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Obesity and inflammation: the effects of weight loss
Open accessAbstract
Following the discovery of TNF-α and leptin as secretory products of adipocytes in the early 1990s, subsequent obesity research focused on the new functional role of adipose tissue, as an active endocrine organ. Many more inflammatory peptides have been linked to adiposity, which ultimately characterised obesity as a state of low-grade systemic inflammation, or ‘metaflammation’ which may link obesity to its co-morbidities. The aim of the present review is to examine the effects of weight loss on inflammation in overweight and obese, but otherwise healthy, populations. Studies were broadly classified into four types (diet, physical activity, diet and physical activity combined, and surgical interventions) and discussed according to the method used to induce weight loss. All studies measured at least one obesity-related inflammatory marker (ORIM). The overall finding from the present review is that weight loss does improve inflammation in terms of both the inflammatory (C-reactive protein, TNF-α, IL-6 and leptin) and anti-inflammatory (adiponectin) ORIM. Within this, the greatest improvements in ORIM are observed in studies achieving a weight loss of at least 10 %. However, a number of methodological issues have been identified as potential limitations within the literature including the sex and age of subjects, sample size, study duration and the assessment of body composition. In conclusion, although a period of weight loss per se is capable of reversing the unfavourable inflammatory profile evident in the obese state, further studies are required to determine the time needed, in which a reduced weight is maintained, in order to benefit from improved inflammatory status long term.
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“Obesity activates macrophages, mast cells and T lymphocytes, promoting a low-level inflammation that results in the secretion of tumour necrosis factor (TNF), leptin and growth hormone (GH)57–59.”
From Sarcopenic obesity in older adults: aetiology, epidemiology and treatment strategies (2018) · cites this paper as [58]
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BackgroundBromelain supplementation and inflammatory markers: A systematic review of clinical trials
Pereira, I. C., Vieira, E. E. S., Torres, L. R. D. O., da Silva, F. C. C., Sousa, J. M. D. C. E., & Torres‐Leal, F. L. (2023) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2023.02.028 · Cited by 28
Inflammation Mediates Body Weight and Ageing Effects on Psychomotor Slowing
Balter, L. J. T., Higgs, S., Aldred, S., Bosch, J. A., & Raymond, J. E. (2019) · Scientific Reports · doi:10.1038/s41598-019-52062-3 · Cited by 25
“38), and age adjusted for BMI (F(1, 80) = 4.”
Ghanavati, M., Hosseinabadi, S. M., Parsa, S. A., Safi, M., Emamat, H., & Nasrollahzadeh, J. (2021) · European Journal of Clinical Nutrition · doi:10.1038/s41430-020-00819-9 · Cited by 26
Heggen, E., Klemsdal, T. O., Haugen, F., Holme, I., & Tonstad, S. (2012) · Metabolic Syndrome and Related Disorders · doi:10.1089/met.2012.0012 · Cited by 24
Physical Activity and Hematologic Cancer Prevention
Pan, S. Y., & MORRISON, H. I. (2010) · Recent results in cancer research/Recent Results in Cancer Research · doi:10.1007/978-3-642-04231-7_6 · Cited by 24
Effect of resistance training on chronic inflammation: A systematic review and meta‐analysis
Rose, G. L., Mielke, G. I., Durr, M., & Schaumberg, M. A. (2021) · Translational Sports Medicine · doi:10.1002/tsm2.294 · Cited by 23
Contributing factors of fatigue in patients with type 2 diabetes: A systematic review
Bi, Y., Zhang, L., Li, X., Kan, Y., Li, S., Zou, Y., Liu, L., Yuanyuan, Gong, W., & Zhang, Y. (2021) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2021.105280 · Cited by 24
The Ketogenic Diet: Is It an Answer for Sarcopenic Obesity?
