{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T07:05:00Z","timestamp":1779433500676,"version":"3.53.1"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"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. Aging"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sarcopenic obesity (SO) is defined as the coexistence of low muscle mass and excess adiposity. Despite growing international attention, SO remains under-researched and under-recognized in Nordic countries, particularly in primary care, where body mass index (BMI)-driven approaches dominate and muscle health is rarely assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The objective of this study is to discuss opportunities for integrating SO screening and treatment into everyday clinical care in primary care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key insights<\/jats:title>\n                    <jats:p>Limited prevalence data and inconsistent diagnostic criteria make SO difficult to detect in Nordic primary care settings. The increasing use of pharmacological weight-loss therapies further highlights the need for age- and muscle-informed approaches. Most studies are cross-sectional and conducted in hospitals\/community samples, limiting insights into disease trajectories and intervention effects and widening the gap between research and clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical relevance<\/jats:title>\n                    <jats:p>Although muscle loss and obesity jointly worsen health outcomes, current obesity strategies rarely assess muscular health, creating a critical blind spot in clinical practice for older adults. Moreover, few clinical guidelines offer age-specific recommendations, limiting recognition and management of SO and contributing to suboptimal care for a growing older population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and call for action<\/jats:title>\n                    <jats:p>Nordic primary care represents a key setting for integrating SO case finding into existing preventive frameworks. We propose that primary care adopts pragmatic diagnostic pathways for SO based on a simple case-finding approach combining basic functional tests, nutritional risk assessment, and anthropometric measures alongside BMI, without additional resources. This should be supported by clinician education and cross-sector collaboration to ensure that both adiposity and muscle decline are addressed. Ultimately, bridging the gap between research and practice remains crucial to improving outcomes for older adults with SO.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fragi.2026.1815247","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T06:08:54Z","timestamp":1779430134000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Unseen and untreated: implementing sarcopenic obesity care in Nordic general practice"],"prefix":"10.3389","volume":"7","author":[{"given":"Fereshteh","family":"Baygi","sequence":"first","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark","place":["Odense, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Haastrup","sequence":"additional","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark","place":["Odense, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sussi Friis","family":"Buhl","sequence":"additional","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark","place":["Odense, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesper Bo","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark","place":["Odense, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"Suetta","sequence":"additional","affiliation":[{"name":"Department of Geriatric and Palliative Medicine, Copenhagen University Hospital Bispebjerg and Frederiksberg and Department of Clinical Medicine, Faculty of Health, University of Copenhagen","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael Skovdal","family":"Rathleff","sequence":"additional","affiliation":[{"name":"Department of Health Science and Technology, Aalborg University, and Center for General Practice at Aalborg University","place":["Aalborg, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[{"name":"Research Unit of General Practice, Department of Public Health, University of Southern Denmark","place":["Odense, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"B1","volume-title":"Fysisk aktivitet for \u00e6ldre (+65 \u00e5r): viden om sundhed og forebyggelse","author":"Ahrensberg","year":"2023"},{"key":"B3","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1370\/afm.2795","article-title":"General practitioners' perspectives on appropriate use of ultrasonography in primary care in Denmark: a multistage mixed methods study","volume":"20","author":"Andersen","year":"2022","journal-title":"Ann. Fam. Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1007\/s11154-020-09578-1","article-title":"Double burden of malnutrition in persons with obesity","volume":"21","author":"Barazzoni","year":"2020","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"B5","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1186\/s12877-024-04970-x","article-title":"Sarcopenia and sarcopenic obesity among older adults in the nordic countries: a scoping review","volume":"24","author":"Baygi","year":"2024","journal-title":"BMC Geriatr."