Correction of nutritional status in a comprehensive program for the prevention and treatment of sarcopenic obesity

Sarcopenic obesity is a complex condition characterized by a combination of obesity and sarcopenia. This pathology has a significant impact on the health and quality of life of the elderly and old people, increasing the risk of chronic diseases and impairing physical functions. Nutritional status plays a key role in maintaining the health and functional ability of older people, influencing the development of sarcopenia and obesity. Understanding the relationship between sarcopenic obesity and nutritional status is critical for developing prevention and treatment strategies. Our scientific article covers the various mechanisms of development of sarcopenic obesity and the influence of nutritional status on sarcopenic obesity, and also examines the role of various nutrients and dietary supplements in the management of this condition. Our scientific article highlights the need for a comprehensive approach to the treatment and prevention of sarcopenic obesity among elderly and elderly patients to improve overall health and quality of life.

sarcopenic obesity, sarcopenia, nutritional status, malnutrition, microbiota, body composition, macronutrients, micronutrients, omega-3 polyunsaturated fatty acids, vitamin D

1. Ilnitski A. N., Kravchenko E. S., Prashchayeu K. I. Resilience as a new concept of gerontology and geriatrics. Institute of psychology of the russian academy of sciences. Organizational psychology and labor psychology. 2021;6(4):63-86. (In Russ.) doi: 10.38098/ipran.opwp_2021_21_4_003.@@ Ильницкий А. Н., Кравченко Е. С., Прощаев К. И. Возрастная жизнеспособность как новый концепт геронтологии и гериатрии. Институт психологии Российской академии наук. Организационная психология и психология труда. 2021;6(4):63-86. doi: 10.38098/ipran.opwp_2021_21_4_003.

2. Sharonova L. A., Bulgakova S. V., Dolgikh Yu.A. et al. Obesity as a main component of metabolic syndrome and a risk factor for comorbidity. Experimental and Clinical Gastroenterology. 2024;(2):101-110. (In Russ.) doi: 10.31146/1682-8658-ecg-222-2-101-110.@@ Шаронова Л. А., Булгакова С. В., Долгих Ю. А. и др. Ожирение как основной компонент метаболического синдрома и фактор риска коморбидности. Экспериментальная и клиническая гастроэнтерология. 2024;(2):101-110. doi: 10.31146/1682-8658-ecg-222-2-101-110.

3. Romantsova T. I. Adipose tissue: colors, depots and functions. Obesity and metabolism. 2021;18(3):282-301. (In Russ.) doi: 10.14341/omet12748.@@ Романцова Т. И. Жировая ткань: цвета, депо и функции. Ожирение и метаболизм. 2021;18(3):282-301. doi: 10.14341/omet12748.

4. Eliashevich S. O., Nunes Araukho D. D., Drapkina O. M. Eating behavior: disorders and how to assess them. Cardiovascular Therapy and Prevention. 2023;22(8):3663. (In Russ.) doi: 10.15829/1728-8800-2023-3663.@@ Елиашевич С. О., Нуньес Араухо Д. Д., Драпкина О. М. Пищевое поведение: нарушения и способы их оценки. Кардиоваскулярная терапия и профилактика. 2023;22(8):3663. doi: 10.15829/1728-8800-2023-3663.

5. Kim O. T., Drapkina O. M. Obesity epidemic through the prism of evolutionary processes. Cardiovascular Therapy and Prevention. 2022;21(1):3109. (In Russ.) doi: 10.15829/1728-8800-2022-3109.@@ Ким О. Т., Драпкина О. М. Эпидемия ожирения через призму эволюционных процессов. Кардиоваскулярная терапия и профилактика. 2022;21(1):3109. doi: 10.15829/1728-8800-2022-3109.

6. Eliashevich S. O., Orekhova A. V., Kontsevaya A. V., Drapkina O. M. The problem of excess sugar consumption: culinary and medical aspects. Cardiovascular Therapy and Prevention. 2024;23(4):3929. (In Russ.) doi: 10.15829/1728-8800-2024-3929.@@ Елиашевич С. О., Орехова А. В., Концевая А. В., Драпкина О. М. Проблема избыточного потребления сахара: кулинарные и медицинские аспекты. Кардиоваскулярная терапия и профилактика. 2024;23(4):3929. doi: 10.15829/1728-8800-2024-3929.

