How to avoid sarcobesity, a condition that threatens healthy aging

As we age, the human body undergoes several physiological transformations. Possible changes include loss of muscle mass and strength (sarcopenia) and the accumulation of body fat, which can lead to obesity. When these two conditions occur simultaneously, an increasingly common and worrying condition emerges: sarcobesity, also known as sarcopenic obesity. This combination has attracted the attention of researchers, especially because it poses risks to the physical and metabolic health of the elderly population.

Concerned about population aging and the impacts of this clinical condition, nutritionist Gabriela Ortiz, a researcher at the Laboratory of Exercise Physiology and Metabolism (LAFEM), at the University of São Paulo's School of Physical Education and Sports of Ribeirão Preto (EEFERP/USP), and her team decided to delve deeper into the topic through a scientific review of the main studies on the disease.

The results, recently published in the journal Ageing Research Reviews , reveal the lack of standardized diagnostic criteria for sarcobesity and the complexity of its treatment, which must be multifactorial and personalized. "Given the aging population, studying conditions that primarily affect the elderly, such as sarcobesity, is a topic of great interest to the scientific community, with the aim of investigating prevention and treatment options, ensuring support for this population," comments Ortiz in an interview with Agência Einstein .

The condition is concerning because it combines two diseases that threaten health in several ways. "Sarcobesity combines the risks of obesity—such as type 2 diabetes, hypertension, and cardiovascular disease—with those of sarcopenia, which include a higher risk of falls, fractures, and loss of independence," explains nutritionist Diogo Toledo, coordinator of the Nutrition Department at Einstein Hospital Israelita.

The function of muscles, in fact, goes far beyond enabling mobility and balance. "Muscle tissue is essential for maintaining an active metabolism. It helps the body expend energy efficiently and prevent excessive fat accumulation," Toledo points out.

Muscles also contribute to hormone production and strengthen the immune system. "With aging, it's natural to lose muscle mass and gain fat, especially when you don't have healthy habits. That's why sarcobesity has become a growing public health concern," warns the Einstein physician.

In a review of studies conducted at USP Ribeirão Preto, three therapeutic strategies stood out as promising against sarcobesity: taurine supplementation, gut microbiota modulation, and regular exercise. Learn more about them below.

Supplement

Taurine is a sulfonated amino acid naturally present in tissues such as the brain, muscles, heart, and retina. Although the human body produces a small amount, the majority must be obtained through diet—meat, fish, seafood, and dairy are the main sources.

Taurine levels decline with aging, and this decline is associated with conditions such as diabetes, hypertension, cardiovascular disease, and cellular aging. Therefore, supplementation—typically in doses of 1.5g to 3g per day—has been studied as a potential intervention to improve muscle and metabolic health in older adults.

In the study, the supplement demonstrated potential antioxidant and anti-inflammatory effects, but more research is needed. "Most of the robust evidence comes from animal studies and in vitro experiments. More clinical studies in humans are still needed," Ortiz ponders.

According to Toledo, taurine can be an ally in combating sarcobesity, as it reduces muscle catabolism, the process by which the body breaks down muscle proteins to use as an energy source. The substance also helps directly and indirectly minimize muscle loss. "It acts as a powerful antioxidant, improving the body's balance. This protects muscles against oxidative damage, mitochondrial dysfunction, and muscle weakness. Furthermore, it plays a fundamental role in maintaining mitochondrial function," he explains.

However, like the USP researcher, the nutritionist emphasizes that more evidence is needed to understand the role of taurine supplementation. "Its clinical viability is not yet established. Data on ideal doses, precise mechanisms, and actual effects in elderly individuals with sarcobes are lacking. We need well-controlled clinical trials with larger sample sizes to establish its efficacy and safety as a standard therapy," emphasizes the Einstein physician.

Gut microbiota

Another highlight of the review was the importance of the gut microbiota, which undergoes significant changes with aging. The loss of microbiome diversity and increased intestinal permeability promote chronic inflammation and compromise muscle protein synthesis, especially in older adults.

"The gut microbiota plays a central role in health. Obesity presents a typical pattern of dysbiosis, with an increase in some bacteria and a reduction in other protective species. This imbalance creates an inflammatory environment that affects nutrient absorption and overall body function," explains Toledo. "This can even compromise muscle gain and maintenance."

According to Ortiz, the connection between the gut and muscles is mediated by compounds produced by beneficial bacteria, which stimulate protein synthesis, reduce inflammation, and improve insulin sensitivity. In this context, modulating the microbiota—with a diet rich in fiber and sources of prebiotics and probiotics—emerges as a promising approach.

Physical exercise

The third strategy highlighted by the Brazilian study is physical exercise. It's common for older adults to struggle with adherence due to issues such as physical limitations, motor skills, joint pain, chronic illnesses, and even fear of injury. "They also face psychological obstacles, such as lack of motivation, low self-esteem, and fear of not being able to complete the proposed activities," warns Gabriela Ortiz.

According to the nutritionist, strength training is particularly effective because it stimulates protein synthesis, contributing to increased muscle mass. The recommendation is that this training be done two to three times a week, at moderate to high intensity, always under supervision.

"Aerobic exercise, such as walking or cycling, is also important, as it helps reduce body fat, improves cardiorespiratory fitness, increases insulin sensitivity, and promotes psychological well-being. The combination of both—strength and aerobic exercise—has shown even more promising effects," says the researcher.

Experts agree that sarcobesity treatment must be multifactorial and integrated. "Combined actions, such as resistance exercise, adequate protein intake, a mildly calorie-restricted diet, and microbiota modulation, are more effective in improving body composition and quality of life in older adults," says Toledo. "We need to treat muscular and metabolic aging systemically," emphasizes Ortiz. "Current findings are promising. By integrating different strategies, we can promote healthier and more functional aging," concludes the author.

Source: Einstein Agency

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