Researchers from the Federal University of São Carlos (UFSCar) in Brazil, in collaboration with University College London (UCL) in the UK, have found that both excess abdominal fat and reduced muscle mass significantly increase the risk of death. People with this combination were 83% more likely to die than people without either condition.
This combination is indicative of a more serious underlying problem known as sarcopenic obesity. It occurs when muscle mass decreases and body fat increases. This condition can be difficult to identify and is closely associated with decreased independence and quality of life in older adults. It is also associated with frailty, increased risk of falls, and other health complications.
“In addition to assessing the mortality risk associated with abdominal obesity and low muscle mass, we were able to demonstrate that a simple method can be used to detect sarcopenic obesity. This is important because the lack of consensus on the diagnostic criteria for this disease makes it difficult to detect and treat,” said Tiago da Silva Alexandre, professor in the Department of Geriatrics at UFSCar and one of the authors of the FAPESP-supported study. “Our findings therefore make it easier for older adults to access early interventions such as nutritional monitoring and physical exercise, ensuring an improved quality of life.”
The survey results are Clinical and experimental research on aging These are based on 12 years of data from 5,440 participants aged 50 and over in the UK Longitudinal Study of Aging (ELSA).
Simple screening could replace expensive tests
Diagnosis of sarcopenic obesity typically requires advanced imaging tools such as magnetic resonance imaging, computed tomography, electrical bioimpedance, and densitometry. Although these methods can accurately measure body fat and muscle mass, they are expensive and not widely available, making routine diagnosis difficult.
“By correlating data from participants in the ELSA study, we show for the first time that simple measurements such as measuring waist circumference and estimating lean body mass (using an integrated equation that takes into account clinical variables such as age, sex, weight, race, and height) can screen these people early,” Alexandre praised.
Why this combination is especially dangerous
Gaining abdominal fat while losing muscle has a compounding effect on your body’s metabolism. “This study found that people with both conditions had an 83% higher risk of death than those without. We also found that people with low muscle mass and no abdominal obesity had a 40% reduced risk of death. This finding , confirming the potential risk of coexistence of these diseases. Interestingly, having abdominal obesity but sufficient muscle mass was not associated with an increased risk of death,” explains Professor Valdete Regina Guandalini. He holds a PhD from the Federal University of Espírito Santo (UFES) and is a researcher in the Department of Geriatrics at UFSCar. She is also the original author of this article.
According to Guandalini, excess fat worsens inflammation in the body and causes metabolic changes that promote muscle breakdown. “In addition to one condition interfering with the other, fat infiltrates the muscle and takes up its space. This systemic, progressive inflammation directly affects the muscle tissue, impairing its metabolic, endocrine, immunological, and functional capabilities,” she says.
Clearer definition using simple measurements
Because researchers around the world do not agree on a single definition of sarcopenic obesity, the research team used pragmatic criteria to identify at-risk obesity. Abdominal obesity was defined as waist circumference >102 cm for men and 88 cm for women. Low muscle mass was defined as a skeletal muscle mass index less than 9.36 kg/m2 for men and less than 6.73 kg/m2 for women.
These simpler measures will make it easier to identify sarcopenic obesity early and give more people access to interventions that may reduce risk and improve long-term health.