Ilyas, Z., Perna, S., Alalwan, T. A., Zahid, M. N., Spadaccini, D., Gasparri, C., Peroni, G., Faragli, A., Alogna, A., Porta, E. L., et al. (2022) · Nutrients · doi:10.3390/nu14030620 · Cited by 22
“Obesity activates macrophages, mast cells, and T lymphocytes, resulting in low-grade inflammation and tumor necrosis factor tumor necrosis factor (TNF), leptin, and growth hormone secretion [8].”
BackgroundMorbid Obesity and Inflammation: A Prospective Study After Adjustable Gastric Banding Surgery
Ramalho, R., Guimarães, C., Gil, C. F. C., Neves, C., Guimarães, J. T., & Delgado, L. (2009) · Obesity Surgery · doi:10.1007/s11695-009-9848-0 · Cited by 22
“Weight loss does improve inflammation in terms of a number of obesity-related inflammatory markers, specifically characterized by a decrease in C-reactive protein (CRP), TNF-α, IL-6, and leptin and an increase in the anti-inflammatory marker adiponectin [9].”
BackgroundRiesco, É., Tessier, S., Lacaille, M., Pérusse, F., Côté, M., Després, J., Bergeron, J., Weisnagel, J. S., Doré, J., & Mauriège, P. (2012) · Menopause The Journal of The North American Menopause Society · doi:10.1097/gme.0b013e31826f7ebf · Cited by 22
“Among numerous weight loss strategies, diet alone or diet combined with either resistance training or endurance training could reduce inflammation and thus decrease CHD risk in women, regardless of their menopause status.(11) To date, most published studies have not examined the effect of exercise per se and have only…”
BackgroundLancha, A., Moncada, R., Valentí, V., Rodrı́guez, A., Catalán, V., Becerril, S., Ramírez, B., Méndez-Giménez, L., Gil, M. J., Rotellar, F., et al. (2014) · Surgical Endoscopy · doi:10.1007/s00464-014-3490-1 · Cited by 22
“For example, TNF-a and sICAM-1 significantly decrease with caloric restriction, whereas they exhibit no change following BS [19, 20].”
BackgroundAlfadda, A. A., Turjoman, A. A., Moustafa, A. S., Al-Naami, M. Y., Chishti, M. A., Sallam, R. M., Gibson, D. S., & Duncan, M. W. (2014) · Experimental Biology and Medicine · doi:10.1177/1535370214523894 · Cited by 21
“adiponectin).(11) For example, Dalmas and colleagues(12) examined a range of adipocytokines and inflammatory cytokines at various time intervals following Roux-en-Y gastric bypass.”
BackgroundDong, S.-Y., Yan, S., Wang, M.-L., Li, Z.-B., Fang, L.-Q., & Zeng, Q. (2018) · Atherosclerosis · doi:10.1016/j.atherosclerosis.2018.05.007 · Cited by 22
Dietary therapy and non‐surgical periodontal treatment in obese patients with chronic periodontitis
Martínez-Herrera, M., López‐Domènech, S., Donat, F. J. S., Silvestre‐Rangil, J., Bañuls, C., Hernández‐Mijares, A., & Rocha, M. (2018) · Journal Of Clinical Periodontology · doi:10.1111/jcpe.13030 · Cited by 22
Hammes, T. O., Costa, C. D. S., Rohden, F., Margis, R., de Almeida, J. C., Padoin, A. V., Mottin, C. C., & Guaragna, R. M. V. D. C. (2012) · Obesity Facts · doi:10.1159/000339574 · Cited by 22
Quante, M., Iske, J., Uehara, H., Minami, K., Nian, Y., Maenosono, R., Matsunaga, T., Liu, Y., Azuma, H., Perkins, D. L., et al. (2021) · American Journal of Transplantation · doi:10.1111/ajt.16856 · Cited by 21
Genitsaridi, S.-M., Giannios, C., Karampatsou, S., Papageorgiou, I., Papadopoulos, G., Farakla, I., Koui, E., Georgiou, A., Romas, S., Terzioglou, E., et al. (2020) · Hormone Research in Paediatrics · doi:10.1159/000507760 · Cited by 24
Domaszewska, K., Boraczyński, M., Tang, Y., Gronek, J., Wochna, K., Boraczyński, T., Wieliński, D., & Gronek, P. (2022) · Aging and Disease · doi:10.14336/ad.2021.1219 · Cited by 22
Hermsdorff, H. H. M., Volp, A. C. P., Puchau, B., Barbosa, K. B. F., Zulet, M. Á., Bressan, J., & Martínez, J. A. (2012) · Inflammation Research · doi:10.1007/s00011-011-0429-z · Cited by 20
“tory state [8, 13–15] as well as the effect of caloric restriction interventions on weight loss [16, 17] has been studied.”