},{"key":"B6","doi-asserted-by":"publisher","first-page":"e243604","DOI":"10.1001\/jamanetworkopen.2024.3604","article-title":"Sarcopenia and sarcopenic obesity and mortality among older people","volume":"7","author":"Benz","year":"2024","journal-title":"JAMA Netw. Open"},{"key":"B7","volume-title":"Nordic nutrition recommendations: integrating environmental aspects","author":"Blomhoff","year":"2023"},{"key":"B8","doi-asserted-by":"publisher","first-page":"e240084","DOI":"10.20945\/2359-4292-2024-0084","article-title":"Sarcopenic obesity: a review","volume":"68","author":"Borba","year":"2025","journal-title":"Arch. Endocrinol. Metab."},{"key":"B9","doi-asserted-by":"publisher","first-page":"206","DOI":"10.22540\/JFSF-10-206","article-title":"Assessing SARCopenia with ecHOgraphy in community-dwelling older adults: a validation Study (SARCHO)","volume":"10","author":"Brockhattingen","year":"2025","journal-title":"J. Frailty Sarcopenia Falls"},{"key":"B10","doi-asserted-by":"publisher","first-page":"266","DOI":"10.1017\/S0007114521000799","article-title":"Prevalence of low protein intake in 80+-year-old community-dwelling adults and association with dietary patterns and modifiable risk factors: a cross-sectional study","volume":"127","author":"Buhl","year":"2022","journal-title":"Br. J. Nutr."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1451","DOI":"10.1136\/bjsports-2020-102955","article-title":"World Health organization 2020 guidelines on physical activity and sedentary behaviour","volume":"54","author":"Bull","year":"2020","journal-title":"Br. J. Sports Med."},{"key":"B12","doi-asserted-by":"publisher","first-page":"773","DOI":"10.1007\/s11357-013-9586-z","article-title":"Multicomponent exercises including muscle power training enhance muscle mass, power output, and functional outcomes in institutionalized frail nonagenarians","volume":"36","author":"Cadore","year":"2014","journal-title":"Age (Dordr)"},{"key":"B13","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.clnu.2016.09.004","article-title":"ESPEN guidelines on definitions and terminology of clinical nutrition","volume":"36","author":"Cederholm","year":"2017","journal-title":"Clin. Nutr."},{"key":"B14","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s12877-024-05655-1","article-title":"Clinical outcome changes in sarcopenic obesity: a meta-analysis of exercise training methods","volume":"25","author":"Chen","year":"2025","journal-title":"BMC Geriatr."},{"key":"B15","doi-asserted-by":"publisher","first-page":"e658","DOI":"10.1016\/S2468-2667(19)30224-5","article-title":"Life expectancy and disease burden in the Nordic countries: results from the Global Burden of Diseases, Injuries, and risk factors Study 2017","volume":"4","author":"Collaborators","year":"2019","journal-title":"Lancet Public Health"},{"key":"B16","volume-title":"Active and healthy ageing: heterog\u00acenous perspectives and nordic indicators","author":"Cuadrado","year":"2022"},{"key":"B17","unstructured":"Sv\u00e6r overv\u00e6gt: Ikke-kirurgisk behandling\n          \n          \n            \n              Dansk\n              E. S.\n            \n          \n          \n          2023"},{"key":"B18","doi-asserted-by":"publisher","first-page":"929","DOI":"10.1016\/j.clnu.2014.04.007","article-title":"Protein intake and exercise for optimal muscle function with aging: recommendations from the ESPEN Expert Group","volume":"33","author":"Deutz","year":"2014","journal-title":"Clin. Nutr."},{"key":"B19","doi-asserted-by":"publisher","first-page":"633987","DOI":"10.3389\/fnut.2021.633987","article-title":"The aging muscle in experimental bed rest: a systematic review and meta-analysis","volume":"8","author":"Di Girolamo","year":"2021","journal-title":"Front. Nutr."},{"key":"B20","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":"B2","unstructured":"Eldreministeriet\n          \n          \n          2024"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.29219\/fnr.v67.10261","article-title":"Protein - a scoping review for Nordic Nutrition Recommendations 2023","volume":"67","author":"Geirsd\u00f3ttir","year":"2023","journal-title":"Food Nutr. Res."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.2147\/CIA.S82454","article-title":"Sarcopenic obesity and complex interventions with nutrition and exercise in community-dwelling older persons--a narrative review","volume":"10","author":"Goisser","year":"2015","journal-title":"Clin. Interv. Aging"},{"key":"B23","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1080\/02813432.2025.2508929","article-title":"Danish primary care: a focus on general practice in the Danish healthcare system","volume":"43","author":"Haastrup","year":"2025","journal-title":"Scand. J. Prim. Health Care"},{"key":"B24","doi-asserted-by":"publisher","first-page":"121","DOI":"10.3238\/arztebl.m2025.0004","article-title":"The diagnosis and treatment of Sarcopenia and sarcopenic obesity","volume":"122","author":"Habboub","year":"2025","journal-title":"Dtsch. Arztebl Int."