Table 1. . The associations of physical activity, physical fitness or exercise training with sarcopenic obesity.
| Study (year), country | Sample size | Mean age (range) | Study design | Physical activity/fitness/exercise | Sarcopenia definition | Obesity definition | Sarcopenic obesity prevalence | Main results | Ref. |
|---|---|---|---|---|---|---|---|---|---|
| Bouchard et al. (2009), Canada |
904 (465 women) |
74 (68–82) |
Cross-sectional |
Physical fitness using four tests (timed up and go, chair stand, walking speed and leg stand) |
Two SDs below the mean ALM/height2 of young adults (20–35 years) using DXA (<8.51 kg/m2 in men and <6.29 kg/m2 in women) |
% body fat of ≥28% in men and ≥35% in women using DXA |
Men: – Nonsarcopenic and nonobese: 30% – Nonsarcopenic and obese: 31% – Sarcopenic and nonobese: 20% – Sarcopenic and obese: 19% Women: – Nonsarcopenic and nonobese: 23% – Nonsarcopenic and obese: 59% – Sarcopenic and nonobese: 7% – Sarcopenic and obese: 11% |
Physical fitness was more strongly associated with obesity than sarcopenia |
[19] |
| Hwang et al. (2012), South Korea |
2221 (1257 women) |
70 (≥60) |
Cross-sectional |
Self-reported physical activity on frequencies of resistance exercise, flexibility exercise and walking time per day |
Two SDs below the mean (ALM/weight) × 100 of healthy young adults (20–39 years) using DXA (29.53% in men and 23.20% in women) |
Waist circumference ≥90 cm in men and ≥85 cm in women |
Men: – Nonsarcopenic and nonobese: 70% – Sarcopenic and obese: 6% Women: – Nonsarcopenic and nonobese: 57% – Sarcopenic and obese: 7% ‘Nonsarcopenic and obese’ and ‘Sarcopenic and nonobese’ were excluded in the analyses |
Although not significant, higher levels of physical activity were associated with lower risk of SO |
[20] |
| Ryu et al. (2013), South Korea |
2264 (1324 women) |
78 (≥65) |
Cross-sectional |
Physical activity using the International Physical Activity Questionnaire |
Two SDs below the mean (ALM/weight) × 100 of healthy young adults (20–39 years) using DXA (cut-points not reported) |
Waist circumference ≥90 cm in men and ≥85 cm in women |
Men: – Nonsarcopenic: 89% – Sarcopenic: 11% – Sarcopenic and obese: 7% Women: – Nonsarcopenic: 88% – Sarcopenic: 12% – Sarcopenic and obese: 7% |
Higher levels of physical activity was associated with a reduced risk of SO |
[21] |
| Muñoz-Arribas et al. (2013), Spain |
306 (230 women) |
82.5 |
Cross-sectional |
Physical fitness using eight tests (leg stand, chair stand, arm curl, chair sit-and-reach, back scratch, 8-foot up-and-go, 30-m brisk walk and 6-min walk) |
The lowest two quintiles of SMM/height2 Using BIA (<8.62 kg/m2 in men and <6.20 kg/m2 in women) |
The highest two quintiles of% body fat using BIA (≥30.34% in men and ≥40.91% in women) |
Men: – Nonsarcopenic and nonobese: 30% – Nonsarcopenic and obese: 15% – Sarcopenic and nonobese: 30% – Sarcopenic and obese: 25% Women: – Nonsarcopenic and nonobese: 30% – Nonsarcopenic and obese: 17% – Sarcopenic and nonobese: 28% – Sarcopenic and obese: 25% |
Adequate levels of physical fitness were associated with a lower risk of SO |
[22] |
| Pedrero-Chamizo et al. (2015), Spain |
2747 (2102 women) |
72 (65–92) |
Cross-sectional |
Physical fitness using eight tests (leg stand, chair stand, arm curl, chair sit-and-reach, back scratch, 8-foot up-and-go, 30-m brisk walk and 6-min walk) |
The lowest two quintiles of SMM/height2 using BIA (<8.62 kg/m2 in men and <6.20 kg/m2 in women) |
The highest two quintiles of% body fat using BIA (≥30.34% in men and ≥40.91% in women) |
Men: – Nonsarcopenic and nonobese: 36% – Nonsarcopenic and obese: 25% – Sarcopenic and nonobese: 23% – Sarcopenic and obese: 16% Women: – Nonsarcopenic and nonobese: 37% – Nonsarcopenic and obese: 23% – Sarcopenic and nonobese: 24% – Sarcopenic and obese: 16% |
Higher levels of physical fitness were associated with a reduced risk of SO |
[23] |
| Balachandran et al. (2014), USA | 17 included in the analysis (16 women) | 71 (60–90) | RCT | 15-week traditional strength/hypertrophy training versus high-speed circuit training | Meeting ≥2 out of the three sarcopenia criteria: SMM/height2 using BIA (<10.76 kg/m2 in men and <6.76 kg/m2 in women), gait speed (<1 m/s) and handgrip strength (<30 kg in men and <20 in women) according to the EWGSOP definition | Body mass index >30 kg/m2 | All 17 study participants had SO at baseline The primary outcome was the short physical performance battery (SPPB) test including 4-m usual gait speed, chair stand and standing balance tests Secondary outcomes include muscle strength and power tests using leg and chest presses |
A significant 20% improvement in SPPB was found in the high-speed circuit training group. Both resistance training groups showed significant improvements in muscle strength and power |
[24] |
ALM: Appendicular lean mass (arms and legs); BIA: Bioelectrical impedance analysis; DXA: Dual energy x-ray absorptiometry; EWGSOP: European Working Group on Sarcopenia in Older People; RCT: Randomized controlled trial; SD: Standard deviation; SMM: Skeletal muscle mass (whole body); SO: Sarcopenic obesity.