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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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“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]
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“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]
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“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]
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“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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“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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“Similarly, cold stimulation can also accelerate metabolism and build muscle through the activation of brown fat, and maintain mitochondrial integrity and functional recovery while being detected [28–30].”
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The Benefits of Exercise Training in Combination With Weight Loss Therapies
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“[23] previously showed that aerobic exercise combined with resistance training was more effective than aerobic or resistance training alone in improving muscle protein synthesis and myocellular quality during intentional energy-restricted weight loss in obese older adults.”
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“From a mechanistic standpoint, RT may decrease fat mass indirectly by increasing lean tissue and improving metabolic efficiency, whereas MC may exert broader effects on body fat percentage through its more comprehensive and functionally oriented training structure (22, 23, 26).”
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“However, existing studies have shown that, based on caloric restriction, adding exercise (especially aerobic plus resistance exercise) could improve muscle protein synthesis and muscle quantity (Colleluori et al. 2019; Jiang and Villareal 2025).”
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Preservation of Muscle during Treatment for Obesity in Adults with Intellectual Disabilities
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The Role of Insulin Sensitivity in Lean Mass Changes During Weight Loss With or Without Exercise
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Metadata
- 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 (medical) › Nutrition and Health in Aging
- Health Sciences › Nursing › Nutrition and Dietetics › 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
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