title: Osteosarcopenic obesity: the role of bone, muscle, and fat on health.
abstract: Osteopenia/osteoporosis, sarcopenia, and obesity are commonly observed in the process of aging, and recent evidence suggests a potential interconnection of these syndromes with common pathophysiology. The term osteosarcopenic obesity has been coined to describe the concurrent appearance of obesity in individuals with low bone and muscle mass. Although our understanding of osteosarcopenic obesity's etiology, prevalence, and consequences is extremely limited, it is reasonable to infer its negative impact in a population that is aging in an obesogenic environment. It is likely that these individuals will present with poorer clinical outcomes caused by the cascade of metabolic abnormalities associated with these changes in body composition. Clinical outcomes include but are not limited to increased risk of fractures, impaired functional status (including activities of daily living), physical disability, insulin resistance, increased risk of infections, increased length of hospital stay, and reduced survival. These health outcomes are likely to be worse when compared to individuals with obesity, sarcopenia, or osteopenia/osteoporosis alone. Interventions that utilize resistance training exercise in conjunction with increased protein intake appear to be promising in their ability to counteract osteosarcopenic obesity.
authors.affiliation: Department of Nutrition, Food and Exercise Sciences, The Florida State University, 120 Convocation Way, Tallahassee, FL, 32306-1493, USA, mormsbee@fsu.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ormsbee
authors.forename: Carla M
authors.initials: CM
authors.lastname: Prado
authors.forename: Jasminka Z
authors.initials: JZ
authors.lastname: Ilich
authors.forename: Sarah
authors.initials: S
authors.lastname: Purcell
authors.forename: Mario
authors.initials: M
authors.lastname: Siervo
authors.forename: Abbey
authors.initials: A
authors.lastname: Folsom
authors.forename: Lynn
authors.initials: L
authors.lastname: Panton
references.citation: Proc Nutr Soc. 2000 Nov;59(4):505-9
references.pmid: 11115784
references.citation: Nutr Rev. 2012 Jan;70(1):57-64
references.pmid: 22221216
references.citation: J Muscle Res Cell Motil. 1996 Aug;17(4):487-95
references.pmid: 8884603
references.citation: Eur J Appl Physiol. 2006 Aug;97(6):643-63
references.pmid: 16845551
references.citation: Clin Nutr. 2012 Oct;31(5):583-601
references.pmid: 22809635
references.citation: J Am Geriatr Soc. 2002 Nov;50(11):1802-9
references.pmid: 12410898
references.citation: J Clin Endocrinol Metab. 2004 Aug;89(8):3651-5
references.pmid: 15292281
references.citation: Curr Opin Clin Nutr Metab Care. 2013 Sep;16(5):525-33
references.pmid: 23799328
references.citation: JAMA. 2010 Jan 20;303(3):235-41
references.pmid: 20071471
references.citation: Am J Epidemiol. 2004 Feb 15;159(4):413-21
references.pmid: 14769646
references.citation: J Clin Invest. 1981 Feb;67(2):328-35
references.pmid: 7462421
references.citation: Am Fam Physician. 2011 May 15;83(10):1197-200
references.pmid: 21568254
references.citation: J Gerontol A Biol Sci Med Sci. 2006 Oct;61(10):1059-64
references.pmid: 17077199
references.citation: J Bone Miner Res. 1997 Oct;12(10):1539-46
references.pmid: 9333113
references.citation: Ageing Res Rev. 2014 May;15:51-60
references.pmid: 24632496
references.citation: Int J Chron Obstruct Pulmon Dis. 2007;2(3):289-300
references.pmid: 18229567
references.citation: Obes Rev. 2008 Sep;9(5):489-500
references.pmid: 18331420
references.citation: Maturitas. 2013 Jun;75(2):175-80
references.pmid: 23628279
