Major clinical outcomes of the regulation of metainflammation in patients with obesity in the light of nutrology: a systematic review

Abstract

Introduction: Obesity stands out as a multifactorial disease that can cause several public health problems. There are 2.0 billion overweight and obese people in the world, and Brazil is in fifth place in the world ranking. A healthy nutritional status promotes immune function and can prevent the onset of a serious inflammatory process and severe infections, especially in times of pandemics such as COVID-19. Objective: It was to highlight the main clinical outcomes of the regulation of meta-inflammation in patients with obesity in the light of nutrology. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from August to September 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 130 articles were found. A total of 42 articles were fully evaluated and 29 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 29 studies at high risk of bias and 21 studies that did not meet the GRADE. Most studies showed homogeneity in their results, with X2=71.7%>50%. Research has shown that unbalanced eating patterns, such as the Western diet, rich in simple sugars, refined carbohydrates, and saturated and trans fatty acids, lead to chronic inflammatory responses, increased adipose deposition, and future comorbidities associated with overweight and obesity. Calorie restriction decreased CRP in obese patients and diet administration over 12 weeks had a beneficial effect. Furthermore, obese patients with antioxidant supplementation had lower values of BMI, waist circumference, fasting blood glucose level, and assessment of the homeostasis model of insulin resistance when compared to the placebo group, as well as having lower levels of total cholesterol, triglycerides, LDL, malondialdehyde and tumor necrosis factor-alpha. n-3 PUFA supplementation can significantly reduce serum C-reactive protein (CRP), tumor necrosis factor α (TNFα), and interleukin 6 (IL-6) concentrations.