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Sarcopenic obesity is an age-related muscle loss which is compensated by an increase in fat mass. Resistance exercises and a protein rich healthy diet are proven to prevent the complications of this increasingly common disorder.

We all know what is obesity, but only few people will probably able to tell what is sarcopenia. This condition is, however, one of the most common among elderly people. The term sarcopenia describes the age-related muscle loss. It is the condition behind the frail physic of an elderly person. People figure out the effects of sarcopenia when they see an elderly person trembling to walk a few steps due to the fear of falling down. Though sarcopenia is viewed as an inevitable consequence of getting old, researchers who focus on aging have suggested that this condition and its effects can be potentially reversed. Appropriate interventions, however, should be undertaken during the early stages of the condition’s development.

Aging is not the sole reason for sarcopenia

Sarcopenia is the term used to describe the age-related loss of muscle mass, strength and function and it is predominantly seen in the elderly.

Though it is primarily related to aging and seen more commonly in physically inactive people, active individuals are not free of developing this condition.

The reason is that many other factors, not only physical inactivity, are associated with the development of this condition. Some of these factors include:

  • Insufficient protein intake
  • Hormonal changes like decreased serum testosterone and growth hormone levels
  • Body’s resistance to insulin
  • Presence of circulating proteins (cytokines) that initiate inflammation

Apart from these factors that are identified in the context of aging, certain diseases are also found to have a direct effect on the skeletal muscles, thus contributing to sarcopenia. Among them, the most important are diabetes and obesity.

How are obesity and sarcopenia related?

Human body mass broadly constitutes of fat and lean muscle tissues.

It is usual for the percentage of body fat to increase with the age but if it increases to a very high degree, the lean body mass becomes compromised.

Functional disability and dependence, which are the results of sarcopenia, are expressed to a greater extent when obesity accompanies the aging process. A blended expression of these two disorders is termed ‘sarcopenic obesity’. Studies show abundant evidences for the relationship between obesity and sarcopenia. They are actually considered to reinforce each other.

To put the relationship between the two disorders in simple words, the following factors should be mentioned:

  • Obese people tend to be physically inactive.
  • They develop insulin resistance.
  • They take imbalanced diet that, in most of the cases, is protein deficient.
  • When they tend to lose weight, their probability of taking a protein rich diet is even more reduced leading to the depletion of muscle proteins.
  • The accumulated adipose tissues in obese people stimulate inflammatory reactions, calling for even more muscle loss.
  • Obese people have higher levels of free fatty acids which inhibit growth hormone and testosterone secretions, either directly or indirectly.

Researchers are yet to establish the exact mechanism underlying sarcopenic obesity. However they have proposed a strong causal relationship between obesity and sarcopenia.

Sarcopenia Is Not Irreversible And Can Be Effectively Managed

Obesity, which itself is a cause of diminished quality of life in the old age, results in further disability when coupled with sarcopenia in the elderly. This also contributes to the increased rate of hospitalization and mortality in older people.

With a long way to go in assessing the cause of sarcopenic obesity and the methods to recognize it, the best proposed way to control this condition is to intervene in the early stages of aging. The elderly should be encouraged to consume a protein rich diet. High protein dietis found to increase satiety and insulin sensitivity. Thus they help to maintain lean body mass. Various studies propose that creatine supplementation in older adults who also undergo resistance exercise training helps in improving muscle strength and lean body mass.

Interestingly, some recent studies emphasize the positive effects of vitamin D supplementation in the elderly on the improvement of muscle function and prevention of sarcopenia.

In addition, the beneficial effects of this vitamin on the preventing of bone disorders and fractures are well known.

Resistance training helps in sarcopenic obesity

Physical training in the form of resistance exercise is very effective in reversing sarcopenia. The term “resistance training” refers to the exercises with the use of weights that are lifted against a resisting force. This force causes muscles to contract better and thus increases their strength and mass. Resistance training is a cornerstone of general athletic and sport training but is rarely recommended to elderly people due to increased risk of injuries. With careful control, however, resistance training works very well in this age group.

Although changes in diet, supplementation and resistance training may not completely reverse the process, they do help in improving the muscle strength and allow people to stay fit and healthy for a longer period.

The increased fat mass in obese people can easily mask the loss of muscles. When profound muscle loss occurs in an obese person, it presents itself in the form of added functional disability. Unless the coexistence of sarcopenia is recognized and addressed, the disability cannot be managed. Any attempt to lose excess weight without compensating for the protein requirement will only worsen the problem.

Neither sarcopenia nor obesity is an inevitable physical change associated with aging.

It is worthwhile to rely on good physical activity and a healthy diet to prevent the risk of both these conditions early in life to avoid serious problems in the old age.

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