7. Cruz-Jentoft A.J., Bahat G., Bauer J. et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(4):601. doi: 10.1093/ageing/afz046.

8. Kurmaev D. P., Bulgakova S. V., Treneva E. V. Insulin resistance, type 2 diabetes mellitus and sarcopenia. Experimental and Clinical Gastroenterology. 2024;(2):141-148. (In Russ.) doi: 10.31146/1682-8658-ecg-222-2-141-148.@@ Курмаев Д. П., Булгакова С. В., Тренева Е. В. Инсулинорезистентность, сахарный диабет 2 типа и саркопения. Экспериментальная и клиническая гастроэнтерология. 2024;(2):141-148. doi: 10.31146/1682-8658-ecg-222-2-141-148.

9. Bulgakova S. V., Kurmaev D. P., Treneva E. V. et al. Sarcopenia in elderly patients with type 2 diabetes: risk factors. Aspirantskiy Vestnik Povolzhiya. 2023;23(2):66-73. (In Russ.) doi: 10.55531/2072-2354.2023.23.2.66-73.@@ Булгакова С. В., Курмаев Д. П., Тренева Е. В. и др. Саркопения у пациентов пожилого возраста с сахарным диабетом 2 типа: факторы риска. Аспирантский вестник Поволжья. 2023;23(2):66-73. doi: 10.55531/2072-2354.2023.23.2.66-73.

10. Sharashkina N. V., Naumov A. V., Dudinskaya E. N. et al. Expert consensus: Diagnosis of osteoporosis and sarcopenia in elderly and senile patients (abridged version). Therapy. 2023;(10):7-20. (In Russ.) doi: 10.18565/therapy.2023.10.7-20.@@ Шарашкина Н. В., Наумов А. В., Дудинская Е. Н. и др. Консенсус экспертов: диагностика остеопороза и саркопении у пациентов пожилого и старческого возраста (сокращенная версия) Терапия. 2023;(10):7-20. doi: 10.18565/therapy.2023.10.7-20.

11. Kurmaev D. P., Bulgakova S. V., Zakharova N. O. What is primary: frailty or sarcopenia? (literature review). Advances in gerontology. 2021;34(6):848-856. (In Russ.) doi: 10.34922/AE.2021.34.6.005.@@ Курмаев Д. П., Булгакова С. В., Захарова Н. О. Что первично: старческая астения или саркопения? (обзор литературы). Успехи геронтологии. 2021;34(6):848-856. doi: 10.34922/AE.2021.34.6.005.

12. Isaeva B. I., Alieva-Kharkharova К. М. Osteosarcopenia as a satellite of aging. Meditsinskiy Sovet. 2023;17(9):130-136. (In Russ.) doi: 10.21518/ms2023-147.@@ Исаева Б. И., Алиева-Хархарова К. М. Остеосаркопения как спутник старения. Медицинский совет. 2023;17(9):130-136. doi: 10.21518/ms2023-147.

13. Yakushevskaya O. V., Yureneva S. V., Komedina V. I. A pas de deux of osteoporosis and sarcopenia: osteosarcopenia. Meditsinskiy Sovet. 2022;16(6):116-121. (In Russ.) doi: 10.21518/2079-701X-2022-16-6-116-1.@@ Якушевская О. В., Юренева С. В., Комедина В. И. Па-де-де остеопороза и саркопении: остеосаркопения. Медицинский совет. 2022;16(6):116-121. doi: 10.21518/2079-701X-2022-16-6-116-121.

14. Safonova Y. A. The impact of sarcopenia and comorbidity on the predicted risk of death in the elderly.Russian Family Doctor. 2024;28(1):15-22. doi: 10.17816/RFD625689.@@ Сафонова Ю. А. Влияние саркопении и коморбидности на прогнозируемый риск смерти у людей пожилого и старческого возрастов. Российский семейный врач. 2024;28(1):15-22. doi: 10.17816/RFD625689.

