Optimizing health outcomes for older adults with sarcopenic obesity: a scoping review of nutrition, exercise and combined interventions

Background Against the backdrop of an aging population, sarcopenic obesity—a high-risk geriatric syndrome—significantly increases the risk of disability and mortality among older adults. However, current nutrition, exercise, and combined intervention programs for this population are diverse, with scattered outcome measures and a lack of systematic integration, severely limiting the identification and translation of optimal clinical practice strategies. Methods This study was conducted from February to March 2026. Under the leadership of one researcher and with the assistance of two professional librarians, a search strategy was developed to conduct a systematic search of four Chinese databases: CNKI, Wanfang, VIP, and SinoMed, as well as four English-language databases: PubMed, Web of Science, CINAHL, and Embase. The search period spanned from the inception of each database to February 24, 2026. Results This review included a total of 30 studies involving 8,587 obese older adults with sarcopenia. Interventions can be categorized into three major types: exercise training, nutritional intervention, and combined exercise-nutrition interventions. The included studies reported findings across five major domains: body composition, muscle strength and physical function, metabolic and cardiovascular risk, overall health and quality of life, and muscle mass and biomarkers. The existing literature is characterized by diverse intervention protocols and a wide range of outcome measures; some studies reported concurrent changes in body composition and muscle function indicators. Conclusion This review systematically organized the classification of intervention measures and the distribution of outcome measures in studies on nutrition, exercise, and combined interventions for SO older adults, revealing the fragmented state of this field characterized by diverse intervention protocols and scattered outcome measures. Based on these findings, future research should focus on establishing a core set of outcome measures, conducting quantitative studies on the dose-response relationship of interventions, exploring the mechanisms of interaction between different exercise modalities and nutritional supplementation, and developing optimization strategies for personalized intervention plans, thereby providing an evidence-based foundation for the development of precise, localized intervention and care plans.