The DOI matches its Crossref record; 233 of the 234 references it cites were found in a registry or an index; 15 of the 132 sources its claims cite were checked for support.
Sarcopenic obesity in older adults: a clinical overview
Open accessAbstract
Sarcopenic obesity is characterized by a concurrent decline in muscle mass and function, along with increased adipose tissue. Sarcopenic obesity is a growing concern in older adults owing to significant health consequences, including implications for mortality, comorbidities and risk of developing geriatric syndromes. A 2022 consensus statement established a new definition and diagnostic criteria for sarcopenic obesity. The pathophysiology of this condition involves a complex interplay between muscle, adipose tissue, hormonal changes, inflammation, oxidative stress and lifestyle factors, among others. Sarcopenic obesity is treated with a range of management approaches, such as lifestyle interventions, exercise, nutrition and medical therapies. Emerging therapies that were developed for treating other conditions may be relevant to sarcopenic obesity, including novel pharmacological agents and personalized approaches such as precision medicine. In this Review, we synthesize the current knowledge of the clinical importance of sarcopenic obesity, its assessment and diagnosis, along with current and emerging management strategies.
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Claims the paper makes
78 Not checked yet · 13 No basis given · 8 Own interpretation · 4 Partly supported · 2 Supported so far · 1 Supported · 1 Not supported · accuracy not yet measured
At least one cited source doesn’t support this claim or points to a different paper, and none confirmed it — see the verdicts below.
In the paper
“NO can enhance insulin sensitivity by activating insulin receptor substrates and downstream signalling molecules, such as Akt and mTOR, which are involved in protein synthesis in muscle82.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Nitric oxide production
What the sources say
- Disputedcites [82] Muniyappa, R. & Sowers, J. R. Role of insulin resistance in endothelial dysfunction. Rev. Endocr. Metab. Disord. 14, 5–12 (2013). sourceExperimental — accuracy not yet measured
In “Selective Resistance to Insulin Actions in the Endothelium” (page unavailable), the paper gives the opposite signalling direction: insulin activates IRS-1 and Akt, which lead to NO production. The Introduction says NO can increase skeletal-muscle glucose uptake through increased blood flow, but the paper does not describe NO activating IRS-1, Akt, or mTOR to promote muscle protein synthesis. (LLM, conf=0.85)
Checked by a reasoning model — may be wrong.
plaindirect- Asserted: passes — The authors put it forward as true.
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- Disputed
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“The pathophysiology of this condition involves a complex interplay between muscle, adipose tissue, hormonal changes, inflammation, oxidative stress and lifestyle factors, among others.”
§ Sarcopenic obesity in older adults: a clinical overview > Abstract
What the sources say
- Partly supportedcites [47] JafariNasabian, P., Inglis, J. E., Reilly, W., Kelly, O. J. & Ilich, J. Z. Aging human body: changes in bone, muscle and body fat with consequent changes in nutrient intake. J. Endocrinol. 234, R37–R51 (2017). sourceExperimental — accuracy not yet measured
The hormonal-changes section describes muscle and fat as interconnected endocrine tissues, and the discussion at 234:1 links inflammation and fat accumulation to sarcopenic obesity. The discussion at 234:1 also links diet and reactive oxygen species to adipogenesis and bone changes, but it does not establish oxidative stress as part of the pathophysiology of sarcopenic obesity specifically; that part of the claim is more specific than the source. (LLM, conf=0.82)
- Supportedcites [48] Sakuma, K. & Yamaguchi, A. Sarcopenic obesity and endocrinal adaptation with age. Int. J. Endocrinol. 2013, 204164 (2013). source
The Conclusions describe sarcopenic obesity as having a complex, multifactorial pathogenesis involving lifestyle, endocrine and immunological factors. Section 2 links adipose tissue, inflammation and changes in muscle; the Introduction also identifies oxidative stress among factors involved in age-related muscle loss. Page numbers are not provided in our copy. (LLM, conf=0.88)
- Not checked yetcites [49] Moreira-Pais, A., Ferreira, R., Oliveira, P. A. & Duarte, J. A. A neuromuscular perspective of sarcopenia pathogenesis: deciphering the signaling pathways involved. Geroscience 44, 1199–1213 (2022). source
- Supportedcites [50] Gonzalez, A. et al. The critical role of oxidative stress in sarcopenic obesity. Oxid. Med. Cell Longev. 2021, 4493817 (2021). source
Section 3 identifies adipose and skeletal muscle dysfunction, age-associated hormonal changes, proinflammatory cytokines, oxidative stress, and decreased physical activity as factors in sarcopenic obesity. Section 3.4 further describes how physical inactivity and increased adipose tissue reinforce one another. (LLM, conf=0.93)
- Partly supportedcites [51] Huo, F., Liu, Q. & Liu, H. Contribution of muscle satellite cells to sarcopenia. Front. Physiol. 13, 892749 (2022). sourceExperimental — accuracy not yet measured
The Introduction and §2.2 (page unavailable) describe sarcopenia as involving hormonal changes, inflammation, reactive oxygen species, inactivity, and nutrition. Section 2.2 also discusses fat gain and fat infiltration into muscle, but it does not establish the claimed interplay with adipose tissue as the pathophysiology of sarcopenic obesity specifically. (LLM, conf=0.85)
- Partly supportedcites [52] Jeon, Y. K. et al. Vascular dysfunction as a potential culprit of sarcopenia. Exp. Gerontol. 145, 111220 (2021). sourceExperimental — accuracy not yet measured
The Introduction lists hormonal changes, inflammation, oxidative stress, reduced physical activity, and malnutrition as factors present in older adults with sarcopenia. The cited passages do not establish the claimed interplay with adipose tissue or address the pathophysiology of sarcopenic obesity specifically. (LLM, conf=0.87)
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“However, in individuals with sarcopenic obesity, this adaptive physiological process can falter, leading to excessive adipose tissue accumulation (‘load’) without a corresponding increase in muscle mass and functionality (‘capacity’)12,13.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
What the sources say
- Partly supportedcites [12] Siervo, M. et al. Body composition indices of a load-capacity model: gender- and BMI-specific reference curves. Public. Health Nutr. 18, 1245–1254 (2015). sourceExperimental — accuracy not yet measured
The paper’s discussion of sarcopenic obesity describes high adiposity alongside low muscle mass, and its load–capacity discussion treats adiposity as ‘load’ and skeletal muscle as ‘capacity’ (page numbers unavailable). It also notes that fat-free mass normally increases with body mass. However, it does not establish that an adaptive process fails or that muscle functionality fails to increase as adipose tissue accumulates. (LLM, conf=0.83)
- Partly supportedcites [13] Wells, J. C. Historical cohort studies and the early origins of disease hypothesis: making sense of the evidence. Proc. Nutr. Soc. 68, 179–188 (2009). sourceExperimental — accuracy not yet measured
In “Interpreting birth weight” (page unavailable), Wells describes homeostatic adaptation to metabolic load and a disease model based on disparity between load and capacity. The paper treats adiposity and lean mass as contributors to load, but does not address sarcopenic obesity or say that adipose tissue accumulates without a corresponding increase in muscle mass or function. (LLM, conf=0.84)
plaindirect- Asserted: passes — The authors put it forward as true.
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- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“Importantly, all such measures of strength and physical function consistently demonstrate improvements when bariatric surgery is coupled with a resistance exercise programme197–199.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Bariatric surgery
What the sources say
- Not checked yetcites [197] Hassannejad, A., Khalaj, A., Mansournia, M. A., Rajabian Tabesh, M. & Alizadeh, Z. The effect of aerobic or aerobic-strength exercise on body composition and functional capacity in patients with BMI ≥35 after bariatric surgery: a randomized control trial. Obes. Surg. 27, 2792–2801 (2017). source
- Not checked yetcites [198] Huck, C. J. Effects of supervised resistance training on fitness and functional strength in patients succeeding bariatric surgery. J. Strength. Cond. Res. 29, 589–595 (2015). source
- Supportedcites [199] Oliveira, G. S. et al. Resistance training improves muscle strength and function, regardless of protein supplementation, in the mid- to long-term period after gastric bypass. Nutrients 14, 14 (2021). source
The Results (section 3; page unavailable) report significant improvements across the measured strength and physical-function outcomes in the resistance-training groups, with no significant changes in the non-exercise groups. The study concerns people 2–7 years after Roux-en-Y gastric bypass, a form of bariatric surgery. (LLM, conf=0.92)
boosteddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Sarcopenic obesity is a growing concern in older adults owing to significant health consequences, including implications for mortality, comorbidities and risk of developing geriatric syndromes.”
