Dominic Stone
Adiposity is the scientific term for the amount of fat in the body. The distribution of body fat changes with age, with a reduction in appendicular fat and an increase in trunk fat. This is accompanied by a loss of muscle mass and strength. The accumulation of fat in non-adipose tissues such as bone, liver, and muscle is a common feature of aging. This process is known as fatty infiltration of skeletal muscle or myosteatosis. Myosteatosis has been recognized as an important component of aging and frailty, and it is associated with an increased risk of fractures in the elderly. Several studies have examined the impact of adiposity on muscle function and clinical events in older adults, finding that increased adiposity, with or without reduced muscle mass, is related to muscle function decline.
| Characteristics | Values |
|---|---|
| Definition | Muscle adiposity refers to the infiltration of fat in non-adipose tissues, such as bone, liver, and muscle. |
| Common Names | Visceral and intermuscular adiposity, dynapenic or sarcopenic obesity, myosteatosis, intramuscular fat, intramyocellular (IMC) lipid |
| Age Group | Muscle adiposity is observed in older persons, children, and adolescents. |
| Health Risks | Muscle adiposity is associated with reduced muscle function, muscle strength, functional decline, metabolic syndrome, fall risk, and increased fracture risk. |
| Interventions | Specific exercises, pain management, nutritional interventions, and psychosocial support can help prevent functional decline related to muscle adiposity. |
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What You'll Learn
Muscle adiposity and muscle function decline
Adiposity refers to the amount of fat in the body. It is a common feature of aging, with an increase in trunk fat and a reduction in appendicular fat. This is accompanied by a loss of muscle mass and strength, which leads to functional decline. The accumulation of fat in non-adipose tissues, such as bone, liver, and muscle, is known as fatty infiltration and is also a recognized component of aging. This process is especially evident in skeletal muscle, known as myosteatosis, and has been linked to an increased risk of bone fractures in the elderly.
Several studies have examined the impact of adiposity on muscle function in older adults. One study found that community-dwelling older people with dynapenia had higher obesity rates and were at a higher risk of falling and developing metabolic syndrome than those with sarcopenia. Presarcopenia older adults, on the other hand, had lower obesity rates and a reduced risk of metabolic syndrome. Importantly, muscle function was found to be a more critical factor than muscle mass in determining the risk of falling. This suggests that increased adiposity, irrespective of muscle mass, contributes to reduced muscle function and adverse clinical outcomes.
The relationship between adiposity and muscle function is complex. While obesity is a contributing factor, it is not the sole determinant of muscle function decline. The distribution of body fat and the infiltration of fat into non-fat tissues, such as muscle, play a significant role. Additionally, the loss of muscle mass and strength with age also contributes to functional decline. This loss of muscle mass reduces basal metabolic expenditure, leading to increased adiposity and worsening insulin resistance, further exacerbating the problem.
Interventions focusing on the loss of fat mass and the preservation of muscle mass and strength are crucial for preventing functional decline in older persons. These interventions may include specific exercises, pain management, nutritional strategies, and psychosocial support. By addressing both the loss of muscle mass and the accumulation of fat, it may be possible to delay or mitigate age-related functional decline and improve overall health outcomes in older individuals.
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Muscle adiposity and bone health
Adiposity refers to the state of having excess adipose tissue, or body fat. Muscle adiposity, therefore, refers to excess body fat in the muscles. This can be caused by fatty infiltration of the muscles, which is a common component of aging and frailty. This fatty infiltration of skeletal muscle is also known as myosteatosis.
Muscle adiposity can have a detrimental effect on bone health. For example, lipid accumulation in the muscles of the lower limbs is associated with an increased risk of fractures in older people. This is because muscle weakness and postural instability are major contributors to falls, which are the primary cause of hip fractures. Furthermore, bone and muscle share common embryological origins and growth trajectories, and are both mechanoresponsive tissues, meaning that the mass and strength of both decline with age.
The relationship between muscle and bone health is complex and multifactorial. While body weight has a strong positive association with bone mass, the data regarding which has a greater influence on bone mass, muscle or fat, is conflicting. However, both play a significant role in the development and maintenance of bone mass. During aging and diseases such as diabetes and obesity, the expansion of adipose tissue is not associated with muscle or bone strengthening or performance.
There are several ways to mitigate the negative effects of muscle adiposity on bone health. Exercise and physical activity are one of the most effective countermeasures against fatty infiltration of the muscles. For example, resistance training has been shown to reduce intramuscular fat and increase muscle strength and power, thereby reducing the risk of fractures. Similarly, low-magnitude whole-body vibration has been observed to reduce adipose tissue and increase muscle fiber area.
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Muscle adiposity in adolescents
Adiposity refers to the amount of fat in the body. Muscle adiposity, therefore, refers to the amount of fat in the muscles. This is distinct from muscle mass, which refers to the amount of muscle tissue in the body.
In adolescents, some authors have highlighted the reduction of muscle mass in relation to excessive fat mass. This creates a vicious cycle where reduced muscle mass leads to increased adiposity, which in turn further reduces muscle mass. This can lead to an inadequate metabolic profile and the early onset of hypertensive measures.
