The Efficacy of an Energy-Restricted Anti-Inflammatory Diet for the Management of Obesity in Younger Adults

There is growing evidence of the dietary impact on obesity-induced low-grade chronic inflammation and the associated chronic non-communicable diseases modification. We determined changes in body composition and cardiometabolic and inflammatory status of participants with obesity after 24 weeks of a dietary intervention based on an energy-reduced anti-inflammatory diet and examined the relationship of these changes with changes in the inflammatory potential of the diet. The anthropometric and body composition parameters of 81 participants (average age of 43 years, 74 women) were assessed. Metabolic status was determined using the glycemic and lipid statuses, and the cardiometabolic index and inflammatory status were determined using the concentration of high-sensitivity C-reactive protein (hs-CRP), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α). The inflammatory potential of the diet was assessed using the Dietary Inflammatory Index (DII®). Intervention with an anti-inflammatory diet resulted in a significant reduction in body weight and visceral adipose tissue and caused improvements in the participants’ cardiometabolic and inflammatory statuses. The anti-inflammatory diet was shown to be effective regarding obesity management. The study data could advance current scientific knowledge in the field of inflammation and diet, provide guidelines for obesity management, and find its application in routine clinical practice.

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Anti-inflammatory dietary intervention improved metabolic profile and body composition of obese adults

Proceedings of The Nutrition Society ◽

10.1017/s0029665120003493 ◽

2020 ◽

Vol 79 (OCE2) ◽

Author(s):

Gordana Kenđel Jovanović ◽

Sandra Pavičić Žeželj ◽

Sanja Klobučar Majanović ◽

Ines Mrakovčić Šutić ◽

Greta Krešić

Keyword(s):

Insulin Resistance ◽

Body Composition ◽

Body Weight ◽

Intervention Study ◽

Dietary Intervention ◽

Homa Index ◽

Obese Patients ◽

Inflammatory Status ◽

Anti Inflammatory ◽

Hs Crp

AbstractIt has become evident that chronic low-grade inflammation associated with excess adipose tissue plays an important role in the etiology of insulin resistance and other obesity related metabolic disturbances. Weight loss intervention focusing on anti-inflammatory dietary modification might help to attenuate and eventually reverse these disturbances. In this random case-control nutrition intervention study we hypothesized that obese patients will improve their inflammatory and metabolic status together with body composition following anti-inflammatory diet during 24 weeks. Body composition parameters of 42 obese patients, who completed the study, were determined by bioelectrical impedance analysis (Seca®, mBCA 515 Medical Body Composition Analyzer). Their inflammatory status was assessed with high-sensitivity C-reactive protein (hs-CRP), and insulin resistance with HOMA index. The inflammatory potential of their diet was assessed by the Dietary Inflammatory Index (DII®), based on 37 food parameters which derived from 123-item food frequency questionnaire. A positive DII® designates a diet with pro-inflammatory potential, while negative DII® designates a diet with anti-inflammatory potential. Data and z-scores were analyzed with Statistica v13.3 (StatSoft Inc., Tulsa, USA) for baseline and study end parameters differences. Obtained results have shown that, at the end of study, the patients significantly reduced their body weight (-3.3 %, p < 0.001), BMI (-3.2 %, p < 0.001), waist circumference (-1.9 %, p < 0.001), total (-3.3 %, p < 0.001) and visceral body fat (-10.4 %, p < 0.001), total (-3.1 %, p < 0.001) and extracellular water (-2.9 %, p < 0.001). The patients also significantly reduced hs-CRP (-37.7 %, p = 0.0025). Although we observed noteworthy -10.7 % reduction of HOMA index, this finding did not reach statistical significance (p = 0.862). The inflammatory potential of patients’ diet changed significantly from -0.45 to -1.73 on average (p < 0.001). With presented dietary intervention study it could be concluded that the change of the diet toward more anti-inflammatory milieu had significant influence on body weight, total and visceral body fat reduction. Consequently, those changes could have been involved in observed significant improvement of their inflammatory status. However, mild reduction of insulin resistance and rather small study group pointed out the need for further studies with more comprehensive dietary intervention.

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A Traditional Korean Diet with a Low Dietary Inflammatory Index Increases Anti-Inflammatory IL-10 and Decreases Pro-Inflammatory NF-κB in a Small Dietary Intervention Study

Nutrients ◽

10.3390/nu12082468 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2468

Author(s):

Phil-Kyung Shin ◽

Seon-Joo Park ◽

Myung Sunny Kim ◽

Dae Young Kwon ◽

Min Jung Kim ◽

...