},{"key":"B25","doi-asserted-by":"publisher","first-page":"2815","DOI":"10.3390\/nu13082815","article-title":"Effects of milk protein in resistance training-induced lean mass gains for older adults aged \u2265 60 y: a systematic review and meta-analysis","volume":"13","author":"Huang","year":"2021","journal-title":"Nutrients"},{"key":"B26","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.exger.2016.03.018","article-title":"Voluntary muscle activation improves with power training and is associated with changes in gait speed in mobility-limited older adults - a randomized controlled trial","volume":"80","author":"Hvid","year":"2016","journal-title":"Exp. Gerontol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"100401","DOI":"10.1016\/j.jnha.2024.100401","article-title":"Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR)","volume":"29","author":"Izquierdo","year":"2025","journal-title":"J. Nutr. Health Aging"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1007\/s00198-017-3964-9","article-title":"Prevalence of sarcopenia and sarcopenic obesity in older German men using recognized definitions: high accordance but low overlap","volume":"28","author":"Kemmler","year":"2017","journal-title":"Osteoporos. Int."},{"key":"B29","article-title":"Systematic assessment of physical function in adult patients across diagnoses","volume":"184","author":"Kristensen","year":"2022","journal-title":"Ugeskr. Laeger"},{"key":"B30","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s40265-025-02263-0","article-title":"Safety and tolerability of glucagon-like Peptide-1 receptor agonists: a state-of-the-art narrative review","volume":"86","author":"Kunutsor","year":"2026","journal-title":"Drugs"},{"key":"B31","doi-asserted-by":"publisher","first-page":"67","DOI":"10.7146\/sjsep.v3i.127390","article-title":"Danske seniorers (65+) motiver og barrierer for fysisk aktivitet","volume":"3","author":"Larsen","year":"2022","journal-title":"SJSEP"},{"key":"B32","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.3390\/nu11081713","article-title":"The role of muscle mass gain following protein supplementation plus exercise therapy in older adults with sarcopenia and frailty risks: a systematic review and meta-regression analysis of randomized trials","volume":"11","author":"Liao","year":"2019","journal-title":"Nutrients"},{"key":"B33","doi-asserted-by":"publisher","first-page":"1039","DOI":"10.1007\/s41999-025-01395-6","article-title":"Improving care for older patients living with frailty: a collaborative approach to creating the DANFRAIL quality database","volume":"17","author":"Lietzen","year":"2026","journal-title":"Eur. Geriatr. Med"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1431","DOI":"10.1002\/ncp.11200","article-title":"Global leadership Initiative on Malnutrition criteria using calf and upper arm circumference as phenotypic criteria for assessing muscle mass demonstrate satisfactory validity for diagnosing malnutrition in hospitalized patients: a prospective cohort study","volume":"39","author":"Maffini","year":"2024","journal-title":"Nutr. Clin. Pract."},{"key":"B35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s13679-013-0087-2","article-title":"Social inequalities in obesity persist in the nordic Region despite its relative affluence and equity","volume":"3","author":"Magnusson","year":"2014","journal-title":"Curr. Obes. Rep."},{"key":"B36","doi-asserted-by":"publisher","first-page":"307","DOI":"10.2147\/CLEP.S456170","article-title":"Semaglutide (Ozempic(\u00ae)) use in Denmark 2018 through 2023 \u2012 User Trends and off-Label prescribing for Weight Loss","volume":"16","author":"Mailhac","year":"2024","journal-title":"Clin. Epidemiol."},{"key":"B37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.4103\/jopcs.jopcs_8_23","article-title":"Sarcopenic obesity: a new challenge for primary care physicians","volume":"4","author":"Mondal","year":"2023","journal-title":"J. Prim. Care Spec."},{"key":"B38","doi-asserted-by":"publisher","first-page":"E161","DOI":"10.1017\/s0029665120001093","article-title":"Prevalence of sarcopenia in community-dwelling older adults in Ireland: comparison of EWGSOP1 and EWGSOP2 definitions","volume":"79","author":"Murphy","year":"2020","journal-title":"Proc. Nutr. Soc."