Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons – a narrative review

This expert review summarises current knowledge on the treatment of sarcopenic obesity in older people through a combination of physical activity, nutrition and other non-pharmacological interventions. The authors analyse available studies focused on strength training, aerobic activity, weight reduction, protein intake, vitamin D and novel approaches, which also include whole-body electromyostimulation (WB-EMS). The publication points out that weight reduction alone can lead to a loss of muscle mass in older people. It therefore regards the combination of strength training, sufficient intake of quality protein and moderate energy restriction as the most effective strategy. The authors also report that the first studies with WB-EMS show a positive effect on muscle mass, strength, body composition and physical performance in older people at risk of sarcopenia or obesity, although further high-quality clinical studies are needed.

- Sarcopenic obesity significantly increases the risk of disability and loss of independence. - The best results are achieved by combined programmes linking exercise and nutrition. - A weight-reduction diet alone can lead to a loss of muscle mass. - Strength training is the best-supported intervention for preserving muscle mass in older people. - Sufficient protein intake supports the preservation of muscle mass during weight reduction. - Initial studies suggest that EMS can favourably affect muscle mass, strength, body composition and aerobic capacity in older people at increased risk of sarcopenia or obesity.

The publication supports the use of a comprehensive approach when working with older people. A combination of strength training, properly configured nutrition and modern methods such as WB-EMS can help slow the loss of muscle mass, improve physical function and prolong the period of active and independent living. At the same time, it points out that weight reduction without protecting muscle mass is not an appropriate strategy.