Exercise Improves Body Composition and Function in Sarcopenic Obesity

This systematic review and meta-analysis evaluates the effects of exercise interventions on body composition, metabolic health, and physical function in older adults with sarcopenic obesity. The analysis included 917 participants across multiple studies, examining outcomes such as body mass index (BMI), body fat mass (BFM), body fat percentage (PBF), low-density lipoprotein cholesterol (LDL-C), appendicular skeletal muscle (ASM), skeletal muscle index (SMI), handgrip strength (HG), gait speed (GS), knee extension strength (KES), and insulin-like growth factor 1 (IGF-1).

Exercise interventions led to statistically significant reductions in BMI (MD = -0.51, 95%CI: -0.76 to -0.25), BFM (MD = -1.74, 95%CI: -2.67 to -0.81), PBF (MD = -2.64, 95%CI: -3.27 to -2.00), and LDL-C (MD = -7.17, 95%CI: -13.62 to -0.71). These findings indicate clinically meaningful improvements in adiposity and lipid profile.

Concurrently, exercise significantly increased ASM (MD = 0.34, 95%CI: 0.13 to 0.55), SMI (MD = 0.21, 95%CI: 0.10 to 0.32), HG (SMD = 0.97, 95%CI: 0.47 to 1.47), GS (MD = 0.14, 95%CI: 0.07 to 0.21), KES (SMD = 0.36, 95%CI: 0.06 to 0.65), and IGF-1 (SMD = 0.65, 95%CI: 0.30 to 1.00). These results demonstrate enhanced muscle mass, strength, and functional capacity.

The evidence for body composition and physical function outcomes was graded as moderate certainty, while metabolic health outcomes (LDL-C, IGF-1) were low certainty. The authors caution that the beneficial effects are not supported by high-quality evidence due to methodological limitations across included studies.

Limitations include heterogeneity in exercise protocols, small sample sizes in some trials, and lack of standardized diagnostic criteria for sarcopenic obesity. No adverse events or discontinuations were reported, but safety data were limited.

For clinicians, these findings support prescribing structured exercise—combining resistance and aerobic training—to improve body composition and physical function in older adults with sarcopenic obesity. However, the low certainty for metabolic benefits suggests that exercise alone may not suffice for lipid management, and adjunctive therapies should be considered.

Future research should focus on high-quality randomized controlled trials with standardized outcomes, longer follow-up, and assessment of patient-important endpoints such as falls, fractures, and quality of life.