Effects of a combined intervention of a nutritional supplementation associated with a walking exercise training to improve health in sarcopenic-obese elderly men: its influence on fatness and fitness

Abstract

Sarcopenic obesity is considered a geriatric syndrome that involves a reduction in skeletal muscle mass coupled with an increase in adiposity within elderly people. Recent research focusing on metabolic and functional outcomes in sarcopenic-obesity individuals have been gaining significant interest worldwide due to the progressive increase in life expectancy, being one of the major current public issues concerning to health risks and quality of life in this disabled condition. It is important to point out that men generally face poorer health outcomes, experience higher mortality rates and have a shorter average life expectancy than women. They exhibit greater gain of fat mass and greater loss of muscle mass compared to females, which lead to poorer functional and metabolic status. In addition, physical inactivity, along with aging-related changes and obesity-dependent consequences, seems to accelerate loss of muscle mass and strength and thus functional capacities. Therefore, identifying forms of physical exercise that are easily accessible, feasible, versatile enough to include older adults performing moderate intensity to improve f1tness and health is warranted. Likewise, current anti-obesity drugs are not highly effective and are fraught with side effects. So thus, identifying new interventions to reduce fatness and increase muscle fitness will be extremely beneficial for elderly health. Our proposal aims to study the effects of an efficient exercise training modality, the Nordic Walking Training (NWT), combined to Citrulline supplementation (CIT) on body composition, metabolic profile and muscle mass and strength in elderly using a 12-week double blind randomized controlled trial. This knowledge is essential since it could change the clinical approach to counteract the adverse effects induced by sarcopenia-obesity with age. We will recruit, evaluate, treat and analyze 32 eligible elderly obese (BMI>30 kg.m-2) men aged 65 years and older, distributed in 4 groups: CIT; CIT+NWT; NWT; Placebo. Resting metabolic rate; body composition: body mass index (BMI), fat free mass (FFM) and fat mass (FM) by Dual-energy X-ray absorptiometry (DXA); detailed muscle composition: muscular adipose volume and muscle mass volume by tomography scan (QPCT); and muscle strength: handgrip (JAMAR Dynamometer®) and knee extensor strength using a dynamometer BTE Primus® will be evaluated before and after the 12-week supervised intervention (5 times per week, 55-75% of maximal Heart Rate). If our hypothesis is correct, millions of elderly people with sarcopenia-obesity could benefit from CIT supplementation combined with NWT which are expect to improve body composition and prevent mobility loss and metabolic risks in the millions of elderly people. (AU)