Prevention and Treatment of Sarcopenic Obesity in Women

Abstract

Sarcopenic obesity (SO) is referred to as the combination of obesity with low skeletal muscle mass and function. However, its definition and diagnosis is debated. SO represents a sizable risk factor for the development of disability, possibly with a worse prognosis in women. The present narrative review summarizes the current evidence on pharmacological, nutrition and exercise strategies on the prevention and/or treatment of SO in middle-aged and older-aged women. A literature search was carried out in Medline and Google Scholar between 29th January and 14th March 2019. Only controlled intervention studies on mid-age and older women whose focus was on the prevention and/or treatment of sarcopenia associated with obesity were included. Resistance training (RT) appears effective in the prevention of all components of SO in women, resulting in significant improvements in muscular mass, strength, and functional capacity plus loss of fat mass, especially when coupled with hypocaloric diets containing at least 0.8 g/kg body weight protein. Correction of vitamin D deficit has a favorable effect on muscle mass. Treatment of SO already established is yet unsatisfactory, although intense and prolonged RT, diets with higher (1.2 g/kg body weight) protein content, and soy isoflavones all look promising. However, further confirmatory research and trials combining different approaches are required.

Keywords: aging; body composition; exercise; hormone replacement treatment; nutrition; physical therapy; phytoestrogens; sarcopenic obesity.

Figure 1

Overview of interventions for the prevention and/or treatment of sarcopenic obesity in women based on a non-systematic review of 24 papers including 1820 women. The three layers of intervention are superimposed to show that they are not mutually exclusive. Resistance training is the most effective strategy with effects directly related to its frequency and duration; when coupled with hypocaloric diets with normal-to-high protein content the effects on both prevention and treatment are amplified. Vitamin D deficit should be corrected whenever present. Evidence on HRT and phytoestrogens needs confirmation by future research.