Effects of Exercise and Nutritional Intervention on Body Composition, Metabolic Health, and Physical Performance in Adults with Sarcopenic Obesity: A Meta-Analysis

Hsu, Kuo Jen; Liao, Chun De; Tsai, Mei Wun; Chen, Chiao Nan

doi:10.3390/nu11092163

Cited by 169 publications

(172 citation statements)

References 49 publications

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“…Applying exercise intensity peaks in the range corresponding to 60-85% 1RM, high velocity, and RM with intensifying strategies (Gießing, 2008), most determinants responsible for initiating a hypertrophic response (Schoenfeld, 2010) were considered by our protocol. In summary, we observed significant favorable effects on LBM, total and abdominal fat, and lower extremity strength (MILES) that were superior to current studies on sarcopenic/SO cohorts, be it with or without protein supplementation (review in Martinez-Amat et al, 2018;Vlietstra et al, 2018;Hsu et al, 2019). Closest to our study, after 8 months of multiple-set DRT on machines (+whey protein supplementation) applied either two or three times/week, Stec et al (2017) reported LBM changes of 0.4-1.89 kg in older people (60-75 years) with age-related muscle atrophy.…”

Section: Discussionmentioning

confidence: 71%

Effects of High-Intensity Resistance Training on Fitness and Fatness in Older Men With Osteosarcopenia

et al. 2020

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To date, there has been no study on the long-term effects of resistance exercise on sarcopenia and obesity indices for people with sarcopenia. The present study thus aimed to determine the effect of 18 months of periodized, high-velocity/intensity/effort progressive resistance training (HIT-RT) on body composition and strength in older men with osteosarcopenia. Using a single-blind, two-group parallel design, 43 community-dwelling men, 72 years and older, with osteopenia and sarcopenia in Erlangen-Nürnberg, Germany, were randomly assigned to two study arms by drawing lots: (1) an exercise group that conducted a consistently supervised periodized high-velocity/intensity/effort protocol (HIT-RT; n = 21) on machines twice a week for 18 months or (2) a control group (CG; n = 22) that maintained their physical activity/exercise habits. Both groups were supplied with protein, cholecalciferol, and calcium according to current recommendations. The study outcomes were lean body mass (LBM), total and abdominal body fat as determined by dual-energy X-ray absorptiometry and maximum hip/leg extensor strength as assessed on an isokinetic leg press at baseline and after 8, 12, and 18 months of follow-up. The intention-to-treat principle and multiple imputation were applied to calculated study outcomes. After 18 months of HIT-RT, altogether five participants were lost to follow up (HIT-RT: n = 2, CG: n = 3). The attendance rates (95%) for HIT-RT were high; relevant adverse effects were not observed. Significant effects (i.e., differences between HIT-RT vs. CG) in favor of HIT-RT were determined for LBM (+1.73 kg, 95% CI: +1.13 to +2.32 kg), total body fat mass (−2.44 kg, 95% CI: −1.28 to 3.60 kg), abdominal body fat percentage (−2.68, 95% CI: −1.70 to −3.66), and maximum hip/leg extensor strength (+533 N, 95% CI: +397 to +670 N; all p < 0.001). Even after adjusting for multiple testing, all effects remained significant. Of note, after 8 months of HIT-RT, only slight (LBM and fat indices) to moderate (maximum strength) ongoing effects were observed. Carefully introduced, continuously supervised HIT-RT is an effective, attractive, feasible, and safe method to improve body composition and muscle strength in older community-dwelling men with sarcopenia. However, even when consequently applying principles of exercise intensity progression within the RT protocol, only slight further positive changes were observed after 8 months of exercise.

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Section: Discussionmentioning

confidence: 71%

Effects of High-Intensity Resistance Training on Fitness and Fatness in Older Men With Osteosarcopenia

et al. 2020

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“…To our knowledge, this is the first meta-analysis that compares RT plus PS with RT alone or plus placebo supplementation in a healthy elderly population. Notably, there are similar previous studies that compared different populations, such as a younger population [45,46] or elderly hospitalized people [47]; included a combination of other supplements, such as vitamin 3, omega-3, or a dietary intake modification [19,[48][49][50][51]; or studied other outcomes related to body composition [52,53].…”

