{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:59:26Z","timestamp":1781085566897,"version":"3.54.1"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Sarcopenic obesity (SO) is an increasingly important nutrition- and exercise-relevant phenotype in middle-aged and older adults, but the secondary evidence base is complicated by heterogeneous SO definitions, mixed exercise and nutrition interventions, and repeated use of the same primary trials across reviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an umbrella review of systematic reviews with pairwise meta-analysis or network meta-analysis. PubMed, Web of Science, SPORTDiscus, Cochrane Library, Embase and Scopus were searched from inception to 1 March 2026. Eligible reviews focused on middle-aged and\/or older adults with SO and reported quantitative syntheses for body composition and\/or physical function. Broader non-pharmacological reviews were retained only when exercise-related quantitative syntheses were separately reported and extractable. Two reviewers independently screened records, extracted review-level data and assessed methodological quality with AMSTAR-2; disagreements were resolved by discussion and, where necessary, third-reviewer adjudication. Primary-study overlap was quantified using the corrected covered area (CCA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight reviews met strict exercise-based eligibility criteria, including seven pairwise meta-analyses and one network meta-analysis. They represented 33 unique primary-study units and 88 review-level primary-study occurrences. Primary-study overlap was very high (CCA\u202f=\u202f0.238). AMSTAR-2 confidence was low in seven reviews and critically low in one, and umbrella-level outcome certainty was judged low or very low. Adiposity outcomes were directionally favorable across all eight reviews, and physical-function outcomes were generally favorable, particularly for grip strength and gait- or mobility-related performance. Muscle-mass outcomes were mixed, while metabolic and inflammatory outcomes were sparse and inconsistent. Resistance training showed the most consistent strength-related signal, whereas combined or multicomponent exercise provided hypothesis-supporting, not definitive, signals when adiposity and mobility targets were considered together.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Exercise-centered interventions may be associated with improvements in adiposity and functional outcomes in middle-aged and older adults with SO; however, clinical, modality-ranking and comparative-effectiveness claims should remain cautious because the review corpus is methodologically weak and highly overlapping.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      PROSPERO CRD420261370155,\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261370155<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1859967","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T09:15:32Z","timestamp":1781082932000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Exercise-based interventions for sarcopenic obesity in middle-aged and older adults: an umbrella review of systematic reviews with pairwise meta-analyses and network meta-analyses"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiaoge","family":"Ma","sequence":"first","affiliation":[{"name":"School of Physical Education and Leisure, Guangdong Ocean University","place":["Zhanjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanping","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Physical Education, Kunsan National University","place":["Gunsan-si, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuannan","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Physical Education and Health, Zunyi Medical University","place":["Zunyi, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xujie","family":"Yan","sequence":"additional","affiliation":[{"name":"School of Physical Education and Sports Science, Hengyang Normal University","place":["Hengyang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weibao","family":"Liang","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences and Sports, Macao Polytechnic University","place":["Macao, Macao SAR, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengda","family":"Ma","sequence":"additional","affiliation":[{"name":"Hebei Sport University","place":["Shijiazhuang, Hebei, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"294","DOI":"10.1159\/000490361","article-title":"Sarcopenic obesity: time to meet the challenge","volume":"11","author":"Barazzoni","year":"2018","journal-title":"Obes Facts"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1159\/000521241","article-title":"Definition and diagnostic criteria for sarcopenic obesity: ESPEN and EASO consensus statement","volume":"15","author":"Donini","year":"2022","journal-title":"Obes Facts"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"4633","DOI":"10.1016\/j.clnu.2021.06.009","article-title":"Global prevalence of sarcopenic obesity in older adults: a systematic review and meta-analysis","volume":"40","author":"Gao","year":"2021","journal-title":"Clin 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