Obesity sarcopenic, origin, diet and exercise in their treatment

Fonte: bpblogspot

Fonte: bpblogspot

Obesity sarcopenic (OS) it is the simultaneous occurrence of obesity and sarcopenia (loss of muscle mass and strength from the aging) (Stenholm et al., 2009), excessively increase the risk of death with respect to the existence of each of isolation.

The disease is not very common, but there is a tendency to increase their number. As an example, in the United States is already 10% of the affected population (Stenholm et al., 2008).

Below, check the table found in the article by Hershberger and Bollinger (2015) which highlights the clinical differences of sarcopenia, obesity and obesity sarcopenic.


The causes of sarcopenia and obesity are multifactorial and has been studied by several authors, as mentioned Ilich et al. (2014).

The study produced by Villareal et al. (2004) mentions a comparison between obese and non-obese elderly and the relationship with their quality of life, where they found that people aged over 65 and obese have much lower level of quality of life to individuals of the same age who do not are overweight.

The skeletal muscle mass balance is dictated by the synthesis and protein degradation, wherein the atrophy occurs when the degradation level is high whereas the same level of synthesis decreases (SACHECK et al., 2007).

Since sarcopenia can be characterized by reduction of myocellular number. This factor is especially related to type II fibers (Lexell et al., 1983). In response, we noticed a decrease in function and strength of the affected muscle.

Obesity can aggravate sarcopenia in a multitude of ways. First, obesity is known to cause anabolic response decreasing the resistance of protein synthesis and muscle hypertrophy (paturi et al., 2010). This also appears to be intimately associated with insulin resistance caused by obesity.

Therefore, people affected by sarcopenic obesity may be unable to increase muscle protein synthesis in response to anabolic stimuli such as diet and resistance training. And besides resistance to anabolic stimuli, the affected tend to have a more pronounced degradation of protein (Hershberger et al., 2015).

Despite the complexity involving protein degradation studies show that key factors in this process, such as myostatin, NF-kB and MuRF-1 has marked deterioration in severely obese subjects (Hittel et al, 2009;.. Sishi et al 2011 ).

For years it was discovered that obesity causes increased body fat both within and between the muscle fibers (Goodpaster et al., 2000). Recently it was reported by Hioki et al., (2015) that the fat infiltrating the muscle cell affect the power output.

The concentration of muscle mass is an important factor for the metabolic speed of action. Therefore, sarcopenia leading to a decrease in muscle mass leads to a decrease of the metabolic work and consequently leads to a higher concentration of fat (Hershberger et al., 2015). Sedentary lifestyle is also an important variable in reducing metabolic activity.

Treatment related to changes in lifestyle

Considering the information mentioned above, various treatments are proposed for this population, especially involving dietary changes and physical exercise by sarcopenic affected by obesity.

Dietary changes

Changes related to power tend to bring improvements in the population’s lifestyle.

Gweon et al. (2010) suggests the implementation of 0.8g / kg body weight to stimulate protein synthesis. Study mentions that Leucine to have the greatest influence in protein synthesis and its quantity is directly related (XU et al., 2014).

In addition, recent research has suggested that essential fatty acid intake (DHA, EPA) increases the rate of protein synthesis in skeletal muscle (Smith et al., 2010) and neutralizes muscle atrophy induced by saturated fats (WOODWORTH-HOBBS et al. 2014). Of course, we note the use of dietary restrictions as the method for reducing body fat, however, this technique eventually leads to muscle mass also decreases (BREHN et al. 2003).

Weinheimer et al. (2010) produced a revision which provided 52 studies and compared the use of food restriction, physical exercise or both for reducing body fat. The results show that both the restriction and exercise have the same efficiency, however, the use of both was able to enhance the reduction of body fat and reduced risk of reduced muscle mass.

Physical exercise

The physical exercise can cause sharp results in weight control and preventing the loss of lean body mass, it is able to increase the concentration of the same. Another very important factor is the acceleration capacity of the metabolic work, able to reduce the possibility of increased body fat (HORNBERGER, 2011).

Aerobic exercises may have a more direct influence on weight loss and can improve cardiovascular comorbidities, such as hypertension and vascular resistance (Moore et al., 2009).

Therefore, the use of physical exercise and dietary changes seem to be the most interesting measure for sarcopenic affected by obesity, which together are able to reduce body fat, increase muscle mass and quality of life.


