Poor muscle health is linked to an increased risk of an early death in obese individuals, according to new research being presented at the European Congress on Obesity (ECO) in Venice, Italy (12–15 May).

A Swedish study of individuals in the UK found that those with bad muscle composition were up to three times more likely to die during the research than those with healthy muscles.

“We found that just by looking at muscle composition we can predict which individuals with obesity are most likely to die during the next few years,” explains lead researcher Dr. Jennifer Linge of Linköping, Sweden-based AMRA Medical, a health informatics business.

Weight loss medications are making it possible for patients to shed more weight than in the past, and weight loss is becoming more and more advised in the treatment of chronic illnesses including type 2 diabetes and cardiovascular disease.

But when weight loss with medicines approaches that of surgery, worries about potential negative consequences on muscular health—like marked loss of muscle mass and decreased mobility—are becoming more pressing.

“Research has shown that although individuals with obesity have more muscle mass, their muscles are, in general, relatively weaker,” according to Dr. Linge. “They are less mobile and functional, and their muscles are of poorer condition.

“Accurate assessment of muscle composition, assessing both quantity and quality of the muscles during evaluation these treatments will teach us whether significant and rapid weight loss is safe – especially for the more vulnerable patients, such as those with sarcopenic obesity or of older age.”

Further study is also required to fully understand the significance of preserving muscular health.

In the general population and in individuals with non-alcoholic fatty liver disease (NAFLD), poor muscle health has been linked in previous research using magnetic resonance imaging (MRI) to poor functional performance (lower grip strength, slower walking pace, more difficulty climbing stairs, and more prone to falls), illness, and death from any cause.

However, there is a paucity of information on those who suffer from obesity.

In order to learn more, Dr. Linge and associates analyzed MRI images from 56,109 people in the UK Biobank research using AMRA Researcher, software that calculates body composition from MRI scans.

A customized muscle volume z-score, which shows how an individual’s muscle volume relates to the average for their sex and body size, was computed after measuring muscle volume (a measure of muscle amount) and muscular fat (a measure of muscle quality).

Depending on whether they had normal muscle composition, high muscle fat only, low muscle volume z-score only, or adverse muscle composition (both high muscle fat and low muscle volume z-score), participants were divided into four groups.

There were 9,840 participants in all (50% men, average age 64.4 years, BMI 33.5 kg/m2) who were obese; information on their sex, age, BMI, and muscle composition was provided. Among them. There were 2,001 (20.3%) with a poor muscular composition.

174 of the participants passed away during the 3.9 years on average that they were followed up. Ischemic disease (coronary heart disease) and hypertensive disease (primary hypertension, hypertensive heart disease, and hypertensive kidney disease) were the leading causes of death.

Adverse muscular composition, or having both low muscle volume z-score and high muscle fat, was substantially related with an increased risk of death from any cause, while neither low muscle volume z-score nor high muscle fat alone were. According to the researchers, this emphasizes how crucial it is to measure both muscle volume and muscle fat content when assessing the health of muscles.

Compared to those with normal muscle composition, those with unfavorable muscle composition had a threefold increased risk of passing away during follow-up.

Even after accounting for strength (hand grip), other diseases (cancer, type 2 diabetes, and coronary heart disease), and lifestyle factors (smoking, alcohol use, and physical exercise), there was still a significant correlation between poor muscle health and all-cause mortality. Unfavorable muscle composition was linked in this fully adjusted model to a 70% increased risk of dying young.

A increased risk of dying young was also linked to smoking, age, sex, and type 2 diabetes.

The researchers came to the conclusion that people with obesity frequently had abnormal muscle composition, which was strongly correlated with all-cause death.

Dr. Linge continues, “The results indicate that maintaining muscle health is of paramount importance for people with obesity.”

“Determining whether drugs achieving significant or rapid weight loss are causing excessive loss of muscle or worsen muscle quality will lead to safer treatment of obesity, both in general and in more vulnerable patients.”