Keyword(s):

Dietary Intervention ◽

Control Diet ◽

Diet Group ◽

Control Group ◽

Low Grade ◽

Dietary Inflammatory Index ◽

Obese Women ◽

Inflammatory Index ◽

Animal Fat ◽

Anti Inflammatory

Chronic low-grade inflammation may increase the risk of chronic disease, while diets rich in anti-inflammatory components may reduce it. To determine the anti-inflammatory properties of the traditional Korean diet (K-diet) that comprises high amounts of vegetables, fiber and phytochemicals, moderate amounts of legumes, and low amounts of animal fat, ten obese women aged 50–60 years were randomly assigned to the K-diet or control diet group. The control diet was a Westernized Korean diet commonly consumed in Korea, which is high in animal fat and protein. Subjects were housed in metabolic unit-like conditions during the 2-week intervention. Plasma was collected before and after the intervention to measure inflammatory cytokines using ELISA. The dietary inflammatory index (DII) was calculated based on nutrients and food intake. The DII score for the K-diet was lower than that of the control diet (−0.94 ± 1.39 vs. 1.04 ± 1.61, p < 0.001). In the K-diet group, anti-inflammatory interleukin (IL)-10 levels increased (4.45 ± 0.34 pg/mL vs. 5.94 ± 0.33 pg/mL, p = 0.0102), whereas pro-inflammatory nuclear factor kappa B (NF-κB) levels decreased (7.70 ± 0.62 pg/mL vs. 2.71 ± 0.49 pg/mL, p = 0.0015), but not in the control group. In the K-diet group, NF-κB levels negatively correlated with IL-10 levels (r = −0.794, p = 0.006). The K-diet has anti-inflammatory properties, and IL-10 and NF-κB are putative inflammatory markers for K-diet studies.

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Regular Practice of Moderate Physical Activity by Older Adults Ameliorates Their Anti-Inflammatory Status

Nutrients ◽

10.3390/nu10111780 ◽

2018 ◽

Vol 10 (11) ◽

pp. 1780 ◽

Cited By ~ 9

Author(s):

Miguel Ferrer ◽

Xavier Capó ◽

Miquel Martorell ◽

Carla Busquets-Cortés ◽

Cristina Bouzas ◽

...

Keyword(s):

Physical Activity ◽

Older Adults ◽

Body Composition ◽

Healthy Aging ◽

The Body ◽

Moderate Physical Activity ◽

Metabolic Equivalents ◽

Inflammatory Status ◽

Anti Inflammatory ◽

Regular Practice

A chronic inflammatory state is a major characteristic of the aging process, and physical activity is proposed as a key component for healthy aging. Our aim was to evaluate the body composition, hypertension, lipid profile, and inflammatory status of older adults, and these factors’ association with physical activity. A total of 116 elderly volunteers were categorized into terciles of quantitative metabolic equivalents of task (MET). Subjects in the first and third terciles were defined as sedentary and active subjects, respectively. Anthropometric and biochemical parameters, hemograms, and inflammatory markers were measured in plasma or peripheral mononuclear blood cells (PBMCs). The active groups exercised more than their sedentary counterparts. The practice of physical activity was accompanied by lower weight, fat mass, body mass index, and diastolic blood pressure when compared to a more sedentary life-style. Physical activity also lowered the haematocrit and total leukocyte, neutrophil, and lymphocyte counts. The practice of exercise induced a decrease in the IL-6 circulating levels and the TLR2 protein levels in PBMCs, while the expression of the anti-inflammatory IL-10 was activated in active subjects. The regular practice of physical activity exerts beneficial effects on body composition and the anti-inflammatory status of old people.

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Dietary Fiber's Effect on High Sensitivity C-reactive Protein Serum in Sedentary Workers

World Nutrition Journal ◽

10.25220/wnj.v05.i1.0006 ◽

2021 ◽

Vol 5 (1) ◽

pp. 40

Author(s):

Livia Kurniati Saputra ◽

Dian Novita Chandra ◽

Ninik Mudjihartini

Keyword(s):

Body Weight ◽

High Sensitivity ◽

The Body ◽

Low Grade ◽

C Reactive Protein ◽

Reactive Protein ◽

Dietary Fiber Intake ◽

Anti Inflammatory ◽

Low Grade Inflammation ◽

Inflammatory Effect

Low grade inflammation has been recognized of being involved in the pathogenesis of chronic disease pandemic. Individual lifestyle plays a major role in the development of low grade inflammation. Sedentary workers are at risk of low grade inflammation due to the nature of their work. Dietary habit also contributes to inflammatory status in the body. Dietary fiber intake indirectly affects the immune system. It has been hypothesized that fiber has anti-inflammatory effects, both body weight-related and body weight-unrelated This review will focus more on body weight-unrelated anti-inflammatory effect of fiber, especially through fiber’s fermentation metabolites, the short chain fatty acid (SCFA). Its anti-inflammatory effect can be seen by monitoring a biomarker of inflammation in the body, the high sensitivity C-reactive protein (hsCRP). This review’s objective is to cover the mechanisms and role of dietary fiber intake on serum hsCRP level as a marker of low grade inflammation on sedentary workers.

