Effectiveness of nutritional and exercise interventions to improve body composition and muscle strength or function in sarcopenic obese older adults: A systematic review

Although sarcopenic obesity (SO) poses a major public health concern, a robust approach for the optimization of body composition and strength/function in SO has not yet been established. The purpose of this systematic review was to assess the effectiveness of nutritional (focusing on energy and protein modulation) and exercise interventions, either individually or combined, on body composition and strength/function in older adults with SO. MEDLINE, the Cochrane Central Register of Controlled Trials, CINAHL and SPORTDiscus were searched. Main inclusion criteria comprised sarcopenia as defined by the European Working Group on Sarcopenia in Older People (EWGSOP) and obesity defined as % body fat ≥40% (women) and ≥28% (men). Randomized controlled trials (RCTs), randomized controlled crossover trials and controlled clinical trials with older adults (mean age ≥65 years) following a nutritional regimen and/or an exercise training program were considered. Out of 109 full text articles identified, only two RCTs (61 participants) met the inclusion criteria. One study was a nutritional intervention adding 15 g protein·day−1 (via cheese consumption) to the participants' habitual diet. The second study was a high-speed circuit resistance training intervention. Body composition did not change significantly in either of the studies. However, the exercise intervention improved significantly muscle strength and physical function. Although this review was limited by the small number of eligible studies, it provides evidence for the potential benefits of exercise and highlights the necessity for future research to develop effective interventions including dietary and exercise regimens to combat sarcopenic obesity.