Section: Discussionmentioning

confidence: 92%

Effectiveness of Protein Supplementation Combined with Resistance Training on Muscle Strength and Physical Performance in Elderly: A Systematic Review and Meta-Analysis

et al. 2020

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The aim of this study was to evaluate the effectiveness of the combination of resistance training (RT) and protein supplementation (PS), compared to RT alone or combined with a placebo (plS), in the improvement of muscle strength and physical performance. The search strategy in PubMed, Cochrane Library, and Web of Sciences databases found a total of 294 studies. Once inclusion and exclusion criteria were applied, 16 studies were included for the qualitative analysis. A total of 657 healthy elderly (>60 years) participants were analysed. Finally, 15 articles were included in the quantitative analysis with one being excluded due to issues with data availability. Upper-limb, lower-limb, and handgrip strength were the primary outcomes of the meta-analysis. The secondary outcomes, related to physical performance, were Short Physical Performance Battery (SPPB), gait speed, and the five-chair-rise test (5CRT). The main results of the meta-analysis show no statistical differences for upper-limb (SMD: 0.56, 95% CI: −0.09, 1.21, p = 0.09, I2 = 68%), lower-limb (SMD: 0.00, 95% CI: −0.18, 0.18, p = 1.0, I2 = 11%), and handgrip strength (SMD: 0.03, 95% CI: −0.26, 0.32, p = 0.84, I2 = 0%) between the RT + PS and the RT alone (or combined with plS). Moreover, no statistical differences were found relating to physical performance. In view of these results, protein supplementation combined with RT does not provide additional benefits compared to RT alone or with plS in healthy elderly adults.

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“…As such, nutritional strategies for sarcopenic obesity should target not only an optimal energy intake in order to decrease excess fat mass, but also an optimal nutrient intake in order to increase skeletal muscle mass (60). Recent studies have shown that a combination of a moderate weight loss diet with concurrent exercise (especially resistance exercise) may improve body composition and physical performance in subjects with sarcopenic obesity (61).…”

Section: Discussionmentioning

confidence: 99%

Nonalcoholic Fatty Liver Disease Is Associated With Low Skeletal Muscle Mass in Overweight/Obese Youths

et al. 2020

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Background: Recent studies in adult non-elderly and elderly individuals have reported a link between nonalcoholic fatty liver disease (NAFLD) and sarcopenia. Nonetheless, whether this relationship would be found outside these populations it is still unknown. Hence, we evaluated the relationship between NAFLD and skeletal muscle mass in children and adolescents with overweight/obesity. Methods: Two-hundred and thirty-four overweight/obese youths were enrolled. NAFLD was diagnosed by ultrasononography, after exclusion of infectious and metabolic disorders. Forty of the patients with NAFLD had also liver biopsy. Total and regional lean body mass and total fat mass measurements were obtained by dual-energy X-ray absorptiometry. The relative muscle mass (RMM) was defined as the percent of muscle mass (kg) relative to the sum of muscle and fat (kg) mass. Appendicular skeletal muscle mass (ASM) was calculated by the sum of muscle masses of the four limbs (kg), and expressed as percent of body weight. Results: Subjects were stratified according to tertiles of RMM. The prevalence of abdominal obesity, dyslipidemia, insulin resistance, metabolic syndrome, NAFLD as well as biopsy-proven nonalcoholic steatohepatitis (NASH) was significantly increased in the lowest tertile of RMM. After controlling for age, sex and Tanner stage, children in the lowest tertile of RMM had an increased risk for NAFLD (OR= 2.80, 95% CI=1.57-5.02) compared to those in the other two tertiles. This association persisted after additional adjustments for clinical and metabolic variables. Similarly, the risk of NAFLD in the lowest tertile of ASM/weight index was significantly higher compared to those in the other two tertiles after adjustment for the above confounders. Conclusions: This is the first study to establish an independent association between low muscle mass and NAFLD/NASH in overweight/obese youths. Considering the worldwide increase of pediatric obesity, measurements of muscle mass may serve as useful method of identifying among obese children those at high metabolic risk who may need intensive lifestyle interventions to prevent NAFLD and its progression.

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Effects of Exercise and Nutritional Intervention on Body Composition, Metabolic Health, and Physical Performance in Adults with Sarcopenic Obesity: A Meta-Analysis

Cited by 169 publications

References 49 publications

Effects of High-Intensity Resistance Training on Fitness and Fatness in Older Men With Osteosarcopenia

Effects of High-Intensity Resistance Training on Fitness and Fatness in Older Men With Osteosarcopenia

Effectiveness of Protein Supplementation Combined with Resistance Training on Muscle Strength and Physical Performance in Elderly: A Systematic Review and Meta-Analysis

Nonalcoholic Fatty Liver Disease Is Associated With Low Skeletal Muscle Mass in Overweight/Obese Youths

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