BackgroundUnderstanding Chronic Pain in a Lifestyle Context
Hayes, C., Naylor, R., & Egger, G. J. (2012) · American Journal of Lifestyle Medicine · doi:10.1177/1559827612439282 · Cited by 20
“Physical activity programs have been noted to reduce metaflammation in the context of obesity management and weight loss.(56) Sleep impairment has been associated with cytokine changes in the brain(57) and elevations in adipokines related to inflammation and insulin resistance.”
BackgroundCan bariatric surgery delay the need for knee replacement in morbidly obese osteoarthritis patients
Rishi, L., Bhandari, M., & Kumar, R. (2017) · Journal of Minimal Access Surgery · doi:10.4103/jmas.jmas_129_16 · Cited by 20
“[31] With weight reduction, there is relative loss of muscle mass and strength over time due to protein deficiency which may contribute lately for recurrence of OA symptoms.”
QUEIROZ, E. R., de Abreu, C. M. P., Rocha, D. A., de Sousa, R. V., Fráguas, R. M., Braga, M. A., & César, P. H. S. (2017) · Anais da Academia Brasileira de Ciências · doi:10.1590/0001-3765201720150638 · Cited by 20
“Obese people exhibit an increased secretion of inflammatory cytokines related to obesity, such as leptin, TNF-α and IL-6, and decreased levels of anti-inflammatory cytokines, such as adiponectin (Forsythe et al. 2008).”
BackgroundKanbay, M., Yerlikaya, A., Sag, A. A., Ortíz, A., Kuwabara, M., Covic, A. C., Więcek, A., Stenvinkel, P., & Afşar, B. (2019) · Clinical Kidney Journal · doi:10.1093/ckj/sfz106 · Cited by 21
“PubMed first recorded use of the term metaflammation in 2008 [18].”
BackgroundKey Molecular Mechanisms of Aging, Biomarkers, and Potential Interventions
Proshkina, E., Solovev, I. A., Shaposhnikov, M. V., & Moskalev, A. (2020) · Molecular Biology · doi:10.1134/s0026893320060096 · Cited by 21
Relationship between bariatric surgery and periodontal status: a systematic review and meta-analysis
de Souza, G. M., de Oliveira, D. W. D., Lages, F. S., Fernandes, I. A., & Falci, S. G. M. (2018) · Surgery for Obesity and Related Diseases · doi:10.1016/j.soard.2018.04.018 · Cited by 20
Binou, P., Yanni, A. E., Kartsioti, K., Barmpagianni, A., Konstantopoulos, P. S., Karathanos, V. Τ., & Kokkinos, A. D. (2022) · Nutrients · doi:10.3390/nu14122516 · Cited by 19
“These findings seem to be explained by the greater weight loss experienced by subjects in this group, since weight reduction has proven to be beneficial to the reduction of low-grade inflammation [43,44].”
