‘Take good care of your muscles!’

The SO-NUTS-project aims at an optimal healthy body composition for people around the retirement age

Text: Wendy van Koningsbruggen

That’s the main message the Austrian researcher Doris Eglseer wants to send out. She participates in the international SO-NUTS-project consortium that aims to develop practical and innovative strategies to prevent and cure of sarcopenic obesity in people around the retirement age.

‘Sarcopenic obesity’ (SO) is the combination of high fat mass (obesity) and the loss of muscle mass, strength and function (sarcopenia). It increases the risk of adverse health outcomes. The two conditions often co-occur; they reinforce each other and share common etiologies, mainly poor nutrition and inactivity. “People in the age of 55 till 70 are an increasingly growing population at high risk of sarcopenic obesity”, Eglseer says. “In order to address the problems of obesity and sarcopenia, behavioral changes are needed, but, as we all know, difficult. The transition time around retirement is a unique opportunity to adapt your lifestyle, because you have to restructure your daily routines anyway. That’s why in the SO-NUTS-project we aim at this specific population.”

 

About Doris Eglseer

Doris Eglseer is a researcher and dietitian at the Institute of Nursing Science at the Medical University of Graz, Austria. In her research she focuses on nutritional problems and nutritional interventions for different patient groups, including older people and persons with chronic diseases. Her main research topics are malnutrition and sarcopenia.

Focus on resistance training and protein

Eglseer and her research group conducted three systematic literature reviews and meta-analyses and secondary data analyses with already existing studies. “Within the SO-NUTS-project I am the work package leader of WP 3. This work package includes the identification of current best practices regarding the prevention and treatment of obesity, sarcopenia and sarcopenic obesity.”

“In our research we found that resistance training, 2-3 times/week for 20 to 60 minutes, is the most studied intervention; it improves body fat, muscle mass, muscle strength and gait speed. If you are already obese, you should combine (!) resistance training (or mixed training aerobic and resistance) with energy restriction to reduce fat mass and maintain or improve muscle mass. Added protein also seems of importance, but more studies are needed to know the exact amounts of protein and, for example, the best timing of the protein intake.”

 

Do’s and don’ts

What practical advices can be given based on your research? “To improve your muscles, we know that aerobic training alone for example is not really effective. Another persistent misconception is that energy restriction is always a good thing. Only energy restriction, or more specifically extreme energy restriction, can even be harmful when you want to address sarcopenic obesity. With energy restriction alone you will not only loose fat mass, but also a significant amount of muscle mass. Therefore energy restriction without training and/or exercise is not recommended for older persons.”

So if you want to improve or maintain muscle mass you should choose resistance training in combination with a balanced diet. Added proteins seem to be important but, like I said, the exact amount and timing should be further examined.”

She gives the following practical guidelines:

  • Try to be physically active for at least 30 minutes every day
  • Do bone- and muscle strengthening exercises (resistance training) twice a week, for example with gymnastic bands
  • Increase your daily activities (such as cycling, climbing stairs or walking)
  • Follow a balanced diet according to official recommendations
  • Avoid crash diets, they usually cause you to lose muscle
  • Contact a nutrition expert (dietitian) to look at your protein requirements and how you can reach them in a healthy and sustainable way

 

Knowledge is not the problem

Eglseer stresses out that knowledge is not the main problem, adherence is. “Most people are well aware of their problem and know the importance of a healthy weight and enough exercise and , in general, how to address it. They usually start off highly motivated, but that tends to fade away quickly. Adherence is very difficult. Therefore support is needed, at least in the beginning, preferably with the guidance of a physiotherapist and dietitian. They can give specific and personalized advice on how to prevent or cure sarcopenic obesity. But also the support by peers (through group sessions ) and family and friends can be helpful to stimulate people to maintain healthy behavior. In addition, with the SO-NUTS-project we will use an online intervention, in the expectation that the application can be a good addition in the support of persons and will therefore stimulate the adherence even more.”

Within the SO-NUTS-project the findings of Eglseer’s research will be used in a pilot study, in which she will participate. A specially developed app, with practical advises and digital guidance to prevent sarcopenic obesity, will be tested in the designated group of people in the retirement age.

 

 

Further research

Eglseer adds: “Our systematic reviews show that there are only few intervention studies available that have a high scientific quality. We therefore recommend to conduct further high-quality intervention studies to evaluate the effectiveness of nutrition and exercise interventions for the prevention and treatment of sarcopenic obesity. The results of the SO-NUTS-app-pilotstudy will be unique contribution to achieve this goal!

The SO-NUTS project

SO-NUTS (Sarcopenic Obesity NUTrition Seniors) is funded by JPI HDHL and received funding from the European Union’s Horizon 2020 research and innovation programme under the ERA-NET Cofund action N° 727565. The project is targeted at people in and around retirement, who are at high risk to get sarcopenic obesity. SO-NUTS aims to provide essential insights for the development of innovative strategies to prevent sarcopenic obesity. Within the project, an app will be developed to help persons around retirement age to lose weight and simultaneously preserve muscle mass.