Major evidence of nutrological regulation in obese patients with meta-inflammation: 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 ranks fifth in the world. A healthy nutritional status promotes immune function and can prevent the onset of a serious inflammatory process and severe infections, especially in times of a pandemic such as COVID-19. Objective: It was to highlight the main clinical considerations of nutrological and dietary regulation in obese patients with marked inflammatory processes and meta-inflammation through a systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from August to September 2022 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 127 articles were found. A total of 74 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 32 studies at high risk of bias and 25 studies that did not meet the GRADE. Research has shown that unbalanced dietary patterns, such as the Western diet, rich in simple sugars, refined carbohydrates, and saturated and trans fatty acids, lead to chronic inflammatory responses, increased fat deposits, and future comorbidities associated with overweight and obesity. Caloric restriction decreased polymerase chain reaction (PCR) 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 insulin resistance homeostasis model assessment when compared to the placebo group, as well as lower total cholesterol levels, triglycerides, LDL, malondialdehyde and tumor necrosis factor-alpha. Supplementation of n-3 PUFA can significantly reduce serum PCR, tumor necrosis factor α (TNFα), and interleukin 6 (IL-6) concentrations.