§ Sarcopenic obesity in older adults: a clinical overview > Abstract
What the sources say
- Not checked yetcites 21–46
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Hormonal shifts associated with ageing and obesity strongly influence the pathophysiology of sarcopenic obesity48.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Oxidative stress and hormonal shifts
What the sources say
- Not checked yetcites [48] Sakuma, K. & Yamaguchi, A. Sarcopenic obesity and endocrinal adaptation with age. Int. J. Endocrinol. 2013, 204164 (2013). source
boosteddirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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In the paper
“With ageing, there is an increase in infiltration of skeletal muscle by adipose tissue (termed myosteatosis) within multiple different adipose depots, including intermuscular adipose tissue and intramyocellular lipids55.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Changes in muscle health
What the sources say
- Not checked yetcites [55] Correa-de-Araujo, R. et al. Myosteatosis in the context of skeletal muscle function deficit: an Interdisciplinary Workshop at the National Institute on Aging. Front. Physiol. 11, 963 (2020). This workshop discusses the impact of myosteatosis on skeletal muscle function during aging, detailing its connection to metabolic disease, evaluation techniques and prospective interventions, and emphasizing the importance of innovative research domains and interdisciplinary synergy. source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The ageing process leads to a gradual decline in the proportion of fast-twitch (type II) muscle fibres, which may contribute to decreased muscle strength and power56.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Changes in muscle health
What the sources say
- Not checked yetcites [56] Larsson, L. et al. Sarcopenia: aging-related loss of muscle mass and function. Physiol. Rev. 99, 427–511 (2019). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Long-term accumulation of adipose tissue, when paired with the secondary consequences of triggers such as ageing, including oxidative stress and chronic inflammation, among others, may progressively induce muscle loss and gain in adipose tissue, leading to sarcopenic obesity15.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
What the sources say
- Not checked yetcites [15] Baumgartner, R. N. & Waters, D. L. in Principles and Practice of Geriatric Medicine (eds Pathy, M. S. J., Sinclair, A. J. & Morley, J. E.) 909–933 (Wiley, 2005). source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Ultimately, a vicious cycle of muscle loss and adipose tissue gain can cause sarcopenic obesity15.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
What the sources say
- Not checked yetcites [15] Baumgartner, R. N. & Waters, D. L. in Principles and Practice of Geriatric Medicine (eds Pathy, M. S. J., Sinclair, A. J. & Morley, J. E.) 909–933 (Wiley, 2005). source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Neuromuscular function impairment could also contribute to the development of sarcopenia via reduction in the number of active motor units, altered neuromuscular junction activity, reduced activation and innervation of muscle fibres, and impaired excitation–contraction coupling49.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Changes in muscle health
What the sources say
- Not checked yetcites [49] Moreira-Pais, A., Ferreira, R., Oliveira, P. A. & Duarte, J. A. A neuromuscular perspective of sarcopenia pathogenesis: deciphering the signaling pathways involved. Geroscience 44, 1199–1213 (2022). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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None of the sources cited for this claim have been checked yet.
In the paper
“Sarcopenic obesity is treated with a range of management approaches, such as lifestyle interventions, exercise, nutrition and medical therapies.”
§ Sarcopenic obesity in older adults: a clinical overview > Abstract
What the sources say
- Not checked yetcites [124] Trouwborst, I. et al. Exercise and nutrition strategies to counteract sarcopenic obesity. Nutrients 10, 605 (2018). source
- Not checked yetcites [125] Petroni, M. L. et al. Prevention and treatment of sarcopenic obesity in women. Nutrients 11, 1302 (2019). source
- Not checked yetcites [126] Schoufour, J. D. et al. The relevance of diet, physical activity, exercise, and persuasive technology in the prevention and treatment of sarcopenic obesity in older adults. Front. Nutr. 8, 661449 (2021). source
- Not checked yetcites [127] Batsis, J. A. & Villareal, D. T. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat. Rev. Endocrinol. 14, 513–537 (2018). This comprehensive review addresses the mechanisms, definitions and diagnostic approaches for sarcopenic obesity in older adults, as well as treatments such as dietary modifications, exercise and emerging therapeutic interventions, focusing on their clinical implications for this high-risk demographic group. source
- Not checked yetcites [128] Bouchonville, M. F. & Villareal, D. T. Sarcopenic obesity: how do we treat it? Curr. Opin. Endocrinol. Diabetes Obes. 20, 412–419 (2013). source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Muscle mass is estimated to decrease by about 3–8% per decade after the age of 30 years, primarily due to a decrease in the size and number of muscle fibres54.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Changes in muscle health
What the sources say
- Not checked yetcites [54] Volpi, E., Nazemi, R. & Fujita, S. Muscle tissue changes with aging. Curr. Opin. Clin. Nutr. Metab. Care 7, 405–410 (2004). source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Reduced insulin signalling or insulin resistance can impair muscle protein metabolism, leading to muscle wasting and sarcopenia58.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Changes in adipose tissue
What the sources say
- Not checked yetcites [58] Shou, J., Chen, P. J. & Xiao, W. H. Mechanism of increased risk of insulin resistance in aging skeletal muscle. Diabetol. Metab. Syndr. 12, 14 (2020). source
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Given the concomitant rising rates of obesity and sedentary lifestyles in ageing populations, we can expect a substantial surge in the prevalence of this syndrome in the next decade.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“The prevalence of sarcopenic obesity in older adults varies substantially, depending on which diagnostic criteria are applied5.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
What the sources say
- Not checked yetcites [5] Gao, Q. et al. Global prevalence of sarcopenic obesity in older adults: a systematic review and meta-analysis. Clin. Nutr. 40, 4633–4641 (2021). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“The clinical importance of sarcopenic obesity in older adults arises from the cumulative impact of excess adiposity and the functional and systemic roles of skeletal muscle16.”
§ Sarcopenic obesity in older adults: a clinical overview > Clinical importance
What the sources say
- Not checked yetcites [16] Cruz-Jentoft, A. J., Gonzalez, M. C. & Prado, C. M. Sarcopenia ≠ low muscle mass. Eur. Geriatr. Med. 14, 225–228 (2023). source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Supplementation with leucine (2.0–2.5 g per day) is associated with increased muscle protein synthesis in older adults, independently of ingestion of other amino acids181.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [181] Devries, M. C. et al. Protein leucine content is a determinant of shorter- and longer-term muscle protein synthetic responses at rest and following resistance exercise in healthy older women: a randomized, controlled trial. Am. J. Clin. Nutr. 107, 217–226 (2018). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Providing (a high proportion of) essential amino acids may counteract the first-pass extraction effect by splanchnic tissues178 (mainly gut and liver) that reduces amino acid availability (particularly in older subjects with high BMI) for muscle protein synthesis.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [178] Boirie, Y., Gachon, P. & Beaufrère, B. Splanchnic and whole-body leucine kinetics in young and elderly men. Am. J. Clin. Nutr. 65, 489–495 (1997). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Below this amount, muscle protein synthesis may be suboptimal, while no substantial advantages in the anabolic response have been found with an intake above 30 g176,177.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [176] Agergaard, J. et al. Effect of light-load resistance exercise on postprandial amino acid transporter expression in elderly men. Physiol. Rep. 5, e13444 (2017). source
- Not checked yetcites [177] Arnal, M. A. et al. Protein pulse feeding improves protein retention in elderly women. Am. J. Clin. Nutr. 69, 1202–1208 (1999). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“To date, evidence is lacking about the effects of macronutrient manipulation168 (that is, fat versus carbohydrate restriction) compared with conventional calorie restriction (that is, total calorie intake) in terms of weight loss and effects on body composition, particularly on the sarcopenic obesity phenotype.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [168] Poggiogalle, E., Migliaccio, S., Lenzi, A. & Donini, L. M. Treatment of body composition changes in obese and overweight older adults: insight into the phenotype of sarcopenic obesity. Endocrine 47, 699–716 (2014). source
plain- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Below this amount, muscle protein synthesis may be suboptimal, while no substantial advantages in the anabolic response have been found with an intake above 30 g176,177.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [176] Agergaard, J. et al. Effect of light-load resistance exercise on postprandial amino acid transporter expression in elderly men. Physiol. Rep. 5, e13444 (2017). source
- Not checked yetcites [177] Arnal, M. A. et al. Protein pulse feeding improves protein retention in elderly women. Am. J. Clin. Nutr. 69, 1202–1208 (1999). source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Physical inactivity further impairs insulin sensitivity, exacerbating obesity-related muscle loss88.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Energy metabolism and dietary factors
What the sources say
- Not checked yetcites [88] Yaribeygi, H., Maleki, M., Sathyapalan, T., Jamialahmadi, T. & Sahebkar, A. Pathophysiology of physical inactivity-dependent insulin resistance: a theoretical mechanistic review emphasizing clinical evidence. J. Diabetes Res. 2021, 7796727 (2021). source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Considering the often-reduced energy expenditure in these individuals, a conventional hypocaloric diet would lead to a gradual, long-term approach to weight loss171.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [171] Haywood, C. J. et al. Very low calorie diets for weight loss in obese older adults – a randomized trial. J. Gerontol. A Biol. Sci. Med. Sci. 73, 59–65 (2017). source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“adherence to a moderate energy-restricted diet170 (for example, a reduction of ~500 kcal per day) may be further enhanced by a potential satiating effect attributed to protein intake.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [170] Goisser, S. et al. Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons – a narrative review. Clin. Interv. Aging 10, 1267–1282 (2015).
