The influence of different exercises on body composition and physical function among older adults with sarcopenic obesity

Abstract

Abstract: Background: In 2023, the population aged over 65 in China reached 21.1%. The health issues

of the elderly have also drawn attention as the aging process at an accelerated pace. Fat accumulation and

lower muscle quality caused by age and unhealthy lifestyle will lead to sarcopenic obesity, which is related

to falls, fractures, metabolic diseases, and increases the mortality rate among the elderly. Exercise is a

non-invasive, economical, and non-pharmaceutical way to improve body composition and physical

function. This study aims to compare the influence of different exercises on body composition and

physical function among older adults with sarcopenic obesity.

Methods: Selecting Embase, PubMed,Cochrane Library, and Web of Science published up to August 19, 2025, utilizing a comprehensive list of

keywords related to sarcopenic obesity and exercise outcomes(‘sarcopenic obesity’, ‘sarcopenic adiposity’,

‘obesity with muscle depletion’, ‘sport’, ‘exercise’, ‘resistant training’, ‘resistant exercise’, ‘aerobic

exercise’, ‘mind-body exercise’, ‘Tai Chi’, ‘Baduanjin, ‘Yijinjing’, ‘combination training’, ‘exercise

intervention’, ‘exercise prescription’). Inclusion criteria: (1) Subjects were aged over 60; (2) Subjects met

the sarcopenic obesity diagnostic criteria; (3) Intervention: resistant exercise, aerobic training, mind-body

exercise, and combination exercise. Exclusion criteria: (1) Re-publishing literature;(2) Crossover study is

excluded;(3) Participants with serious diseases or irreversible muscular diseases that affect the

experimental results.

Results: Sixty-two studies were included. The combined impact of fat accumulation

and lower muscle quality caused by sarcopenic obesity decreases the quality of life of the elderly and

increases the risk of falls and death. Aerobic exercise is effective at reducing fat-free mass, BMI, and body

fat rate. Resistant exercise and combination exercise are focused on improving strength, endurance. No

research has explored the influence of traditional Chinese exercises, such as Taijiquan, Baduanjin,

Yijinjing, on people with sarcopenic obesity. Some studies have shown that traditional Chinese exercise

can enhance strength, body composition, and physical function in people with sarcopenia and those who

are overweight or obese.

Conclusion: Different exercises had different effects on elderly people with

sarcopenic obesity. Aerobic exercise decreases body mass by increasing energy metabolism, reducing

free-fat body mass, BMI, and body fat rate, and the effect on BMI and body mass is better than resistance

exercise. Resistant exercise increases muscle tissue generation by promoting muscle protein synthesis and

activating satellite cells, then enhancing strength, endurance, and physical function. The combination

exercise integrates the advantages of the above two exercises, increasing physical function by enhancing

body composition and muscle function. Inflammation and fat accumulation caused by obesity will interfere

with the exercise effect. It is recommended that these people should choose long-period and high-intensity

exercise to improve body composition and physical function. Currently, no study explores the effect of

mind-body exercise on people with sarcopenic obesity. Many studies have confirmed the effectiveness of

traditional Chinese exercise on strength, body composition, and physical function among people with

sarcopenia or obesity, thereby future studies can focus on this field.