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The Effects of Different Exercise Training Types on Body Composition and Physical Performance in Older Adults with Sarcopenic Obesity: A Systematic Review and Meta-Analysis

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  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

To carry out a systematic review and meta-analysis to verify the effects of different exercise training types on body composition and physical performance in older adults with sarcopenic obesity (SO).

Design

Systematic review and meta-analysis.

Setting and Participants

Older adults (≥60 years).

Methods

Database searches were performed in MEDLINE (via PubMed), EMBASE, Cochrane Library, Web of Science, SCOPUS, and LILACS on January 10th, 2023. We included: randomized and/or controlled clinical trials; physical exercise as an intervention; analysis of body composition and/or muscle function; and sarcopenic obesity diagnosis. We used the Risk of Bias 2 tool and PEDro scale. The GRADE certainty of evidence was also performed.

Results

Fourteen studies were included in the systematic review and nine studies in the meta-analysis. A decrease in body fat (%) favoring the exercise group was identified (SMD: −0.34 [95% CI: −0.53 to −0.16]; p=0.0003) (GRADE: ⊕⊕⊕○ Moderate). Only resistance training showed fat reduction (SMD: −0.27 [95% CI: −0.48 to −0.06]; p=0.01). Increases in upper (SMD: 0.41 [95% CI: 0.04 to 0.78]; p=0.03) (GRADE: ⊕⊕○○ Low) and lower (SMD: 0.80 [95% CI: 0.22 to 1.39]; p=0.007) (GRADE: ⊕⊕⊕⊕ High) limb strength was identified with exercise. Chair stand test showed increases with exercise (SMD: 0.73 [95% CI: 0.40 to 1.07]; p<0.0001) (GRADE ⊕⊕⊕⊕ High), especially for resistance training (SMD: 0.62 [95% CI: 0.21 to 1.02]; p=0.003) and combined training (SMD: 0.99 [95% CI: 0.40 to 1.57]; p=0.0005). The PEDro scale for the studies in our review ranged from 3 to 8 (mean = 5.8 (1.6)), meaning fair methodological quality, and most studies were overall judged with at least low/some concerns in terms of risk of bias.

Conclusion and Implications

Overall, moderate to high certainty of evidence was found for body fat, lower limb strength, and chair stand test. On the other hand, low certainty of evidence was found for upper limb strength. Resistance, combined, and aerobic training evoked divergent results between the variables analyzed. Although promising, our results should be considered sparingly, but may guide additional exercise recommendations to improve specific health parameters in older adults with SO.

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Data availability statement: The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

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Funding

Funding: The present work received financial support from the São Paulo Research Foundation (FAPESP; process number 2019/11820-5; 2022/06638-6; 2022/00221-6; 2022/07280-8), National Council for Scientific and Technological Development (CNPq; process number 303766/2022-0) and the Coordination for the Improvement of Higher Education Personnel (CAPES; finance code 001).

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Authors and Affiliations

  1. School of Physical Education and Sport of Ribeirão Preto (EEFERP/USP), University of São Paulo, Ribeirão Preto, Brazil

    L. da Silva Gonçalves, Leonardo Santos Lopes da Silva, M. F. Tasinafo Jr. & E. C. de Freitas

  2. Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil

    C. J. Rodrigues Benjamim

  3. Lusofona University, Faculty of Psychology, Education and Sport, Porto, Portugal

    L. Bohn

  4. Research Center in Physical Activity, Health and Leisure (CIAFEL) and Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal

    L. Bohn

  5. Faculty of Sports, University of Porto, Porto, Portugal

    L. Bohn

  6. Department of Health Sciences, Ribeirao Preto Medical School, University of Sao Paulo - FMRP USP, Ribeirao Preto, Sao Paulo, Brazil

    G. Ferreira Abud, G. U. Ortiz & E. C. de Freitas

  7. Bandeirantes Avenue n° 3900, University Campus - Monte Alegre, Ribeirao Preto, SP, Brazil

    Leonardo Santos Lopes da Silva

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Contributions

Author contributions: LSG and LSLS performed the conduction of experiments, performed the statistical analysis, and wrote the introduction, methods, results, and discussion sections. CJRB, MFTJ, LB, GFA, and GUO improved interpretation analysis and reviewed the manuscript. ECF supervised the study, draft the manuscript, and gave final approval for the version submitted for publication. All authors contributed to the article and approved the submitted version.

Corresponding author

Correspondence to Leonardo Santos Lopes da Silva.

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Competing interests: The authors declare that they have no competing interests.

Electronic supplementary material

Supplementary Figure 1

. Flowchart PRISMA

Supplementary Table 1

. Physiotherapy Evidence Database (PEDro) scale of the studies included in this review.

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da Silva Gonçalves, L., Santos Lopes da Silva, L., Rodrigues Benjamim, C.J. et al. The Effects of Different Exercise Training Types on Body Composition and Physical Performance in Older Adults with Sarcopenic Obesity: A Systematic Review and Meta-Analysis. J Nutr Health Aging 27, 1076–1090 (2023). https://doi.org/10.1007/s12603-023-2018-6

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