People with sarcopenic obesity (SO) are characterized by both low muscle mass (sarcopenia) and high body fat (obesity); they have greater risks of metabolic diseases and physical disability than people with sarcopenia or obesity alone. Exercise and nutrition have been reported to be effective for both obesity and sarcopenia management. Thus, we aimed to investigate the effects of exercise and nutrition on body composition, metabolic health, and physical performance in individuals with SO. Studies investigating the effects of exercise and nutrition on body composition, metabolic health, and physical performance in SO individuals were searched from electronic databases up to April 2019. Fifteen studies were included in the meta-analysis. Aerobic exercise decreased body weight and fat mass (FM). Resistance exercise (RE) decreased FM and improved grip strength. The combination of aerobic exercise and RE decreased FM and improved walking speed. Nutritional intervention, especially low-calorie high-protein (LCHP) diet, decreased FM but did not affect muscle mass and grip strength. In addition to exercise training, nutrition did not provide extra benefits in outcome. Exercise, especially RE, is essential to improve body composition and physical performance in individuals with SO. Nutritional intervention with LCHP decreases FM but does not improve physical performance.

Background Obesity accelerates and exacerbates the age-related changes on muscle function and exercise capacity. In addition, the middle-aged population is often overlooked when talking about the prevention of sarcopenia. This study investigated the effects of exercise alone or in combination with a high-protein diet on muscle function and physical fitness in middle-aged obese adults. Materials and methods Sixty-nine middle-aged (501–64 years old) obese adults were randomly assigned to one of the following groups: control group (C; n=23), exercise group (E; n=23) or exercise plus high-protein group (EP; n=23). Individuals within the E and EP groups received 12 weeks of exercise training; whereas, the individuals in the EP group also received a highprotein diet intervention (1.6g/kg/day). Individuals within the C group were asked to maintain their lifestyle for 12 weeks. Participants were evaluated before and after the intervention. Outcome measures included maximal exercise capacity, muscle function and functional physical performance. Analysis of covariance was used to determine the effects of the intervention. Results After the intervention, the E and EP groups had greater maximal work rate, peak oxygen consumption, and muscle power during muscle contractions at 180°/sec than that in the C group (P<0.05). The EP group, but not the E group, showed significant improvement in the sit-to-stand test and climbing stairs test than the C group after the intervention (P<0.05). Within group comparisons showed that the anaerobic threshold only increased in the EP group (+12% from pre-test). Conclusions For middle-aged obese adults, exercise with a high-protein diet not only improved muscle power and exercise capacity but also enhanced their functional physical performance.

Background: Obesity is the main risk factor of cardiovascular diseases (CVD) and metabolic diseases. The middle-aged population is the age group with the highest prevalence of obesity. Thus, improving cardiometabolic health is important to prevent CVD and metabolic diseases in middle-aged obese adults. The aim of this study was to examine the effects of exercise alone or in combination with a high-protein diet on markers of cardiometabolic health in middle-aged adults with obesity.Methods: Sixty-nine middle-aged adults with obesity were assigned randomly to the control group (C; n = 23), exercise group (E; n = 23), or exercise combined with high-protein diet group (EP; n = 23). Individuals in the E and EP groups received supervised exercise training and individuals in the EP group received high-protein diet intervention. Body composition (assessed by dual-energy X-ray absorptiometry), oral glucose tolerance test (OGTT), lipid profiles, and inflammatory markers were determined before and after 12 weeks of intervention. Insulin sensitivity index (ISI_0,120) was calculated from values of fasting and 2-h insulin and glucose concentration of OGTT. Insulin-peak-time during the OGTT was recorded to reflect β-cell function. Analysis of covariance with baseline values as covariates was used to examine the effects of the intervention. The significant level was set at 0.05.Results: After 12 weeks of intervention, the E group had a greater percentage of individuals with early insulin-peak-time during the OGTT than that in the C and EP groups (p = 0.031). EP group had lower total cholesterol and triglycerides than that in the C group (p = 0.046 and 0.014, respectively). Within-group comparisons showed that the 2-h glucose of OGTT and C-reactive protein decreased in the EP group (p = 0.013 and 0.008, respectively) but not in the E and C groups; insulin sensitivity improved in the EP group (p = 0.016) and had a trend to improve in the E group (p = 0.052); and abdominal fat mass and total body fat mass decreased in both intervention groups (p < 0.05).Conclusion: Combined high-protein diet and exercise intervention significantly decreased fat mass and improved lipid profiles, insulin sensitivity, glucose tolerance, and inflammation in middle-aged adults with obesity.Clinical Trial Registration: Thai Clinical Trials Registry, TCTR20180913003, 13-09-2018.

Purpose: Obesity commonly results from the combination of excessive caloric intake and lack of physical activity. However, it is not well known if a chronic high‐fat diet leads to negative changes in resting physical activity level, which would be expected to accelerate the development of obesity. Therefore, the purpose of this study was to investigate whether a 10‐week high‐fat diet would suppress spontaneous locomotor activity in Sprague Dawley rats. Methods: Sixteen male Sprague Dawley rats were randomly assigned into one of two treatment groups: 1) standard diet (SD: 10% fat, 20% protein and 70% carbohydrate) or 2) high‐fat diet (HFD: 45% fat, 20% protein and 35% carbohydrate). After one‐week acclimation, rats were fed either the SD or HFD for 10‐weeks. Throughout the dietary intervention period, body weight, water and food intake were recorded on a weekly basis. In addition, body composition (via DEXA) and spontaneous locomotor activity (via image analysis) were measured at the 9‐week time point. Immediately following the completion of the dietary intervention fasting blood glucose, plasma insulin, HbA1c and the hormones leptin and adiponectin were assess. Thereafter, an intraperitoneal glucose tolerance test (IPGTT) and insulin tolerance test (ITT) were performed at two‐day intervals in order to evaluate whole‐body glucose metabolism. All results were analyzed using a t‐Test. Significance was set at p ≤0.05. Results: Spontaneous locomotor activity (inactive time, standing frequency, movement distance, and movement velocity) were not different between SD and HFD treatment groups. Consumption of the high‐fat diet significantly increased weight gain and increased fat accumulation (whole body and visceral part), while significantly decreasing muscle mass compared to the control diet ( p <0.05). In addition, rats fed the high‐fat diet showed a significant increase (by ~310%) in circulating leptin levels compared to rats fed the standard diet ( p <0.05), whereas the adiponectin levels were not different between treatment groups. However, blood glucose, HbA1c and the homeostatic model assessment (HOMA) were all significantly elevated for HFD compared to SD ( p <0.05). In addition, the area under the curve (AUC) for the ITT and IPGTT tests were also significantly greater for the HFD treatment group ( p <0.05). Conclusion: This investigation demonstrates that despite negative changes in body composition, impaired whole‐body glycemic control, and spontaneous locomotor activity were not affected by a high‐fat diet in Sprague Dawley rats. Thus, these results suggest that excessive caloric intake may play a more critical role in the development of obesity rather than the lack of spontaneous locomotor activity.