15. Ivannikova E. V., Dudinskaya E. N., Onuchina Yu. S. Muscle metabolism in older adults.Russian Journal of Geriatric Medicine. 2022;(2):96-102. (In Russ.) doi: 10.37586/2686-8636-2-2022-96-102.@@ Иванникова Е. В., Дудинская Е. Н., Онучина Ю. С. Метаболизм мышечной ткани у лиц пожилого возраста. Российский журнал гериатрической медицины. 2022;(2):96-102. doi: 10.37586/2686-8636-2-2022-96-102.

16. Kurmaev D. P., Bulgakova S. V., Treneva E. V. et al. Malnutrition, dysfunction of the gastrointestinal tract and sarcopenia - features of combined pathology. Experimental and Clinical Gastroenterology. 2024;(2):111-119. (In Russ.) doi: 10.31146/1682-8658-ecg-222-2-111-119.@@ Курмаев Д. П., Булгакова С. В., Тренева Е. В. и др. Мальнутриция, нарушение функции желудочно-кишечного тракта и саркопения - особенности сочетанной патологии. Экспериментальная и клиническая гастроэнтерология. 2024;(2):111-119. doi: 10.31146/1682-8658-ecg-222-2-111-119.

17. Safonova Yu.A., Toroptsova N. V. Frequency and risk factors of sarcopenia in the elderly people. The Clinician. 2022;16(2):40-47. (In Russ.) doi: 10.17650/1818-8338-2022-16-2-K661.@@ Сафонова Ю. А., Торопцова Н. В. Частота и факторы риска саркопении у людей старших возрастных групп. Клиницист. 2022;16(2):40-47. doi: 10.17650/1818-8338-2022-16-2-K661.

18. Safonova Y. A., Zotkin E. G., Toroptsova N. V. Quality of life and fatigue in elderly patients with sarcopenia. Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2021;15(6):41-47. (In Russ.) doi: 10.14412/1996-7012-2021-6-41-47.@@ Сафонова Ю. А., Зоткин Е. Г., Торопцова Н. В. Качество жизни и синдром усталости у пожилых пациентов с саркопенией. Современная ревматология. 2021;15(6):41-47. doi: 10.14412/1996-7012-2021-6-41-47.

19. Safonova Yu. A. Sarcopenia risk factor for falls and fractures. The Clinician. 2019;13(3-4):22-28. (In Russ.) doi: 10.17650/1818-8338-2019-13-3-4-22-28.@@ Сафонова Ю. А. Саркопения как фактор риска падений и переломов. Клиницист. 2019;13(3-4):22-28. doi: 10.17650/1818-8338-2019-13-3-4-22-28.

20. Donini L. M., Busetto L., Bischoff S. C. et al. Definition and Diagnostic Criteria for Sarcopenic Obesity: ESPEN and EASO Consensus Statement. Obes Facts. 2022;15(3):321-335. doi: 10.1159/000521241.

21. Kurmaev D. P., Bulgakova S. V., Treneva E. V. Sarcopenic obesity - a current problem of modern geriatrics.Russian Journal of Geriatric Medicine. 2022;(4):228-235. (In Russ.) doi: 10.37586/2686-8636-4-2022-228-235.@@ Курмаев Д. П., Булгакова С. В., Тренева Е. В. Саркопеническое ожирение - актуальная проблема современной гериатрии. Российский журнал гериатрической медицины. 2022;(4):228-235. doi: 10.37586/2686-8636-4-2022-228-235.

22. Berns S. A., Sheptulina A. F., Mamutova E. M. et al. Sarcopenic obesity: epidemiology, pathogenesis and diagnostic criteria. Cardiovascular Therapy and Prevention. 2023;22(6):3576. (In Russ.) doi: 10.15829/1728-8800-2023-3576.@@ Бернс С. А., Шептулина А. Ф., Мамутова Э. М. и др. Саркопеническое ожирение: эпидемиология, патогенез и особенности диагностики. Кардиоваскулярная терапия и профилактика. 2023;22(6):3576. doi: 10.15829/1728-8800-2023-3576.

23. Samoilova Yu.G., Matveeva M. V., Khoroshunova E. A. et al. Cardiometabolic risk factors in patients with type 2 diabetes and sarcopenia. Cardiovascular Therapy and Prevention. 2024;23(1):3655. (In Russ.) doi: 10.15829/1728-8800-2024-3655.@@ Самойлова Ю. Г., Матвеева М. В., Хорошунова Е. А. и др. Кардиометаболические факторы риска у пациентов с сахарным диабетом 2 типа и саркопенией. Кардиоваскулярная терапия и профилактика. 2024;23(1):3655. doi: 10.15829/1728-8800-2024-3655.