  • Stenholm S, Harris TB, Rantanen T,Visser M, Kritchevsky SB, and Ferrucci L.Sarcopenic obesity: Definition, cause and consequences. Curr Opin Clin Nutr Metab Care 11: 693–700, 2008.
  • Stenholm S, Alley D, Bandinelli S,Griswold ME, Koskinen S, Rantanen T,Guralnik JM, and Ferrucci L. The effect of obesity combined with low muscle strength on decline in mobility in older persons: Results from the InCHIANTI study. Int J Obes 33: 635–644, 2009.
  • Ilich JZ, Kelly OJ, Inglis JE, Panton LB, Duque G, and Ormsbee MJ. Interrelationship among muscle, fat, and bone: Connecting the dots on cellular, hormonal, and whole body levels. Ageing Res Rev 15: 51–60, 2014.
  • Villareal DT, Banks M, Siener C, Sinacore DR, and Klein S. Physical frailty and body composition in obese elderly men and women. Obes Res 12: 913–920, 2004.
  • Sacheck JM, Hyatt JPK, Raffaello A, Jagoe RT, Roy RR, Edgerton VR, Lecker SH, and Goldberg AL. Rapid disuse and denervation atrophy involve transcriptional changes similar to those of muscle wasting during systemic diseases. FASEB J 21: 140–155, 2007.
  • Lexell J, Henriksson-Larse´n K, Winblad B, and Sjo¨ stro¨m M. Distribution of different fiber types in human skeletal muscles: Effects of aging studied in whole muscle cross sections. Muscle Nerve 6: 588–595, 1983.
  • Paturi S, Gutta AK, Kakarla SK, Katta A, Arnold EC, Wu M, Rice KM, and Blough ER. Impaired overload-induced hypertrophy in obese Zucker rat slowtwitch skeletal muscle. J Appl Physiol (1985) 108: 7–13, 2010.
  • Hittel DS, Berggren JR, Shearer J, Boyle K, and Houmard JA. Increased secretion and expression of myostatin in skeletal muscle from extremely obese women. Diabetes 58: 30–38, 2009.
  • Sishi B, Loos B, Ellis B, Smith W, du Toit EF, and Engelbrecht AM. Diet-induced obesity alters signalling pathways and induces atrophy and apoptosis in skeletal muscle in a prediabetic rat model. Exp Physiol 96: 179–193, 2011.
  • Goodpaster BH, Theriault R, Watkins SC, and Kelley DE. Intramuscular lipid content is increased in obesity and decreased by weight loss. Metabolism 49: 467–472, 2000.
  • Hioki M, Kanehira N, Koike T, Saito A, Takahashi H, Shimaoka K, Sakakibara H, Oshida Y, and Akima H. Associations of intramyocellular lipid in vastus lateralis and biceps femoris with blood free fatty acid and muscle strength differ between young and elderly adults [published online ahead of print June 5, 2015]. Clin Physiol Funct Imaging 2015. doi: 10.1111/cpf.12250.
  • Gweon HS, Sung HJ, and Lee DH. Shortterm protein intake increases fractional synthesis rate of muscle protein in the elderly: Meta-analysis. Nutr Res Pract 4:375–382, 2010.
  • Xu ZR, Tan ZJ, Zhang Q, Gui QF, and Yang YM. The effectiveness of leucine on muscle protein synthesis, lean body mass and leg lean mass accretion in older people: A systematic review and metaanalysis. Br J Nutr 113: 25–34, 2014.
  • Woodworth-Hobbs ME, Hudson MB, Rahnert JA, Zheng B, Franch HA, and Price SR. Docosahexaenoic acid prevents palmitate-induced activation of proteolytic systems in C2C12 myotubes. J Nutr Biochem 25: 868– 874, 2014.
  • Smith GI, Atherton P, Reeds DN, Mohammed BS, Rankin D, Rennie MJ, and Mittendorfer B. Dietary omega-3 fatty acid supplementation increases the rate of muscle protein synthesis in older adults: A randomized controlled trial. Am J Clin Nutr 93: 402–412, 2010.
  • Brehm BJ, Seeley RJ, Daniels SR, and D’Alessio DA. A randomized trial comparing a very low carbohydrate diet and a calorie-restricted low fat diet on body weight and cardiovascular risk factors in healthy women. J Clin Endocrinol Metab 88: 1617–1623, 2003.
  • Weinheimer EM, Sands LP, and Campbell WW. A systematic review of the separate and combined effects of energy restriction and exercise on fat-free mass in middle-aged and older adults: Implications for sarcopenic obesity. Nutr Rev 68: 375–388, 2010.
  • Hornberger TA. Mechanotransduction and the regulation of mTORC1 signaling in skeletal muscle. Int J Biochem Cell Biol 43: 1267–1276, 2011.
  • Moore DR, Robinson MJ, Fry JL, Tang JE, Glover EI, Wilkinson SB, Prior T, Tarnopolsky MA, and Phillips SM. Ingested protein dose response of muscle and albumin protein synthesis after resistance exercise in young men. Am J Clin Nutr 89: 161–168, 2009.