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Energy metabolism is also disrupted in sarcopenia and sarcopenic obesity86.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Energy metabolism and dietary factors
What the sources say
- Not checked yetcites [86] Shoemaker, M. E. et al. Differences in muscle energy metabolism and metabolic flexibility between sarcopenic and nonsarcopenic older adults. J. Cachexia Sarcopenia Muscle 13, 1224–1237 (2022). source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Whey proteins are effective in stimulating postprandial muscle protein accretion, owing to their fast digestion and absorption kinetics and high leucine content180.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [180] Hector, A. J. et al. Whey protein supplementation preserves postprandial myofibrillar protein synthesis during short-term energy restriction in overweight and obese adults. J. Nutr. 145, 246–252 (2015). source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Potential negative effects on micronutrient status and on bone mineral density may also occur166.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [166] Jiang, B. C. & Villareal, D. T. Weight loss-induced reduction of bone mineral density in older adults with obesity. J. Nutr. Gerontol. 38, 100–114 (2019). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Physical inactivity and a sedentary lifestyle are common risk factors for developing sarcopenic obesity87.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Energy metabolism and dietary factors
What the sources say
- Not checked yetcites [87] Du, Y. et al. Associations of physical activity with sarcopenia and sarcopenic obesity in middle-aged and older adults: the Louisiana Osteoporosis Study. BMC Public. Health 22, 896 (2022). source
plaindirect- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“muscle loss following diet-induced intentional weight loss may be more frequently observed in older adults with pre-existing sarcopenia159,165,167.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [159] Villareal, D. T. et al. Aerobic or resistance exercise, or both, in dieting obese older adults. N. Engl. J. Med. 376, 1943–1955 (2017). This study involving 160 older adults with obesity finds that weight loss combined with aerobic and resistance exercise is most effective in enhancing functional status and mitigating the muscle and bone mass loss typically seen with weight reduction, compared with other exercise modalities or no exercise at all. source
- Not checked yetcites [165] Batsis, J. A. et al. Weight loss interventions in older adults with obesity: a systematic review of randomized controlled trials since 2005. J. Am. Geriatr. Soc. 65, 257–268 (2017). This systematic review of clinical trials between 2005 and 2015 finds that combined dietary and exercise interventions are more effective for improving physical performance and quality of life in older adults with obesity than either intervention alone. source
- Not checked yetcites [167] Villareal, D. T. et al. Weight loss, exercise, or both and physical function in obese older adults. N. Engl. J. Med. 364, 1218–1229 (2011). In a 1-year study of 107 older adults with obesity, combining weight loss and exercise led to greater enhancements in physical function and performance than either strategy alone, with participants also experiencing less decrease in lean body mass and bone density. source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Sufficient blood flow is crucial for the delivery of nutrients, including glucose and amino acids, to muscle tissues83.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Nitric oxide production
What the sources say
- Not checked yetcites [83] Murrant, C. L. & Sarelius, I. H. Coupling of muscle metabolism and muscle blood flow in capillary units during contraction. Acta Physiol. Scand. 168, 531–541 (2000). source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Insufficient intake of some micronutrients, such as vitamin D, calcium, ω−3 fatty acids and antioxidant nutrients, which are vital for muscle health, can also contribute to sarcopenia90.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Energy metabolism and dietary factors
What the sources say
- Not checked yetcites [90] Robinson, S., Cooper, C. & Aihie Sayer, A. Nutrition and sarcopenia: a review of the evidence and implications for preventive strategies. J. Aging Res. 2012, 510801 (2012). source
plainconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Amino acids derived from animal-based sources have a more pronounced anabolic effect than those derived from plant-based sources179.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [179] van Vliet, S., Burd, N. A. & van Loon, L. J. C. The skeletal muscle anabolic response to plant- versus animal-based protein consumption. J. Nutr. 145, 1981–1991 (2015). source
plaindirect- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“To our knowledge, subanalyses of only two studies have evaluated outcomes in older adults.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
hedged- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Of note, potential improvements in muscle (and lean) mass may not directly result in improved muscle function214,215.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [214] Snyder, P. J. et al. Effects of testosterone treatment in older men. N. Engl. J. Med. 374, 611–624 (2016). source
- Not checked yetcites [215] Storer, T. W. et al. Effects of testosterone supplementation for 3 years on muscle performance and physical function in older men. J. Clin. Endocrinol. Metab. 102, 583–593 (2017).
hedgedconditional- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Existing data suggest that marked adipose tissue loss with semaglutide and tirzepatide occurs with concomitant muscle loss202,204,205.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [202] Jastreboff, A. M. et al. Tirzepatide once weekly for the treatment of obesity. N. Engl. J. Med. 387, 205–216 (2022). source
- Not checked yetcites [204] Wilding, J. P. H. et al. Once-weekly semaglutide in adults with overweight or obesity. N. Engl. J. Med. 384, 989–1002 (2021). source
- Not checked yetcites [205] Yabe, D., Kawamori, D., Seino, Y., Oura, T. & Takeuchi, M. Change in pharmacodynamic variables following once-weekly tirzepatide treatment versus dulaglutide in Japanese patients with type 2 diabetes (SURPASS J-mono substudy). Diabetes Obes. Metab. 25, 398–406 (2023). source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Existing studies have focused on younger populations that differ in the type of surgery, in age groups and in comorbidities.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Bariatric surgery
plain- Asserted: passes — The authors put it forward as true.
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The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“The number of studies of this treatment that focused specifically on individuals with sarcopenic obesity is low.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Bariatric surgery
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“a 2023 subanalysis of East Asian participants in the SURPASS trials211 demonstrated similar outcomes in younger adults (<65 years of age) and older adults (≥65 years of age).”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [211] Kiyosue, A. et al. Safety and efficacy analyses across age and body mass index subgroups in East Asian participants with type 2 diabetes in the phase 3 tirzepatide studies (SURPASS programme). Diabetes Obes. Metab. 25, 1056–1067 (2023). source
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“Although all types of surgery lead to reduced muscle mass, sleeve gastrectomy demonstrated greater preservation of bone and muscle than Roux-en-Y bypass in a study in 71 patients191.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Bariatric surgery
What the sources say
- Not checked yetcites [191] Baad, V. M. A. et al. Body composition, sarcopenia and physical performance after bariatric surgery: differences between sleeve gastrectomy and Roux-en-Y gastric bypass. Obes. Surg. 32, 3830–3838 (2022). source
boosteddirectn = 71- Asserted: passes — The authors put it forward as true.
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In the paper
“In one study assessing the influence of sarcopenia on outcomes in 69 individuals with obesity, the observed remission rates for comorbidities were similar, with no difference at 1 year192.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Bariatric surgery
What the sources say
- Not checked yetcites [192] Mastino, D. et al. Bariatric surgery outcomes in sarcopenic obesity. Obes. Surg. 26, 2355–2362 (2016). source
plainn = 69- Asserted: passes — The authors put it forward as true.
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- Based: passes — The paper gives a reason why it holds.
In the paper
“Last, adverse effects may be more pronounced in older than in younger adults, again in a dose-dependent fashion, as demonstrated in the 2023 subanalysis211.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [211] Kiyosue, A. et al. Safety and efficacy analyses across age and body mass index subgroups in East Asian participants with type 2 diabetes in the phase 3 tirzepatide studies (SURPASS programme). Diabetes Obes. Metab. 25, 1056–1067 (2023). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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None of the sources cited for this claim have been checked yet.