references.citation: Rev Endocr Metab Disord. 2004 Aug;5(3):261-8
references.pmid: 15211098
references.citation: Diabetes Obes Metab. 2007 Nov;9(6):799-812
references.pmid: 17924864
references.citation: HIV Med. 2006 Jul;7(5):299-310
references.pmid: 16945075
references.citation: FASEB J. 1999;13 Suppl:S101-12
references.pmid: 10352151
references.citation: Trends Neurosci. 2014 Jan;37(1):39-46
references.pmid: 24239063
references.citation: J Nutr Health Aging. 2008 Aug-Sep;12(7):433-50
references.pmid: 18615225
references.citation: Calcif Tissue Int. 2008 Oct;83(4):260-71
references.pmid: 18815824
references.citation: Clin Geriatr Med. 2008 Aug;24(3):455-69, vi
references.pmid: 18672182
references.citation: Am J Clin Nutr. 1989 Nov;50(5 Suppl):1121-235
references.pmid: 2816807
references.citation: J Appl Physiol (1985). 1998 May;84(5):1716-22
references.pmid: 9572822
references.citation: Aging Clin Exp Res. 2007 Aug;19(4):277-83
references.pmid: 17726357
references.citation: Maturitas. 2012 Feb;71(2):109-14
references.pmid: 22153348
references.citation: Osteoporos Int. 2010 Apr;21(4):543-59
references.pmid: 19779761
references.citation: J Am Geriatr Soc. 2004 Jan;52(1):80-5
references.pmid: 14687319
references.citation: J Appl Physiol (1985). 2003 Nov;95(5):1851-60
references.pmid: 14555665
references.citation: J Gerontol A Biol Sci Med Sci. 2007 Dec;62(12):1375-81
references.pmid: 18166688
references.citation: Br Med Bull. 1997;53(2):238-52
references.pmid: 9246834
references.citation: Am J Med. 2011 Nov;124(11):1043-50
references.pmid: 22017783
references.citation: J Appl Physiol (1985). 2009 May;106(5):1529-37
references.pmid: 19265063
references.citation: Proc Natl Acad Sci U S A. 1994 Apr 26;91(9):3569-73
references.pmid: 7513424
references.citation: Obes Res. 2004 Jun;12(6):887-8
references.pmid: 15229325
references.citation: J Clin Densitom. 2009 Oct-Dec;12(4):413-6
references.pmid: 19733110
references.citation: World Health Organ Tech Rep Ser. 1995;854:1-452
references.pmid: 8594834
references.citation: Am J Epidemiol. 1998 Apr 15;147(8):755-63
references.pmid: 9554417
references.citation: Am J Clin Nutr. 1993 Nov;58(5):589-91
references.pmid: 8237861
references.citation: J Nutr. 2003 Feb;133(2):411-7
references.pmid: 12566476
references.citation: Am J Med. 1997 Aug 18;103(2A):12S-17S; discussion 17S-19S
references.pmid: 9302893
references.citation: Curr Pharm Des. 2004;10(21):2629-41
references.pmid: 15320750
references.citation: Age Ageing. 2013 Mar;42(2):203-9
references.pmid: 23321202
references.citation: Amino Acids. 2013 Aug;45(2):231-40
references.pmid: 23645387
references.citation: Ann N Y Acad Sci. 2000 May;904:437-48
references.pmid: 10865787
references.citation: Obes Rev. 2011 Jan;12(1):50-61
references.pmid: 20059703
references.citation: Am J Clin Nutr. 1990 Aug;52(2):214-8
references.pmid: 2375286
references.citation: J Appl Physiol (1985). 1994 Aug;77(2):614-20
references.pmid: 8002507
references.citation: Age Ageing. 2010 Jul;39(4):412-23
references.pmid: 20392703
references.citation: Nutr Metab Cardiovasc Dis. 2008 Jun;18(5):388-95
references.pmid: 18395429
references.citation: J Bone Miner Res. 1997 Oct;12(10):1547-51
references.pmid: 9333114
references.citation: Curr Opin Clin Nutr Metab Care. 2008 Nov;11(6):693-700
references.pmid: 18827572
references.citation: Medscape Womens Health. 2002 May-Jun;7(3):2
references.pmid: 12142855
references.citation: Br J Sports Med. 1999 Jun;33(3):190-5
references.pmid: 10378072
references.citation: BMC Musculoskelet Disord. 2011 May 20;12:105
references.pmid: 21599967
references.citation: Am J Clin Nutr. 2009 Jun;89(6):1895-900
