Exercise and Nutrition Strategies for Combating Sarcopenic Obesity

Öz

The increase in fat mass, together with the decrease in skeletal muscle mass, is defined as sarcopenic obesity (SO). Due to the aging of the world population, the number of individuals living with chronic disease and physical limitation is increasing rapidly. Aging causes various changes in body composition, such as increased visceral fat and decreased muscle mass. As the human body ages, skeletal muscle mass decreases by about 0.1-0.5% per year from the age of 30, and after middle age, this rate rises to about 6% per decade. The prevalence of SO in the world varies between 5-10%. SO is closely associated with cardio-metabolic diseases, and the resulting morbidity-mortality and clinical outcomes are much worse than sarcopenia or obesity alone. Diet, low physical activity, smoking, hormonal changes, oxidative stress, neuromuscular changes, and immunological factors play a role in its etiopathogenesis. The main problem in SO management is to preserve skeletal muscle mass while reducing fat mass. Exercise and nutrition are the most important non-pharmacological components used in the prevention and management of SO. However, exercise or nutritional strategies alone are not entirely successful in preventing skeletal muscle losing in SO. According to the literature, combined resistance and aerobic exercise with a spread throughout-the-day diet containing protein and vitamin D supplementation is currently the most effective management strategy. Although the current literature on sarcopenia and obesity is quite rich, studies on SO are limited. The purpose of this review is to provide a summary of recent data on the definition, clinical outcomes, effective exercise, and nutritional strategies for the prevention and/or treatment of SO and to highlight the limitations in the literature.

Anahtar Kelimeler

• Nutrition
• exercise
• obesity
• sarcopenia

Sarkopenik Obezite ile Mücadelede Egzersiz ve Beslenme Stratejileri

Öz

İskelet kas kütlesindeki azalma ile birlikte yağ kütlesindeki artış sarkopenik obezite (SO) olarak tanımlanmaktadır. Dünya nüfusunun yaşlanmasına bağlı olarak kronik hastalık ve fiziksel yetersizlik ile yaşayan bireylerin sayısı da hızla artmaktadır. Yaşlanma, visseral yağda artış ve kas kütlesinde azalma gibi vücut kompozisyonunda çeşitli değişikliklere neden olmaktadır. İnsan vücudu yaşlandıkça, iskelet kas kütlesi 30 yaşından itibaren yılda yaklaşık %0,1-0,5 oranında azalmakta ve orta yaştan sonra bu oran her on yılda yaklaşık %6’ya kadar yükselmektedir. Dünya genelinde SO prevalansı %5-10 arasında değişmektedir. SO kardiyo-metabolik hastalıklar ve bunlardan kaynaklanan morbidite-mortalite ile yakından ilişkilidir ve tek başına sarkopeni ya da obeziteye göre klinik sonuçları çok daha kötüdür. Etyopatogenezinde; diyet, düşük fiziksel aktivite, sigara, hormonal değişiklikler, oksidatif stres, nörömusküler değişiklikler ve immünolojik faktörler rol oynamaktadır. SO yönetiminde yaşanan temel problem yağ kütlesini azaltırken iskelet kas kütlesini korumaktır. Egzersiz ve beslenme SO’nun önlenmesi ve yönetiminde kullanılan en önemli farmakolojik olmayan bileşenlerdir. Ancak tek başına egzersiz veya beslenme stratejileri SO’daki iskelet kas kaybını engellemede tam olarak başarılı değildir. Literatüre göre protein ve D vitamini takviyesi içeren, gün içine yayılmış bir diyetle birlikte kombine dirençli ve aerobik egzersiz şu an için en etkili yönetim stratejisi olarak görülmektedir. Bu derlemenin amacı, SO’nun tanımı, klinik sonuçları, önlenmesi ve/veya tedavisine yönelik etkili egzersiz ve beslenme stratejileri ile ilgili güncel verilerin özetini sunmak ve literatürdeki sınırlamaları vurgulamaktır.

Anahtar Kelimeler

• Beslenme
• egzersiz
• obezite
• sarkopeni

Kaynakça

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