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Impact of a 3-Month Anti-inflammatory Dietary Intervention Focusing on Watermelon on Body Habitus, Inflammation, and Metabolic Markers: A Pilot Study

Nutrition and Metabolic Insights ◽

10.1177/1178638819899398 ◽

2020 ◽

Vol 13 ◽

pp. 117863881989939 ◽

Cited By ~ 3

Author(s):

Michael D Wirth ◽

Nitin Shivappa ◽

Samira Khan ◽

Shraddha Vyas ◽

Lynae Beresford ◽

...

Keyword(s):

Pilot Study ◽

Online Education ◽

Dietary Intervention ◽

Blood Draw ◽

Metabolic Markers ◽

Body Habitus ◽

Management Intervention ◽

Inflammatory Index ◽

Markers Of Inflammation ◽

Anti Inflammatory

An anti-inflammatory dietary intervention called the Inflammation Management Intervention (IMAGINE) was adapted to emphasize watermelon due to its anti-inflammatory properties. This pilot study (n = 23) tested the effect of a watermelon-enhanced IMAGINE intervention (n = 15) on body habitus and markers of inflammation and metabolism. This 3-month self-selection trial, consisting of weekly in-person classes and online education for 12 weeks, focused on incorporating watermelon into an already anti-inflammatory diet. Controls (n = 8) received basic health education via email and blogs. Measurements, including diet, anthropometrics, actigraphy, and a blood draw, were made at baseline and immediately postintervention. Linear regression analyses were conducted using intervention status as the main exposure. Post hoc analyses then ignored intervention assignment and grouped participants based on their change in their energy-adjusted Dietary Inflammatory Index (E-DIITM) score. There were no group-by-time interactions for any of the studied outcomes. However, some intervention participants’ diets became more proinflammatory, and several control participants’ diets became more anti-inflammatory. Those participants below the median of E-DII change (ie, more anti-inflammatory changes) showed reductions in body fat percent (–1.27% vs +0.90%, respectively, P = .01), body mass index (–0.66 vs +0.38 kg/m2, respectively, P = .06) and body weight (–0.99 vs +0.54 kg, respectively, P = .08) compared to those above the median of E-DII change. This study demonstrates that individuals who adopt a more anti-inflammatory diet containing watermelon will have improvements in body anthropometrics. Future studies should focus on increasing adherence and compliance to intervention prescriptions, exploring options to extend interventions to evaluate long-term changes, and further examining changes in inflammatory biomarkers. Clinical Trials Registration: NCT03158740

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A Genetic Score of Predisposition to Low-Grade Inflammation Associated with Obesity May Contribute to Discern Population at Risk for Metabolic Syndrome

Nutrients ◽

10.3390/nu11020298 ◽

2019 ◽

Vol 11 (2) ◽

pp. 298 ◽

Cited By ~ 6

Author(s):

Sebastià Galmés ◽

Margalida Cifre ◽

Andreu Palou ◽

Paula Oliver ◽

Francisca Serra

Keyword(s):

