

et al. 2013

Behav. Med. Pract. Policy Res.

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An increasingly prevalent pattern of risk factors has emerged in middle-aged and older adults that includes the presence of type 2 diabetes or prediabetes, overweight or obese weight status with central obesity and very high body fat, low cardiorespiratory fitness (CRF), low strength, and a low lean-body-mass-to-body-fat ratio. Traditionally, these problems have been approached with a low-fat and low-calorie diet and with lower to moderate intensity activity such as walking. While the treatment has some clear benefits, this approach may no longer be optimal because it does not reflect more recent findings from nutrition and exercise sciences. Specifically, these fields have gained a greater understanding of the metabolic and functional importance of focusing on reducing body fat and central obesity while maintaining or even increasing lean body mass, a quality weight loss, and how to efficiently and effectively increase CRF and strength. Evidence is presented for shifting the treatment paradigm for disease prevention and healthy aging to include the DASH nutrition pattern but with additional protein, higher intensity, brief aerobic training, effortbased, brief resistance training, and structured physical activity. Recent interventions based on social cognitive theory for initiating and then maintaining health behavior changes show the feasibility and efficacy of the approach we are advocating especially within a multiple health behavior change format and the potential for translating the new treatment paradigm into practice. KEYWORDSDiabetes, Quality weight loss, Treatment paradigm, Multiple health behaviors IMPORTANCE OF THE PROBLEM, USUAL TREATMENT, CHANGING THE TREATMENT PARADIGM A pressing public health problem is the high prevalence of engagement in multiple, poor health behaviors, creating patterns of high risk for morbidity and mortality and contributing to considerable individual and societal financial burden [1,2]. One pattern that is becoming increasingly prevalent is the combination of prediabetes, overweight or obese weight status, central obesity (increased visceral adipose tissue), and low cardiorespiratory fitness (CRF) with gradual loss of lean body mass and strength [3], which further increases the risks for type 2 diabetes (T2D), cardiovascular diseases, and some cancers, disabilities, and premature death [4]. The prevalence of T2D, based on fasting glucose or hemoglobin A1c levels in adults, aged 45-64 years old, is~14 %, and the prevalence of prediabetes for adults >20 years old is~35 % [5]. For adults over 65 years old, the prevalence of T2D is 27 % and the prevalence of prediabetes is~50 % [5]. Overweight, not just obesity weight status, is often comorbid for central obesity (waist circumference (WC) ≥102 cm for men and ≥88 cm for women) [3], which is associated with increased risk of T2D, especially for women [6]. Overweight individuals with large WC's, though at high risk, are often not identified for interventions [6,7]. The normal agerelated loss of lean body mass beginning in m...

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“…Debido a que la obesidad sarcopénica acentúa los efectos sobre la discapacidad, la morbilidad y mortalidad de la sarcopenia y la obesidad por separado (46), su presencia tanto en adultos (47) como en personas mayores (48) ha hecho que se reivindique la implantación de programas de ejercicio que prevengan la obesidad sarcopénica (49).…”

Section: Resultados Y Discusión Entrenamiento Contra Resistencias Y Ounclassified

Efectos del entrenamiento contra resistencias o resistance training en diversas patologías

2016

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Palabras clave:Actividad física. Salud. Ejercicio. Enfermedad cardiovascular. Key words:Physical activity. Health. Exercise. Cardiovascular disease. AbstractStrength performance directly affects the health and fi tness ability, so resistance training (RT) is included in those exercise programs aimed at improving the health and quality of life. Because many diseases present with altered muscle mass and functionality as the RT is the main form of exercise aimed at improving muscle function, the purpose of this literature review was to expose the current evidence on the adaptations of RT, and their possible application in diseases such as obesity, diabetes, dyslipidemia, hypertension, cancer, Parkinson's, multiple sclerosis or fi bromyalgia. The RT in these diseases can increase levels of muscle mass, decreasing body fat levels, levels of fatty acids in blood and blood glucose by increasing insulin sensitivity and decreasing levels of infl ammatory cytokines. The RT also improves cardiac output and endothelial function, regulating blood pressure and increasing oxygen consumption. Muscle strength gains improve the functionality and quality of life, especially in people with severe neuromuscular involvement as they could be those suffering from multiple sclerosis, fi bromyalgia and Parkinson's. Therefore, the RT should be incorporated as part of treatment in people who have certain types of diseases. ResumenLa fuerza infl uye directamente en el estado de salud y en la capacidad de fi tness, motivo por el que el entrenamiento contra resistencias o resistance training (RT) se incluye dentro de aquellos programas de ejercicio encaminados a mejorar la salud y calidad de vida. Debido a que muchas enfermedades cursan con alteración de la masa y funcionalidad muscular y a que el RT es la principal modalidad de ejercicio encaminada a mejorar la función muscular, el objetivo de la presente revisión bibliográfi ca ha sido exponer las evidencias actuales sobre las adaptaciones del RT, así como su posible aplicación en patologías como la obesidad, diabetes, dislipemia, hipertensión, cáncer, Parkinson, esclerosis múltiple o fi bromialgia. El RT en estas enfermedades puede aumentar los niveles de masa muscular, disminuyendo los niveles de masa grasa, los niveles de ácidos grasos en sangre y la glucemia, incrementando la sensibilidad a la insulina, y disminuyendo los niveles de citokinas infl amatorias. El RT, además, mejora el gasto cardiaco y la funcionalidad endotelial, regulando la tensión arterial e incrementando el consumo de oxígeno. Las ganancias de fuerza muscular mejoran la funcionalidad y la calidad de vida, especialmente en población con una afectación neuromuscular grave, como pudieran ser los enfermos de esclerosis múltiple, fi bromialgia o Parkinson. Por ello, el RT debe ser incorporado como parte del tratamiento en las personas que presentan determinado tipo de patologías.

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Sarcopenia Exacerbates Obesity-Associated Insulin Resistance and Dysglycemia: Findings from the National Health and Nutrition Examination Survey III

Cited by 480 publications

References 22 publications

Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity

Muscle loss and obesity: the health implications of sarcopenia and sarcopenic obesity

Developing a new treatment paradigm for disease prevention and healthy aging

Efectos del entrenamiento contra resistencias o resistance training en diversas patologías

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