*4.4.5 Phytoestrogens*

Phytoestrogens are plant-derived dietary compounds found in beans, seeds, and grains. The structure of phytoestrogens is similar to 17-β-oestradiol (E2), the primary female sex hormone. This structural similarity to E2 enables phytoestrogens to cause (anti) oestrogenic effects by binding to the oestrogen receptors [63]. Phytoestrogens had so many health benefits such as a lowered risk of menopausal symptoms such as hot flushes and osteoporosis, obesity, metabolic syndrome, and type 2 diabetes and lowered risks of cardiovascular disease, brain function disorders, breast cancer, prostate cancer, bowel cancer, and other cancers [63]. A randomized crossover clinical trial for 8 weeks (*n* = 42, postmenopausal women with

metabolic syndrome) reported that soy nut consumption reduces interleukin-18 [64]. On the other hand, in a randomized, double-blind, controlled trial study (*n* = 50, post-menopausal women age = 58 ± 5 years), it was found that supplementation of soy isoflavone for 6 months had no effects on plasma CRP level [65].

#### *4.4.6 Probiotics, prebiotics and synbiotics*

According to the Food and Agriculture Organization of the United Nations (FAO) and WHO, probiotics are defined as "live microorganisms which, when administered in adequate amounts, confer a health benefit on the host" [66–67]. Earlier studies reported that probiotic bacteria, when administered orally, are able to modulate the immune system; however, differences exist in the immunomodulatory effects of different probiotic strains [15]. A randomized, double-blind, and placebo-controlled parallel-group intervention study compared *Lactobacillus rhamnosus* with *Bifidobacterium animalis* ssp. Lactis Bb12 and *Propionibacterium freudenreichii* ssp. Shermanii JS for 3 weeks in healthy respondents (*n* = 81, 23–58 years of age). The study showed no effect on serum levels of TNF-α, IL-6, IL-10, or IFN-γ but a decreased level of CRP in the *L. rhamnosus* supplementation group [15, 68].

According to FAO/WHO, prebiotics is defined as "non-digestible food ingredients that beneficially affect the host by selectively stimulating the growth and/ or activity of one or a limited number of bacterial species already established in the colon, and thus improve the host health" [67, 69]. Russo et al. reported in the study that intake of 11% enriched inulin-enriched pasta for 5 weeks improved lipidic and glicidic metabolism as well as insulin resistance in healthy young subjects [70]. Another study reported that intake of oligofructose (type of prebiotics) supplementation (8 g/day for 3 weeks) in the elderly (*n* = 19, mean age = 85 years) showed a decrease in the expression of IL-6 mRNA in peripheral blood monocytes [71]. In contrary to the above study, the intervention study showed that supplementation of oligofructose (1.95–3.9 g/day for 12 weeks) did not affect plasma levels of IL-6 or TNF-α in poorly nourished elderly subjects (mean age of 70 years) [15, 72].

Synbiotics are defined as a combination of suitable probiotics and prebiotics that enhances survival and activity of the organism, for example, a fructooligosaccharide (FOS) in conjunction with a Bifidobacterium strain or lactitol in conjunction with *Lactobacillus* strains [73–74]. Ferrarese et al. reported in the study that diet supplementation with Synbiotics prepared using selected strains (such as *Lactobacillus gasseri* strains) showed to exert weight reduction and anti-inflammatory activity. In spite of this, it was also concluded that their administration, together with galactomannan and/or inulin fibers, may increase weight management effects due to synergistic effect on short-chain fatty acid production and microbiota "re-configuration" [75].

#### **5. Discussion**

The pandemic of obesity and its associated comorbidities derives our attention to the mechanism associated with a pathological condition. Earlier investigations revealed how cells and tissues respond to the stress of overnutrition and about the interplay between adipose tissue and other cell types that are critically involved in energy homeostasis. These findings also suggest the inflammatory response of obesity that might be beneficial or harmful, depending on the stage and degree of obesity, as well as other factors [76]. Previously, it was also reported that obesity and its associated comorbidities are due to intermingled interactions between

**37**

*Weight Management: Inflammation*

central role [77].

**6. Conclusion**

gain as its associated comorbidities.

**Acknowledgements**

*DOI: http://dx.doi.org/10.5772/intechopen.92380*

genetic, metabolic, and environmental factors in which dietary pattern plays a

cytokine production in detail are not included in the current study.

As we know that obesity is the condition of excessive accumulation of fat as a result of disequilibrium between energy intake and its expenditure. Several studies showed that adipose tissue acts as an endocrine organ that plays a critical role in maintaining the homeostasis of immunity. Studies also reported that obesity plays a pivotal role in the development of low-grade inflammation. As a result, optimal nutrition is required for maintaining a healthy immune balance. A healthy diet comprising of appropriate GI/GL, n-3 PUFAs, less amount of saturated and transfatty acids, vitamins, minerals, flavonoids, phytoestrogens, probiotics, prebiotics, and Synbiotics is beneficial in combating the obesity and its related complications. Therefore, it is concluded that consuming different dietary components rather than a single component may prove beneficial in combating the burden of weight

I express my deep sense of gratitude to my beloved husband Mr. Nirmal Kumar

for his untiring help, opinions, and valuable suggestions with overwhelming encouragement. I am also deeply regretted if I am not able to cite the papers of all

those authors who have contributed to our understanding of this topic.