references.pmid: 19369381
references.citation: Orthop Clin North Am. 2006 Oct;37(4):611-22
references.pmid: 17141019
references.citation: Sports Med. 2005;35(4):339-61
references.pmid: 15831061
references.citation: Am J Cardiol. 2008 Jun 2;101(11A):69E-77E
references.pmid: 18514630
references.citation: Arthritis Rheum. 2012 Dec;64(12):3947-54
references.pmid: 23192792
references.citation: AIDS Res Hum Retroviruses. 2013 Mar;29(3):435-40
references.pmid: 23072344
references.citation: J Am Geriatr Soc. 2006 Jan;54(1):56-62
references.pmid: 16420198
references.citation: Am J Epidemiol. 1992 Aug 1;136(3):257-65
references.pmid: 1415147
references.citation: N Engl J Med. 2011 Mar 31;364(13):1218-29
references.pmid: 21449785
references.citation: J Bone Miner Res. 2007 Mar;22(3):465-75
references.pmid: 17144789
references.citation: Clin Interv Aging. 2010 Sep 07;5:217-28
references.pmid: 20852669
references.citation: Calcif Tissue Int. 1983 Jul;35(4-5):406-9
references.pmid: 6616313
references.citation: Appl Physiol Nutr Metab. 2006 Dec;31(6):655-60
references.pmid: 17213879
references.citation: Annu Rev Nutr. 1997;17:527-58
references.pmid: 9240939
references.citation: Andrologia. 2001 Nov;33(6):384-9
references.pmid: 11736801
references.citation: Anticancer Agents Med Chem. 2013 Oct;13(8):1197-203
references.pmid: 23919745
references.citation: Cancer Treat Rev. 2012 Oct;38(6):798-806
references.pmid: 22429722
references.citation: Sports Med. 2004;34(12):809-24
references.pmid: 15462613
references.citation: Endocrinology. 2004 Feb;145(2):751-9
references.pmid: 14563699
references.citation: Proc Natl Acad Sci U S A. 1991 Apr 1;88(7):2936-40
references.pmid: 1849281
references.citation: Obes Res. 2004 Dec;12(12):1995-2004
references.pmid: 15687401
references.citation: Lancet Oncol. 2008 Jul;9(7):629-35
references.pmid: 18539529
references.citation: BMJ. 1995 Jul 15;311(6998):158-61
references.pmid: 7613427
references.citation: Osteoporos Int. 2004 Feb;15(2):87-94
references.pmid: 14605799
references.citation: J Nutr. 2011 Aug;141(8):1489-94
references.pmid: 21677076
references.citation: Ann Epidemiol. 1991 Feb;1(3):245-54
references.pmid: 1669505
references.citation: J Am Geriatr Soc. 2002 May;50(5):897-904
references.pmid: 12028178
references.citation: Chest. 2002 Feb;121(2):609-20
references.pmid: 11834678
references.citation: Osteoporos Int. 2005 Apr;16(4):359-71
references.pmid: 15340799
references.citation: Ann N Y Acad Sci. 2000 May;904:553-7
references.pmid: 10865804
references.citation: World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253
references.pmid: 11234459
references.citation: Bone. 2013 Sep;56(1):23-9
references.pmid: 23684802
references.citation: Metabolism. 2008 Jun;57(6):757-65
references.pmid: 18502257
references.citation: Acta Physiol (Oxf). 2011 Sep;203(1):259-69
references.pmid: 21281456
references.citation: J Appl Physiol (1985). 2007 May;102(5):1767-72
references.pmid: 17234805
references.citation: J Appl Physiol (1985). 1997 Jul;83(1):229-39
references.pmid: 9216968
references.citation: Nature. 2000 Apr 6;404(6778):635-43
references.pmid: 10766250
references.citation: Pathobiol Aging Age Relat Dis. 2012 May 9;2(2012):
references.pmid: 22662293
references.citation: Osteoporos Int. 2000;11(11):944-52
references.pmid: 11193247
references.citation: Int J Sport Nutr Exerc Metab. 2006 Aug;16(4):373-92
references.pmid: 17136940
references.citation: Popul Health Metr. 2012 Nov 20;10(1):22
references.pmid: 23167948
references.citation: Osteoporos Int. 2004 Jul;15(7):567-74
references.pmid: 14730422
references.citation: Proc Nutr Soc. 2012 May;71(2):298-306
references.pmid: 22414338