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Background <p>Sarcopenic obesity (SO) is characterized by the co-existence of excess adiposity and low muscle performance, with a high prevalence and poor prognosis in the geriatric population.</p> Objectives <p>This systematic review and network meta-analysis (NMA) aims to assess the most effective non-pharmacological interventions for SO patients, including nutrition, exercise, and physical agent therapy.</p> Methods <p>A systematic search of six electronic databases was conducted from their inception until July 5, 2025, for randomized controlled trials. The NMA utilized a random-effects model, pooled mean difference (MD) and standardized mean difference (SMD), with 95% credible intervals (CrI), accounting for correlations within multi-arm trials. Subgroup analyses and sensitivity analyses were also performed.</p> Results <p>Twenty-five studies were included, with 19 studies (<i>n</i> = 1,085 participants) eligible for the NMA. Interventions were categorized into 12 groups: no intervention, nutrition, whole-body electromyostimulation (WBEMS), WBEMS plus nutrition, resistance training (RT), aerobic training (AT), mixed exercise (RT + AT), mixed exercise plus nutrition, energy restriction plus nutrition, high-speed resistance training, RT plus nutrition, and electrical acupuncture plus nutrition. Intervention duration ranged from 8&#xa0;weeks to 8&#xa0;months. Mixed exercise was the most effective intervention for reducing body fat percentage (BF%) (MD: -3.8, 95% CrI: -6.8, -0.8), followed by RT (MD: -2.4, 95% CrI: -4.5, -0.46). RT also significantly improved grip strength (MD: 4.4, 95% CrI: 1.6, 6.8). In the fat outcomes combined model, electrical acupuncture plus nutrition showed efficacy (MD: -2.2, 95% CrI: -3.5, -0.78). In the muscular outcomes combined model, both RT (MD: 0.36, 95% CrI: 0.14, 0.56) and RT plus nutrition (MD: 0.83, 95% CrI: 0.092, 1.7) were effective. Sensitivity analyses indicate that the models for body weight, BF%, and the two composite outcomes lack robustness.</p> Conclusions <p>RT can reduce BF% while simultaneously improving grip strength, representing an effective management strategy for SO.</p>

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Exercise, nutrition, physical agent therapy in older adults with sarcopenic obesity: a systematic review and network meta-analysis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月9日

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  • Juehan Wang,
  • Lin Mao,
  • Yang Yang,
  • Wangning Peng,
  • Wangxiao Bao,
  • Haijun Li,
  • Rouna Wu,
  • Zhao Yao,
  • Xueqiong Zhu,
  • Daming Wang,
  • Zuobing Chen

摘要

Background

Sarcopenic obesity (SO) is characterized by the co-existence of excess adiposity and low muscle performance, with a high prevalence and poor prognosis in the geriatric population.

Objectives

This systematic review and network meta-analysis (NMA) aims to assess the most effective non-pharmacological interventions for SO patients, including nutrition, exercise, and physical agent therapy.

Methods

A systematic search of six electronic databases was conducted from their inception until July 5, 2025, for randomized controlled trials. The NMA utilized a random-effects model, pooled mean difference (MD) and standardized mean difference (SMD), with 95% credible intervals (CrI), accounting for correlations within multi-arm trials. Subgroup analyses and sensitivity analyses were also performed.

Results

Twenty-five studies were included, with 19 studies (n = 1,085 participants) eligible for the NMA. Interventions were categorized into 12 groups: no intervention, nutrition, whole-body electromyostimulation (WBEMS), WBEMS plus nutrition, resistance training (RT), aerobic training (AT), mixed exercise (RT + AT), mixed exercise plus nutrition, energy restriction plus nutrition, high-speed resistance training, RT plus nutrition, and electrical acupuncture plus nutrition. Intervention duration ranged from 8 weeks to 8 months. Mixed exercise was the most effective intervention for reducing body fat percentage (BF%) (MD: -3.8, 95% CrI: -6.8, -0.8), followed by RT (MD: -2.4, 95% CrI: -4.5, -0.46). RT also significantly improved grip strength (MD: 4.4, 95% CrI: 1.6, 6.8). In the fat outcomes combined model, electrical acupuncture plus nutrition showed efficacy (MD: -2.2, 95% CrI: -3.5, -0.78). In the muscular outcomes combined model, both RT (MD: 0.36, 95% CrI: 0.14, 0.56) and RT plus nutrition (MD: 0.83, 95% CrI: 0.092, 1.7) were effective. Sensitivity analyses indicate that the models for body weight, BF%, and the two composite outcomes lack robustness.

Conclusions

RT can reduce BF% while simultaneously improving grip strength, representing an effective management strategy for SO.