Oxidative balance score is associated with increased risk of sarcopenia and sarcopenic obesity in non-elderly adults: results from NHANES 2011-2018.

Background: Sarcopenia and obesity, two prevalent health conditions, often coexist and exacerbate each other's impact, increasing the risk of chronic diseases and mortality. This dual condition is termed "sarcopenic obesity." The correlation between oxidative stress (OS) and sarcopenia or obesity was established, and the oxidative balance score (OBS) can serve as an indicator of overall dietary or lifestyle-related OS exposure within an individual. Prior reports have not addressed the relationship between OBS and sarcopenia or sarcopenic obesity in adults under 60. This study endeavors to explore these associations and to identify potential dietary and lifestyle risk factors.

Methods: We performed a cross-sectional analysis utilizing data from 4,241 participants in the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018. OBS is a cumulative score derived from 16 dietary components and 4 lifestyle components, where higher scores indicate greater exposure to antioxidants and lower exposure to pro-oxidant factors, reflecting a reduced oxidative stress burden. Weighted multivariate logistic regression was employed to investigate the association of OBS and sarcopenia and sarcopenic obesity. Further subgroup analyses was conducted to examine interactions with various covariates. The least absolute shrinkage and selection operator (LASSO) regression was applied to identify significant components of OBS associated with sarcopenia and sarcopenic obesity, which were subsequently integrated into a risk prediction nomogram model. The model's predictive accuracy was evaluated using the receiver operating characteristic (ROC) curve.

Results: After adjusting for potential confounders, the weighted logistic regression analyses demonstrated a significant negative association between OBS and the prevalence of sarcopenia (odds ratio [OR] = 0.954, 95% confidence interval [CI] = 0.925-0.984, P = 0.004) and sarcopenic obesity (OR = 0.948, 95% CI = 0.918-0.980, P = 0.002). The nomogram models, informed by key OBS components identified through LASSO regression, exhibited considerable predictive value for sarcopenia (area under the ROC curve [AUC] = 0.813, 95% CI = 0.792-0.833) and sarcopenic obesity (AUC = 0.894, 95% CI = 0.879-0.909).

Conclusion: This study reveals a robust inverse correlation between OBS and both sarcopenia and sarcopenic obesity in adults aged 20-59. These results suggest that an antioxidant-rich diet and healthy lifestyle practices, including low-fat diets, adequate vitamin B intake, regular physical activity, and weight management, may help mitigate the risk of sarcopenia and sarcopenic obesity. Further research is warranted to confirm these associations and determine causality.