RESUMO
The development of obesity entails a chronic low-grade inflammatory state with increased pro-inflammatory cells, mainly in visceral adipose tissue (VAT). Additionally, dietary patterns have an influence on the regulation of chronic inflammation. Dietary Approaches to Stop Hypertension (DASH) include foods with an anti-inflammatory profile and that have positive impacts on body composition (BC), suggesting improvements in inflammatory processes. OBJECTIVE: To analyze the impact of the DASH diet on cellular immunity, anthropometric, biochemical and BC parameters in patients with overweight and obesity, who could present metabolic syndrome. METHODOLOGY: Lymphocyte subpopulations, biochemical parameters, anthropometric parameters, and BC before and 8 weeks after intervention with the DASH diet in persons with overweight and obesity were measured. RESULTS: Fifty-nine young adults participated in the study. After the intervention, no significant changes in biochemical parameters were observed, although a significant decrease in nearly all of the anthropometric and BC variables was found: waist circumference (p < 0.001), percentage and kilograms of fat (p < 0.001 and p < 0.025, respectively), VAT (p < 0.020), and weight (p < 0.001), as well as total lymphocytes and double-positive TCD4+ cells. A relation between changes in leukocyte subpopulations (monocytes, natural killer, helper and cytotoxic lymphocytes, and naive TCD4+ cells) and metabolic improvements (glucose, triglycerides, total cholesterol and LDL-c) was also found. CONCLUSIONS: The DASH diet promotes positive changes in lymphocyte subpopulations, anthropometric parameters and BC in persons with overweight and obesity. Future studies should elucidate the cellular and molecular mechanisms through which the DASH diet produces inmunometabolic improvement.
Assuntos
Abordagens Dietéticas para Conter a Hipertensão , Imunidade Celular , Obesidade/dietoterapia , Obesidade/imunologia , Adulto , Composição Corporal , Índice de Massa Corporal , Feminino , Hispânico ou Latino , Humanos , Leucócitos/patologia , Modelos Lineares , Masculino , Obesidade/metabolismo , Adulto JovemRESUMO
La obesidad es un problema de salud pública creciente a nivel mundial. Se ha clasificado como una enfermedad ocasionada por acumulación excesiva de triglicéridos en el tejido adiposo (TA). El TA visceral (TAV), se considera un factor importante en el desarrollo de enfermedades crónicas no transmisibles. Esto principalmente porque el adipocito aumenta en tamaño y número, lo cual lleva a hipoxia, liberación de ácidos grasos, movilización y activación de subpoblaciones leucocitarias (linfocitos T, B, macrófagos, neutrófilos y eosinófilos), liberación de mediadores proinflamatorios (factor de necrosis tumoral- α (TNF-α), interleucina (IL)-6, resistina) y disminución en la secreción de antiinflamatorios (adiponectina, IL-10, IL-4 e IL-13). Estos cambios en el TAV generan un estado de inflamación crónica de baja intensidad, que se ha relacionado con resistencia a la insulina (RI). La RI es el signo fundamental para el desarrollo del Síndrome Metabólico (SM), que inicialmente se presenta localmente en el TAV y después se vuelve sistémica. En la investigación de la obesidad y el desarrollo de sus comorbilidades, la trascendencia del TAV en la interacción entre células adiposas e inmunitarias, así como de liberación de mediadores para desencadenar el proceso inflamatorio crónico, es clave para el desarrollo de RI y SM; sin embargo, se ha observado que la masa músculo-esquelética está implicada en este proceso, aparte de las células y mediadores de los que se sabe su participación. De esta manera a los linfocitos T CD4 y T CD8 se les señala como proinflamatorios, en cambio a los eosinófilos y a la adiponectina se les clasifica como protectores del proceso.
Obesity is a widespread public health problem worldwide. This disease has been classified as a condition caused by excessive accumulation of triglycerides in adipose tissue (TA). Visceral TA is an important factor in the development of several chronic diseases, since the adipocyte increases in size and number, leading to hypoxia, fatty acid release, mo-bilization and activation of leukocyte subpopulations (macrophages, neutrophils, eosinophils, NK cells, T lymphocytes and B); release of pro-inflammatory mediators (TNF-á, IL-6, PAI-1, resistin and visfatin), and decreased secretion of anti-inflammatory cytokines (adiponectin, IL-10, IL-4 and IL-13). These changes in TAV generate a chronic inflammation state of low inten-sity, that has been linked to insulin resistance (IR), initially local and then becomes systemic, which represents the determining factor for the development of metabolic syndrome (SM). The transcendence of TAV in the interaction between adipose and immune cells, as well as the release of mediators that trigger the chronic inflammatory process, is key for the development of IR and SM. However, in the investigation of obesity and the development of its comorbidities, it has been observed that the skeletal-muscle mass is involved in this process, apart from the cells and mediators of which their participation is known. In this way, TCD4 and TCD8 lymphocytes are recognized as pro-inflammatory. In contrast, eosinophils and adiponectin are considered as protective of the process.