Nutrition and Physical Activity as Modulators of Osteosarcopenic Adiposity: A Scoping Review and Recommendations for Future Research

Abstract

Osteosarcopenic adiposity (OSA) syndrome denotes the confluence of bone, muscle, and adipose tissue deterioration. Being a complex entity, numerous uncertainties about OSA still exist, despite the extensive research on the topic. Our objectives were to evaluate human studies addressing dietary intake/nutritional status, and the quantity/types of physical activity related to OSA. The search in PubMed, Scopus, and Web of Science databases was conducted to examine relevant articles published from inception to the end of December 2022, utilizing the MeSH strings in the search strategy. Only studies published in English and conducted in humans (≥18 years) without chronic conditions (cancers, kidney/liver disease) or pregnancy, were used. Book chapters, abstracts-only, and studies in which participants did not have all three body composition components measured to identify OSA, or when body composition components could not be related to the independent/exposure variables were excluded. A total of n = 1020 articles were retrieved from all three databases and eight more from the reference lists. After exclusion of duplicates and other unsuitable articles, n = 23 studies were evaluated. Among those, eleven were from epidemiological or cross-sectional studies relating nutrients/dietary intake or nutritional status with OSA. Another four examined the relationship between serum biomarkers (vitamin D and ferritin) with OSA, while eight articles presented the results of the interventional studies with resistance training. Overall, higher protein, calcium, potassium, and vitamins D and C intakes emerged as nutrients positively modifying OSA, along with diet higher in fruits and low-fat dairy foods. Higher serum vitamin D and ferritin were respectively positively and negatively related to OSA. Resistance training was a safe intervention yielding several beneficial outcomes for the OSA syndrome in older women.

Sarcopenic obesity and the impact on bone health

“…In addition, a link between infectious diseases and the development of complex conditions related to body composition has been suggested [14]. Furthermore, the lack of new original data on the potential cellular and molecular mechanisms involved in the events leading to the skeletal alterations in subjects with sarcopenic obesity, recent interesting reviews highlight the main points of future research in this field [15 Since the concomitant presence of obesity, sarcopenia, and osteoporosis represents a dreadful trio potentially occurring in postmenopausal women and individuals of advanced age, as each of these conditions is related with adverse outcomes in terms of morbidity, quality of life, and mortality [16], recent works have tried to identify clinical potential early biomarkers and factors further involved in OSO development [17]. Interestingly, a few studies have suggested that high serum ferritin levels are strongly linked to metabolic syndrome, obesity, impaired muscle quality, and sarcopenia [18].…”

“…Since the concomitant presence of obesity, sarcopenia, and osteoporosis represents a dreadful trio potentially occurring in postmenopausal women and individuals of advanced age, as each of these conditions is related with adverse outcomes in terms of morbidity, quality of life, and mortality [16], recent works have tried to identify clinical potential early biomarkers and factors further involved in OSO development [17]. Interestingly, a few studies have suggested that high serum ferritin levels are strongly linked to metabolic syndrome, obesity, impaired muscle quality, and sarcopenia [18].…”