DOI: https://doi.org/10.14710/jnc.v15i1.49380

PERAN DIETARY INFLAMMATORY INDEX DAN KOMPOSISI LEMAK TUBUH DALAM MENINGKATKAN KADAR TNF ALPHA PADA INDIVIDU OBESITAS: TINJAUAN NARATIF

1Departemen Ilmu Gizi, Fakultas Kedokteran, Universitas Diponegorom, Semarang, Jawa Tengah, Indonesia

2Departemen Pendidikan Dokter Spesialis, Fakultas Kedokteran, Universitas Diponegoro, Semarang, Jawa Tengah, Indonesia

Received: 13 Mar 2025; Revised: 19 May 2025; Accepted: 22 May 2025; Available online: 28 Jan 2026; Published: 30 Jan 2026.

Citation Format:
Abstract

ABSTRACT

Background: Obesity is a global health issue associated with low-grade chronic inflammation due to increased production of pro-inflammatory cytokines, particularly Tumor Necrosis Factor Alpha (TNF-α). TNF-α plays a role in the development of insulin resistance and metabolic disorders in obese individuals. Additionally, diet contributes to inflammation, which can be measured using the Dietary Inflammatory Index (DII). A higher DII score indicates a pro-inflammatory diet, which is linked to elevated TNF-α levels. Body fat distribution, especially visceral fat accumulation, also contributes to the increased production of pro-inflammatory cytokines;

Objective: This study aimed to explore the relationship between a pro-inflammatory diet, body fat composition, and TNF-α levels in obese individuals;

Methode: This study employs a narrative review approach by gathering data from various national and international articles. The search was conducted through multiple databases, including Google Scholar, PubMed, ScienceDirect, and ResearchGate. Data were retrieved using selected keywords such as Dietary Inflammatory Index, body fat composition, TNF-α, and obesity in adults;

Results: The review results indicate that a high DII diet, characterized by high consumption of sugar, saturated fats, and low fiber intake, contributes to increased inflammation. Meanwhile, body fat distribution, particularly visceral fat, also triggers TNF-α production, exacerbating chronic inflammatory conditions;

Conclusion: The interaction between diet and body fat composition indicates that obese individuals with a pro-inflammatory diet have a higher risk of persistent systemic inflammation. Therefore, intervention strategies that prioritize an anti-inflammatory diet and proper body fat management are crucial in reducing TNF-α levels and preventing obesity-related health complications;

Keywords: Body fat composition; dietary inflammatory index; inflammation; obesity in adults; TNF-α

 

ABSTRAK

Latar Belakang: Obesitas merupakan salah satu masalah kesehatan masyarakat yang ditandai dengan akumulasi lemak tubuh berlebih dan berisiko menimbulkan komplikasi metabolik. Salah satu mekanisme penting yang mendasari komplikasi tersebut adalah inflamasi kronis tingkat rendah, yang ditandai dengan peningkatan kadar sitokin pro-inflamasi seperti TNF-α. Pola makan yang bersifat pro-inflamasi diketahui dapat meningkatkan respon inflamasi tubuh, termasuk kadar TNF-α. Selain itu, komposisi lemak tubuh terutama tingginya massa lemak juga berperan dalam meningkatkan produksi sitokin tersebut. Meski masing-masing faktor ini sudah pernah diteliti, masih sedikit penelitian yang melihat hubungan antara pola makan, lemak tubuh, dan kadar TNF-α secara bersamaan pada orang yang obesitas;

Tujuan: Penelitian ini bertujuan untuk mengeksplorasi hubungan antara pola makan pro-inflamasi, komposisi lemak tubuh dan kadar TNF-α pada individu obesitas;

Metode:  Studi ini menggunakan pendekatan tinjauan naratif dengan mengumpulkan data dari berbagai artikel nasional dan internasional. Pencarian dilakukan melalui beberapa databese seperti Google Scolar, PubMed, dan Science Direct dan Researchgate. Data dicari dengan menggunakan beberapa kata kunci terpilih seperti Dietary Inflammatory Index, body fat compotition, TNF-α, dan obesity in adults;

Hasil: Hasil kajian menunjukkan bahwa pola makan dengan nilai DII tinggi yang ditandai dengan konsumsi tinggi gula, lemak jenuh, dan tendah serat, berkontribusi terhadap peningkatan peradangan. Sementara itu, distribusi lemak tubuh terutama lemak viseral juga memicu produksi TNF-α yang memperparah kondisi inflamasi kronis;

Simpulan: Interaksi antara pola makan dan komposisi lemak tubuh ini menunjukkan bahwa individu obesitas dengan pola makan pro-inflamasi memiliki risiko lebih tinggi terhadap inflamasi sistemik yang berkelanjutan. Oleh karena itu, strategi intervensi yang mengedepankan pola makan anti-inflamasi dan pengelolaan komposisi lemak tubuh sangat penting dalam mengurangi kadar TNF-α dan mencegah komplikasi kesehatan terkait obesitas;

Kata Kunci: Dietary inflammatory index; inflamasi; komposisi lemak tubuh; obesitas dewasa; TNF-α

