‘Sarcobesity’: A metabolic conundrum
Abstract
Two independent but inter-related conditions that have a growing impact on healthy life expectancy and health care costs in developed nations are an age-related loss of muscle mass (i.e., sarcopenia) and obesity. Sarcopenia is commonly exacerbated in overweight and obese individuals. Progression towards obesity promotes an increase in fat mass and a concomitant decrease in muscle mass, producing an unfavourable ratio of fat to muscle. The coexistence of diminished muscle mass and increased fat mass (so-called 'sarcobesity') is ultimately manifested by impaired mobility and/or development of life-style-related diseases. Accordingly, the critical health issue for a large proportion of adults in developed nations is how to lose fat mass while preserving muscle mass. Lifestyle interventions to prevent or treat sarcobesity include energy-restricted diets and exercise. The optimal energy deficit to reduce body mass is controversial. While energy restriction in isolation is an effective short-term strategy for rapid and substantial weight loss, it results in a reduction of both fat and muscle mass and therefore ultimately predisposes one to an unfavourable body composition. Aerobic exercise promotes beneficial changes in whole-body metabolism and reduces fat mass, while resistance exercise preserves lean (muscle) mass. Current evidence strongly supports the inclusion of resistance and aerobic exercise to complement mild energy-restricted high-protein diets for healthy weight loss as…
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Obesity, especially severe obesity (BMI ≥35 kg/m2), increases metabolic and cardiovascular risk as well as the risk of mobility limitations and frailty in older persons, particularly when marked muscle loss has already occurred.
“Obesity, especially severe obesity (BMI ≥35 kg/m²), increases metabolic and cardiovascular risk as well as the risk of mobility limitations and frailty in older persons (277,278,285), particularly when marked muscle loss has already occurred (283).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [283]
Strict dietary regimens, like diets with very low energy intake (<1000 kcal/day), risk developing malnutrition and promoting functional decline in the older population.
“Strict dietary regimens, like diets with very low energy intake (<1000 kcal/day), are strongly discouraged in the older population due to the risk of developing malnutrition and promoting functional decline (60,278,283).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [283]
Common weight regain after a weight-reducing diet is predominantly a regain in fat mass and not in lean mass.
“Moreover, the common weight-regain after a weight-reducing diet is predominantly a regain in fat mass and not in lean mass (283).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [283]
Weight loss increases the risk of sarcopenia, frailty, functional decline, fractures, and malnutrition.
“and consequently increases the risk of sarcopenia, frailty, functional decline, fractures, and malnutrition (276, 282, 283).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [283]
Weight loss, whether intentional or not, enhances the age-related loss of muscle mass.
“Further, weight loss, whether intentional or not, enhances the age-related loss of muscle mass”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [283]
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- Authors
- Parr, E. B., Coffey, V. G., & Hawley, J. A.
- Affiliations
- RMIT University (AU)
- Venue
- Maturitas
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 74
- Issue
- 2
- Pages
- 109-113
- ISSN
- 0378-5122 (ISSN-L)
- OpenAlex
- W1494885974
- Cited by
- 95
- References
- 12
- Citations by year
- 2026: 6 · 2025: 2 · 2024: 7 · 2023: 3 · 2022: 6 · 2021: 7 · 2020: 4 · 2019: 8 · 2018: 5 · 2017: 5 · 2016: 13 · 2015: 12 · 2014: 11 · 2013: 6
- FWCI
- 1.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Maturitas (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Keywords
- sarcopenia, obesity, fat mass, lean body mass, body composition, caloric restriction, high-protein diet, resistance training, aerobic exercise, weight loss, lifestyle intervention, mobility impairment
- MeSH terms
- Diet, Dietary Proteins, Energy Metabolism, Humans, Obesity, Exercise, Caloric Restriction, Mobility Limitation, Sarcopenia
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