Rationale: Sarcopenia and obesity are prevalent conditions and are both associated with negative health outcomes. ESPEN and EASO reached consensus on the definition and diagnostic criteria for sarcopenic obesity (SO) encompassing indicators fat mass, muscle mass, and muscle function. However, few studies report on the effect of lifestyle interventions on these SO indicators. This study aimed to evaluate the effect of combined lifestyle interventions on SO indicators and on a composite SO index.
Methods: Analyses were performed on two pooled RCT’s (MPS, PROBE) in older adults with obesity participating in a 13-wk program targeting weight loss while preserving muscle mass, providing a combination of caloric restriction, higher protein intake and resistance exercise training. SO indicators measured at baseline and post-intervention included 5x chair stand test (CST) in seconds for muscle function, fat mass percentage (FM%) and appendicular lean mass divided by body weight (ALM/W) using DXA. The SO index was calculated using sex-specific z-scores: -CST(s) + ALM/W – FM%; higher scores indicating better muscle function and body composition. Mixed model analyses were performed to assess the changes from baseline to post-intervention, adjusted for sex and age.
Results: A total of 154 participants (age 65±6y; 59% male, BMI 33.1±4.3kg/m2) were included. After the 13-wk lifestyle interventions, weight (-2.87kg 95%CI -4.16;-1.64) and FM% (-1.81% 95%CI -2.42;-1.21) decreased significantly, CST improved significantly (-1.51s 95%CI -2.02;-1.00) from baseline and ALM/W was maintained (0kg/kg 95%CI 0.01;0.01). The SO index improved (+1.16 z-score 95%CI 0.86;1.44).
Conclusion: Lifestyle interventions combining nutrition & exercise improved individual SO indicators and the SO index in older adults with obesity. The SO index could be a useful and sensitive criterion in the prevention and management of sarcopenic obesity.
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