Macronutrient Mitigation Role on Sarcopenic Obesity in Older Adults: An Updated Systematic Review of the Last Decade

Abstract Context Sarcopenic obesity (SO) is a complex condition that affects older adults and is characterized by the coexistence of obesity and sarcopenia (loss of muscle mass and strength). This condition represents a challenge for public health due to its negative impact on the quality of life, mobility, and increased risk of comorbidities, such as cardiovascular disease, diabetes, and frailty. Nutrition is crucial in managing and preventing SO; macronutrients (protein, carbohydrates, and fats) may directly influence body composition, muscle mass, and aging metabolism. Objective This systematic review evaluates the available literature on macronutrient distribution and nutritional supplementation strategies in the treatment of SO. Data Sources Three databases were considered for data analysis: PubMed, Google Scholar, and Cochrane Central. Data Extraction The PICOS (Population, Intervention, Comparison, Outcome, Study design) method was used to identify and analyze studies. Data Analysis Dietary interventions, macronutrient distribution, and nutritional treatments applied in the included studies were analyzed using narrative thematic synthesis, with findings grouped according to the thematic similarity across studies. For selected quantitative data extracted from the studies, descriptive statistics were used, including mean values and reported minimum and maximum ranges. Conclusion This review underscores the need for personalized nutritional interventions that optimize macronutrient balance and integrate targeted supplementation combined with resistance training to improve the metabolic and functional health of older adults with SO. Systematic Review Registration PROSPERO no. CRD420251017389.