In the paper
“Robust evidence on the benefits of combined nutrition and exercise interventions is limited, particularly in relation to protein supplementation182,183.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [182] Hita-Contreras, F. et al. Effect of exercise alone or combined with dietary supplements on anthropometric and physical performance measures in community-dwelling elderly people with sarcopenic obesity: a meta-analysis of randomized controlled trials. Maturitas 116, 24–35 (2018). source
- Not checked yetcites [183] Martínez-Amat, A. et al. Exercise alone or combined with dietary supplements for sarcopenic obesity in community-dwelling older people: a systematic review of randomized controlled trials. Maturitas 110, 92–103 (2018). source
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“Another study in rodents showed that GLP1 directly induces myogenesis via a complex cAMP-dependent signalling network in skeletal muscle209.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [209] Gurjar, A. A. et al. Long acting GLP-1 analog liraglutide ameliorates skeletal muscle atrophy in rodents. Metabolism 103, 154044 (2020). source
plaindirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Trials of tirzepatide, including the SURMOUNT trial, demonstrated dose-dependent changes in lean mass, using various modalities for assessing body composition.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: unclear — It is unclear why the paper says it holds.
In the paper
“The important loss of weight seems to elicit a substantial loss of muscle mass206.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [206] Ida, S. et al. Effects of antidiabetic drugs on muscle mass in type 2 diabetes mellitus. Curr. Diabetes Rev. 17, 293–303 (2021). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“SARMs may be of benefit in patients with sarcopenic obesity who require muscle mass increases rather than strength improvements.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: SARMs selectively target androgen receptors on muscle and bone tissues.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the current evidence for these treatments is inconclusive and sometimes conflicting owing to the limited number of studies and small sample sizes.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“On the other hand, studies in rodents showed that GLP1 receptor agonists may increase microvascular blood volume and glucose transport in skeletal muscle cells, leading to increased delivery of oxygen, nutrients and hormones, such as insulin, to myocytes207,208.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [207] Andreozzi, F. et al. The GLP-1 receptor agonists exenatide and liraglutide activate glucose transport by an AMPK-dependent mechanism. J. Transl. Med. 14, 229 (2016). source
- Not checked yetcites [208] Li, Z., Ni, C. L., Yao, Z., Chen, L. M. & Niu, W. Y. Liraglutide enhances glucose transporter 4 translocation via regulation of AMP-activated protein kinase signaling pathways in mouse skeletal muscle cells. Metabolism 63, 1022–1030 (2014). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“A weight loss of >20% with marked improvements in both subjective and objective physical function measures has been reported with these newer medications200–203.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [200] Aroda, V. R. et al. Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS): a multicentre, randomised, phase 3b trial. Lancet 402, 693–704 (2023). source
- Not checked yetcites [201] Davies, M. et al. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled, phase 3 trial. Lancet 397, 971–984 (2021). source
- Not checked yetcites [202] Jastreboff, A. M. et al. Tirzepatide once weekly for the treatment of obesity. N. Engl. J. Med. 387, 205–216 (2022). source
- Not checked yetcites [203] Knop, F. K. et al. Oral semaglutide 50 mg taken once per day in adults with overweight or obesity (OASIS 1): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 402, 705–719 (2023). This study finds that pharmacological intervention with semaglutide to treat adults with overweight or obesity without type 2 diabetes mellitus results in considerable weight reduction compared with placebo. source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In a trial of the activin receptor type 2B inhibitor bimagrumab (700 mg vs placebo monthly for 6 months) in combination with a healthy diet and a home-based exercise programme among 180 community-dwelling individuals >70 years of age with sarcopenia, bimagrumab improved functional parameters and lean mass222.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [222] Rooks, D. et al. Bimagrumab vs optimized standard of care for treatment of sarcopenia in community-dwelling older adults: a randomized clinical trial. JAMA Netw. Open. 3, e2020836 (2020). source
plaindirectn = 180- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Large-scale studies such as LOOK-AHEAD226 and PREDIMED227 established that individuals have different responses and outcomes to dietary interventions based on individual and genetic characteristics.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Personalized approaches
What the sources say
- Not checked yetcites [226] Pi-Sunyer, X. The Look AHEAD trial: a review and discussion of its outcomes. Curr. Nutr. Rep. 3, 387–391 (2014). source
- Not checked yetcites [227] Martínez-González, M. et al. Cohort profile: design and methods of the PREDIMED study. Int. J. Epidemiol. 41, 377–385 (2012). source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“To date, studies have demonstrated promising results in mice, suggesting that MSC transplantation may bolster improvements observed with exercise without worsening inflammation224.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [224] Kono, Y. et al. Mesenchymal stem cells promote IL-6 secretion and suppress the gene expression of proinflammatory cytokines in contractile C2C12 myotubes. Biol. Pharm. Bull. 45, 962–967 (2022). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“To our knowledge, there are no equivalent studies in humans.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- It may state two separate claims as one. 45
- Probably not a substantial claim. 8
Every source the paper cites for this claim was checked and supports it.
In the paper
“Of note, not all older adults with obesity will exhibit sarcopenia, as excess body weight usually stimulates muscle (and bone) mechanoreceptors, triggering growth factor synthesis that leads to muscle formation11.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
What the sources say
- Supportedcites [11] Stenholm, S. et al. Sarcopenic obesity: definition, cause and consequences. Curr. Opin. Clin. Nutr. Metab. Care 11, 693–700 (2008). source
The Introduction says bone and muscle normally grow with changes in weight, through gravity stimulating mechanoreceptors that modulate growth-factor production. It also says this adaptation may be impaired in some older people who become obese without corresponding muscle growth, supporting the distinction between obesity with and without sarcopenia. (LLM, conf=0.91)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“SARMs indirectly affect non-muscle androgen receptor pathways mediated by muscle fibroblasts and, in some but not all studies have been shown to increase muscle mass and physical function216.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Partly supportedcites [216] Bhasin, S., Krishnan, V., Storer, T. W., Steiner, M. & Dobs, A. S. Androgens and selective androgen receptor modulators to treat functional limitations associated with aging and chronic disease. J. Gerontol. A Biol. Sci. Med. Sci. 78, 25–31 (2023). sourceExperimental — accuracy not yet measured
The Selective Androgen Receptor Modulators section reports increases in lean body mass or muscle size in trials, while physical-function improvements were inconsistent. It describes tissue-specific androgen-receptor activity but does not support the claimed indirect pathway mediated by muscle fibroblasts; the mechanisms section instead discusses receptor binding and tissue-dependent signaling. Page numbers are unavailable in our copy. (LLM, conf=0.87)
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“This dietary approach can lead to weight loss without substantial loss of muscle mass and is associated with improvements in cardiovascular function and other physiological markers188–190.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Partly supportedcites [188] Kirkham, A. A. et al. Implementation of weekday time-restricted eating to improve metabolic health in breast cancer survivors with overweight/obesity. Obesity 31, 150–160 (2023). sourceExperimental — accuracy not yet measured
In Preliminary efficacy for metabolic outcomes (page unavailable), the paper reports a median 1.0 kg decrease in body mass; Steatosis reports a 1.5% decrease in thigh muscle, consistent with a small rather than substantial muscle loss. The Metabolism section does not support the claimed cardiovascular improvement: blood pressure and cardiorespiratory fitness did not change significantly, and fasting insulin increased. The claim also generalizes beyond the breast cancer survivors with overweight or obesity studied here. (LLM, conf=0.88)
- Partly supportedcites [189] Kirkham, A. A., Parr, E. B. & Kleckner, A. S. Cardiometabolic health impacts of time-restricted eating: implications for type 2 diabetes, cancer and cardiovascular diseases. Curr. Opin. Clin. Nutr. Metab. Care 25, 378–387 (2022). sourceExperimental — accuracy not yet measured
The review’s Summary of Recent Evidence reports weight and fat loss and improvements in some cardiometabolic markers, while noting that other studies found no effect. Its Safety of TRE section says more data on lean-mass changes are needed, so it does not establish weight loss without substantial muscle loss. The CVD Measures section discusses cardiovascular risk factors and risk scores, not a demonstrated improvement in cardiovascular function. (LLM, conf=0.87)
- Partly supportedcites [190] Martens, C. R. et al. Short-term time-restricted feeding is safe and feasible in non-obese healthy midlife and older adults. Geroscience 42, 667–686 (2020). sourceExperimental — accuracy not yet measured
In the Results sections on body composition and cardiovascular function (page unavailable), six weeks of time-restricted feeding preserved leg fat-free mass but did not reduce body mass or improve measured cardiovascular function. The Oral glucose tolerance results report a modest improvement in glucose tolerance. Thus, the paper supports muscle preservation and some physiological benefit, but not the claimed weight loss or cardiovascular improvement in its study. (LLM, conf=0.89)
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Partly supported
The sources with a verdict support this claim; the rest weren’t checked yet, have no full text we could read, or their verdicts aren’t rated yet.
