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Several factors contribute to development of SO, including aging, chronic inflammation, oxidative stress, physical inactivity, obesity, inadequate nutrition, and gut dysbiosis. Currently, there is no definitive treatment protocol for SO; existing management strategies primarily focus on alleviating symptoms and improving quality of life through lifestyle modifications. The gut microbiota plays a significant role in the development of SO through dysbiosis, while restoration of microbial balance may contribute to the alleviation of clinical symptoms. In SO, Akkermansia, Escherichia, and Bifidobacterium have been reported as prominent gut microbial signatures. Therapeutic approaches for SO include nutritional and exercise interventions, biotics (probiotics, prebiotics, synbiotics, and postbiotics), protein and vitamin supplementation, and dietary patterns such as ketogenic and MIND diets. These strategies may contribute to SO management through the gut\u2013muscle axis by modulating gut microbiota composition and influencing metabolic mechanisms such as inflammation, energy metabolism, and muscle protein synthesis. This review examines the relationship between SO and the gut microbiota, the mechanisms underlying the gut\u2013muscle axis, and microbiota\u2010based therapeutic approaches, highlighting the importance of evidence\u2010based strategies for managing the health burden associated with this condition.<\/jats:p>","DOI":"10.1002\/mnfr.70495","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T07:19:48Z","timestamp":1779261588000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gut Microbiota as a Mediator of Sarcopenic Obesity: Mechanisms, Modifiable Factors, and Healthcare Burden"],"prefix":"10.1002","volume":"70","author":[{"given":"Mehtap","family":"\u00dcnl\u00fc S\u00f6\u011f\u00fct","sequence":"first","affiliation":[{"name":"Department of Nutrition and Dietetics Faculty of Health Sciences Ondokuz May\u0131s University Samsun Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merve","family":"Ah\u0131skal\u0131","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics Institute of Health Sciences Sel\u00e7uk University Konya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mina","family":"Mohammadzadeh","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics Institute of Health Sciences Ondokuz May\u0131s University Samsun Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Men\u015fure Nur","family":"\u00c7elik","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Dietetics Faculty of Health Sciences Ondokuz May\u0131s University Samsun Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nurcan Co\u015fkun","family":"Us","sequence":"additional","affiliation":[{"name":"Department of Health Management Faculty of Health Sciences Ondokuz May\u0131s University Samsun Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.46413\/boneyusbad.957116"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40520-025-03021-8"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2020.05.018"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41514-024-00148-2"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.14283\/jfa.2021.39"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mam.2024.101270"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.scib.2023.03.024"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2021.01.005"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000521241"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2021.06.009"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afz035"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.metabol.2023.155639"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.med.0000433071.11466.7f"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu13062045"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/10408398.2020.1867054"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0029665114000597"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature11552"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11154-019-09512-0"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu11112690"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.3389\/fbioe.2020.590869"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/2151191"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/ggi.12579"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-018-0062-9"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.nutres.2015.04.002"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41392-022-00974-4"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12123759"},{"key":"e_1_2_12_28_1","first-page":"170","volume":"10","author":"Jeffery I. 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