Metabolic Syndrome ◽

At Risk ◽

Ex Vivo ◽

Low Grade ◽

Omega 3 ◽

Genetic Score ◽

Population At Risk ◽

Inflammatory Status ◽

Anti Inflammatory ◽

Low Grade Inflammation

Omega-3 rich diets have been shown to improve inflammatory status. However, in an ex vivo system of human blood cells, the efficacy of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) modulating lipid metabolism and cytokine response is attenuated in overweight subjects and shows high inter-individual variability. This suggests that obesity may be exerting a synergistic effect with genetic background disturbing the anti-inflammatory potential of omega-3 long-chain polyunsaturated fatty acids (PUFA). In the present work, a genetic score aiming to explore the risk associated to low grade inflammation and obesity (LGI-Ob) has been elaborated and assessed as a tool to contribute to discern population at risk for metabolic syndrome. Pro-inflammatory gene expression and cytokine production as a response to omega-3 were associated with LGI-Ob score; and lower anti-inflammatory effect of PUFA was observed in subjects with a high genetic score. Furthermore, overweight/obese individuals showed positive correlation of both plasma C-Reactive Protein and triglyceride/HDLc-index with LGI-Ob; and high LGI-Ob score was associated with greater hypertension (p = 0.047), Type 2 diabetes (p = 0.026), and metabolic risk (p = 0.021). The study shows that genetic variation can influence inflammation and omega-3 response, and that the LGI-Ob score could be a useful tool to classify subjects at inflammatory risk and more prone to suffer metabolic syndrome and associated metabolic disturbances.

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Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition

Nutrients ◽

10.3390/nu13113925 ◽

2021 ◽

Vol 13 (11) ◽

pp. 3925

Author(s):

Luigi Barrea ◽

Giovanna Muscogiuri ◽

Gabriella Pugliese ◽

Giulia de Alteriis ◽

Annamaria Colao ◽

...

Keyword(s):

Body Composition ◽

Mediterranean Diet ◽

Metabolic Profile ◽

Low Grade ◽

Inflammatory Status ◽

Metabolically Healthy ◽

The Mediterranean ◽

Hs Crp ◽

Metabolic Indices ◽

Lower Adherence

Obesity and obesity-related low-grade inflammation are common findings in polycystic ovary syndrome (PCOS), the most common endocrine-metabolic disorder-affecting women in reproductive age. The terms metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) have been introduced to define individuals with obesity in whom cardio-metabolic risk factors are absent or present, respectively. To date, evidence investigating differences in body composition and adherence to the Mediterranean diet (MD) between MHO and MUO-PCOS women are lacking. Aim of this study was to better characterize the determinants of the metabolic health status in PCOS patients with obesity according to MHO and MUO phenotypes by evaluating endocrine-metabolic profile, inflammatory status, adherence to the MD, and body composition. The study population consisted of 94 treatment-naïve women with PCOS and obesity (BMI = 38.23 ± 6.62 kg/m2 and age = 24.12 ± 3.68 years). Compared PCOS MHO with PCOS MUO patients, the latter had higher levels of high-sensitivity C-reactive protein (hs-CRP) (p < 0.001), testosterone (p < 0.001), and insulin (p < 0.001), worse metabolic parameters, and higher Homeostatic Model Assessment of Insulin Resistance (HoMA-IR), Visceral Adiposity Index (VAI), and Fatty liver Index (FLI) (p < 0.001). Furthermore, PCOS MUO patients had lower adherence to the MD (p < 0.001) in spite of the same total energy intake (p = 0.102) as compared to PCOS MHO. The presence of MUO was associated with highest hs-CRP levels (OR = 1.49, p < 0.001), more severe hyperandrogenism and cardio-metabolic indices (p < 0.001). On the contrary, being PCOS MUO was associated with lower adherence to the MD (OR = 0.28, p < 0.001), and smaller PhAs (OR = 0.04, p < 0.001). Using a regression linear analysis model PREDIMED score entered at the first step (p < 0.001), followed by VAI (p < 0.001), and FLI (p = 0.032) in this analysis. At ROC analysis, a PREDIMED score of ≤4 (p < 0.001, AUC 0.926) could serve as a threshold for a significantly increased risk of presence the MUO-PCOS phenotype. To the best of our knowledge, this is the first study that characterized MHO and MUO-PCOS women on the basis of their adherence to the MD, body composition, and cardio-metabolic indices, providing evidence of the usefulness of adjunctive diagnostic parameters to better differentiate the MHO/MHO phenotypes in this cohort of PCOS patients with obesity.

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Lifestyle Measures to Reduce Inflammation

American Journal of Lifestyle Medicine ◽

10.1177/1559827611411646 ◽

2011 ◽

Vol 6 (1) ◽

pp. 4-13 ◽

Cited By ~ 6

Author(s):

Glenn A. Gaesser ◽

Siddhartha S. Angadi ◽

Dana M. Ryan ◽

Carol S. Johnston

Keyword(s):