In the paper
“This oral ghrelin analogue has mostly been studied in cancer217–219 and has anti-inflammatory and anabolic properties.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Supportedcites [217] Currow, D. C., Maddocks, M., Cella, D. & Muscaritoli, M. Efficacy of anamorelin, a novel non-peptide ghrelin analogue, in patients with advanced non-small cell lung cancer (NSCLC) and cachexia – review and expert opinion. Int. J. Mol. Sci. 19, 3471 (2018). source
The citation is attached to the statement that anamorelin has mostly been studied in cancer. In §1, “Appetite-Improving Drugs: Ghrelin and Ghrelin Agonists” (page unavailable), the review identifies anamorelin as an oral ghrelin analogue and describes its phase 3 trials in patients with advanced non-small cell lung cancer and cachexia. The same section reports effects on inflammation and lean body mass, although those properties appear after the citation in the citing sentence. (LLM, conf=0.88)
- Not checked yetcites [218] Fonseca, G. W. P. D. & von Haehling, S. An overview of anamorelin as a treatment option for cancer-associated anorexia and cachexia. Expert. Opin. Pharmacother. 22, 889–895 (2021). source
- Not checked yetcites [219] Wakabayashi, H., Arai, H. & Inui, A. Anamorelin in Japanese patients with cancer cachexia: an update. Curr. Opin. Support. Palliat. Care 17, 162–167 (2023). source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Supported
In the paper
“These data demonstrate that sarcopenic obesity has a considerable clinical impact, as it is linked to a high risk of death, comorbidities, metabolic disorders and geriatric syndromes, including frailty.”
§ Sarcopenic obesity in older adults: a clinical overview > Clinical importance
What the sources say
- Not checked yetcites 21–46
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“A 2022 consensus statement established a new definition and diagnostic criteria for sarcopenic obesity.”
§ Sarcopenic obesity in older adults: a clinical overview > Abstract
What the sources say
- Not checked yetcites [2] Donini, L. M. et al. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Clin. Nutr. 41, 990–1000 (2022). Collaboration between ESPEN and EASO has established a unified definition and diagnostic criteria for sarcopenic obesity, aiming to streamline research and treatment approaches for this prevalent condition. source
- Not checked yetcites [3] Donini, L. M. et al. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Obes. Facts 15, 321–335 (2022). source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Ageing is associated with an increase in adipose tissue mass and distribution (that is, an increase in visceral adipose tissue), which can be attributed to various factors such as hormonal changes, low muscle mass, low physical activity, unfavourable changes in metabolism and lifestyle factors47.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Changes in adipose tissue
What the sources say
- Not checked yetcites [47] JafariNasabian, P., Inglis, J. E., Reilly, W., Kelly, O. J. & Ilich, J. Z. Aging human body: changes in bone, muscle and body fat with consequent changes in nutrient intake. J. Endocrinol. 234, R37–R51 (2017). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“In addition, changes in body composition may result from precipitating events, such as falls, hip fractures, stroke or other illnesses, all of which temporarily or permanently impair mobility, and are accompanied by acute-phase responses15.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
What the sources say
- Not checked yetcites [15] Baumgartner, R. N. & Waters, D. L. in Principles and Practice of Geriatric Medicine (eds Pathy, M. S. J., Sinclair, A. J. & Morley, J. E.) 909–933 (Wiley, 2005). source
hedgeddirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Sarcopenic obesity was first defined in 1996 (ref. 1) as a syndrome characterized by the simultaneous presence of excess adipose tissue and reduced muscle mass.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
What the sources say
- Not checked yetcites [1] Heber, D. et al. Clinical detection of sarcopenic obesity by bioelectrical impedance analysis. Am. J. Clin. Nutr. 64, 472s–477s (1996). source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Oxidative stress adversely impacts muscle health through muscle protein breakdown60, muscle inflammation61, impaired muscle regeneration62, mitochondrial dysfunction63 and insulin resistance50.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Oxidative stress and hormonal shifts
What the sources say
- Not checked yetcites [50] Gonzalez, A. et al. The critical role of oxidative stress in sarcopenic obesity. Oxid. Med. Cell Longev. 2021, 4493817 (2021). source
- Not checked yetcites [60] Powers, S. K., Smuder, A. J. & Criswell, D. S. Mechanistic links between oxidative stress and disuse muscle atrophy. Antioxid. Redox Signal. 15, 2519–2528 (2011). source
- Not checked yetcites [61] Chen, M., Wang, Y., Deng, S., Lian, Z. & Yu, K. Skeletal muscle oxidative stress and inflammation in aging: focus on antioxidant and anti-inflammatory therapy. Front. Cell Dev. Biol. 10, 964130 (2022). source
- Not checked yetcites [62] Lian, D., Chen, M. M., Wu, H., Deng, S. & Hu, X. The role of oxidative stress in skeletal muscle myogenesis and muscle disease. Antioxidants 11, 755 (2022). source
- Not checked yetcites [63] Ferri, E. et al. Role of age-related mitochondrial dysfunction in sarcopenia. Int. J. Mol. Sci. 21, 5236 (2020). source
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Various metabolic scenarios, such as weight gain or loss, can contribute to the development of sarcopenic obesity.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
What the sources say
- Not checked yetcites [14] Prado, C. M. M., Wells, J. C. K., Smith, S. R., Stephan, B. C. M. & Siervo, M. Sarcopenic obesity: a critical appraisal of the current evidence. Clin. Nutr. 31, 583–601 (2012). This review highlights the significance of sarcopenic obesity due to its dual metabolic burden, and underscores the inconsistency in study methodologies. source
plainconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Population-representative data for the USA demonstrated a prevalence of sarcopenic obesity of 28.3% in people >60 years of age, with a higher prevalence of 66.6% in Mexican Americans7.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
What the sources say
- Not checked yetcites [7] Murdock, D. J. et al. The prevalence of low muscle mass associated with obesity in the USA. Skelet. Muscle 12, 26 (2022). source
boosted- Asserted: passes — The authors put it forward as true.
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In the paper
“Ageing is associated with an increase in oxidative damage to muscle cells, with oxidative stress identified as a key factor in the development and progression of sarcopenia59.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Oxidative stress and hormonal shifts
What the sources say
- Not checked yetcites [59] Meng, S. J. & Yu, L. J. Oxidative stress, molecular inflammation and sarcopenia. Int. J. Mol. Sci. 11, 1509–1526 (2010). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“Weight gain can result in an increase in adipose cell size, which may promote the recruitment of immune cells and secretion of inflammatory factors within adipose tissue, such as IL-6, C-reactive protein and tumour necrosis factor, creating a state of low-grade chronic inflammation that can impair insulin sensitivity57.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Changes in adipose tissue
What the sources say
- Not checked yetcites [57] Kawai, T., Autieri, M. V. & Scalia, R. Adipose tissue inflammation and metabolic dysfunction in obesity. Am. J. Physiol. Cell Physiol. 320, C375–C391 (2021). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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In the paper
“Production of myostatin, a growth-inhibiting myokine, is upregulated in sarcopenia64, whereas that of muscle-mass-stimulating irisin seems to be downregulated65.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Oxidative stress and hormonal shifts
What the sources say
- Not checked yetcites [64] White, T. A. & LeBrasseur, N. K. Myostatin and sarcopenia: opportunities and challenges – a mini-review. Gerontology 60, 289–293 (2014). source
- Not checked yetcites [65] Chang, J. S. et al. Circulating irisin levels as a predictive biomarker for sarcopenia: a cross-sectional community-based study. Geriatr. Gerontol. Int. 17, 2266–2273 (2017). source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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In the paper
“However, the definition has evolved to also incorporate reduced muscle function in the diagnosis of sarcopenia in older adults2,3, with muscle strength being the predominant measure of function.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
What the sources say
- Not checked yetcites [2] Donini, L. M. et al. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Clin. Nutr. 41, 990–1000 (2022). Collaboration between ESPEN and EASO has established a unified definition and diagnostic criteria for sarcopenic obesity, aiming to streamline research and treatment approaches for this prevalent condition. source
- Not checked yetcites [3] Donini, L. M. et al. Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement. Obes. Facts 15, 321–335 (2022). source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Emerging therapies that were developed for treating other conditions may be relevant to sarcopenic obesity, including novel pharmacological agents and personalized approaches such as precision medicine.”
§ Sarcopenic obesity in older adults: a clinical overview > Abstract
hedgedconditional- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Ageing-associated decline in testosterone and oestrogen levels weakens muscle, reducing both muscle mass and strength66.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Oxidative stress and hormonal shifts
What the sources say
- Not checked yetcites [66] Gupta, P. & Kumar, S. Sarcopenia and endocrine ageing: are they related? Cureus 14, e28787 (2022).
plaindirect- Asserted: passes — The authors put it forward as true.
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In the paper
“Sarcopenic obesity exemplifies the intersection of two prevalent health crises: ageing populations and the obesity epidemic4.”
