Immunometabolic Plasticity in Sarcopenic Obesity: Toward a New Paradigm for Precision Immunonutrition

Immunonutrition continues to generate heterogeneous and often contradictory clinical outcomes, suggesting that nutrients do not exert fixed immunological effects but interact with the biological context in which they operate. Sarcopenic obesity (SO) represents a paradigmatic clinical model of this complexity, where chronic low-grade inflammation, mitochondrial dysfunction, anabolic resistance, metabolic inflexibility, and microbiota remodeling converge to compromise the adaptive capacity of integrated immunometabolic networks. We propose that this condition may be interpreted as a state of impaired immunometabolic plasticity, which may help explain the context-dependent variability of nutritional responses. Within this perspective, micronutrients are viewed not simply as cofactors supporting immune competence but as dynamic regulators of interconnected immunometabolic pathways. Particular attention is devoted to vitamin D and resveratrol, presented as complementary regulators of immunometabolic plasticity. Within the proposed framework, vitamin D may contribute to immunometabolic competence, whereas resveratrol may act as a broader signaling modulator through the SIRT1/AMPK-PGC-1α axis, influencing mitochondrial function, inflammatory tone, metabolic flexibility, and epigenetic adaptation. Beyond isolated compounds, bioactive-rich food matrices, exemplified by Opuntia ficus-indica, are discussed as examples of systems-level modulators capable of coordinating inflammatory, metabolic, redox, and microbiota-dependent biological circuitry. This review introduces immunometabolic plasticity as a conceptual framework linking nutritional signals to the coordinated regulation of immune and metabolic adaptation across diverse biological contexts. Finally, we discuss how biomarker-guided phenotyping, multi-omics integration, and context-aware nutritional interventions may provide a foundation for precision immunonutrition, shifting the field from generalized supplementation strategies toward restoration of adaptive immunometabolic resilience.