Researchers from the Federal University of São Carlos (UFSCar) in Brazil, working with University College London (UCL) in the United Kingdom, found that having both excess abdominal fat and reduced muscle mass significantly raises the risk of death. People with this combination were 83% more likely to die than those without either condition.
This pairing points to a more serious underlying issue known as sarcopenic obesity. It occurs when muscle mass declines while body fat increases. The condition can be difficult to identify and is closely tied to reduced independence and poorer quality of life in older adults. It is also associated with frailty, a higher risk of falls, and other health complications.
“In addition to assessing the risk of death associated with abdominal obesity and low muscle mass, we were able to prove that simple methods can be used to detect sarcopenic obesity. This is important because the lack of consensus on diagnostic criteria for this disease makes it difficult to detect and treat,” says Tiago da Silva Alexandre, a professor in the Department of Gerontology at UFSCar and one of the study’s authors, which was supported by FAPESP. “Thus, our findings allow older adults to have greater access to early interventions, such as nutritional monitoring and physical exercise, ensuring an improvement in quality of life.”
The findings were published in Aging Clinical and Experimental Research and are based on 12 years of data from 5,440 participants aged 50 and older in the English Longitudinal Study of Ageing (ELSA).
Simple Screening May Replace Costly Tests
Diagnosing sarcopenic obesity usually requires advanced imaging tools such as magnetic resonance imaging, computed tomography, electrical bioimpedance, or densitometry. These methods can accurately measure body fat and muscle mass, but they are expensive and not widely available, making routine diagnosis difficult.
“By correlating data from ELSA study participants, we found that simple measures, such as measuring abdominal circumference and estimating lean mass [using a consolidated equation that considers clinical variables such as age, sex, weight, race, and height], showed for the first time that it’s possible to screen these individuals early,” Alexandre celebrates.
Why the Combination Is Especially Dangerous
Losing muscle while gaining abdominal fat has a compounded effect on the body’s metabolism. “The study revealed that individuals with both conditions had an 83% higher risk of death compared to those who didn’t have them. We also found that the risk of death was reduced by 40% among those with low muscle mass and no abdominal obesity, a finding that reinforces the potential danger of the coexistence of the conditions. Interestingly, individuals with abdominal obesity but adequate muscle mass weren’t associated with an increased risk of death,” explains Valdete Regina Guandalini, a professor at the Federal University of Espírito Santo (UFES) and researcher in the Department of Gerontology at UFSCar. She is also the first author of the article.
According to Guandalini, excess fat worsens inflammation in the body, triggering metabolic changes that accelerate muscle breakdown. “In addition to one condition interfering with the other, fat infiltrates the muscle and takes up its space. This systemic and progressive inflammation directly affects muscle tissue, compromising its metabolic, endocrine, immunological, and functional capabilities,” she says.
Clearer Definitions Using Simple Measurements
Because researchers around the world have not agreed on a single definition of sarcopenic obesity, the team used practical criteria to identify those at risk. Abdominal obesity was defined as a waist circumference greater than 102 centimeters for men and 88 centimeters for women. Low muscle mass was defined as a skeletal muscle mass index below 9.36 kg/m2 for men and below 6.73 kg/m2 for women.
These simpler measures could make it easier to identify sarcopenic obesity earlier, helping more people access interventions that may reduce risk and improve long-term health.
