SO-NUTS

The aging population faces two conditions that threaten healthy aging: high fat mass (obesity) and low muscle mass and function (sarcopenia). The combination of both –referred to as sarcopenic obesity– synergistically increases the risk of adverse health outcomes. The two conditions often co-occur as they reinforce each other and share common etiologies, mainly poor nutrition and inactivity.

Although all aging people are at risk of gaining weight and losing muscle mass, there is an even higher risk of becoming overweight and sarcopenic during the transition from working life to retirement, due to changes in poor nutritional intakes and lower physical activity levels. However, because of these rapid changes, retirement also offers a great window of opportunity to improve lifestyle, as older adults already need to restructure their daily activities. Furthermore, adopting a healthy lifestyle around the age of retirement offers sufficient time to prevent obesity, sarcopenia, sarcopenic obesity and provides long-term benefits, including healthy ageing and prevention/delay of dependence in later life.

To stimulate weight loss/prevent weight gain while preserving muscle mass, it is critical that both physical activity and adequate nutrition be addressed. It is key to change behavior in a sustainable manner, providing evidence based, personalized, and acceptable behavioural strategies and principles that can be integrated in daily life. Health technologies (e.g. applications, wearables) can provide promising tools for delivering personalized and appealing lifestyle interventions to a large group of people while keeping health care costs low. At this moment, there is a lack of effective, sustainable interventions that focus on retirement as an important turning point to promote both nutrition and physical activity behavior.

We aim to provide essential insights required to develop innovative strategies for preventing obesity, sarcopenia and sarcopenic obesity taking into account sociodemographic and health-related characteristics. Based on these strategies and new knowledge, we will design the personalized, cross-country SO-NUTS application that helps empowering people around the phase of/after retirement to lose weight while preserving muscle mass and function. We will test feasibility and effectiveness in a pilot study and secure implementation and dissemination with the help of an extensive network reaching through Europe and beyond.   

• Overall: The relevance and idea of the SO-NUTS project was published as a perspective article in Frontiers of Nutrition. The relevance of diet, physical activity, exercise and persuasive technology in the prevention and treatment of sarcopenic obesity, Frontiers of Nutrition 2021 https://www.frontiersin.org/articles/10.3389/fnut.2021.661449/full.
• Overall: In June all partners met for a 2-day consortium meeting in Madrid. Results were presented and great input was provided for the development of the SO-NUTS intervention.
• WP1: Performed an extensive literature review, consulted 14 experts and created the first phenotype for sarcopenic obesity. Important steps for the validation of the phenotype are made.
• WP2: Evaluated differences between diet, physical activity, and body composition across retirement groups. No major differences were observed.
• WP3: Performed a systematic review and meta-analyses on the effectiveness of interventions. The first manuscript is currently under review at Nutrition Reviews and presented at Nutrition congress? (June 2022). The second systematic review with network meta-analysis is ready in draft.
• WP4: A very extensive systematic review was performed on psychological interventions to change lifestyle behaviour around the time of retirement. Four focus groups were held with in total 20 participants and important insights on motivators, facilitators and barriers were required.
• WP5: The first low-fidelity prototype of the SO-NUTS application was built. It enables the use of various behaviour change techniques such as goalsetting and action planning. It offers clients to track their dietary intake and physical activity, goal setting, evaluation, communication with health professional and in the future with members of the community.
• WP6: The first discussions and draft on the design of the SO-NUTS intervention were made