1. Introduction

Obesity (adiposity) is a serious health problem, especially in well-developed countries. The regional distribution of fat determines our health. Excessive accumulation of fat in the upper body's region (central obesity) is a stronger predictor of morbidity than excess fat in the lower

© 2018 The Author(s). Licensee IntechOpen. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

© The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and eproduction in any medium, provided the original work is properly cited.

body [1]. Central obesity is associated with insulin resistance (IR) and this condition predisposes to cardiovascular disease (CVD) [2]. Adipose tissue (AT) is not only an energy storage organ but also produces adipokines, which contribute to the development of subclinical inflammation [3]. The compounds released from AT are capable of affecting endothelial cell (EC) functions [4]. The mechanism of obesity-induced endothelial dysfunction is multifactorial mainly due to the omnidirectional impact of various adipokines, leading to the following abnormalities such as elevated blood pressure, formation of atherosclerotic plaques, oxidative stress, prothrombotic state and alterations in glucose and lipid metabolism [5]. AT remodeling is pathologically accelerated in an obese state due to local hypoxia. Reduced angiogenesis is a severe immune cell infiltration with subsequent pro-inflammatory responses which additionally deteriorates EC functions [6]. Therefore, one of the main goals of therapeutic interventions in obesity is to correct abnormalities in EC function and to protect endothelial integrity.

It is believed that EC dysfunction in obesity can be reduced by caloric restriction (CR), but it is unclear whether this benefit requires significant or moderate weight loss. In recent studies conducted on overweight humans, short- and long-lasting CR (6–52 weeks) have shown to improve a number of health outcomes [7–9]. The important issue is that most individuals have difficulty sustaining prolonged CR and the improvement of EC function may be problematic to achieve. Our cooperation with physicians, dieticians and psychologists allows us to claim that it is usually optimal for obese patients if CR is not so burdensome and yet, at the same time, effective. Therefore, we propose a mild CR as a way to lose body weight in obese individuals. Such a type of CR reflects a real-life situation and seems to be optimal to achieve an improvement of EC.
