Faria Isabella, Samreen Sarah, McTaggart Lauren, Arentson-Lantz Emily J, Murton Andrew J
Department of Surgery, University of Texas Medical Branch, Galveston, TX 77554, USA.
Department of Nutrition Sciences & Health Behavior, University of Texas Medical Branch, Galveston, TX 77554, USA.
Nutrients. 2024 Dec 31;17(1):132. doi: 10.3390/nu17010132.
Obesity represents a major health crisis in the United States, significantly increasing risks for chronic diseases and generating substantial economic costs. While bariatric surgery and pharmacological interventions such as GLP-1 receptor agonists have been proven effective in achieving substantial weight loss and improving comorbid conditions, they also raise concerns about the unintended loss of fat-free mass, particularly muscle. This loss of muscle mass compromises physical functionality, quality of life, and long-term metabolic health, particularly in individuals with sarcopenic obesity or those at risk of frailty. To sustain strength, mobility, and metabolic function during weight loss interventions, the preservation of muscle mass is essential. However, current weight-loss strategies often fail to adequately address the need to maintain fat-free mass. This review explores the physiological mechanisms governing muscle mass, the impact of obesity and rapid weight loss on muscle protein turnover, and nutritional and age-based strategies that may help protect muscle during intentional weight reduction. By focusing on these critical countermeasures, this review aims to inform future clinical practice and research initiatives with the long-term goal of achieving effective weight loss through reduction in fat tissue while preserving skeletal muscle mass, enhancing health outcomes, and long-term functionality in patients undergoing significant weight reduction.
肥胖是美国面临的重大健康危机，它显著增加了患慢性病的风险，并产生了巨大的经济成本。虽然减肥手术和诸如胰高血糖素样肽-1受体激动剂等药物干预措施已被证明在实现显著体重减轻和改善合并症方面有效，但它们也引发了对无脂肪体重，尤其是肌肉意外流失的担忧。肌肉量的减少会损害身体功能、生活质量和长期代谢健康，特别是在患有肌少症肥胖症的个体或有虚弱风险的个体中。为了在减肥干预期间维持力量、活动能力和代谢功能，保留肌肉量至关重要。然而，目前的减肥策略往往未能充分满足维持无脂肪体重的需求。本综述探讨了控制肌肉量的生理机制、肥胖和快速减肥对肌肉蛋白周转的影响，以及在有意减轻体重期间可能有助于保护肌肉的营养和基于年龄的策略。通过关注这些关键对策，本综述旨在为未来的临床实践和研究计划提供信息，其长期目标是通过减少脂肪组织实现有效减肥，同时保留骨骼肌量，改善接受显著体重减轻的患者的健康结果和长期功能。