§ Sarcopenic obesity in older adults: a clinical overview > Introduction
What the sources say
- Not checked yetcites [4] Roubenoff, R. Sarcopenic obesity: the confluence of two epidemics. Obes. Res. 12, 887–888 (2004). This commentary discusses how the convergence of the obesity epidemic with an ageing population magnifies the risk of sarcopenic obesity, posing unprecedented health challenges and underscoring the urgent need for interdisciplinary collaboration. source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Decreased levels of anabolic hormones, such as growth hormone, insulin-like growth factor 1 (IGF1) and testosterone, contribute to muscle loss and hindered protein synthesis48.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Oxidative stress and hormonal shifts
What the sources say
- Not checked yetcites [48] Sakuma, K. & Yamaguchi, A. Sarcopenic obesity and endocrinal adaptation with age. Int. J. Endocrinol. 2013, 204164 (2013). source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“NO modulates insulin signalling pathways in muscle cells80, while obesity and metabolic syndrome are associated with decreased whole-body NO synthesis81.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Nitric oxide production
What the sources say
- Not checked yetcites [80] Bergandi, L. et al. Insulin stimulates glucose transport via nitric oxide/cyclic GMP pathway in human vascular smooth muscle cells. Arterioscler. Thromb. Vasc. Biol. 23, 2215–2221 (2003). source
- Not checked yetcites [81] Siervo, M., Jackson, S. J. & Bluck, L. J. In-vivo nitric oxide synthesis is reduced in obese patients with metabolic syndrome: application of a novel stable isotopic method. J. Hypertens. 29, 1515–1527 (2011). source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Ageing has also been related to a decline in nitric oxide (NO) production76 and skeletal muscle blood flow77.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Nitric oxide production
What the sources say
- Not checked yetcites [76] Sverdlov, A. L., Ngo, D. T. M., Chan, W. P. A., Chirkov, Y. Y. & Horowitz, J. D. Aging of the nitric oxide system: are we as old as our NO? J. Am. Heart Assoc. 3, e000973 (2014). source
- Not checked yetcites [77] Hearon, C. M. Jr & Dinenno, F. A. Regulation of skeletal muscle blood flow during exercise in ageing humans. J. Physiol. 594, 2261–2273 (2016). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“NO and insulin are crucial for muscle metabolism and are implicated in the development and progression of sarcopenia78,79.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Nitric oxide production
What the sources say
- Not checked yetcites [78] Cleasby, M. E., Jamieson, P. M. & Atherton, P. J. Insulin resistance and sarcopenia: mechanistic links between common co-morbidities. J. Endocrinol. 229, R67–R81 (2016). source
- Not checked yetcites [79] Timmerman, K. L. & Volpi, E. Endothelial function and the regulation of muscle protein anabolism in older adults. Nutr. Metab. Cardiovasc. Dis. 23, S44–S50 (2013). source
plaincorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“For example, older adults might be at high risk of a low protein intake and inadequate consumption of essential amino acids89.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Energy metabolism and dietary factors
What the sources say
- Not checked yetcites [89] Deutz, N. E. et al. Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group. Clin. Nutr. 33, 929–936 (2014). This expert opinion highlights the importance of maintaining muscle function during ageing through adequate protein intake (1.0–1.2 g/kg body weight daily for healthy older adults and 1.2–1.5 g/kg daily for malnourished adults or those facing illness) and daily physical activity or exercise for sustained muscle health. source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As such, not only the amount of protein but also the source of protein might be crucial for preserving muscle mass.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Concurrently, increased levels of catabolic hormones, such as cortisol, promote protein breakdown and inhibit protein synthesis, exacerbating muscle wasting and sarcopenia67.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Oxidative stress and hormonal shifts
What the sources say
- Not checked yetcites [67] Braun, T. P. & Marks, D. L. The regulation of muscle mass by endogenous glucocorticoids. Front. Physiol. 6, 12 (2015). source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Chronic stress can lead to overeating and/or a sedentary lifestyle67,72, factors that may increase the risk of sarcopenia.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Oxidative stress and hormonal shifts
What the sources say
hedgeddirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Chronic stress and consistently high cortisol levels can negatively impact muscle tissue and increase sarcopenia risk68.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Oxidative stress and hormonal shifts
What the sources say
- Not checked yetcites [68] Yanagita, I. et al. A high serum cortisol/DHEA-S ratio is a risk factor for sarcopenia in elderly diabetic patients. J. Endocr. Soc. 3, 801–813 (2019). source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Furthermore, cortisol can negatively affect bone health73 and exacerbate age-related bone density decline, possibly contributing to the development of osteosarcopenic obesity74.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Oxidative stress and hormonal shifts
What the sources say
- Not checked yetcites [73] Chiodini, I., Torlontano, M., Carnevale, V., Trischitta, V. & Scillitani, A. Skeletal involvement in adult patients with endogenous hypercortisolism. J. Endocrinol. Invest. 31, 267–276 (2008). source
- Not checked yetcites [74] Ormsbee, M. J. et al. Osteosarcopenic obesity: the role of bone, muscle, and fat on health. J. Cachexia Sarcopenia Muscle 5, 183–192 (2014). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“Both NO and insulin have crucial roles in regulating mitochondrial function by enhancing mitochondrial respiration and promoting mitochondrial biogenesis, whereas insulin stimulates cellular glucose uptake and its subsequent utilization within the mitochondria85.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Nitric oxide production
What the sources say
- Not checked yetcites [85] Tengan, C. H., Rodrigues, G. S. & Godinho, R. O. Nitric oxide in skeletal muscle: role on mitochondrial biogenesis and function. Int. J. Mol. Sci. 13, 17160–17184 (2012). The review discusses the physiological roles of nitric oxide in mitochondrial energetics and skeletal muscle function. source
plaindirect- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Importantly, a higher protein intake is particularly important in older adults who are at higher risk of anabolic resistance174,175.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
What the sources say
- Not checked yetcites [174] Burd, N. A., Gorissen, S. H. & van Loon, L. J. C. Anabolic resistance of muscle protein synthesis with aging. Exerc. Sport. Sci. Rev. 41, 169–173 (2013). source
- Not checked yetcites [175] Boirie, Y., Morio, B., Caumon, E. & Cano, N. J. Nutrition and protein energy homeostasis in elderly. Mech. Ageing Dev. 136–137, 76–84 (2014). source
plain- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim.
In the paper
“Food insecurity has also been proposed as a risk factor in developing sarcopenic obesity91, as it may be associated with poor diet quality, nutritional deficiencies, physical inactivity and unfavourable metabolic changes.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Energy metabolism and dietary factors
What the sources say
- Not checked yetcites [91] Fonseca-Pérez, D., Arteaga-Pazmiño, C., Maza-Moscoso, C. P., Flores-Madrid, S. & Álvarez-Córdova, L. Food insecurity as a risk factor of sarcopenic obesity in older adults. Front. Nutr. 9, 1040089 (2022). source
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“NO-mediated vasodilation can enhance blood flow and nutrient delivery to muscles, supporting muscle metabolism and potentially mitigating sarcopenia84.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Nitric oxide production
What the sources say
- Not checked yetcites [84] Wagenmakers, A. J., Strauss, J. A., Shepherd, S. O., Keske, M. A. & Cocks, M. Increased muscle blood supply and transendothelial nutrient and insulin transport induced by food intake and exercise: effect of obesity and ageing. J. Physiol. 594, 2207–2222 (2016). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Mechanisms that might link high cortisol levels to the loss of muscle mass include inhibition of the mammalian target of rapamycin (mTOR) pathway69, suppression of the anabolic effects of IGF1 (ref. 69) and testosterone70, and activation of the ubiquitin–proteasome system in skeletal muscle71.”
§ Sarcopenic obesity in older adults: a clinical overview > Pathophysiology > Oxidative stress and hormonal shifts
What the sources say
- Not checked yetcites [69] Shimizu, N. et al. Crosstalk between glucocorticoid receptor and nutritional sensor mTOR in skeletal muscle. Cell Metab. 13, 170–182 (2011). source
- Not checked yetcites [70] Brownlee, K. K., Moore, A. W. & Hackney, A. C. Relationship between circulating cortisol and testosterone: influence of physical exercise. J. Sports Sci. Med. 4, 76–83 (2005).
- Not checked yetcites [71] Sun, L., Trausch-Azar, J. S., Muglia, L. J. & Schwartz, A. L. Glucocorticoids differentially regulate degradation of MyoD and Id1 by N-terminal ubiquitination to promote muscle protein catabolism. Proc. Natl Acad. Sci. USA 105, 3339–3344 (2008). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“The SURPASS-1 trial demonstrated improvements in HbA1c that were lower in older adults than in younger individuals and not dose-dependent210”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [210] Rosenstock, J. et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet 398, 143–155 (2021). source
boostedcorrelational- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Few studies have evaluated the impact of bariatric surgery on sarcopenic obesity, as most studies focused solely on postsurgical evaluation of musculoskeletal health.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Bariatric surgery
plain- Asserted: passes — The authors put it forward as true.
