Bioactive Nutritional Components Within the Planetary Health Diet for Preventing Sarcopenic Obesity and Diabetic Sarcopenia: A Systematic Review.

BACKGROUND

Sarcopenic obesity (SO) and diabetic sarcopenia (DS) represent overlapping metabolic-musculoskeletal disorders characterized by the coexistence of excessive adiposity, insulin resistance, and progressive muscle wasting. The Planetary Health Diet (PHD), proposed by the EAT-Lancet Commission, emphasizes plant-forward, nutrient-dense, and environmentally sustainable food patterns that may concurrently address metabolic and muscle health. This review aimed to systematically evaluate dietary and bioactive nutritional interventions aligned with the PHD and their effects on muscle mass, strength, metabolism, and underlying mechanisms in SO and DS.

METHODS

Following PRISMA guidelines, studies published between 2015 and 2025 were identified across PubMed, Scopus, and Google Scholar. Eligible studies included dietary, nutritional, or supplement-based interventions reporting muscle-related outcomes in obesity- or diabetes-associated conditions.

RESULTS

Ninety-one eligible studies were categorized into plant-derived, animal/marine-based, microorganism/fermented, synthetic/pharmaceutical, and environmental interventions. Across diverse models, bioactive compounds such as D-pinitol, umbelliferone, resveratrol, GABA, ginseng, whey peptides, probiotics, and omega-3 fatty acids consistently improved muscle mass, strength, and mitochondrial function via AMPK-SIRT1-PGC-1α and Akt-mTOR signaling. These mechanisms promoted mitochondrial biogenesis, suppressed proteolysis (MuRF1, Atrogin-1), and enhanced insulin sensitivity, antioxidant capacity, and gut-muscle communication.

CONCLUSIONS

PHD-aligned foods combining plant proteins, polyphenols, and fermented products strengthen nutrient sensing, mitochondrial efficiency, and cellular resilience, representing a sustainable nutritional framework for preventing and managing SO and DS.