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Cited by 17Nutrition and Health in AgingFrailty in Older AdultsBody Composition Measurement Techniques

Training modalities for elder sarcopenic obesity: a systematic review and network meta-analysis

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Qiu, Hao, Zheng, Wanxia, Zhou, Xi, Liu, Qianrong, Zhao, Xuehong·2025·Frontiers in Nutrition
DOI 10.3389/fnut.2025.1537291PMC PMC11879820
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Abstract

Introduction: Sarcopenic obesity (SO) is a condition characterized by the coexistence of age-related obesity and sarcopenia. This systematic review and network meta-analysis (NMA) aimed to compare the effects of different training modalities, such as aerobic training (AT), resistance training (RT), combined resistance with AT (CT), and multicomponent training (MCT) on body composition, muscle strength, and physical performance in elderly patients with SO. Methods: We electronically searched randomized controlled trials, published from inception to March 2024 in PubMed, Embase, Cochrane Library, Web of Science and Scopus. Effect estimates were presented as mean differences (MD) or Standard Mean Difference (SMD) with 95% confidence interval (CI). The comprehensive effects of all treatments were ranked by the surface under the cumulative ranking (SUCRA) probabilities. Results: 14 trials enrolling 955 participants were included. The body fat percentage (BFP) in MCT (MD= −6.37, 95% CI: −8.67, −4.07), CT (MD = −2.08, 95% CI: −4.00, −0.16), and RT (MD = −1.85, 95% CI: −3.25, −0.44) was significantly lower than in the normal control group, with MCT showing superior effects compared to CT and RT. Furthermore, only MCT significantly improved fat-free mass (FFM; MD = 5.21, 95% CI:1.51, 8.91), as well as in body mass index (BMI; MD = 0.74, 95% CI:0.08, 1.40). In addition, handgrip strength (HGS) significantly improved under both MCT (SMD = 0.87, 95% CI: 0.19, 1.5) and RT(SMD = 0.84, 95% CI: 0.43, 1.25). The performance on the 30s chair stand test also yielded better outcomes for MCT (MD = 3.10, 95% CI: 1.33, 4 0.86), CT(MD = 2 0.50, 95% CI: 0.18, 5.18), and RT(MD = 3.91, 95% CI: 2.30, 5.52) when compared to the control group. Lastly, gait speed was enhanced by both MCT (MD = 0.35, 95% CI: 0.30, 0.41) and CT(MD = 0.14, 95% CI: 0.06, 0.21). The ranking results indicated that MCT was superior to other training modalities in enhancing body composition and gait speed. In contrast, RT appears to be more advantageous in the 30-second chair standing test and in improving HGS. Conclusion: MCT outperformed other training modalities in improving body composition and gait speed. RT was more beneficial for the 30-second chair standing test and enhancing HGS. These findings provide valuable insights for clinicians and researchers to customize exercise prescriptions for older patients with SO. Systematic review registration: http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42024544962 .

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  • In a network meta-analysis, machine training (MT) produced statistically significant improvements in body composition and gait speed (GS), while resistance training (RT) was most effective for improving handgrip strength (HG) and the 30 s chair stand test.

    “Their results indicated that MT produced statistically significant improvements in body composition and GS, while RT was most effective for improving HG and the 30 s chair stand test [12].”

    From Efficacy of Power Training on Sarcopenic Obesity in Community-Dwelling Older Women: A 32-Week Randomized Clinical Trial (2025) · cites this paper as [12]

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  • Many prior investigations of exercise in older adults with sarcopenic obesity present methodological limitations, such as short intervention durations (usually 12 weeks) and designs with high risk of bias.

    “However, many of these investigations present methodological limitations, such as short intervention durations (usually 12 weeks) and designs with high risk of bias, underscoring the need for more rigorous studies with prolonged interventions as mentioned in the meta-analyses.”

