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Abstract
Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and strength, with a risk of adverse outcomes such as physical disability, poor quality of life, and death. Sarcopenic obesity is defined as having both sarcopenia and obesity, a condition reported to be associated with a higher risk for adverse outcomes including functional disability, frailty, poor quality of life, longer hospitalization, and higher mortality rates. The definition and diagnostic criteria for sarcopenia have been described by several working groups on the disease; however, there is no standardized definition and diagnostic criteria for sarcopenic obesity. In this review, we summarize nutrition, exercise, and pharmaceutical therapies for counteracting sarcopenic obesity in humans. Although there are some pharmaceutical therapies for both sarcopenia (i.e., testosterone, growth hormone, ghrelin, and vitamin D) and obesity (orlistat, lorcaserin, phentermine-topiramate, and vitamin D), therapies combining nutrition and exercise remain the first-line choice for preventing and treating sarcopenic obesity. Resistance training combined with supplements containing amino acids are considered most effective for treating sarcopenia. Low-calorie, high-protein diets combined with aerobic exercise and resistance training are recommended for preventing and treating obesity. Therefore, nutrition therapies (low-calorie, high-protein diets, protein and amino acid supplementation) and exercise therapies (resistance training and aerobic exercise) would be expected to be the most effective option for preventing and treating sarcopenic obesity. In cases of severe sarcopenic obesity or failure to achieve muscle gain and weight loss through nutrition and exercise therapies, it is necessary to add pharmaceutical therapies to treat the condition.
Highlights
The term sarcopenia was used by Rosenberg to describe an age-related decrease in muscle mass, and originated from the Greek words sarx and penia [1, 2]
In 2011, the International Working Group on Sarcopenia defined the disease as an “ageassociated loss of skeletal muscle mass and function"
102 Journal of Nutritional Therapeutics, 2013 Vol 2, No 2. Because both resistance training and protein supplementation are effective treatments for sarcopenia, resistance training combined with supplements containing amino acids would be expected to be the most effective option for preventing and treating age-related muscle wasting and weakness [5,6,7]
Summary
The term sarcopenia was used by Rosenberg to describe an age-related decrease in muscle mass, and originated from the Greek words sarx (flesh) and penia (loss) [1, 2]. Another study classified sarcopenic obesity as cases with a percentage body fat in the upper two quintiles and a relative muscle mass in the lower two quintiles [12]. Sarcopenic obesity is associated with adverse health effects such as physical disability, cardiovascular disease risk, and death [10, 11, 13, 14]. The relative risk (RR) for incident disability in obese sarcopenic subjects was reported to be 2.63 (95% confidence interval (CI), 1.19 to 5.85) after adjustment for age, sex, physical activity level, length of follow-up, and prevalent morbidity in the elderly [10]. We first review nutrition, exercise and pharmaceutical therapies used to treat sarcopenia and obesity in humans, and summarize a comprehensive approach for inhibiting sarcopenic obesity
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