| Abstract | Cilj: Sve je više dokaza o utjecaju prehrane na mijenjanje pretilošću uzrokovane kronične upale niskog intenziteta i povezanih kroničnih nezaraznih bolesti. Cilj istraživanja bio je utvrditi promjene u sastavu tijela, metaboličkom, upalnom i imunosnom statusu ispitanika s pretilošću nakon 24-tjedne nutricionističke intervencije temeljene na protuupalnoj prehrani te ispitati povezanost upalnog potencijala prehrane s metaboličkim, upalnim i imunosnim statusom.
Materijali i metode: Određeni su antropometrijski parametri 81 ispitanika (42 ispitanika intervencijske skupine, 39 ispitanika kontrolne skupine) i analiza sastava tijela metodom bioelektrične impedance. Metabolički status utvrđen je glikemijskim i lipidnim statusom, kardiometaboličkim indeksom te indeksom steatoze jetre. Upalni status procijenjen je koncentracijom hs-CRP, IL-6 i TNF-α, a imunosni status imunofenotipskim profilom limfocitnih subpopulacija stanica. Upalni potencijal prehrane procijenjen je Prehrambenim upalnim indeksom (DII®). Negativniji DII® indeks ukazuje na prehranu s većim protuupalnim potencijalom. Linearna regresijska analiza koristila se za procjenu mogućih odnosa i korelacija između upalnog potencijala prehrane kao neovisne varijable s antropometrijskim, metaboličkim, upalnim i imunološkim varijablama kao ovisnim varijablama.
Rezultati: Intervencija protuupalnom prehranom omogućila je statistički značajno smanjenje tjelesne mase (-7,1%, P<0,0001), osobito visceralnog masnog tkiva (-22,3%, P<0,0001), te poboljšanje metaboličkog statusa ispitanika. Utvrđeno je statistički značajno poboljšanje upalnog statusa smanjenjem hs-CRP (-29,5%, P=0,0025), IL-6 (-17,6%, P=0,0126) te TNF-α (-35,6%, P=0,0016),
kao i imunosnog statusa smanjenjem udjelaNK (-15,6, P<0,0001) i NKT stanica (-35,4%, P<0,0001). Najveća smanjenja navedenih parametra ostvarena su u ispitanika s najvećim stupnjem pretilosti. Iako je utvrđena blaga pozitivna povezanost promjene upalnog potencijala prehrane sa smanjenjem tjelesne mase, metaboličkih, upalnih i imunosnih parametara, te povezanosti nisu bile statistički značajne.
Zaključak: Primjena protuupalne prehrane pokazala se učinkovitom u liječenju pretilosti jer je omogućila značajna smanjenja tjelesne mase i visceralnog masnog tkiva, poboljšanje sastava tijela, metaboličkih, upalnih i imunosnih parametara. Dobiveni podaci ovog istraživanja unapređuju trenutne znanstvene spoznaje, mogu poslužiti u davanju smjernica za liječenje pretilosti, te naći primjenu u rutinskoj kliničkoj praksi liječenja pretilosti. |
| Abstract (english) | Objective: There is a growing evidence of diet impact on obesity-induced low-grade chronic inflammation, and associated chronic noncommunicable diseases modification. The study aimed to determine changes in body composition, metabolic, inflammatory and immune status of participants with obesity after 24 weeks of diet intervention based on anti-inflammatory diet and to examine the relationship of inflammatory potential of diet with metabolic, inflammatory and immune status.
Materials and methods: The anthropometric parameters of 81 participant (42 in intervention group, 39 in control group) and their body composition analysis with bioelectrical impedance method was assessed. Metabolic status was determined with glycemic and lipid status, cardiometabolic index and liver steatosis index, inflammatory status by concentration of hs-CRP, IL-6 and TNF-α, and immune status by immunophenotypic profile of lymphocytes subgroups cells. The inflammatory potential of the diet was assessed by the Dietary Inflammatory Index (DII®). A more negative DII® index indicates a diet with higher anti-inflammatory potential. Linear regression analysis was used to assess possible relationships and correlations between the inflammatory potential of diet as an independent variable with anthropometric, metabolic, inflammatory, and immune variables as dependent variables.
Results: Intervention with anti-inflammatory diet resulted with statistically significant reduction of body weight (-7.1%, P<0.0001), especially of visceral adipose tissue (-22.3%, P<0.0001), and improvement of participants' metabolic status. A statistically significant inflammatory status improvement was achieved with decrease of hs-CRP (-29.5%, P = 0.0025), IL-6 (-17.6%, P = 0.0126) and TNF-α (-35.6 %, P = 0.0016), and immune status improvement with decrease of NK (-15.6%, P<0.0001) and NKT cells fractions (-35.4%, P<0.0001). The largest reductions were achieved in participants with the highest obesity degree. Although a mild positive association of the inflammatory potential of the diet changes with body weight, metabolic, inflammatory and immune parameters reductionswas oberved, these associations were not statistically significant.
Conclusion: The anti-inflammatory diet has been shown to be effective in obesity treatment because it caused significant reductions in body weight and visceral adipose tissue, and improvements of body composition, metabolic, inflammatory and immune parameters. The study data might contribute to current scientific knowledge, provide guidelines for for the treatment of obesity, and find its application in routine clinical practice for obesity treatment. |