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1091","DOI":"10.1016\/j.clnesp.2025.07.848","article-title":"Role of socioeconomic factors on the development of sarcopenic obesity: evidence from the English Longitudinal Study of ageing","volume":"69","author":"Nishioka","year":"2025","journal-title":"Clin. Nutr. ESPEN"},{"key":"B40","volume-title":"Nordic nutrition recommendations copenhagen","year":"2023"},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afac137","article-title":"Community-based exercise enhanced by a self-management programme to promote independent living in older adults: a pragmatic randomised controlled trial","volume":"51","author":"Olsen","year":"2022","journal-title":"Age Ageing"},{"key":"B42","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1038\/s41574-023-00943-z","article-title":"Sarcopenic obesity in older adults: a clinical overview","volume":"20","author":"Prado","year":"2024","journal-title":"Nat. Rev. Endocrinol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"100652","DOI":"10.1016\/j.jnha.2025.100652","article-title":"Weighing the risk of GLP-1 treatment in older adults: should we be concerned about sarcopenic obesity?","volume":"29","author":"Prokopidis","year":"2025","journal-title":"J. Nutr. Health Aging"},{"key":"B44","doi-asserted-by":"publisher","first-page":"1640030","DOI":"10.3389\/fragi.2025.1640030","article-title":"Moving beyond the scale: musculoskeletal risks, evidence gaps and emerging combination strategies to optimize the quality of weight loss pharmacotherapy in older adults","volume":"6","author":"Reid","year":"2025","journal-title":"Front. Aging"},{"key":"B45","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1503\/cmaj.050051","article-title":"A global clinical measure of fitness and frailty in elderly people","volume":"173","author":"Rockwood","year":"2005","journal-title":"Cmaj"},{"key":"B46","doi-asserted-by":"publisher","first-page":"a439","DOI":"10.1136\/bmj.a439","article-title":"Association between muscular strength and mortality in men: prospective cohort study","volume":"337","author":"Ruiz","year":"2008","journal-title":"Bmj"},{"key":"B47","doi-asserted-by":"publisher","first-page":"706","DOI":"10.1159\/000527804","article-title":"Probable sarcopenia, obesity, and risk of all-cause mortality: a pooled analysis of 4,612 participants","volume":"69","author":"S\u00e4\u00e4ksj\u00e4rvi","year":"2023","journal-title":"Gerontology"},{"key":"B48","doi-asserted-by":"publisher","first-page":"112752","DOI":"10.1016\/j.exger.2025.112752","article-title":"Sarcopenic obesity is associated with long-term trajectories of physical activity and sedentary behavior","volume":"204","author":"Salinas-Rodr\u00edguez","year":"2025","journal-title":"Exp. Gerontol."},{"key":"B49","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1186\/s12877-025-06105-2","article-title":"Sarcopenic obesity is linked to worse clinical outcomes than sarcopenia or obesity alone in hospitalized older adults","volume":"25","author":"Silay","year":"2025","journal-title":"BMC Geriatr."},{"key":"B50","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1007\/s13679-016-0206-y","article-title":"Obesity prevention in the nordic countries","volume":"5","author":"Stockmarr","year":"2016","journal-title":"Curr. Obes. Rep."},{"key":"B51","volume-title":"Preventive home visits for older adults-a guideline","year":"2020"},{"key":"B52","doi-asserted-by":"publisher","first-page":"105135","DOI":"10.1016\/j.healthpol.2024.105135","article-title":"Stimulating implementation of clinical practice guidelines in hospital care from a central guideline organization perspective: a systematic review","volume":"148","author":"Thoonsen","year":"2024","journal-title":"Health Policy"},{"key":"B53","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.clnu.2018.05.024","article-title":"ESPEN guideline on clinical nutrition and hydration in geriatrics","volume":"38","author":"Volkert","year":"2019","journal-title":"Clin. Nutr."},{"key":"B54","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1186\/s12877-020-01578-9","article-title":"Sarcopenic obesity and associations with mortality in older women and men - a prospective observational study","volume":"20","author":"von Berens","year":"2020","journal-title":"BMC Geriatr."},{"key":"B55","doi-asserted-by":"publisher","first-page":"1185221","DOI":"10.3389\/fendo.2023.1185221","article-title":"Sarcopenic obesity: epidemiology, pathophysiology, cardiovascular disease, mortality, and management","volume":"14","author":"Wei","year":"2023","journal-title":"Front. Endocrinol. (Lausanne)"},{"key":"B56","volume-title":"Promoting physical activity for older people: a toolkit for action","year":"2023"},{"key":"B57","doi-asserted-by":"publisher","first-page":"802651","DOI":"10.3389\/fmed.2022.802651","article-title":"Publication trends for sarcopenia in the world: a 20-Year bibliometric analysis","volume":"9","author":"Yuan","year":"2022","journal-title":"Front. Med. (Lausanne)"}],"container-title":["Frontiers in Aging"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fragi.2026.1815247\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T06:08:59Z","timestamp":1779430139000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fragi.2026.1815247\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,22]]},"references-count":57,"alternative-id":["10.3389\/fragi.2026.1815247"],"URL":"https:\/\/doi.org\/10.3389\/fragi.2026.1815247","relation":{},"ISSN":["2673-6217"],"issn-type":[{"value":"2673-6217","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,22]]},"article-number":"1815247"}}