24. Tsygankov D. A., Krivoshapova K. E., Tsygankova D. P. Ultrasound potential in sarcopenic obesity diagnosis: a literature review.Russian Journal of Cardiology. 2023;28(3S):5345. (In Russ.) doi: 10.15829/1560-4071-2023-5345.@@ Цыганков Д. А., Кривошапова К. Е., Цыганкова Д. П. Ультразвуковые возможности диагностики саркопенического ожирения. Российский кардиологический журнал. 2023;28(3S):5345. doi: 10.15829/1560-4071-2023-5345.

25. Tkacheva O. N., Tutelyan V. A., Shestopalov A. E. et al. Nutritional insuf ciency (malnutrition) in older adults. Clinical recommendations.Russian Journal of Geriatric Medicine. 2021;(1):15-34. (In Russ.) doi: 10.37586/2686-8636-1-2021-15-34.@@ Ткачева О. Н., Тутельян В. А., Шестопалов А. Е. и др. Недостаточность питания (мальнутриция) у пациентов пожилого и старческого возраста. Клинические рекомендации. Российский журнал гериатрической медицины. 2021;(1):15-34. doi: 10.37586/2686-8636-1-2021-15-34.

26. Kurmaev D. P., Bulgakova S. V., Treneva E. V. et al. Nutritional support in a comprehensive program of prevention and treatment of sarcopenia.Russian Journal of Geriatric Medicine. 2023;(1):29-38. (In Russ.) doi: 10.37586/2686-8636-1-2023-29-38.@@ Курмаев Д. П., Булгакова С. В., Тренева Е. В. и др. Нутритивная поддержка в комплексной программе профилактики и лечения саркопении. Российский журнал гериатрической медицины. 2023;(1):29-38. doi: 10.37586/2686-8636-1-2023-29-38.

27. Prashchayeu K. I., Satardinova E. E., Pokachalova M. A. et al. Nutritional support as a basis for correcting premature aging. Current problems of health care and medical statistics. 2020;(1):69-81. (In Russ.) doi: 10.24411/2312-2935-2020-00006.@@ Прощаев К. И., Сатардинова Э. Е., Покачалова М. А. и др. Нутритивная поддержка как основа коррекции преждевременного старения. Современные проблемы здравоохранения и медицинской статистики. 2020;(1):69-81. doi: 10.24411/2312-2935-2020-00006.

28. Tkacheva O. N., Kotovskaya Yu.V., Krylov K. Yu. et al. Malnutrition as a factor aggravating the heart failure course in the elderly and senile age.Russian Journal of Cardiology. 2022;27(1S):4583. doi: 10.15829/1560-4071-2022-4583.@@ Ткачева О. Н., Котовская Ю. В., Крылов К. Ю. и др. Мальнутриция как фактор, усугубляющий течение хронической сердечной недостаточности в пожилом и старческом возрасте. Российский кардиологический журнал. 2022;27(1S):4583. doi: 10.15829/1560-4071-2022-4583.

29. Donini L. M., Busetto L., Bauer J. M. et al. Critical appraisal of definitions and diagnostic criteria for sarcopenic obesity based on a systematic review. Clin Nutr. 2020;39(8):2368-2388. doi: 10.1016/j.clnu.2019.11.024.

30. Batsis J. A., Villareal D. T. Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies. Nat Rev Endocrinol. 2018;14(9):513-537. doi: 10.1038/s41574-018-0062-9.

31. Batsis J. A., Mackenzie T. A., Lopez-Jimenez F., Bartels S. J. Sarcopenia, sarcopenic obesity, and functional impairments in older adults: National Health and Nutrition Examination Surveys 1999-2004. Nutr Res. 2015;35(12):1031-1039. doi: 10.1016/j.nutres.2015.09.003.

32. Jin K., Simpkins J. W., Ji X. et al. The Critical Need to Promote Research of Aging and Aging-related Diseases to Improve Health and Longevity of the Elderly Population. Aging Dis. 2014;6(1):1-5. doi: 10.14336/AD.2014.1210.

