The Relevance of Diet, Physical Activity, Exercise, and Persuasive Technology in the Prevention and Treatment of Sarcopenic Obesity in Older Adults

Josje D Schoufour,Alfonso J Cruz-Jentoft,Bart Visser,Doris Eglseer,Trudy Voortman,Michael Tieland,Somaya Ben Allouch,Amalia Tsagari,Eva Topinková,Yves Boirie,Rocco Barazzoni,Peter J M Weijs,Joey Van Der Bie

doi:10.3389/fnut.2021.661449

Abstract

The aging population faces two conditions that threaten healthy aging: high fat mass (obesity) and low muscle mass and function (sarcopenia). The combination of both—referred to as sarcopenic obesity—synergistically increases the risk of adverse health outcomes. The two conditions often co-occur because they reinforce each other and share common etiologies, including poor nutrition and inactivity. All aging people are at risk of gaining weight and losing muscle mass and could benefit from improvements in physical activity, exercise and dietary intake. one specific window of opportunity is during the transient time of retirement, as older adults already need to restructure their daily activities. It is key to change lifestyle behavior in a sustainable manner, providing scientifically proven, personalized, and acceptable principles that can be integrated in daily life. Health technologies (e.g., applications) can provide promising tools to deliver personalized and appealing lifestyle interventions to a large group of people while keeping health care costs low. Several studies show that health technologies have a strong positive effect on physical activity, exercise and dietary intake. Specifically, health technology is increasingly applied to older people, although strong evidence for long term effects in changing lifestyle behavior is generally lacking. Concluding, technology could play an important role in the highly warranted prevention of sarcopenic obesity in older adults. Although health technology seems to be a promising tool to stimulate changes in physical activity, exercise and dietary intake, studies on long lasting effects and specifically targeted on older people around the time of retirement are warranted.

Highlights

Two severe public health threats strike Europe: obesity and sarcopenia, defined as loss of skeletal muscle mass and function [1, 2]
Sole focus on physical activity during weight loss may lead to insufficient effects regarding both the reduction of fat mass and the preservation of muscle mass
Sole focus on energy restriction can be successful for body weight loss, but can be costly is terms of losses in muscle mass [48]

Summary

INTRODUCTION

Two severe public health threats strike Europe: obesity and sarcopenia, defined as loss of skeletal muscle mass and function [1, 2]. One good example of a blended care intervention for older adults, that was built on well-described theoretical principles of behavior change is the VITAMIN trial [111] This trial was developed to counteract the decline in physical functioning and sarcopenia using a blended-care home-based exercise and dietary protein intervention and showed positive effects on among others muscle mass, muscle strength and protein intake, but not on physical performance in healthy older adults (55 years and over) [110, 112]. Whether this approach works for frail older people and people with or at risk for sarcopenic obesity should be further explored. There is a need for well-designed health applications for older people in general, or those going through retirement, that aim to prevent or treat sarcopenic obesity

CONCLUSION

Findings

DATA AVAILABILITY STATEMENT