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The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched the Sarcopenic Obesity Global Leadership Initiative (SOGLI) to reach expert consensus on a definition and diagnostic criteria for Sarcopenic Obesity (SO).The present paper describes the proceeding of the Sarcopenic Obesity Global Leadership Initiative (SOGLI) meeting that was held on November 25th and 26th, 2022 in Rome, Italy. This consortium involved the participation of 50 researchers from different geographic regions and countries.The document outlines an agenda advocated by the SOGLI expert panel regarding the pathophysiology, screening, diagnosis, staging and treatment of SO that needs to be prioritized for future research in the field.

Introduction: Loss of skeletal muscle mass and function (sarcopenia) is common in individuals with obesity due to metabolic changes associated with a sedentary lifestyle, adipose tissue derangements, comorbidities (acute and chronic diseases), and during the ageing process. Co-existence of excess adiposity and low muscle mass/function is referred to as sarcopenic obesity (SO), a condition increasingly recognized for its clinical and functional features that negatively influence important patient-centred outcomes. Effective prevention and treatment strategies for SO are urgently needed, but efforts are hampered by the lack of an universally established SO Definition and diagnostic criteria. Resulting inconsistencies in the literature also negatively affect the ability to define prevalence as well as clinical relevance of SO for negative health outcomes. Aims and methods: The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) launched an initiative to reach expert consensus on a Definition and diagnostic criteria for SO. The jointly appointed international expert panel proposes that SO is defined as the co-existence of excess adiposity and low muscle mass/function. The diagnosis of SO should be considered in at-risk individuals who screen positive for a co-occurring elevated body mass index or waist circumference, and markers of low skeletal muscle mass and function (risk factors, clinical symptoms, or validated questionnaires). Diagnostic procedures should initially include assessment of skeletal muscle function, followed by assessment of body composition where presence of excess adiposity and low skeletal muscle mass or related body compartments confirm the diagnosis of SO. Individuals with SO should be further stratified into Stage I in the absence of clinical complications, or Stage II if cases are associated with complications linked to altered body composition or skeletal muscle dysfunction

The aim of this study was to compare muscle oxygenation of the vastus lateralis during a high-volume isokinetic resistance exercise protocol (HVP) between young adult (YA) and middle-aged adult (MA) men. Twenty recreationally trained men were assigned to either the YA (age 21.8±2.0 years, body mass 90.7±11.6 kg, body height 179±4.7 cm) or MA (age 47.0±4.4 years, body mass 96.1±21.6 kg, body height 177±7.7 cm) group. The HVP consisted of eight sets of 10 repetitions of unilateral isokinetic concentric knee extension and eccentric knee flexion at 60°·s-1. Changes in tissue hemoglobin saturation index (TSI), tissue oxygenated hemoglobin concentration (O2Hb), deoxygenated hemoglobin (HHb), and muscle oxidation index (O2Hb-HHb) were measured during the exercise session using the near-infrared spectroscopy (NIRS). Data were analyzed using two-way mix factorial analyses of variance. Prior to exercise, TSI was significantly greater (p=.024) for YA compared to MA. Significant decreases in O2Hb and O2Hb-HHb and increases in HHb were observed during each of the eight sets relative to the rest periods (p<.05) for both groups. The average change during the eight sets of the HVP revealed a significantly higher (p=.036) level of HHb and a lower (p=.029) level of O2Hb-HHb for MA compared to YA. A significant negative correlation was also noted at baseline between O2Hb-HHb index and the cross-sectional area of the vastus lateralis muscle (r=-.45, p=.045). During a high- volume resistance exercise, MA experienced reduced muscle oxygen saturation levels compared to YA. These results may be attributed to reductions in local tissue oxidative capacity and reduced blood delivery occurring during middle-age, and possibly due to group differences in muscle morphology.