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Effectiveness of non-pharmacological interventions on the management of sarcopenic obesity: A systematic review and meta-analysis

Välimäki M; Yin YH; Liu JYW

dc.contributor.authorVälimäki M
dc.contributor.authorYin YH
dc.contributor.authorLiu JYW
dc.date.accessioned2022-10-28T13:44:59Z
dc.date.available2022-10-28T13:44:59Z
dc.identifier.urihttps://www.utupub.fi/handle/10024/167154
dc.description.abstractBackground: Sarcopenic obesity is a combination of both sarcopenia and obesity, which potentiate each other and maximize the negative influences of each, such as physical disability, morbidity, or even mortality. Objectives: To describe the criteria used to identify people with sarcopenic obesity and the components of the non-pharmacological interventions used to manage it, and to evaluate the effectiveness of those interventions.Methods: Randomized controlled trials (RCTs) in Cochrane Library, Scopus, EMBASE, PscyINFO, CINAHL and PubMed were searched. The risk of bias was examined using the Cochrane risk of bias tool. The template for intervention description and replication (TIDieR) checklist was used to summarize the intervention components. Meta-analyses were conducted using random-effect models to pool estimates of the effects of the non-pharmacological interventions on body composition, BMI, grip strength, and gait speed.Results: Sixteen papers (12 RCTs) with 863 participants were included. Diverse diagnostic criteria were used in the studies. Four categories of interventions were used: exercise (aerobic exercises, resistance exercises and exercise machines), nutritional interventions (supplements or dietary control), combined intervention and electrical acupuncture. Intervention durations varied from 8 to 28 weeks. Meta-analyses revealed that exercise with or without nutritional interventions had significant effects on grip strength (exercise: mean difference (MD): 1.63 kg, 95% confidence interval (CI): 0.94, 2.32, P < 0.00001; exercise + nutrition: MD: 1.24 kg, 95% CI: 0.48, 1.99, P = 0.001) and gait speed (exercise: MD: 0.13 m/s, 95% CI: 0.08, 0.18, P < 0.00001, I-2 = 0%; exercise + nutrition: MD: 0.04 m/s, 95% CI: 0.02, 0.06, P = 0.0002). Exercise had significant effects on reducing the percentage of body fat (PBF) compared to usual care (MD: -1.08%, 95% CI: -1.99, -0.17, P = 0.02), while exercise combined with nutritional interventions showed no superiority over exercise solely on decreasing PBF (P = 0.49). Exercise combined with nutritional interventions had significant effects on increasing appendicular skeletal muscle mass (MD: 0.43 kg, 95% CI: 0.20, 0.66, P = 0.0003). Low-caloric high-protein diets showed no superiority over low-caloric low-protein diets in increasing fat-free mass. Subgroup analyses showed that using different formulas to estimate the skeletal muscle mass index may lead to significant differences in determining the effects of exercise on grip strength.Conclusion: The diagnostic criteria for sarcopenic obesity used in future studies should refer to the latest consensus definition. Exercise tended to be the most effective method of improving grip strength and physical performance (e.g. gait speed). The combined effects of exercise and nutritional interventions on muscle mass and muscle strength require further exploration.
dc.language.isoen
dc.publisherPERGAMON-ELSEVIER SCIENCE LTD
dc.titleEffectiveness of non-pharmacological interventions on the management of sarcopenic obesity: A systematic review and meta-analysis
dc.identifier.urnURN:NBN:fi-fe2021042823304
dc.relation.volume135
dc.contributor.organizationfi=hoitotieteen laitos|en=Department of Nursing Science|
dc.contributor.organization-code2607400
dc.converis.publication-id47470203
dc.converis.urlhttps://research.utu.fi/converis/portal/Publication/47470203
dc.identifier.jour-issn0531-5565
dc.okm.affiliatedauthorVälimäki, Maritta
dc.okm.discipline316 Hoitotiedefi_FI
dc.okm.discipline3121 Sisätauditfi_FI
dc.okm.discipline3121 Internal medicineen_GB
dc.okm.discipline316 Nursingen_GB
dc.okm.internationalcopublicationinternational co-publication
dc.okm.internationalityInternational publication
dc.okm.typeA2 Review article
dc.publisher.countryYhdysvallat (USA)fi_FI
dc.publisher.countryUnited Statesen_GB
dc.publisher.country-codeUS
dc.relation.articlenumberARTN 110937
dc.relation.doi10.1016/j.exger.2020.110937
dc.relation.ispartofjournalExperimental Gerontology
dc.year.issued2020


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