Hormonal
Sarcopenic obesity (SO) creates a synergistic, vicious cycle with diabetes where insulin resistance accelerates muscle catabolism and loss of muscle mass worsens insulin sensitivity, leading to significantly higher all-cause mortality and metabolic disorder risks than either condition alone.
If you have excess body fat and low muscle mass/strength, standard weight loss advice may be harmful. Focus on preserving muscle through adequate protein (1-1.2 g/kg/day for older adults) and resistance training, rather than just caloric restriction. This combination is critical to breaking the cycle of insulin resistance and reducing mortality risk.
On the one hand, insulin loses the function to enhance cellular glucose uptake and utilization in diabetics, which is defined clinically as insulin resistance which promotes obesity. Furthermore, the increasing fat mass facilitates various cytokines which accelerate the catabolism of muscles. On the other hand, the loss of muscle mass leads to less insulin-responsive target tissue, resulting in a severe condition of insulin resistance (12, 13). Therefore, the vicious cycle continues until more negative health consequences occur.
Why this rating
The paper is a review citing multiple meta-analyses and prospective cohort studies, though it does not present new primary data.
Source
Diabetes and Sarcopenic Obesity: Pathogenesis, Diagnosis, and Treatments
Mina Wang et al. · Frontiers in Endocrinology · 2020
DOI 10.3389/fendo.2020.00568
More from this paper
- Low-grade inflammation driven by adipose tissue expansion (secreting TNF-a, IL-6, leptin) directly contributes to insulin resistance and muscle protein catabolism, accelerating the progression of sarcopenic obesity.Good
- Dietary interventions for sarcopenic obesity should prioritize increased protein intake (1-1.5 g/kg/day) and chronic (not acute) caloric restriction combined with resistance training to prevent muscle loss during weight loss.Moderate
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