The current review is a narrative review of the impact of inflammation on weight management. In this review, a model is outlined in which inflammation is closely associated with obesity. However, this is a simplified view. Earlier studies reveal that severely underweight people such as patients with anorexia nervosa (AN) also display an overproduction of inflammatory cytokines. Dalton et al. reported from an exploratory cross-sectional study that interleukin (IL)-6, IL-15, and vascular cell adhesion molecule (VCAM)-1 concentrations were significantly elevated, and concentrations of BDNF (brain-derived neurotrophic factor), tumor necrosis factor (TNF)-β, and vascular endothelial growth factor (VEGF)-A were significantly lower in anorexia nervosa (AN) participants [78]. An almost similar result was reported through meta-analysis by Solmi et al. that patients with anorexia nervosa (AN) have increased TNF-α, IL6, IL1-β, and TNF-R-II levels but decreased C-reactive protein and IL-6R [79]. Earlier studies also reported that immunosuppressive medications such as corticosteroids lead to visceral adiposity. Galitzky and Bouloumie reported that long-term exposure of glucocorticoids (GCs), either due to anti-inflammatory and immunosuppressive therapies or endocrine disturbances, accumulation of abdominal fat was observed in individuals with Cushing syndrome [80]. Lee et al. stated in the study that glucocorticoids (GCs) have profound effects on adipose tissue, adipogenesis, adipose tissue metabolic, and endocrine function. In the study, it was found that glucocorticoids (GCs) have multiple, depot-dependent effects on adipocyte gene expression and metabolism that enhances central fat deposition and lead to visceral obesity [81]. Further, contradicting study results are not included in the current study in order to provide a stringent model. Additionally, due to the limited space, important aspects of the topic such as physical activity and its influence on body weight regulation and

#### *Weight Management: Inflammation DOI: http://dx.doi.org/10.5772/intechopen.92380*

genetic, metabolic, and environmental factors in which dietary pattern plays a central role [77].

The current review is a narrative review of the impact of inflammation on weight management. In this review, a model is outlined in which inflammation is closely associated with obesity. However, this is a simplified view. Earlier studies reveal that severely underweight people such as patients with anorexia nervosa (AN) also display an overproduction of inflammatory cytokines. Dalton et al. reported from an exploratory cross-sectional study that interleukin (IL)-6, IL-15, and vascular cell adhesion molecule (VCAM)-1 concentrations were significantly elevated, and concentrations of BDNF (brain-derived neurotrophic factor), tumor necrosis factor (TNF)-β, and vascular endothelial growth factor (VEGF)-A were significantly lower in anorexia nervosa (AN) participants [78]. An almost similar result was reported through meta-analysis by Solmi et al. that patients with anorexia nervosa (AN) have increased TNF-α, IL6, IL1-β, and TNF-R-II levels but decreased C-reactive protein and IL-6R [79]. Earlier studies also reported that immunosuppressive medications such as corticosteroids lead to visceral adiposity. Galitzky and Bouloumie reported that long-term exposure of glucocorticoids (GCs), either due to anti-inflammatory and immunosuppressive therapies or endocrine disturbances, accumulation of abdominal fat was observed in individuals with Cushing syndrome [80]. Lee et al. stated in the study that glucocorticoids (GCs) have profound effects on adipose tissue, adipogenesis, adipose tissue metabolic, and endocrine function. In the study, it was found that glucocorticoids (GCs) have multiple, depot-dependent effects on adipocyte gene expression and metabolism that enhances central fat deposition and lead to visceral obesity [81]. Further, contradicting study results are not included in the current study in order to provide a stringent model. Additionally, due to the limited space, important aspects of the topic such as physical activity and its influence on body weight regulation and cytokine production in detail are not included in the current study.

#### **6. Conclusion**

As we know that obesity is the condition of excessive accumulation of fat as a result of disequilibrium between energy intake and its expenditure. Several studies showed that adipose tissue acts as an endocrine organ that plays a critical role in maintaining the homeostasis of immunity. Studies also reported that obesity plays a pivotal role in the development of low-grade inflammation. As a result, optimal nutrition is required for maintaining a healthy immune balance. A healthy diet comprising of appropriate GI/GL, n-3 PUFAs, less amount of saturated and transfatty acids, vitamins, minerals, flavonoids, phytoestrogens, probiotics, prebiotics, and Synbiotics is beneficial in combating the obesity and its related complications.

Therefore, it is concluded that consuming different dietary components rather than a single component may prove beneficial in combating the burden of weight gain as its associated comorbidities.

#### **Acknowledgements**

I express my deep sense of gratitude to my beloved husband Mr. Nirmal Kumar for his untiring help, opinions, and valuable suggestions with overwhelming encouragement. I am also deeply regretted if I am not able to cite the papers of all those authors who have contributed to our understanding of this topic.

*Weight Management*