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In the paper
“A separate study in 80 women with obesity assigned to Roux-en-Y bypass with or without exercise found no differences in the phenotypic and genotypic characteristics between groups193.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Bariatric surgery
What the sources say
- Not checked yetcites [193] Gil, S. et al. A randomized clinical trial on the effects of exercise on muscle remodelling following bariatric surgery. J. Cachexia Sarcopenia Muscle 12, 1440–1455 (2021). source
plainn = 80- Asserted: passes — The authors put it forward as true.
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Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Nevertheless, based on the available evidence, physiologically the combination of nutrition and exercise may substantially reduce adiposity with concomitant increase in muscle mass (in some cases without any BMI variation) and physical function (for example, handgrip strength and gait speed).”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Nutritional interventions
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
In the paper
“While the use of newer medications may lead to substantial weight loss, with resultant improvements in comorbidities and reductions in risk of heart failure212, obtaining a solid understanding of the long-term consequences of these interventions is of the utmost importance, particularly in older adults.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [212] Harris, E. Semaglutide improves heart failure and cardiovascular disease. JAMA 330, 1127–1127 (2023).
hedgedconditional- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“These AOMs have not been specifically tested in populations with sarcopenic obesity and, furthermore, clinical trials have both restricted the number of older adults enrolled in their studies and limited the number of individuals with chronic diseases.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
plain- Asserted: passes — The authors put it forward as true.
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It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Crucially, body composition was not assessed, and in all such trials there have been no objective measurements of physical function.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“When combined with growth hormone, testosterone supplementation can mitigate the negative effects of obesity (increasing diet-induced adipose tissue loss) and of the ageing process, by promoting IGF1 mRNA and protein expression, and increasing muscle protein synthesis, and muscle mass and function, particularly when combined with exercise intervention.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Studies investigating anamorelin are characterized by high heterogeneity; however, treatment with this hormone analogue improved lean mass but failed to improve muscle function in different trials.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“However, the proportion of muscle mass loss (relative to adipose tissue) and the degree of resolution of myosteatosis and ectopic adipose tissue deposition (that is, improvement in muscle composition) remain unclear.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Nonetheless, the data are conflicting: some trials found no significant effects of testosterone supplementation on muscle health, while others found there was no impact on physical function.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Ageing leads to testosterone deficiency that may impair muscle adaptation to exercise, as reduced muscle mass and IGF1 expression can increase pro-inflammatory cytokines213.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [213] Pataky, M. W., Young, W. F. & Nair, K. S. Hormonal and metabolic changes of aging and the influence of lifestyle modifications. Mayo Clin. Proc. 96, 788–814 (2021). source
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Studies in patients with sarcopenic obesity have not been conducted, and it is unclear whether the improvements in lean mass observed have differential effects in different patient populations.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This lack of association can be related to how muscle mass was assessed (that is, quantity only versus quantity and composition), or to other factors associated with muscle function besides muscle mass.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Mixed findings have been observed in strength measures, while more consistent improvements have been found in physical function measures, including walking speed and sit-to-stand tests193,195,196.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Bariatric surgery
What the sources say
- Not checked yetcites [193] Gil, S. et al. A randomized clinical trial on the effects of exercise on muscle remodelling following bariatric surgery. J. Cachexia Sarcopenia Muscle 12, 1440–1455 (2021). source
- Not checked yetcites [195] Alba, D. L. et al. Changes in lean mass, absolute and relative muscle strength, and physical performance after gastric bypass surgery. J. Clin. Endocrinol. Metab. 104, 711–720 (2019). source
- Not checked yetcites [196] Reinmann, A. et al. Bariatric surgery: consequences on functional capacities in patients with obesity. Front. Endocrinol. 12, 646283 (2021). source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Interestingly, myostatin can be modulated by diet221.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [221] Perry, C. A., Van Guilder, G. P. & Butterick, T. A. Decreased myostatin in response to a controlled DASH diet is associated with improved body composition and cardiometabolic biomarkers in older adults: results from a controlled-feeding diet intervention study. BMC Nutr. 8, 24 (2022). source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In mice fed a high-fat diet, injection of umbilical cord MSCs led to improvements in physical function and mitigated obesity-related muscle atrophy225.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [225] Song, J. et al. Mesenchymal stromal cells ameliorate diabetes-induced muscle atrophy through exosomes by enhancing AMPK/ULK1-mediated autophagy. J. Cachexia Sarcopenia Muscle 14, 915–929 (2023). source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“While inhibition of myostatin leads to muscle cell hyperplasia and hypertrophy, suppresses irisin and downregulates pro-inflammatory cytokines, it may also have beneficial effects on metabolism, adiposity and insulin sensitivity220.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
What the sources say
- Not checked yetcites [220] Consitt, L. A. & Clark, B. C. The vicious cycle of myostatin signaling in sarcopenic obesity: myostatin role in skeletal muscle growth, insulin signaling and implications for clinical trials. J. Frailty Aging 7, 21–27 (2018).
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“While the study population included participants with BMI up to 32 kg/m2, there was no specific subanalysis for those with obesity.”
§ Sarcopenic obesity in older adults: a clinical overview > Management strategies > Medical therapies
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
The paper relies on this without support.
Acute or chronic conditions magnify the impact of pathophysiological factors in older adults by increasing inflammation, limiting mobility, causing prolonged bed rest, altering medication pharmacokinetics and pharmacodynamics, and inducing nutrition impact symptoms.
“These factors become even more important when older adults are affected by acute or chronic conditions, which can magnify the impact of these factors by further increasing inflammation, limiting mobility or leading to prolonged bed rest, altering medication pharmacokinetics and pharmacodynamics, and inducing nutrition impact symptoms.”
The paper relies on this without support.
Loss of muscle mass is closely associated with ageing and typically begins in middle age and accelerates in later years.
“The loss of muscle mass is closely associated with ageing and typically begins in middle age and accelerates in later years.”
The paper relies on this without support.
The shift in muscle composition toward adipose infiltration contributes to decreased muscle quality and impaired muscle function.
“This shift in composition contributes to decreased muscle ‘quality’ (that is, composition) and impaired muscle function.”
The paper relies on this without support.
Insulin resistance impairs protein anabolism, directly affecting muscle fibre atrophy and promoting muscle catabolism.
“Insulin resistance impairs protein anabolism, directly affecting muscle fibre atrophy and promoting muscle catabolism.”
The paper relies on this without support.
Mitochondrial dysfunction and myosteatosis may further contribute to insulin resistance, which in turn impacts glucose metabolism and muscle protein synthesis.
“Mitochondrial dysfunction and myosteatosis may further contribute to insulin resistance, which in turn, impacts glucose metabolism and muscle protein synthesis.”
The paper relies on this without support.
Insulin stimulates uptake of glucose and amino acids into muscle cells, promoting protein synthesis and muscle growth.
“Insulin stimulates the uptake of glucose and amino acids into muscle cells, promoting protein synthesis and muscle growth.”
The paper relies on this without support.
Hormonal alterations further contribute to reduced muscle mass and adipose tissue deposition.
“These hormonal alterations further contribute to reduced muscle mass and adipose tissue deposition.”
The paper relies on this without support.
Increased insulin signalling in response to NO might help maintain muscle mass and function.
“Increased insulin signalling in response to NO might help maintain muscle mass and function.”
The paper relies on this without support.
NO is a potent vasodilator that regulates blood flow.
“NO is also a potent vasodilator that regulates blood flow.”
The paper relies on this without support.
The interplay between NO and insulin in maintaining mitochondrial health may contribute to muscle preservation.
“The interplay between NO and insulin in maintaining mitochondrial health may contribute to muscle preservation.”
The paper relies on this without support.
Hypocaloric diets can promote muscle loss by downregulating muscle protein synthesis and increasing proteolysis.
“Hypocaloric diets can effectively reduce adipose tissue but may promote muscle loss by downregulating muscle protein synthesis and increasing proteolysis.”
The paper relies on this without support.
The long-term sustainability of very-low-calorie diets is questionable because many individuals regain weight after stopping the diet.
“Moreover, the sustainability of VLCDs is questionable, with many individuals regaining weight after transitioning off the diet.”
The paper relies on this without support.
Recommendations based on current body weight may not be feasible in individuals with obesity, especially during a low-calorie diet.
“Interestingly, recommendations based on current body weight may not be feasible in individuals with obesity, especially in the context of a low-calorie diet.”