33. Dalle S., Rossmeislova L., Koppo K. The Role of Inflammation in Age-Related Sarcopenia. Front Physiol. 2017;8:1045. doi: 10.3389/fphys.2017.01045.

34. Goisser S., Kemmler W., Porzel S. et al. Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons - A narrative review. Clin.Interv. Aging. 2015;10:1267-1282. doi: 10.2147/CIA.S82454.

35. Khan R. M.M., Chua Z. J.Y., Tan J. C. et al. From Pre-Diabetes to Diabetes: Diagnosis, Treatments and Translational Research. Medicina (Kaunas). 2019;55(9):546. doi: 10.3390/medicina55090546.

36. Hong S. H., Choi K. M. Sarcopenic Obesity, Insulin Resistance, and Their Implications in Cardiovascular and Metabolic Consequences.Int J Mol Sci. 2020;21(2):494. doi: 10.3390/ijms21020494.

37. Kalyani R. R., Corriere M., Ferrucci L. Age-related and disease-related muscle loss: the effect of diabetes, obesity, and other diseases. Lancet Diabetes Endocrinol. 2014;2(10):819-829. doi: 10.1016/S2213-8587(14)70034-8.

38. Gonzalez A., Simon F., Achiardi O. et al. The Critical Role of Oxidative Stress in Sarcopenic Obesity. Oxid Med Cell Longev. 2021;2021:4493817. doi: 10.1155/2021/4493817.

39. Diago-Galmés A., Guillamón-Escudero C., Tenías-Burillo J.M. et al. Salivary Testosterone and Cortisol as Biomarkers for the Diagnosis of Sarcopenia and Sarcopenic Obesity in Community-Dwelling Older Adults. Biology (Basel). 2021;10(2):93. doi: 10.3390/biology10020093.

40. Ouchi N., Parker J. L., Lugus J. J., Walsh K. Adipokines in inflammation and metabolic disease. Nat Rev Immunol. 2011;11(2):85-97. doi: 10.1038/nri2921.

41. Olefsky J. M., Glass C. K. Macrophages, inflammation, and insulin resistance. Annu Rev Physiol. 2010;72:219-246. doi: 10.1146/annurev-physiol-021909-135846.

42. Shulman G. I. Cellular mechanisms of insulin resistance. J Clin Invest. 2000;106(2):171-176. doi: 10.1172/JCI10583.

43. Li C. W., Yu K., Shyh-Chang N. et al. Pathogenesis of sarcopenia and the relationship with fat mass: descriptive review. J Cachexia Sarcopenia Muscle. 2022 Apr;13(2):781-794. doi: 10.1002/jcsm.12901.

44. Bulgakova S. V., Kurmaev D. P., Treneva E. V. Diagnostics of the body composition of an elderly person to assess the prognosis of his health. Experimental and Clinical Gastroenterology. 2024;(2):89-100. (In Russ.) doi: 10.31146/1682-8658-ecg-222-2-89-100.@@ Булгакова С. В., Курмаев Д. П., Тренева Е. В. Диагностика композиционного состава тела пожилого человека для оценки прогноза состояния его здоровья. Экспериментальная и клиническая гастроэнтерология. 2024;(2):89-100. doi: 10.31146/1682-8658-ecg-222-2-89-100.

45. Takahara T., Amemiya Y., Sugiyama R. et al. Amino acid-dependent control of mTORC1 signaling: a variety of regulatory modes. J Biomed Sci. 2020;27(1):87. doi: 10.1186/s12929-020-00679-2.

46. Ruegsegger G. N., Creo A. L., Cortes T. M. et al. Altered mitochondrial function in insulin-deficient and insulin-resistant states. J Clin Invest. 2018;128(9):3671-3681. doi: 10.1172/JCI120843.

47. Dickinson J. M., Fry C. S., Drummond M. J. et al. Mammalian target of rapamycin complex 1 activation is required for the stimulation of human skeletal muscle protein synthesis by essential amino acids. J Nutr. 2011;141(5):856-862. doi: 10.3945/jn.111.139485.

48. Dong X. C., Copps K. D., Guo S. et al. Inactivation of hepatic Foxo1 by insulin signaling is required for adaptive nutrient homeostasis and endocrine growth regulation. Cell Metab. 2008;8(1):65-76. doi: 10.1016/j.cmet.2008.06.006.

