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Functional foods have role in reversing 'thin outside, fat inside' phenomenon, paper's authors conclude

By Hank Schultz

18-Apr-2017
Last updated on 18-Apr-2017 at 16:45 GMT2017-04-18T16:45:49Z

 iStock/monkeybusinessimages
iStock/monkeybusinessimages

Functional foods could have a key role to play in combating the global rise of the phenomenon of sarcopenic obesity, according to a published report of the proceedings of a recent scientific convention.

The conference report, titled “The Emerging Global Phenomenon of Sarcopenic Obesity: Role of Functional Foods,” was published recently in the Journal of Functional Foods.  Written by Andrew Shao, PhD, VP of global nutrition policy for Herbalife and James Griffiths, PhD, VP of scientific and international affairs for the Council for Responsible Nutrition, among others, the paper brought together the research presented at the meeting in October, 2016 in Orlando, FL of the International Society for Nutraceuticals and Functional Foods.

Griffiths said the prevalence of sarcopenic obesity or SO is a malaise of the modern age. Before the advent of refrigeration, elevators, easy automobile travel or mass transit and the like, only a very few of the ultra wealthy could afford to live the kind of ultra-low energy lifestyle that is now available to most people in developed societies.  Couple that with the changes in food moving toward more highly processed, highly refined and generally more calorie dense offerings and you create an ideal climate for the spread of this mostly self inflicted contagion.  And the insidious thing about the condition is you don’t have to technically obese to suffer from it.

Another way to look at SO is thin outside, fat inside,’” Griffiths told NutraIngredients-USA. These people might look the same on the outside as other people but inside it is like night and day in terms of fat and muscle distribution.

Griffiths said it is unclear if the modern diet has reset the metabolism of certain perhaps more susceptible people.  What’s more likely, he said, is that  modern demographic trends account for the lion’s share in the uptick in the prevalence of the condition.

We are all aging and we are all experiencing this problem with fat distribution. But in the past we either died too young, or we stayed more active later into life, he said.

Individuals in this state are in something of a chicken and egg position;  is SO causative of other disease processes, or a symptom of underlying problems?

Subjects with SO are considered to be in a hyper-inflamed state, contributing to an increased risk for chronic disease . . . SO is associated with a higher risk of frailty, disability, morbidity, and mortality than obesity or sarcopenia alone,the authors wrote.  At the same time, SO subjects are metabolically compromised due to a decided decline in skeletal muscle mass, which in turn contributes to a reduction in the basal metabolic rate.

Role of functional foods

What to do about this issue has confounded health authorities for decades.  The rising tide of obesity earlier in life is an obviously intractable problem, with rates inching up steadily in almost every developed society and in almost every age group. But SO lurks out there among older populations, too, and combining the prevalence of this condition with the more obvious uptick in the number of overweight individuals could mean that despite all of the advances of modern health care, a big chunk of older individuals in developed societies are nowhere near as healthy as they could be.

Griffiths noted that the given the nature of the meeting, the proceedings were aligned more with the role of foods, leaving supplementation more or less aside.  Within the realm of macronutrients, getting enough protein is seen by the paper’s authors as one potential way to address the SO issue. The authors noted that there is no data from large-scale trials to determine whether it’s better to eat more protein at breakfast, or throughout the day.  And there is not enough data to firmly support the notion that protein amounts in excess of common recommendations (the World Health Organization recommends consuming 0.8 grams of protein per kilogram of body weight) have an effect on restraining the development of SO.

Enthusiasm for highly prescriptive use of high-protein diets (including within-day dietary patterning) to promote the retention of lean body mass, including muscle mass, and function in older adults (Paddon-Jones et al., 2008 ;  Thalacker-Mercer and Drummond, 2014) must be supported by high-quality longitudinal research, not just theories, hypotheses or extrapolations from short-term studies, the authors wrote.

IMCL as a risk factor

There is some support for higher protein intakes in connection with physical activity, the authors noted.  And another factor, the buildup of intramyocellular lipid (IMCL) content in the skeletal muscle of older subjects, is an important risk factor (and one that is rarely mentioned in the popular press).

Increases in IMCL content may play an important mechanistic role in the development of the muscles resistance to anabolic stimuli and the progression of sarcopenia with aging and muscle atrophy in obesity,the authors wrote.  Indeed, IMCL content in skeletal muscle is a hot research topic; a search on the Pubmed database maintained by the National Institute of Health using “intramyocellular lipid” as a search term shows dozens of studies published since the Orlando meeting took place.

Omega-3s, green tea lead the way for bioactives

Bioactives contained in foods, on the other hand, are better supported for their effectiveness on restraining the progression of SO.  Among specific bioactives, teh paper mentioned green tea catechins, resveratrol and soy isoflavones.  While the paper repeated a call for more research on the role of bioactives in general, it mentioned omega-3s as having a body of evidence showing significant neuromuscular effects to go with their proven cardioprotective benefits.

These findings suggest fish oil-derived n-3 PUFAs as a potential novel nutritional strategy to counteract the age-associated decline in skeletal muscle mass and function without potential adverse or possibly even beneficial effects on cardiometabolic health, the authors wrote.

While high protein intake per se is not well supported by the evidence, Griffiths noted that many older adults don’t consume enough, and emphasizing protein intake for these individuals in the context of a high quality diet and an exercise plan.

Protein is indeed an area that we dont eat enough of and as we age we need to focus on it, Griffiths said.

Consumption of diets rich in protein, bioactive food components, such as catechins from green tea and omega-3 fatty acids, along with resistance exercise have been studied as lifestyle approaches to prevent and combat SO, the authors concluded.

Source: Journal of Functional Foods
Volume 33, pp. 244–250, doi.org/10.1016/j.jff.2017.03.048
“The Emerging Global Phenomenon of Sarcopenic Obesity: Role of Functional Foods,”
Authors: Shao A et al.

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