Sarkopenic obesity

Sarkopenic obesity is a type of obesity that occurs in older people.

It is characterized by increasing the amount of body fat while losing muscle mass. What are the causes of sarcopene obesity and how is it treated? 

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Sarkopenic obesity is most often associated with changes in the composition of the body depending on age. As the body ages, muscle mass gradually decreases in it. Such a reaction occurs even in very physically active people. But at some seniors, fat gain may also occur at the same time. The close relationship between older age, obesity and loss of muscle mass is confirmed by research. The development of one of these factors leads to the appearance or intensification of the other, causing the phenomenon of a closed circle. 

Saratopenic obesity is diagnosed in those with concurrent occurrence 

1. Changes in the composition of the body associated with aging 

With age, the body changes in the proportions of muscle and fat tissue. From about 40 years of age, the process of loss of muscle mass and strength begins to progress, and around 60-75 years the amount of fat begins to increase. In the elderly, adipose tissue usually accumulates around the internal organs and penetrates the muscles. Changes in body composition may, however, remain unnoticed for a long time in people who maintain a relatively constant body weight. 

2. Low physical activity or lack of physical activity.

Under the term low physical activity are hidden activities that do not increase the energy expenditure of the body, i.e. sleeping, sitting, lying. With little or no activity, muscle mass decreases and the risk of storing unused energy in the form of adipose tissue increases. Another vicious circle appears. People with obesity are less active in everyday life due to significant overweight and it is more difficult for them to do physical exercises, which contributes to the reduction of strength and to atrophy, i.e. muscle atrophy. On the other hand, when they lose strength they start to avoid effort, which in turn favors the development of obesity. 

3. Too much body fat. The more fat (especially visceral fat, internal fat) accumulates in the body, the more it secrete so-called. cytokines – substances that trigger inflammatory reactions.

They have a direct impact on the operation of many systems, including they accelerate changes in the body composition typical of the aging process and cause chronic inflammation. Some of them (eg interleukin-6 – IL-6) accelerate the rate of muscle breakdown thus leading to a reduction in their strength and to the development of sarcopenia.

4. Insulin resistance.

The secondary effect of insulin resistance is the increased insulin concentration, which accelerates the breakdown of skeletal muscle tissues. In turn skeletal muscle atrophy leads to an increase in insulin resistance, which in turn favors the development of obesity. 

5. Hormonal changes.

The more adipose tissue, the more there is in the bloodstream of free fatty acids, which inhibit the production of growth hormone (GH) and testosterone. And the fewer these hormones, the lower is the strength of muscles and the muscles of people with obesity are less active. 

6. Incorrect nutrition.

Older people do not know or forget that as their age decreases their body’s need for calories. Usable for many years for specific products, size and quantity of meals, they have difficulty introducing nutritional restrictions. The caloric value of products that they consume every day exceeds the needs of their body, which leads to the development of overweight and obesity. It often happens that older people, especially women, limit the amount of protein consumed. And when the protein in the diet is not enough, the loss of muscle mass progresses faster. 

How do weak muscles and excess fat affect the health and life of an elderly person? 

The main goal of treatment of sarcopene obesity is weight loss and increase of muscle strength, and as a result improve the patient’s daily function and receive his body in good condition for the longest possible time. Sarkopenic obesity therapy focuses on the so-called conservative treatment, that is changing the principles of nutrition and improving physical activity. In some patients with sarcopene obesity, pharmacotherapy is also introduced. 

Weight reduction in the elderly should not be sought at any price. The first necessary step to modify the diet is to assess the patient’s nutritional status. It can be done with the help of the practical, generally available Mini Nutritional Assessment Test – MNA. If an older person has malnutrition or a risk of malnutrition, the main goal of the new diet is to improve the nutritional status of the body and not to lose weight. 

In elderly people with sarcopene obesity, slimming therapy is used to minimize the loss of muscle mass. Because older people often suffer from many other diseases and take many medications, the introduction of a new diet must be monitored by a doctor and dietitian. 

The diet in sarcopene obesity is determined individually for each patient, and its planning takes into account such parameters as providing adequate for the age and condition of the patient the amount of vitamins and minerals, caloric demand, preferences and eating habits, the degree of mobility of the patient and forms of physical activity that he undertakes, as well as medical conditions and accompanying pharmacotherapies. The goal of the diet is the loss within 6 months from 5% -10% of the patient’s initial body weight, but above all in the area of ​​adipose tissue, with the maximum preservation of muscle tissue. This effect can be obtained by reducing the daily caloric intake of the patient by 500-700 kcal. 

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You can read also: Diet and exercise as one of the main ways to lose body fat

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