Higher levels of physical fitness are associated with a reduced risk of suffering sarcopenic obesity and better perceived health among the elderly. The EXERNET multi-center study

Abstract

Abstract:Objective: To evaluate the associations between physical fitness levels, health related quality of life (HRQoL) and sarcopenic obesity (SO) and to analyze the usefulness of several physical fitness tests as a screening tool for detecting elderly people with an increased risk of suffering SO. Design: Cross-sectional analysis of a population-based sample. Setting: Non-institutionalized Spanish elderly participating in the EXERNET multi-centre study. Participants: 2747 elderly subjects aged 65 and older. Measurements: Body weight, height and body mass index were evaluated in each subject. Body composition was measured by bioelectrical impedance. Four SO groups were created based on percentage of body fat and relative muscle mass; 1) normal group, 2) sarcopenic group, 3) obesity group and 4) SO group. Physical fitness was evaluated using 8 tests (balance, lower and upper body strength, lower and upper body flexibility, agility, walking speed and aerobic capacity). Three tertiles were created for each test based on the calculated scores. HRQoL was assessed using the EuroQol visual analogue scale. Results: Participants with SO showed lower physical fitness levels compared with normal subjects. Better balance, agility, and aerobic capacity were associated to a lower risk of suffering SO in the fittest men (odds ratio < 0.30). In women, better balance, walking speed, and aerobic capacity were associated to a lower risk of suffering SO in the fittest women (odds ratio < 0.21) Superior perceived health was associated with better physical fitness performance. Conclusions: Higher levels of physical fitness were associated with a reduced risk of suffering SO and better perceived health among elderly. SO elderly people have lower physical functional levels than healthy counterparts.

Associations between obesity, physical fitness, and urinary incontinence in non-institutionalized postmenopausal women: The elderly EXERNET multi-center study

“…Poor lower-extremity function is related to mobility-related disabilities in elderly [11]. Moreover, the odds ratio of having better perceived health showed in a previous study was associated with better upper body (UB) flexibility compared with those women placed in the medium and lowest tertiles (34 and 77%, respectively) after adjusting for age [12]. Furthermore, obesity interferes with walking ability in older women, not only by reduced aerobic capacity and its association with a sedentary lifestyle, but also by sensations of discomfort and pain [13].…”

“…In fact, sitting time increases the overweight and obesity risk independently of walking time in elderly [14]. Additionally, higher odds ratio for having sarcopenic obesity were present in the unfit elderly compared with fit subjects [12].…”

Physical Activity and Sarcopenic Obesity: Definition, Assessment, Prevalence and Mechanism

“…Most studies used ALM index divided by height 2 <2.0 SDs [4,5,19,56] or ALM index divided by weight ≤2.0 SDs [8,20,21,57] using DXA to define sarcopenia. However, other studies used the lowest two quintiles of SMM divided by height 2 using BIA [22,23], handgrip strength lowest tertile [58,59] or walking speed ≤0.8 m/s [60]. To define obesity, some studies used BMI ≥30 kg/m 2 in men and women [51,59] or BMI >27.5 kg/m 2 in men [60], and others used different % body fat values of >27% in men and >38% in women [4], >28% in men and >35% in women [19], >30% in men and >40% in women [5,61] or the highest two quintiles of % body fat [22,23].…”

“…However, other studies used the lowest two quintiles of SMM divided by height 2 using BIA [22,23], handgrip strength lowest tertile [58,59] or walking speed ≤0.8 m/s [60]. To define obesity, some studies used BMI ≥30 kg/m 2 in men and women [51,59] or BMI >27.5 kg/m 2 in men [60], and others used different % body fat values of >27% in men and >38% in women [4], >28% in men and >35% in women [19], >30% in men and >40% in women [5,61] or the highest two quintiles of % body fat [22,23]. Instead of BMI or % body fat, some studies also used visceral fat area >100 cm 2 by CT scan [8], or waist circumference upper tertile [58], ≥90 cm in men and ≥85 cm in women [20,21,57] or >102 cm in men and >88 cm in women [56].…”

“…Also, the SO prevalence is significantly higher in people aged ≥80 years, compared with that in older adults aged <80 years. However, SO prevalence was higher (16–25%) when a more arbitrary definition of SO was used such as the lowest two quintiles of muscle mass or the highest two quintiles of % body fat [22,23]. …”