49. Sancak Y., Peterson T. R., Shaul Y. D. et al. The Rag GTPases bind raptor and mediate amino acid signaling to mTORC1. Science. 2008;320(5882):1496-1501. doi: 10.1126/science.1157535.

50. Lecker S. H., Goldberg A. L., Mitch W. E. Protein degradation by the ubiquitin-proteasome pathway in normal and disease states. J Am Soc Nephrol. 2006;17(7):1807-1819. doi: 10.1681/ASN.2006010083.

51. Calnan D. R., Brunet A. The FoxO code. Oncogene. 2008;27(16):2276-2288. doi: 10.1038/onc.2008.21.

52. Ma K., Zhang Y., Zhao J. et al. Endoplasmic reticulum stress: bridging inflammation and obesity-associated adipose tissue. Front Immunol. 2024;15:1381227. doi: 10.3389/fimmu.2024.1381227.

53. Shin M. J., Jeon Y. K., Kim I. J. Testosterone and Sarcopenia. World J Mens Health. 2018;36(3):192-198. doi: 10.5534/wjmh.180001.

54. Unger R. H. Longevity, lipotoxicity and leptin: the adipocyte defense against feasting and famine. Biochimie. 2005;87(1):57-64. doi: 10.1016/j.biochi.2004.11.014.

55. Lynch G. M., Murphy C. H., Castro E. M., Roche H. M. Inflammation and metabolism: the role of adiposity in sarcopenic obesity. Proc Nutr Soc. 2020. doi: 10.1017/S0029665120007119.

56. Guan L., Li T., Wang X. et al. Predictive Roles of Basal Metabolic Rate and Body Water Distribution in Sarcopenia and Sarcopenic Obesity: The link to Carbohydrates. Nutrients. 2022;14(19):3911. doi: 10.3390/nu14193911.

57. Lee J. H., Park H. M., Lee Y. J. Using Dietary Macronutrient Patterns to Predict Sarcopenic Obesity in Older Adults: A Representative Korean Nationwide Population-Based Study. Nutrients. 2021;13(11):4031. doi: 10.3390/nu13114031.

58. Walton C. M., Jacobsen S. M., Dallon B. W. et al. Ketones Elicit Distinct Alterations in Adipose Mitochondrial Bioenergetics.Int J Mol Sci. 2020;21(17):6255. doi: 10.3390/ijms21176255.

59. Cohen C. W., Fontaine K. R., Arend R. C. et al. A Ketogenic Diet Reduces Central Obesity and Serum Insulin in Women with Ovarian or Endometrial Cancer. J Nutr. 2018;148(8):1253-1260. doi: 10.1093/jn/nxy119.

60. Tagliabue A., Ferraris C., Uggeri F. et al. Short-term impact of a classical ketogenic diet on gut microbiota in GLUT1 Deficiency Syndrome: A 3-month prospective observational study. Clin Nutr ESPEN. 2017;17:33-37. doi: 10.1016/j.clnesp.2016.11.003.

61. Guasch-Ferré M., Willett W. C. The Mediterranean diet and health: a comprehensive overview. J Intern Med. 2021;290(3):549-566. doi: 10.1111/joim.13333.

62. Bauer J., Biolo G., Cederholm T. et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14(8):542-559. doi: 10.1016/j.jamda.2013.05.021.

63. Bauer J., Biolo G., Cederholm T. et al. Evidence-based recommendations for optimal dietary protein intake in older people: a position paper from the PROT-AGE Study Group. J Am Med Dir Assoc. 2013;14(8):542-559. doi: 10.1016/j.jamda.2013.05.021.

64. Morley J. E., Argiles J. M., Evans W. J. et al. Nutritional recommendations for the management of sarcopenia. J Am Med Dir Assoc. 2010;11(6):391-396. doi: 10.1016/j.jamda.2010.04.014.

65. Sri-On J., Fusakul Y., Kredarunsooksree T. et al. The prevalence and risk factors of sarcopenia among Thai community-dwelling older adults as defined by the Asian Working Group for Sarcopenia (AWGS-2019) criteria: a cross-sectional study. BMC Geriatr. 2022;22(1):786. doi: 10.1186/s12877-022-03471-z.

