Chronic Stress Contributes to Osteosarcopenic Adiposity via Inflammation and Immune Modulation: The Case for More Precise Nutritional Investigation

Abstract

Chronic stress and low-grade chronic inflammation (LGCI) are key underlying factors for many diseases, including bone and body composition impairments. Objectives of this narrative review were to examine the mechanisms by which chronic stress and LGCI may influence osteosarcopenic adiposity (OSA) syndrome, originally named as ostoesarcopenic obesity (OSO). We also examined the crucial nutrients presumed to be affected by or cause of stress and inflammation and compared/contrasted them to those of our prehistoric ancestors. The evidence shows that stress (particularly chronic) and its related inflammatory processes, contribute to osteoporosis, sarcopenia, and adiposity ultimately leading to OSA as a final and most deranged state of body composition, commencing at the mesenchymal cell lineage disturbance. The foods/nutrients consumed by modern humans, as well as their altered lifestyle, also contribute to stress, LGCI and subsequently to OSA. The processes can also go in opposite direction when stress and inflammation impact nutritional status, particularly some micronutrients’ levels. While nutritional management of body composition and LGCI have been studied, the nutrients (and their quantities) most affected by stressors and those which may act toward the alleviation of stressful state, ultimately leading to better body composition outcomes, need to be elucidated.

<p>Osteosarcopenic Obesity Associated with Poor Physical Performance in the Elderly Chinese Community</p>

“…An interesting finding in this study showed, different from women, men with OSO had a significantly higher PBF% and a lower muscle mass compared with O and OO groups, but their BMI values are not increasing in OSO group. 33,36 In other words, OSO appears to be more associated with high-fat/low-muscle mass body composition types in men. This finding is also supported by a previous study, they found that senior males with OSO showed unfavorable body composition compared with their peers with SO, OO or O.…”

“…32 Also, a new concept of osteosarcopenic adiposity (OSA) has been implemented, it is suggested that OSO definition is not just overt overweight/obesity (BMI), special attention should also be paid to infiltrating fat in bone and redistributing fat in visceral area. 33 For example, the reduction of muscle satellite cells caused by myosteatosis and the infiltration of bone marrow adipocytes. 34,35 The incidence of OSO in this study is 10.2%, which is a little higher than a previous study in China (7.3%).…”

Nutritional and Behavioral Approaches to Body Composition and Low-Grade Chronic Inflammation Management for Older Adults in the Ordinary and COVID-19 Times

“…OSA refers to the simultaneous loss of bone mass and strength (osteopenia/osteoporosis), diminished skeletal muscle mass, strength and functionality (sarcopenia/dynapenia), and gain in adipose tissue (either as overt obesity, or as redistributed fat in abdominal/visceral area, or as infiltrated fat into bone and muscle) [ 1 , 2 , 3 , 4 ]. OSA has been studied across the world and associated with poor diet, various metabolic disorders and compromised functionality, including balance, walking speed and handgrip strength, in populations of different backgrounds, sex and age, as recently reviewed in [ 5 , 6 ].…”

“…Another critical health aspect is the presence of low-grade chronic inflammation (LGCI) which might run undetected and unresolved for long periods, but which is increasingly recognized as a contributing factor to numerous comorbidities, including OSA [ 6 , 7 ]. In fact, the “cytokine storm” manifested in COVID-19 infection [ 8 ] has been suggested to be triggered or at least worsened by the presence of LGCI.…”

“…The most obvious differences are a decrease in energy expenditure and an increase in energy intake via foods low in nutrients but high in energy. [ 6 , 7 ]. To compensate for the decreased intake of nutrient-dense foods, research has expanded on investigating numerous bioactive food components as well as the microbiome in the context of their health benefits and this has been particularly heightened in the COVID-19 pandemic; all addressed below.…”