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Review
. 2020 Apr 2;12(4):989.
doi: 10.3390/nu12040989.

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

Jasminka Z Ilich  1 , Jennifer C Gilman  2 , Selma Cvijetic  3 , Dario Boschiero  4
Affiliations
Review

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

Jasminka Z Ilich et al. Nutrients. .

Abstract

Chronic stress and low-grade chronic inflammation (LGCI) are key underlying factors formany diseases, including bone and body composition impairments. Objectives of this narrativereview were to examine the mechanisms by which chronic stress and LGCI may influenceosteosarcopenic adiposity (OSA) syndrome, originally named as ostoesarcopenic obesity (OSO).We also examined the crucial nutrients presumed to be affected by or cause of stress andinflammation and compared/contrasted them to those of our prehistoric ancestors. The evidenceshows that stress (particularly chronic) and its related inflammatory processes, contribute toosteoporosis, sarcopenia, and adiposity ultimately leading to OSA as a final and most derangedstate of body composition, commencing at the mesenchymal cell lineage disturbance. Thefoods/nutrients consumed by modern humans, as well as their altered lifestyle, also contribute tostress, LGCI and subsequently to OSA. The processes can also go in opposite direction when stressand inflammation impact nutritional status, particularly some micronutrients' levels. Whilenutritional management of body composition and LGCI have been studied, the nutrients (and theirquantities) most affected by stressors and those which may act toward the alleviation of stressfulstate, ultimately leading to better body composition outcomes, need to be elucidated.

Keywords: chronic stress; low grade chronic inflammation; micronutrients; nutrition; osteosarcopenic adiposity; osteosarcopenic obesity.

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Conflict of interest statement

J.Z.I., J.C.G., S.C., and D.B. declare no potential conflicts of interest. D.B. is employee of BioTekna®.

Figures

Figure 1
Figure 1
Immune system response to insult leading to low-grade chronic inflammation.
Figure 2
Figure 2
Hypothetical presentation of cortisol activity in normal diurnal variation, full green line (with slight ups and downs during eating or other activities) and under chronic stress, full red line (flat-high, when it is lower than normal-morning and higher than normal-night) or dashed red line (flat-low, when it is lower all the time).
Figure 3
Figure 3
Beneficial vs. harmful effects of stress on immune system and potential health outcomes.
Figure 4
Figure 4
Major contributors to bone and body composition impairments.
Figure 5
Figure 5
Major nutritional shortfalls or excesses of modern diets compared to our prehistoric ancestors.
Figure 6
Figure 6
Various factors affecting osteoblastogenesis, myogenesis and adipogenesis, under the influence of stress and low-grade chronic inflammation (LGCI), prompted by poor diets, ultimately leading to disturbance of normal bone, muscle and adipose tissue lineages and development of osteosarcopenic adiposity (OSA).
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