66. Altashina M. V., Ivannikova E. V., Troshina E. A. High protein diet: benefits and risks. Obesity and metabolism. 2020;17(4):393-400. (In Russ.) doi: 10.14341/omet12662.@@ Алташина М. В., Иванникова Е. В., Трошина Е. А. Высокобелковая диета: польза и риски. Ожирение и метаболизм. 2020;17(4):393-400. doi: 10.14341/omet12662.

67. Hengeveld L. M., Wijnhoven H. A.H., Olthof M. R. et al. Prospective Associations of Diet Quality With Incident Frailty in Older Adults: The Health, Aging, and Body Composition Study. J Am Geriatr Soc. 2019;67(9):1835-1842. doi: 10.1111/jgs.16011.

68. van Dronkelaar C., Fultinga M., Hummel M. et al. Minerals and Sarcopenia in Older Adults: An Updated Systematic Review. J Am Med Dir Assoc. 2023;24(8):1163-1172. doi: 10.1016/j.jamda.2023.05.017.

69. Bloom I., Shand C., Cooper C. et al. Diet Quality and Sarcopenia in Older Adults: A Systematic Review. Nutrients. 2018;10(3):308. doi: 10.3390/nu10030308.

70. Areta J. L., Burke L. M., Ross M. L. et al. Timing and distribution of protein ingestion during prolonged recovery from resistance exercise alters myofibrillar protein synthesis. J Physiol. 2013;591(9):2319-2331. doi: 10.1113/jphysiol.2012.244897.

71. Witard O. C., McGlory C., Hamilton D. L., Phillips S. M. Growing older with health and vitality: a nexus of physical activity, exercise and nutrition. Biogerontology. 2016;17(3):529-546. doi: 10.1007/s10522-016-9637-9.

72. Weinheimer E. M., Sands L. P., Campbell W. W. A systematic review of the separate and combined effects of energy restriction and exercise on fat-free mass in middle-aged and older adults: implications for sarcopenic obesity. Nutr Rev. 2010;68(7):375-388. doi: 10.1111/j.1753-4887.2010.00298.x.

73. Trouwborst I., Verreijen A., Memelink R. et al. Exercise and Nutrition Strategies to Counteract Sarcopenic Obesity. Nutrients. 2018;10(5):605. doi: 10.3390/nu10050605.

74. Nabuco H. C.G., Tomeleri C. M., Fernandes R. R. et al. Effect of whey protein supplementation combined with resistance training on body composition, muscular strength, functional capacity, and plasma-metabolism biomarkers in older women with sarcopenic obesity: A randomized, double-blind, placebo-controlled trial. Clin Nutr ESPEN. 2019;32:88-95. doi: 10.1016/j.clnesp.2019.04.007.

75. Muscariello E., Nasti G., Siervo M. et al. Dietary protein intake in sarcopenic obese older women. Clin Interv Aging. 2016;11:133-140. doi: 10.2147/CIA.S96017.

76. Kemmler W., Kohl M., Freiberger E. et al. Effect of whole-body electromyostimulation and / or protein supplementation on obesity and cardiometabolic risk in older men with sarcopenic obesity: the randomized controlled FranSO trial. BMC Geriatr. 2018;18(1):70. doi: 10.1186/s12877-018-0759-6.

77. Farsijani S., Payette H., Morais J. A. et al. Even mealtime distribution of protein intake is associated with greater muscle strength, but not with 3-y physical function decline, in free-living older adults: the Quebec longitudinal study on Nutrition as a Determinant of Successful Aging (NuAge study). Am J Clin Nutr. 2017;106(1):113-124. doi: 10.3945/ajcn.116.146555.

78. Bouillanne O., Curis E., Hamon-Vilcot B. et al. Impact of protein pulse feeding on lean mass in malnourished and at-risk hospitalized elderly patients: a randomized controlled trial. Clin Nutr. 2013;32(2):186-192. doi: 10.1016/j.clnu.2012.08.015.

79. Bouillanne O., Neveux N., Nicolis I. et al. Long-lasting improved amino acid bioavailability associated with protein pulse feeding in hospitalized elderly patients: a randomized controlled trial. Nutrition. 2014;30(5):544-550. doi: 10.1016/j.nut.2013.10.006.

