Sarcopenic Obesity in Africa: A Call for Diagnostic Methods and Appropriate Interventions

Abstract

This perspective aims to highlight the lack of current knowledge on sarcopenic obesity in Africa and to call for diagnostic methods and appropriate interventions. Sarcopenic obesity has been defined as obesity that occurs in combination with low muscle mass and function, which is typically evident in older adults. However, there has been no clear consensus on population-specific diagnostic criterion, which includes both gold-standard measures that can be used in a more advanced health care system, and surrogate measures that can be used in low-income settings with limited resources and funding. Importantly, low and middle-income countries (LMICs) across Africa are in an ongoing state of economic and social transition, which has contributed to an increase in the aging population, alongside the added burden of poverty, obesity, and associated co-morbidities. It is anticipated that alongside the increased prevalence of obesity, these countries will further experience an increase in age-related musculoskeletal diseases such as sarcopenia. The developmental origins of health and disease (DOHaD) approach will allow clinicians and researchers to consider developmental trajectories, and the influence of the environment, for targeting high-risk individuals and communities for treatment and/or prevention-based interventions that are implemented throughout all stages of the life course. Once a valid and reliable diagnostic criterion is developed, we can firstly assess the prevalence and burden of sarcopenic obesity in LMICs in Africa, and secondly, develop appropriate and sustainable interventions that target improved dietary and physical activity behaviors throughout the life course.

Osteoporosis, Rather Than Sarcopenia, Is the Predominant Musculoskeletal Disease in a Rural South African Community Where Human Immunodeficiency Virus Prevalence Is High: A Cross-Sectional Study

“…( 40 , 41 ) There is currently no consensus agreement over the definition of sarcopenia in male and female African populations. ( 42 , 43 )…”

Waist-to-calf circumstance ratio and cognitive function among Chinese older adults: Mediating roles of physical performance and social activity

“…As described in a recent study (Mendham et al, 2021 ), by adding the dietary pattern and daily habit scores, a combined lifestyle score was calculated between 10 and 50, as described in Supplementary Table S5 . Since the missing proportion of the collected data in this domain was <5%, the average scores of each variable were utilized to replace the missing values.…”

“…For analysis, the eight frequency options of food intake were measured, including staple foods, meat, fish, fresh fruits and vegetables, milk, sugar, and nuts (Mo et al, 2022 ). The dietary pattern score is determined as the total of all eight food category scores, ranging from 7 to 38, with higher scores reflecting better eating patterns, as indicated in prior research (Moreno-Franco et al, 2018 ; Mendham et al, 2021 ; Mo et al, 2022 ). Tobacco and alcohol consumption as well as the amount of outdoor exercise were also recalled by participants.…”

Food insecurity as a risk factor of sarcopenic obesity in older adults

“…Food insecurity is paradoxically associated with obesity in high-income countries. The first hypothesis of whether food insecurity causes obesity was published 27 years ago ( 66 ).…”