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Aerobic Exercise ◽

Inflammatory Markers ◽

Dietary Factors ◽

Low Grade ◽

Inflammatory Status ◽

Anti Inflammatory ◽

Low Grade Inflammation

Chronic low-grade inflammation associated with cardiovascular disease and type 2 diabetes (T2D) may be ameliorated with exercise and/or diet. High levels of physical activity and/or cardiorespiratory fitness are associated with reduced risk of low-grade inflammation. Both aerobic and resistance exercise have been found to improve inflammatory status, with the majority of evidence suggesting that aerobic exercise may have broader anti-inflammatory effects. In particular, aerobic exercise appears to improve the balance between pro- and anti-inflammatory markers. Improvement in inflammatory status is most likely to occur in persons with elevated levels of pro-inflammatory markers prior to intervention. A number of dietary factors, including fiber-rich foods, whole grains, fruits (especially berries), omega-3 fatty acids, antioxidant vitamins (eg, C and E), and certain trace minerals (eg, zinc) have been documented to reduce blood concentrations of inflammatory markers. Anti-inflammatory foods may also help mitigate the pro-inflammatory postprandial state that is particularly evident after ingestion of meals high in saturated fat. Intensive lifestyle interventions involving both exercise and diet appear to be most effective. For the most part, anti-inflammatory effects of exercise and diet are independent of weight loss. Thus overweight and obese men and women, who are most likely to have a pro-inflammatory profile, do not necessarily have to normalize body mass index to improve inflammatory status and reduce risk of type 2 diabetes and cardiovascular disease.

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Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review

Nutrients ◽

10.3390/nu11081873 ◽

2019 ◽

Vol 11 (8) ◽

pp. 1873 ◽

Cited By ~ 21

Author(s):

Catherine M. Phillips ◽

Ling-Wei Chen ◽

Barbara Heude ◽

Jonathan Y. Bernard ◽

Nicholas C. Harvey ◽

...

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Disease Risk ◽

Narrative Review ◽

Mental Health Outcomes ◽

Low Grade ◽

Dietary Inflammatory Index ◽

Inflammatory Index ◽

Inflammatory Status ◽

Wide Range

There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed to characterize the inflammatory potential of habitual diet. Subsequently, a large and rapidly growing body of research investigating associations between dietary inflammatory potential, determined by the DII, and risk of a wide range of NCDs has emerged. In this narrative review, we examine the current state of the science regarding relationships between the DII and cancer, cardiometabolic, respiratory and musculoskeletal diseases, neurodevelopment, and adverse mental health outcomes. We synthesize the findings from recent studies, discuss potential underlying mechanisms, and look to the future regarding novel applications of the adult and children’s DII (C-DII) scores and new avenues of investigation in this field of nutritional research.

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Assessment of Dietary Patterns Represents a Potential, Yet Variable, Measure of Inflammatory Status: A Review and Update

Disease Markers ◽

10.1155/2019/3102870 ◽

2019 ◽

Vol 2019 ◽

pp. 1-13 ◽

Cited By ~ 3

Author(s):

Mariana C. Calle ◽

Catherine J. Andersen

Keyword(s):

Chronic Disease ◽

Systemic Inflammation ◽

Dietary Patterns ◽

Dietary Pattern ◽

Functional Foods ◽

Disease Risk ◽

Current Evidence ◽

Low Grade ◽

Inflammatory Status ◽

Anti Inflammatory

Chronic low-grade, systemic inflammation is a well-characterized risk factor in the development of chronic metabolic diseases, such as cardiovascular disease, type 2 diabetes, and metabolic syndrome. Diet could be an effective strategy for reducing inflammation associated with chronic disease. While anti-inflammatory properties of isolated dietary bioactive and functional foods have been routinely studied, the evaluation of dietary patterns on inflammation warrants further review—especially given the recent inclusion of dietary pattern recommendations into dietary guidelines and policies. Therefore, the objective of this narrative review is to examine current evidence linking diet to low-grade, systemic inflammation within the context of chronic disease. Specifically, we provide an update on the findings from human trials that have characterized anti-inflammatory properties of dietary patterns, defined by various methods and indexes. Given the complexity of interpreting results from dietary pattern analysis, we further present recent evidence on the anti-inflammatory roles of isolated bioactive nutrients and functional foods that are common components of distinct dietary patterns, in addition to considerations for interpreting dietary pattern research, population-specific dietary recommendations, and future studies. Overall, we observe a vast range of variability in the evidence from observational studies that have evaluated the relationships between healthy dietary patterns and inflammatory markers. These studies highlight the need for additional intervention studies with study designs that account for metabolic status, diversity in populations, breadth of inflammatory measurements, fasting vs. postprandial effects of diet, and control of confounding factors (e.g., genotype, microbiome profiles, and dietary adherence) in order to better understand the effect that diet has, as a whole, on inflammation. These strategies will help to strengthen diet recommendations aimed at reducing inflammation and chronic disease risk.

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