    From Efficacy of Power Training on Sarcopenic Obesity in Community-Dwelling Older Women: A 32-Week Randomized Clinical Trial (2025) · cites this paper as [12]

    The Results (Study characteristics; page unavailable) show that 12 weeks was the most common intervention duration, though several studies ran for 16 or 24 weeks. The Results (Risk of bias assessment; page unavailable) classify only 2 of 14 studies as high risk of bias; 10 were unclear and 2 were low risk. Thus, the duration concern is supported, but the claim overstates how prevalent high-risk designs were. (LLM, conf=0.84)

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  • Machine training (MT) led to significant improvements in adiposity-related variables (BF% and VF).

    “Notably, MT also led to significant improvements in these variables, suggesting that combined aerobic, resistance, and balance training may be a viable option for improving body composition and functionality in individuals who may not tolerate or have access to more intensive protocols such as PT [12].”

    From Efficacy of Power Training on Sarcopenic Obesity in Community-Dwelling Older Women: A 32-Week Randomized Clinical Trial (2025) · cites this paper as [12]

    The Results (Abstract; page unavailable) report a significant reduction in body fat percentage with multicomponent training (MCT), and the Introduction defines MCT as integrating training types such as strength, aerobic, and balance exercise. The paper does not identify MCT as machine training (MT) or report a visceral-fat (VF) improvement, so it supports only the body-fat-percentage part of the attributed claim. (LLM, conf=0.86)

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  • Combined aerobic, resistance, and balance training (MT) may be a viable option for improving body composition and functionality in individuals who may not tolerate or have access to more intensive protocols such as PT.

    “Notably, MT also led to significant improvements in these variables, suggesting that combined aerobic, resistance, and balance training may be a viable option for improving body composition and functionality in individuals who may not tolerate or have access to more intensive protocols such as PT [12].”

    From Efficacy of Power Training on Sarcopenic Obesity in Community-Dwelling Older Women: A 32-Week Randomized Clinical Trial (2025) · cites this paper as [12]

    The Results and Conclusion (page unavailable) report that multicomponent training improved body composition and measures of physical function in older adults with sarcopenic obesity. The Introduction describes it as integrating at least three types of training, which may include aerobic, resistance, and balance work. The paper does not establish that it is suitable for people unable to tolerate or access more intensive protocols such as PT; its findings also do not extend beyond the population studied. (LLM, conf=0.86)

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  • Resistance training and multicomponent training (MT) have been shown to be more valid strategies to improve physical function and body composition in older adults with sarcopenic obesity.

    “So far, RT and multicomponent training (MT) have been shown to be more valid strategies to improve physical function and body composition in older adults with SO, as evidenced by several meta-analyses [12,13,14].”

    From Efficacy of Power Training on Sarcopenic Obesity in Community-Dwelling Older Women: A 32-Week Randomized Clinical Trial (2025) · cites this paper as [12]

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Research works printed but not linked: 1

  1. Wang, 2019, Effects of home exercise on sarcopenia obesity for aging people, Chin J Rehabil Theory Pract, 25, 90, 10.3969/j.issn.1006-9771.2019.01.012 · DOI

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Authors
Qiu, H., Zheng, W., Zhou, X., Liu, Q., & Zhao, X.
Affiliations
Hubei University of Arts and Science (CN)
Corresponding author
Zhao, Xuehong
Venue
Frontiers in Nutrition
Publisher
Frontiers Media SA
Published
2025-02-19
Volume
12
Pages
1537291-1537291
ISSN
2296-861X (ISSN-L)
DOI
10.3389/fnut.2025.1537291
PMC
PMC11879820
OpenAlex
W4407757869
Semantic Scholar
b02472a1165a1da264d25c402b38d83c1146bb9b
Cited by
17
References
107
Citations by year
2026: 10 · 2025: 7
FWCI
1.96
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Nutrition (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
  • Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
  • Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
Keywords
sarcopenic obesity, older adults, multicomponent training, resistance training, aerobic exercise, combined resistance and aerobic training, body composition, fat-free mass, body fat percentage, muscle strength, grip strength, physical performance, 30-s chair stand test, exercise intervention, sarcopenia, body mass index, body mass index reduction

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