Abstract
Background: Sarcopenic obesity (SO), the coexistence of low muscle mass and excess adiposity, poses a major challenge for healthy aging. Resistance exercise is known to mitigate muscle loss, yet long-term interventions comparing different modalities remain scarce. This study explored the efficacy of power training (PT) versus multicomponent training (MT) and no-exercise control (CG) on muscle and fat parameters in older women with SO.
Methods: A 32-week randomized controlled trial was conducted with 40 community-dwelling women aged ≥65 years diagnosed with SO according to EWGSOP2 and ESPEN criteria. Participants were assigned to PT, MT, or CG. Both training groups performed supervised 50-minute sessions three times per week. Primary outcomes included appendicular skeletal muscle mass index (ASMI) and body fat percentage (BF%), while secondary outcomes were visceral fat (VF), gait speed (GS), timed up and go (TUG), and five-times sit-to-stand test (5STS). Nutritional intake was assessed at baseline to control for dietary effects.
Results: PT induced significant improvements in ASMI (+0.36 ± 0.34 kg/m², p = 0.039), BF% (−6.9 ± 6%, p = 0.002), and VF (p = 0.044), with large effect sizes (Cohen’s d > 0.8). Functional gains were notable in GS (p = 0.018), TUG (p = 0.005), and 5STS (p < 0.001), outperforming MT. Remarkably, 35.7% of PT participants no longer met diagnostic criteria for SO after the intervention. No adverse events were reported, and adherence exceeded 85%.
Conclusions: Long-term power training was more effective than multicomponent or no exercise in enhancing muscle mass, reducing fat, and improving functional performance in older women with SO. Its capacity to reverse SO in one-third of participants supports PT as a feasible, safe, and clinically relevant first-line strategy for managing sarcopenic obesity in aging populations.