Macronutrient Intake and Distribution in the Etiology, Prevention and Treatment of Osteosarcopenic Obesity

Abstract

Early humans probably consumed a diet closer to what the human body was designed for; however, we do not know the ideal energy and macronutrient proportions for optimal health or for preventing/treating aging and osteosarcopenic obesity.

Osteosarcopenic obesity in women: impact, prevalence, and management challenges

“…The latter two play a substantial role in metabolic homeostasis, determining to what extent an individual is able to preserve bone mass, muscle mass and overall function, while still preserving an optimal body weight or reducing obesity with age 61,62…”

“…Some of the reasons why older adults in the US are potentially at nutritional risk include increased consumption of high-energy and low-nutrient dense types of food, inadequate dietary fiber consumption and decreased ability to absorb or utilize some essential nutrients 61–63. The Western diet being heavily based on processed food provides an increased amount of energy but decreased amount of many essential nutrients.…”

“…A typically low dietary fiber intake in older Americans is associated with insulin resistance and increased inflammation, especially in the obese 64. The Western diet is also characterized by a high ratio of omega-6 to omega-3 polyunsaturated fatty acids, which contributes to low-grade chronic inflammation and other unfavorable physiological outcomes 3,61,62. Besides the relatively unwholesome diet, older adults also often consume less nutrients secondary to decreased appetite, side effects from medications, dementia or a desire for weight loss.…”

“…Regarding polyunsaturated fatty acids, in addition to the beneficial effects of omega-3 fatty acids on numerous health outcomes, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), specifically, were shown to promote bone formation and reduce the negative effects of adiposity on bone 77. The combination of low protein, high simple carbohydrates, deficiencies of calcium, magnesium and potassium and excess of phosphorus, sodium and iron may be associated with lower bone mass, sarcopenia and obesity and, therefore, OSO syndrome 61,62. Overall, the nutrient composition of the Western diet, distribution and amounts, for both macro and micronutrients may not promote healthy aging and may be contributing to the development of OSO syndrome.…”

How Exercise and Dietary Intervention Affect the Outcome of Osteosarcopenic Obesity Syndrome?

“…However, it is important to balance high protein diet with calcium and vitamin D, as extensive high protein diet is associated with increased urinary calcium excretion, which may affect bone mineral density [29,30]. Aside from energy imbalance and lower protein intakes, it has been revealed that high level of simple carbohydrates and low omega-3 polyunsaturated fatty acids may also contribute to OSO syndrome [28,31]. It is also worth noting that elderly including frail women living in an assisted living facility or living alone tend to rely on someone else for food preparation.…”