Fulltext View|Download
Keywords: Dietary inflammatory index; inflamasi; komposisi lemak tubuh; obesitas dewasa; TNF-α

Article Metrics:

Article Info
Section: Articles
Language : ID
Recent articles
POTENSI HIDROLISAT PROTEIN IKAN DALAM KONTROL GLUKOSA DARAH DAN NAFSU MAKAN PADA OBESITAS UNTUK MENCEGAH DIABETES MELITUS TIPE 2: LITERATURE REVIEW IMPACT OF STATIN THERAPY ON LDL REDUCTION AND ITS NUTRITIONAL IMPLICATIONS: A SYSTEMATIC REVIEW HUBUNGAN ASUPAN YODIUM DENGAN KEJADIAN STUNTING PADA BALITA: LITERATURE REVIEW More recent articles
  1. Masrul M. Epidemi obesitas dan dampaknya terhadap status kesehatan masyarakat serta sosial ekonomi bangsa. Maj Kedokt Andalas [Internet]. 2018 Oct 2;41(3):152. DOI: 10.25077/mka.v41.i3.p152-162.2018.Availablefrom:http://jurnalmka.fk.unand.ac.id/index.php/art/article/view/612
  2. Firsta Yosika G, Sukoco P, Pranoto A, Purwoto SP. Penurunan malondialdehyde serum setelah latihan interval dan continuous di pagi hari pada perempuan obesitas. J Sport J Penelit Pembelajaran [Internet]. 2020 Aug 25;6(2):288-303. DOI: 10.29407/js_unpgri.vi.14289.Availablefrom:https://ojs.unpkediri.ac.id/index.php/pjk/article/view/14289
  3. Tzanavari T, Giannogonas P, Karalis KP. TNF-α and Obesity. In: TNF Pathophysiology [Internet]. Basel: KARGER; 2010. p. 145-156. DOI: 10.1159/000289203.Availablefrom:https://karger.com/books/book/2686/chapter/5761108
  4. Mello RN de, Gois BP de, Kravchychyn ACP, Dâmaso AR, Horst MA, Lima GC, et al. Dietary inflammatory index and its relation to the pathophysiological aspects of obesity: a narrative review. Arch Endocrinol Metab [Internet]. 2023 Jun 21;67(6):DOI: 10.20945/2359-3997000000631.Availablefrom:https://www.aem-sbem.com/article/dietary-inflammatory-index-and-its-relation-to-the-pathophysiological-aspects-of-obesity-a-narrative-review/
  5. Belančić A, Kenđel Jovanović G, Klobučar Majanović S. Obesity-related low-grade chronic inflammation: implementation of the dietary inflammatory index in clinical practice is the milestone? Med Flum [Internet]. 2018 Dec 1;54(4):373-378. DOI: 10.21860/medflum2018_207350.Availablefrom:https://hrcak.srce.hr/index.php?show=clanak&id_clanak_jezik=304678
  6. Samaras K, Botelho NK, Chisholm DJ, Lord R V. Subcutaneous and Visceral Adipose Tissue Gene Expression of Serum Adipokines That Predict Type 2 Diabetes. Obesity [Internet]. 2010 May 6;18(5):884-889. DOI: 10.1038/oby.2009.443.Availablefrom:https://onlinelibrary.wiley.com/doi/10.1038/oby.2009.443
  7. Tina AR, Kurniawan LB, Bahrun U. Analisis Hubungan Berbagai Indeks Obesitas dengan Kadar Interleukin-6 pada Subjek Obesitas dan Non-obesitas Sentral. J Med Heal [Internet]. 2021 Aug 17;3(2):DOI: 10.28932/jmh.v3i2.3502.Availablefrom:https://journal.maranatha.edu/index.php/jmh/article/view/3502
  8. Trisnadi, Reza Adityas, Wibowo, Joko Wahyu, Thomas S. Pengaruh Diet Tinggi Kolesterol terhadap Kadar TNF α Reza Adityas Trisnadi. 2021;12(April):132-134. DOI: 10.33846/sf12205
  9. Kord Varkaneh H, Fatahi S, Tajik S, Rahmani J, Zarezadeh M, Shab-Bidar S. Dietary inflammatory index in relation to obesity and body mass index: a meta-analysis. Nutr Food Sci [Internet]. 2018 Sep 10;48(5):702-721. DOI: 10.1108/NFS-09-2017–0203.Availablefrom:https://www.emerald.com/insight/content/doi/10.1108/NFS-09-2017-0203/full/html
  10. Hariharan R, Odjidja EN, Scott D, Shivappa N, Hébert JR, Hodge A, et al. The dietary inflammatory index, obesity, type 2 diabetes, and cardiovascular risk factors and diseases. Obes Rev [Internet]. 2022 Jan 27;23(1):DOI: 10.1111/obr.13349.Availablefrom:https://onlinelibrary.wiley.com/doi/10.1111/obr.13349
  11. Susantiningsih T, Mustofa S. Ekspresi IL-6 dan TNF- α Pada Obesitas IL-6 and TNF- α Expression in Obesity. JK Unila. 2018;2(2):174-180. DOI: 10.28932/jmh.v3i2.3502