80. Bollwein J., Diekmann R., Kaiser M. J. et al. Distribution but not amount of protein intake is associated with frailty: a cross-sectional investigation in the region of Nürnberg. Nutr J. 2013;12:109. doi: 10.1186/1475-2891-12-109.

81. Kouw I. W., Holwerda A. M., Trommelen J. et al. Protein Ingestion before Sleep Increases Overnight Muscle Protein Synthesis Rates in Healthy Older Men: A Randomized Controlled Trial. J Nutr. 2017;147(12):2252-2261. doi: 10.3945/jn.117.254532.

82. Vanweert F., Schrauwen P., Phielix E. Role of branched-chain amino acid metabolism in the pathogenesis of obesity and type 2 diabetes-related metabolic disturbances BCAA metabolism in type 2 diabetes. Nutr Diabetes. 2022 Aug 5;12(1):35. doi: 10.1038/s41387-022-00213-3.

83. Kurmaev D. P., Bulgakova S. V., Treneva E. V. et al. Possibilities of using branched-chain amino acids for the treatment and prevention of sarcopenia in elderly and old patients (literature review). Acta Biomedica Scientifica. 2023;8(3):106-114. doi: 10.29413/ABS.2023-8.3.11.@@ Курмаев Д. П., Булгакова С. В., Тренева Е. В. и др. Возможности применения аминокислот с разветвлёнными боковыми цепями (BCAA) для лечения и профилактики саркопении у пациентов пожилого и старческого возраста (обзор литературы). Acta Biomedica Scientifica. 2023;8(3):106-114. doi: 10.29413/ABS.2023-8.3.11.

84. Liu S., Zhang L., Li S. Advances in nutritional supplementation for sarcopenia management. Front Nutr. 2023;10:1189522. doi: 10.3389/fnut.2023.1189522.

85. Machekhina L. V., Balashova A. V., Tkacheva O. N. et al. Vitamin D and Geriatric Assessment: A Cross-Sectional Study on the Cohort of Centenarians in the Central Region of Russian Federation.Russian Journal of Geriatric Medicine. 2024;(1):21-29. (In Russ.) doi: 10.37586/2686-8636-1-2024-21-29.@@ Мачехина Л. В., Балашова А. В., Ткачева О. Н. и др. Витамин D и гериатрический статус: когортное исследование долгожителей центрального региона Российской Федерации. Российский журнал гериатрической медицины. 2024;(1):21-29. doi: 10.37586/2686-8636-1-2024-21-29.

86. Kim Y., Park Y.Intake of omega-3 polyunsaturated fatty acids and fish associated with prevalence of low lean mass and muscle mass among older women: Analysis of Korea National Health and Nutrition Examination Survey, 2008-2011. Front Nutr. 2023;10:1119719. doi: 10.3389/fnut.2023.1119719.

87. Jang I. Y., Jung H. W., Park J. H. et al. Lower Serum n-3 Fatty Acid Level in Older Adults with Sarcopenia. Nutrients. 2020;12(10):2959. doi: 10.3390/nu12102959.

88. Yang W., Lee J. W., Kim Y. et al. Increased Omega-3 Fatty Acid Intake is Inversely Associated with Sarcopenic Obesity in Women but not in Men, Based on the 2014-2018 Korean National Health and Nutrition Examination Survey. J Clin Med. 2020;9(12):3856. doi: 10.3390/jcm9123856.

89. Xie H., Wang H., Wu Z. et al. The association of dietary inflammatory potential with skeletal muscle strength, mass, and sarcopenia: a meta-analysis. Front Nutr. 2023;10:1100918. doi: 10.3389/fnut.2023.1100918.

90. Pleshchev I. E., Achkasov E. E., Nikolenko V. N. et al. Methods of physical rehabilitation of elderly people for the prevention and treatment of sarcopenia. Acta Biomedica Scientifica. 2023;8(2):80-92. doi: 10.29413/ABS.2023-8.2.8.@@ Плещёв И. Е., Ачкасов Е. Е., Николенко В. Н. и др. Роль и специфика физических нагрузок при саркопении у пожилых людей. Acta Biomedica Scientifica. 2023;8(2):80-92. doi: 10.29413/ABS.2023-8.2.8.