Reflection on the Symposium 'Strong against sarcopenia and obesity: the synergy of nutrition and exercise'

On March 22, the moderators Josje Schoufour and Esmee Reijnierse opened the symposium. After welcoming the diverse audience consisting of students, dietitians, researchers, professors, lecturers, and exercise professionals, Prof. Dr. Peter Weijs took the stage. Weijs is the coordinator of the SO-NUTS project, a lecturer at the Amsterdam University of Applied Sciences, and a professor of Nutrition and Exercise at the Vrije Universiteit Amsterdam. During his opening presentation, he briefly explained what sarcopenic obesity entails and provided a brief overview of the SO-NUTS project and other initiatives in the field of sarcopenia and obesity.

Following the opening presentation, speakers including Prof. Dr. Alfonso Cruz-Jentoft, Prof. Dr. Yves Boirie, Dr. Doris Eglseer, and Prof. Dr. Somaya Ben Allouch, researchers from various disciplines within the SO-NUTS project, shared their contributions to research on sarcopenia, obesity, and sarcopenic obesity within the project.

Alfonso Cruz-Jentoft, the Spanish partner within the SO-NUTS project from Ramón y Cajal University Hospital, discussed a new European definition of sarcopenic obesity developed by his research group. Yves Boirie (French partner from the University of Clermont Auvergne) discussed the interaction between muscles and body fat and how these two factors contribute to sarcopenic obesity in the elderly. Doris Eglseer, from the Medical University of Graz and a partner of SO-NUTS, presented her search for the most suitable nutritional interventions through various systematic reviews of scientific literature. Finally, Somaya Ben Allouch from the Amsterdam University of Applied Sciences provided a profound insight into the creation of innovative technologies that prioritise human needs. She emphasised the crucial importance of digital tools closely aligned with the desires and needs of the patient, highlighting the need for regular testing and evaluation.

These presentations illustrated the interdisciplinary collaboration at the international level. Professionals from various countries and disciplines, including dietitians, researchers, professors, lecturers, and exercise professionals, join forces to address the issues surrounding sarcopenia and obesity.

Before the lunch break, a panel discussion took place featuring the SO-NUTS project team and was moderated by Peter Weijs. During the discussion, project members had the opportunity to explain their contributions within the project from their expertise, share challenges and next steps, and answer questions from the audience. Doris Eglseer mentioned that based on a series of interviews with patients and screenings, it was found that personalised treatment of patients with sarcopenia, obesity, and sarcopenic obesity is of great importance. Prof. Dr. Eva Topinkova, a partner within SO-NUTS, discussed the challenge of motivating patients and a segment of the target group showing no interest in treatment and even resistance. Additionally, Somaya Ben Allouch emphasised the importance of funding to develop and sustain creative technology.

The discussion and various presentations highlighted the crucial synergy between nutrition and exercise in the fight against and prevention of sarcopenia, obesity, and sarcopenic obesity. A unilateral focus on weight loss can lead to muscle loss. However, preserving muscle mass is essential during weight loss. Sufficient protein intake and exercise (strength training) are crucial in this regard. Only with the right combination of nutrition with adequate proteins and regular exercise, especially strength training, can muscle mass be maintained or even increased in individuals with sarcopenic obesity, while simultaneously reducing fat mass. This helps older adults to age healthily.

Everyone has their own eating habits and behavioral patterns. To help the elderly live healthier lives and ultimately prevent and combat sarcopenia, obesity, and sarcopenic obesity, improvements need to be made in their lifestyle. Creative technology is being used to facilitate this. For example, the SO-NUTS project is developing an application to support older adults in making, achieving, and maintaining personalised lifestyle adjustments, taking into account socio-demographic differences. The pilot application is currently being tested in various countries, including the Netherlands.

In addition to SO-NUTS, three other projects/initiatives are working towards a similar goal, as revealed during the various presentations. For example, the 2Do project (in Dutch) has developed a lifestyle program for elderly individuals with type 2 diabetes and obesity, focusing on weight loss while maintaining muscles through strength training and a healthy diet with protein-rich foods. Furthermore, ProMuscle (in Dutch) offers a lifestyle program for individuals aged 65 and older, combining muscle strength training with increasing daily protein intake. Finally, the LOFIT project (in Dutch), funded by ZonMw, has resulted in a lifestyle desk LOFIT, aiming to integrate lifestyle medicine into the treatment of patients with chronic diseases in hospitals, including older adults.

The symposium concluded with a panel discussion involving researchers from SO-NUTS, 2Do, ProMuscle, and LOFIT. Questions such as 'How do we implement lifestyle interventions in practice?' and 'What are the challenges and needs (from patient/professional perspective)?' were addressed.

During the discussion, it was noted that there is a need for collaboration with municipalities and insurance companies to implement lifestyle interventions for sarcopenia, obesity, and sarcopenic obesity in practice. Municipalities can embrace and implement certain interventions, while insurance companies can provide reimbursements. Furthermore, the panelists discussed how to reach the target group with limited health literacy, as this group is less effectively reached by conventional lifestyle interventions. Josje Schoufour, a researcher within SO-NUTS, noted that since the beginning of March, the LION project (in Dutch) has started, which adopts a neighborhood-based approach through a lifestyle desk, optimising the accessibility of the target group.

After the panel discussion and answering some questions from the audience, the symposium came to an end. The participants were thanked for their presence and invited to a networking reception.

Recordings of the presentations and more information about the symposium can be found on the symposium SO-NUTS website (mainly in Dutch).