BackgroundMazaheri‐Tehrani, S., Yazdi, M., Heidari‐Beni, M., Yazdani, Z., & Kelishadi, R. (2023) · Complementary Therapies in Clinical Practice · doi:10.1016/j.ctcp.2023.101733 · Cited by 20
Campbell, E. K., Campbell, T. M., Culakova, E., Blanchard, L., Wixom, N., Guido, J. J., Fetten, J. V., Huston, A. J., Shayne, M., Janelsins, M. C., et al. (2024) · Breast Cancer Research and Treatment · doi:10.1007/s10549-024-07284-z · Cited by 19
“Evidence suggests that weight loss [20] and dietary change [21] might reduce systemic inflammation leading to improvements in cognitive function [22, 23] and fatigue [24] and thereby QOL.”
BackgroundZuza, E. P., Pires, J. R., de Almeida, A. A., de Toledo, B. E. C., Guimarães, M. R., Rossa, C., & Barroso, E. M. (2020) · Journal of Periodontology · doi:10.1002/jper.19-0534 · Cited by 19
Τραγομάλου, Α., Moschonis, G., Kassari, P., Papageorgiou, I., Genitsaridi, S.-M., Karampatsou, S., Μanios, Y., & Charmandari, E. (2020) · Nutrients · doi:10.3390/nu12092858 · Cited by 19
“Therefore, adequately addressing the epidemic of obesity in childhood and adolescence is of major importance in reducing systemic inflammation [28,29] and atherosclerotic cardiovascular disease in adulthood.”
Background(1980) · Advances in experimental medicine and biology · doi:10.1007/978-1-4684-8914-9 · Cited by 19
Park, H., Yu, S., & Kim, W. (2021) · Foods · doi:10.3390/foods10020359 · Cited by 18
“Although the exact molecular mechanisms linking obesity and immune changes have not been fully elucidated, activation of adipose tissue residual macrophages and their secretion of inflammatory mediators in adipose tissue have been shown to be downregulated by loss of body weight [5,6].”
BackgroundVecchiato, C. G., Golinelli, S., Pinna, C., Pilla, R., Suchodolski, J. S., Tvarijonaviciute, A., Rubio, C. P., Dorato, E., Delsante, C., Stefanelli, C., et al. (2023) · Frontiers in Microbiology · doi:10.3389/fmicb.2022.1050474 · Cited by 18
“, 2021) and weight loss has been shown to reverse this condition (Forsythe et al., 2008), while controversial results have been obtained in dogs (German et al.”
ResultInflammation, Reproduction, and the Goldilocks Principle
Clancy, K. B. H. (2012) · Springer eBooks · doi:10.1007/978-1-4614-4060-4_1 · Cited by 17
Metadata
- Authors
- Forsythe, L. K., Wallace, J. M. W., & Livingstone, M. B. E.
- Affiliations
- University of Ulster (GB)
- Corresponding author
- Livingstone, M. Barbara E.
- Venue
- Nutrition Research Reviews
- Publisher
- Cambridge University Press (CUP)
- Published
- 2008-12
- Volume
- 21
- Issue
- 2
- Pages
- 117-133
- ISSN
- 0954-4224 (ISSN-L)
- 1475-2700
- OpenAlex
- W2162846451
- Cited by
- 381
- References
- 132
- Citations by year
- 2026: 12 · 2025: 20 · 2024: 21 · 2023: 21 · 2022: 23 · 2021: 21 · 2020: 28 · 2019: 23 · 2018: 25 · 2017: 15 · 2016: 17 · 2015: 19 · 2014: 28 · 2013: 22 · 2012: 34
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nutrition Research Reviews (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Physiology (medical) › Adipose Tissue and Metabolism
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Keywords
- obesity, weight loss, low-grade inflammation, metabolic inflammation, adipose tissue endocrine function, adipokines, TNF-α, leptin, adiponectin, C-reactive protein, interleukin-6, diet, physical activity, bariatric surgery, weight loss maintenance
- MeSH terms
- Adipose Tissue, Adult, Body Composition, Diet Therapy, Diet, Reducing, Female, Humans, Inflammation, Male, Middle Aged, Biomarkers, Weight Loss, Exercise, Adipocytes, Bariatric Surgery, Overweight
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