Recent studies have focused on the reduction in muscle quantity and cardiometabolic alterations, as well as understanding the mediating role of muscle quantity in the relationship between adiposity and bone mineral content. However, there is a scientific gap in understanding the mediating role of muscle quantity, according to adiposity, components of physical fitness, and the presence of cardiometabolic factors in this age group.
One study hypothesized that muscle quantity mediates the relationships between adiposity, physical fitness, and cardiometabolic risk factors in adolescents. The study evaluated the mediation role of muscle quantity in the relationship between physical fitness and cardiometabolic risk in adolescents. The main findings indicated that muscle quantity shows a 26% mediation between CRF and CMRF in the total sample, whose relationship is most evident for girls (32%). LMI mediates 32% between fat mass and CRMF, and a 16% mediation effect was observed regarding MFR between RM-leg press and CMRF, being found as 25% in boys and 22% in girls.
Other studies have shown that adolescents who practice physical activity have adequate food choices, regardless of the level of somatic maturation and adiposity. This reinforces the need to encourage the regular practice of physical activities from an early age, mainly aimed at preventing obesity in children and adolescents.
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Muscle adiposity and cardiometabolic risk
Muscle adiposity refers to the amount of fat present in skeletal muscle tissue. It is associated with several health risks, particularly in older people. Studies have shown that increased muscle adiposity is linked to reduced muscle function and an increased risk of metabolic syndrome, which can lead to cardiovascular issues and other health complications.
The relationship between muscle adiposity and cardiometabolic risk has been the subject of several studies. One study found that increased intermuscular fat is associated with coronary microvascular dysfunction (CMD) and adverse cardiovascular outcomes, independent of body mass index (BMI) and other conventional risk factors. This suggests that muscle adiposity may be a novel risk factor for cardiometabolic diseases.
Another study focused on the impact of adiposity on muscle function in older adults with dynapenia, presarcopenia, and sarcopenia. The results indicated that community-dwelling older individuals with dynapenia had higher obesity levels and a greater risk of metabolic syndrome compared to those with sarcopenia. This study highlights the importance of muscle function in maintaining overall health and reducing the risk of cardiometabolic issues.
In children and adolescents, the relationship between muscle mass and adiposity is also significant. Some studies have found a reduction in muscle mass in relation to excessive fat mass, which can contribute to a higher risk of cardiometabolic alterations and the early onset of hypertensive measures. Additionally, the "Fat but Fit" interaction suggests that physical fitness may mitigate the harmful effects of excess weight, highlighting the importance of fitness in maintaining health.
Overall, muscle adiposity is a critical factor in cardiometabolic risk. The distribution of body fat changes with age, and increased fat infiltration into non-fat tissues, such as muscles, can have detrimental effects on overall health. Understanding the complex relationship between muscle adiposity and cardiometabolic risk is essential for developing interventions and treatments to improve health outcomes, particularly in older adults and individuals with obesity-related disabilities.
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Muscle adiposity and physical fitness
Muscle adiposity refers to the amount of fat present in muscle tissue. This can be measured using computed tomography or magnetic resonance imaging, which differentiate between skeletal muscle and adipose tissue based on their respective Hounsfield unit thresholds. Skeletal muscle adiposity is associated with physical activity levels, exercise capacity, and fibre shift in patients with chronic obstructive pulmonary disease (COPD). Higher percentages of intramuscular fat are observed in patients with COPD compared to healthy controls, and these percentages are associated with physical activity levels and exercise capacity.
In healthy individuals, there is a negative association between adiposity and muscle quality (MQ). Subcutaneous adipose tissue (SAT) is negatively associated with MQ in both males and females, and this relationship is not improved by resistance exercise (RE) training. However, RE training has been shown to increase muscle mass and strength in both males and females.
In adolescents, excessive fat mass is associated with reduced muscle mass, contributing to lower relative muscle mass and potentially compromising motor competence. The "Fat but Fit" interaction suggests that physical fitness may mitigate the negative effects of excess weight. Muscle strength is an important aspect of physical fitness that contributes to overall health in both adults and adolescents.
To improve muscle adiposity, one can engage in recreational activities that build muscle, such as climbing, yoga, or biking, and incorporate a high-protein diet to fuel muscle development. Weight loss is not just about building muscle but also about eating a balanced diet with nutritious foods and reducing empty calories. Consulting with a nutritionist can help tweak dietary and portion adjustments to achieve weight loss goals.
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Frequently asked questions
Muscle adiposity is the accumulation of fat in non-adipose tissues such as bone, liver, and muscle. This phenomenon is now recognised as a common feature of aging.
Muscle adiposity is associated with a decline in muscle strength and physical functioning, which can lead to an increased risk of falls and metabolic syndrome.
Factors such as estrogen deficiency, glucocorticoid treatment, disuse atrophy, and altered leptin signalling have been observed to stimulate the accumulation of fat in skeletal muscle.
