title: Macronutrient Intake and Distribution in the Etiology, Prevention and Treatment of Osteosarcopenic Obesity.
abstract: Osteosarcopenic obesity, the combined deterioration of bone, muscle and fat tissues, could become the ultimate trajectory of aging. Aging stem cells are deregulated by low-grade chronic inflammation and possibly by diet. The metabolic shift of stem cells towards adipogenesis results in osteo obesity, sarco obesity and obesity. Macronutrients have numerous physiological functions but are regarded mainly for their energy contribution. Currently, no nutritional causes or treatment/prevention guidelines exist for osteosarcopenic obesity.
  
  
  
  The aim of this review is to assemble the evidence to elucidate if the macronutrient composition of the Western diet has an effect on the development of osteosarcopenic obesity. In view of the role of brain in locomotion a section examining the macronutrients as possible modulators of brain functioning was included.
  
  
  
  An extensive literature search of PubMed and Medline was conducted for human data using combinations and synonyms of osteoporosis, sarcopenia and obesity, and energy, carbohydrate, protein and lipid, and brain. US National Health and Nutrition Examination Survey (NHANES) food intake data from 2002-2012 were obtained and transposed to Microsoft Excel for analysis.
  
  
  
  NHANES data showed that energy imbalances in aging, excess high glycemic carbohydrate, lower protein intakes and low long chain polyunsaturated fat intakes may contribute to osteosarcopenic obesity. 135 articles were included in the review.
  
  
  
  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.
authors.affiliation: Abbott Nutrition, Columbus, Ohio, United States.
authors.forename: Owen J
authors.initials: OJ
authors.lastname: Kelly
authors.affiliation: Abbott Nutrition, Columbus, Ohio, United States.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Gilman
authors.affiliation: School of Environmental and Biological Sciences, Rutgers University, New Brunswick, New Jersey, United States.
authors.forename: Youjin
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, Florida, United States.
authors.forename: Jasminka Z
authors.initials: JZ
authors.lastname: Ilich
mesh_terms: D050154:Adiposity; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000375:Aging / Q000378:metabolism; D001921:Brain / Q000378:metabolism / Q000503:physiopathology; D002648:Child; D004032:Diet / Q000009:adverse effects; D000072001:Diet, Healthy; D004435:Eating; D002149:Energy Intake; D004734:Energy Metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D009753:Nutritive Value; D009765:Obesity / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control; D010024:Osteoporosis / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control; D064167:Recommended Dietary Allowances; D012307:Risk Factors; D055948:Sarcopenia / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control; D055815:Young Adult
keywords: Adiposity; aging; bone; carbohydrate; fat; muscle; osteosarcopenic obesity; protein