Aerobic plus resistance exercise in obese older adults improves muscle protein synthesis and preserves myocellular quality despite weight loss
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SUMMARY Anabolic resistance and impaired myocellular quality contribute to age-related sarcopenia, which exacerbates with obesity. Diet-induced muscle mass loss is attenuated by resistance or aerobic plus resistance exercise compared to aerobic exercise in obese elderly. We assessed chronic effects of weight loss plus different exercise modalities on muscle protein synthesis response to feeding and myocellular quality. Obese older adults were randomized to weight-management program plus aerobic, resistance or combined aerobic and resistance exercise or to control. Participants underwent vastus lateralis biopsies at baseline and 6 months. Muscle protein synthesis rate increased more in resistance and combined than in control. Autophagy mediators’ expression decreased more in combined than in aerobic, which experienced a higher increase in inflammation and mitochondrial regulators’ expression. In obese elderly, combined aerobic and resistance exercise is superior to either mode independently for improving muscle protein synthesis and myocellular quality, thereby maintaining muscle mass during weight-loss therapy.
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Resistance training stimulates muscle protein synthesis during negative energy balance, promoting myogenesis, and is crucial for mitigating muscle mass loss associated with calorie restriction in adults with obesity.
“RT stimulates muscle protein synthesis even during negative energy balance, promoting myogenesis, and is particularly crucial to mitigating the loss of muscle mass associated with CR in this population (18).”
From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [18]
The Results section ('MPS rate in response to feeding improved most in COMB and REX groups'; page unavailable) reports increased meal-stimulated muscle protein synthesis during calorie-restriction-induced weight loss and says resistance exercise is particularly important for preserving lean mass in obese older adults. The Results section on myogenesis regulators reports that MEF2A expression was preserved with resistance or combined exercise, not that resistance training promoted myogenesis itself. The study also did not include a weight-loss-only group, limiting what it can establish about exercise versus calorie restriction alone. (LLM, conf=0.86)
Experimental — accuracy not yet measuredProgressive resistance training during calorie restriction reduces the loss of lean mass.
“When performed alongside CR, progressive resistance training (RT) attenuates this loss of lean mass and bone mass, while the addition of aerobic training (AT) further improves cardiorespiratory fitness.”
From The Benefits of Exercise Training in Combination With Weight Loss Therapies (2025) · cites this paper as [18]
Exercise training reduces frailty in older adults by suppressing muscle inflammation and promoting anabolism, thereby increasing muscle protein synthesis rate.
“Exercise training reduces frailty in older adults by suppressing muscle inflammation and promoting anabolism, thereby increasing muscle protein synthesis rate [148,336,337].”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [336]
Colleluori et al. showed that 6-month multicomponent training among obese older adults was more effective than aerobic or PRT alone for improving muscle protein synthesis and myocellular quality, even though mitochondrial biogenesis increased the most in the aerobic exercise group.
“In a well-designed RCT, Colleluori et al. [148,336,337] showed that 6-month multicomponent training among obese older adults was more effective than aerobic or PRT alone for improving muscle protein synthesis and myocellular quality, even though mitochondrial biogenesis increased the most in the aerobic exercise group.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [336]
6-month multicomponent training among obese older adults was more effective than aerobic or PRT alone for improving muscle protein synthesis and myocellular quality, even though mitochondrial biogenesis increased most in the aerobic exercise group.
“In a well-designed RCT, Colleluori et al. [148,336,337] showed that 6-month multicomponent training among obese older adults was more effective than aerobic or PRT alone for improving muscle protein synthesis and myocellular quality, even though mitochondrial biogenesis increased the most in the aerobic exercise group.”
From Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR) (2025) · cites this paper as [336]
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- Authors
- Colleluori, G., Aguirre, L., Phadnis, U., Fowler, K., Armamento-Villareal, R., Sun, Z., Brunetti, L., Hyoung Park, J., Kaipparettu, B. A., Putluri, N., Auetumrongsawat, V., Yarasheski, K., Qualls, C., & Villareal, D. T.
- Affiliations
- Michael E. DeBakey VA Medical Center (US)
- University of New Mexico (US)
- Baylor College of Medicine (US)
- Washington University in St. Louis (US)
- Corresponding author
- Villareal, Dennis T.
- ORCID
- Venue
- Cell Metabolism
- Publisher
- Elsevier BV
- Published
- 2019-08
- Volume
- 30
- Issue
- 2
- Pages
- 261-273.e6
- ISSN
- 1550-4131 (ISSN-L)
- PMC
- PMC6685749
- OpenAlex
- W2956000224
- Semantic Scholar
- 8d030ce1c96c46d8b6fce98d3a921045b127138c
- Cited by
- 135
- References
- 75
- Citations by year
- 2026: 17 · 2025: 18 · 2024: 21 · 2023: 22 · 2022: 23 · 2021: 15 · 2020: 17 · 2019: 2
- FWCI
- 9.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Cell Metabolism (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
- Funders
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- aerobic exercise, resistance training, concurrent training, muscle protein synthesis, sarcopenia, obesity, older adults, weight loss, autophagy, inflammation, mitochondrial function, vastus lateralis, muscle mass preservation
- MeSH terms
- Aged, Humans, Muscle Proteins, Obesity, Weight Loss, Exercise, Muscle, Skeletal, Resistance Training
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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