The paper relies on this without support.
Bariatric surgery leads to marked adipose tissue loss and relative improvements in physical function but also profound muscle mass losses.
“Although bariatric surgery leads to marked adipose tissue loss with relative improvements in physical function, it also leads to profound muscle mass losses.”
The paper relies on this without support.
Myosteatosis and ectopic adipose tissue deposition are at the heart of a vicious pro-inflammatory cycle in the pathophysiology of sarcopenic obesity.
“Myosteatosis and ectopic adipose tissue deposition are extremely important as they are at the heart of a vicious, pro-inflammatory cycle observed in the pathophysiology of sarcopenic obesity.”
The paper relies on this without support.
SARMs selectively target androgen receptors on muscle and bone tissues.
“Selective androgen receptor modulators (SARMs) selectively target androgen receptors on muscle and bone tissues.”
The paper relies on this without support.
Myostatin is a contributor to muscle–adipose tissue crosstalk.
“myostatin is a contributor to muscle–adipose tissue crosstalk.”
The paper relies on this without support.
Myostatin is a member of the TGFβ superfamily and inhibits skeletal muscle growth and development.
“Myostatin is a member of the TGFβ superfamily and inhibits skeletal muscle growth and development.”
The paper relies on this without support.
Individuals with sarcopenia have elevated levels of myostatin, which is also expressed in adipose tissue.
“Individuals with sarcopenia have elevated levels of myostatin, which is also expressed in adipose tissue.”
The paper relies on this without support.
The development and progression of sarcopenic obesity is influenced by an interplay of multiple factors including ageing, inflammation, and lifestyle.
“The development and progression of this complex syndrome is influenced by an interplay of multiple factors including ageing, inflammation, lifestyle, among others.”
The paper relies on this without support.
The clinical implications of sarcopenic obesity span from physical impairments to elevated morbidity and mortality rates.
“The clinical implications of sarcopenic obesity span from physical impairments to elevated morbidity and mortality rates.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Specifically, the current definition of SO may not include adults exhibiting early signs of risk factors for SO, potentially delaying therapeutic or preventive interventions [19, 20, 21, 22].”
From Sarcopenic Obesity Phenotype Index (SOP i ): A Population‐Based Study (2025) · cites this paper as [22]
Experimental — accuracy not yet measuredIn the citing paper
“Protein plays a central role in the preservation of LBM and a high protein diet that exceeds the recommended 0.8 g protein/kg bodyweight/day is the best option to mitigate the reduction in LBM, with patients encouraged to increase their protein intake to maintain and recover muscle mass and function over the long term [51,59,73,74].”
From Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions (2025) · cites this paper as [59]
In the citing paper
“In addition to higher protein intake, addressing physical inactivity through regular exercise can further help to preserve muscle mass and functionality [49,54,59,74,78].”
From Application of nutrition interventions with GLP-1 based therapies: A narrative review of the challenges and solutions (2025) · cites this paper as [59]
Citations
Cites
Sarcopenia: revised European consensus on definition and diagnosis
Cruz-Jentoft, A. J., Bahat, G., Bauer, J., Boirie, Y., Bruyère, O., Cederholm, T., Cooper, C., Landi, F., Rolland, Y., Sayer, A. A., et al. (2019) · Age and Ageing · doi:10.1093/ageing/afy169 · Cited by 13,818 · cited 2×
“The progressive loss of muscle mass and function in sarcopenic obesity can also occur alongside changes in muscle composition 53 .”
The metabolic phenotype in obesity: Fat mass, body fat distribution, and adipose tissue function
Goossens, G. H. (2017) · Obesity Facts · doi:10.1159/000471488 · Cited by 8,481
Protective and Damaging Effects of Stress Mediators
McEwen, B. S. (1998) · New England Journal of Medicine · doi:10.1056/nejm199801153380307 · Cited by 6,733
Once-Weekly Semaglutide in Adults with Overweight or Obesity
Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T. D., Wadden, T. A., et al. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2032183 · Cited by 5,205
Gait speed and survival in older adults.
Studenski, S. (2011) · JAMA · doi:10.1001/jama.2010.1923 · Cited by 4,558 · cited 1×
“…of complications, which include functional disabilities (such as difficulty or a need for assistance with activities of daily living or instrumental activities of daily living essential for independent living), falls, low gait speed, and metabolic, cardiovascular and respiratory diseases 120,121 .”
2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2013.11.004 · Cited by 4,058
Tirzepatide Once Weekly for the Treatment of Obesity
Jastreboff, A. M., Aronne, L. J., Ahmad, N. N., Wharton, S., Connery, L., Alves, B., Kiyosue, A., Zhang, S., Liu, B., Bunck, M. C., et al. (2022) · New England Journal of Medicine · doi:10.1056/nejmoa2206038 · Cited by 3,838 · cited 1×
“Existing data suggest that marked adipose tissue loss with semaglutide and tirzepatide occurs with concomitant muscle loss 202,204,205 .”
Physical Activity and Public Health in Older Adults
Nelson, M. E., Rejeski, W. J., Blair, S. N., Duncan, P. W., Judge, J. O., King, A. C., Macera, C. A., & Castaneda‐Sceppa, C. (2007) · Circulation · doi:10.1161/circulationaha.107.185650 · Cited by 3,057
Jensen, M. D., Ryan, D. H., Apovian, C. M., Ard, J. D., Comuzzie, A. G., Donato, K. A., Hu, F. B., Hubbard, V. S., Jakicic, J. M., Kushner, R. F., et al. (2014) · Circulation · doi:10.1161/01.cir.0000437739.71477.ee · Cited by 2,735
Kaiser, M., Bauer, J. M., Rämsch, C., Uter, W. J. C., Guigoz, Y., Cederholm, T., Thomas, D. R., Anthony, P. S., Charlton, K. E., Maggio, M. G., et al. (2009) · The journal of nutrition health & aging · doi:10.1007/s12603-009-0214-7 · Cited by 2,083
Cited by
Sorted by citations
Sayer, A. A., Cooper, R., Arai, H., Cawthon, P. M., Essomba, M.-J. N., Fielding, R. A., Grounds, M. D., Witham, M. D., & Cruz-Jentoft, A. J. (2024) · Nature Reviews Disease Primers · doi:10.1038/s41572-024-00550-w · Cited by 441
Look, M., Dunn, J. P., Kushner, R. F., Cao, D., Harris, C., Gibble, T. H., Stefanski, A., & Griffin, R. (2025) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.16275 · Cited by 181
Sattar, N., Neeland, I. J., Dahlqvist Leinhard, O., Fernández Landó, L., Bray, R., Linge, J., & Rodriguez, A. (2025) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(25)00027-0 · Cited by 131
2025 ACC Scientific Statement on the Management of Obesity in Adults With Heart Failure
Kittleson, M. M., Benjamin, E. J., Blumer, V., Harrington, J., Januzzi, J. L., McMurray, J. J. V., & Vest, A. R. (2025) · JACC · doi:10.1016/j.jacc.2025.05.008 · Cited by 79
Updates in Cancer Cachexia: Clinical Management and Pharmacologic Interventions
Pandey, S., Bradley, L., & Fabbro, E. D. (2024) · Cancers · doi:10.3390/cancers16091696 · Cited by 42
Metadata
- Authors
- Prado, C. M., Batsis, J. A., Donini, L. M., Gonzalez, M. C., & Siervo, M.
- Affiliations
- University of Alberta (CA)
- University of North Carolina at Chapel Hill (US)
- Sapienza University of Rome (IT)
- Curtin University (AU)
- Corresponding author
- Prado, Carla M.
- Venue
- Nature Reviews Endocrinology
- Published
- 2024-02-06
- Volume
- 20
- Issue
- 5
- Pages
- 261-277
- ISSN
- 1759-5029 (ISSN-L)
- 1759-5037
- PMC
- PMC12854800
- OpenAlex
- W4391577587
- Cited by
- 355
- References
- 234
- Citations by year
- 2026: 178 · 2025: 146 · 2024: 31
- FWCI
- 20.17
- Type
- journal article
- Language
- en
- Open access
- Licence
- Locations
- Nature Reviews Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (acceptedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Funders
- National Institute on Aging (R01AG077163)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK056350)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Muscle Physiology and Disorders
- Keywords
- sarcopenic obesity, older adults, adipose tissue, geriatric syndromes, pathogenesis, inflammation, oxidative stress, hormonal changes, exercise therapy, nutritional therapy, pharmacotherapy, precision medicine, mortality, comorbidities
- MeSH terms
- Aged, Body Composition, Humans, Nutritional Status, Obesity, Exercise, Comorbidity, Sarcopenia
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.
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