**5. Molecular and cellular of the combined ketogenic diet and walking exercise interventions in the community older skeletal muscle sarcopenia**

The physiological molecular and cellular mechanisms of the combined ketogenic diet and walking exercise interventions in the older community groups that underlie diminished aging response in older age. About 120 days of walking exercise training interventions produced a reduction in plasmatic levels of protein carbonylation and lipid peroxidation in older [73]. Lipid peroxidation is one of the most irreversible changes of oxidative protein modifications, observed on an increase in the protein carbonylation and lipid peroxidation in the community older groups [74–76]. However, nonpharmacological strategies such as exercise interventions and ketone body supplements are of significant difference decreased. In the combined ketogenic diet and walking exercise interventions in the older community groups reduced nucleic acid oxidation and lipid peroxidation were observed [76, 77–79]. Ketone body supplementation and walking exercise interventions have been shown to result in a reduction in superoxide dismutase (Mn-SOD) levels [80]. While 120 days of the walking training exercise was seen to be associated with increased SOD activity. The earliest studies showed glutathione reductase [81, 82], catalase [83, 84], glutamine synthetase [85] that these compounds cause older lifestyle changes like you know, people talk about exercising and walking that improve your health for your body, and managing stress, among participants give lifestyle tips on the ketogenic diet and walking exercise training to control their mitochondria keep moving. After exercise interventions, although another study showed approximately no change in protein carbonylation across the age groups. Nitric oxide synthase (NOS) induces nitric oxide synthase (iNOS) inducible to produce NO. Increasing nitric oxide (NO) and nitric oxide synthase are promoted the repairment of damaged pathways and accelerated endothelial nitric oxide synthase [86]. In this walking exercise training interventions regimens, inhibition of the extracellular-signal-regulated inducible nitric oxide synthase and down-requirement endothelial nitric oxide synthase (eNOS) resulting in disturbed RAS system. The ACE2-Ang II-AT1R/AT2R axis is a well-established component of RAS through angiotensin (Ang II)/angiotensinII type 1 receptor (AT1R) or angiotensin (Ang II)/angiotensinII type 1 receptor (AT2R) [87, 88]. Walking exercise training interventions improved cognitive remediation reninangiotensin system (ARS) in the community older groups. After adaptive walking exercise training intervention with the ketogenic diet for two rounds of walking exercise, the maximal exercise capacity test was measured. Walking exercise training

*Combined Ketogenic Diet and Walking Exercise Interventions in Community Older Frailty… DOI: http://dx.doi.org/10.5772/intechopen.101579*

intervention after ketogenic diet activated SIRT-1/SIRT-3 signaling pathways [87–90] and vascular endothelial growth factor (VEGF) [91, 92] because walking exercise training interventions increased NAD/NADH ratio in the community older groups. SIRT-1/SIRT-3 signaling pathways belonging to the renin-angiotensin system (ARS) have also been thoroughly explored [93, 94]. SIRT-1/SIRT-3 pathway is a signaling pathway that preserves health under conditions demonstrated that the activation of AMPK through walking exercise training increases SIRT activation and mTOR inhibition [95]. Although walking exercise training is an effective way to improve SIRT-1, SIRT-3, VEGF, AMPK, and mTOR. Walking exercise training to regulate vascular endothelial growth factor (VEGF) and nitric oxide synthase (NOS) synthesis can rise various interventional. SIRT-1, SIRT-3, VEGF, AMPK, and mTOR are seen increases before and after our exercise intervention. NO and VEG has been demonstrated measurable decreases in the community older groups. VEGF plays an important role in the benefits of walking exercise training performance and brain blood flow in the community older groups. The synthesis of VEGF can be induced by NO [88]. In addition, combined ketogenic diet and walking exercise training intervention were seen to increase intracellular AMPK pathway, the AMPK pathway was the main pathway through PI3K/Akt/mTOR pathway in the community older groups. Therefore, a walking exercise training was planned for up-regulation PI3K/Akt/mTOR and AMPK pathways and anti-inflammatory [96–101]. Walking exercise training interventions generally leads to bred with mitochondrial DNA (mtDNA) affecting genes involved in every aspect of the mtDNA repair [102–109]. These findings combined are particularly interesting when considering mtDNA deletions and inflammation factor, NF-KB, in the community older groups.