  12. Son M, Wu J. Egg white hydrolysate and peptide reverse insulin resistance associated with tumor necrosis factor-α (TNF-α) stimulated mitogen-activated protein kinase (MAPK) pathway in skeletal muscle cells. Eur J Nutr [Internet]. 2019 Aug 28;58(5):1961-1969. DOI: 10.1007/s00394-018-1753–7.Availablefrom:http://link.springer.com/10.1007/s00394-018-1753-7
  13. Ren K, Mo Z, Liu X, Tang Z, Jiang Y, Peng X, et al. TGF‐β Down‐regulates Apolipoprotein M Expression through the TAK‐1‐JNK‐c‐Jun Pathway in HepG2 Cells. Lipids [Internet]. 2017 Feb;52(2):109-117. DOI: 10.1007/s11745-016-4227–9.Availablefrom:https://aocs.onlinelibrary.wiley.com/doi/10.1007/s11745-016-4227-9
  14. Pratiwi AQ. HUBUNGAN PERSENTASE LEMAK TUBUH DAN AKTIVITAS FISIK DENGAN KEBUGARAN WANITA 26-45 TAHUN. Sport Nutr J [Internet]. 2022 Dec 5;4(2):24–30. Available from: https://journal.unnes.ac.id/sju/spnj/article/view/58691
  15. Putri AS, Nilasari K, Mariana RR, Kurniawan A. Hubungan Screen Time dan Durasi Tidur terhadap Status Gizi Siswa dan Siswi MAN 2 Kota Malang. Sport Sci Heal [Internet]. 2025 Mar 11;6(12):1325–42. Available from: https://journal3.um.ac.id/index.php/fik/article/view/6567
  16. Brawijaya FPU. Prosiding Seminar Nasional Hasil-Hasil Penelitian dan Pengabdian Kepada Masyarakat. In 2023
  17. Saufi FM, Nurkadri N, Sitopu GS, Habeahan GF. Hubungan Olahraga Dan Kesehatan Mental. Cerdas Sifa Pendidik [Internet]. 2024 May 28;13(1):1–15. Available from: https://online-journal.unja.ac.id/csp/article/view/33728
  18. Arıkan Ş, REVAN S. Relationship Between Physical Activity Levels and Body Compositions of University Students. Turkish J Sport Exerc [Internet]. 2019 May 5; Available from: https://dergipark.org.tr/en/doi/10.15314/tsed.531201
  19. Chen H, Gao Y, Wei N, Du K, Jia Q. Strong association between the dietary inflammatory index(DII) and breast cancer: a systematic review and meta-analysis. Aging (Albany NY) [Internet]. 2021 May 15;13(9):13039-13047. DOI: 10.18632/aging.202985.Availablefrom:https://www.aging-us.com/lookup/doi/10.18632/aging.202985
  20. Nouri-Majd S, Salari-Moghaddam A, Keshteli AH, Esmaillzadeh A, Adibi P. Dietary Inflammatory Potential in relation to General and Abdominal Obesity. Stankovic S, editor. Int J Clin Pract [Internet]. 2022 Jan 31;2022:1-7. DOI: 10.1155/2022/5685249.Availablefrom:https://www.hindawi.com/journals/ijclp/2022/5685249/
  21. Shivappa N, Steck SE, Hurley TG, Hussey JR, Hébert JR. Designing and developing a literature-derived, population-based dietary inflammatory index. Public Health Nutr [Internet]. 2014 Aug 14;17(8):1689-1696. DOI: 10.1017/S1368980013002115.Availablefrom:https://www.cambridge.org/core/product/identifier/S1368980013002115/type/journal_article
  22. Shivappa N, Hebert JR, Marcos A, Diaz LE, Gomez S, Nova E, et al. A1. Shivappa N, Hebert JR, Marcos A, Diaz L-E, Gomez S, Nova E, et al. Association between dietary inflammatory index and inflammatory markers in the HELENA study. Mol Nutr Food Res. 2017;61(6):1–18. ssociation between dietary inflammatory index and infla. Mol Nutr Food Res. 2017;61(6):1-18. DOI: 10.1002/mnfr.201600707.Association
  23. Wirth MD, Hébert JR, Shivappa N, Hand GA, Hurley TG, Drenowatz C, et al. Anti-inflammatory Dietary Inflammatory Index scores are associated with healthier scores on other dietary indices. Nutr Res [Internet]. 2016 Mar;36(3):214-219. DOI: 10.1016/j.nutres.2015.11.009.Availablefrom:https://linkinghub.elsevier.com/retrieve/pii/S0271531715002894
  24. Kotemori A, Sawada N, Iwasaki M, Yamaji T, Shivappa N, Hebert JR, et al. Dietary Inflammatory Index Is Associated With Inflammation in Japanese Men. Front Nutr [Internet]. 2021 Apr 9;8:DOI: 10.3389/fnut.2021.604296.Availablefrom:https://www.frontiersin.org/articles/10.3389/fnut.2021.604296/full
  25. Kenđel Jovanović G, Mrakovcic-Sutic I, Pavičić Žeželj S, Šuša B, Rahelić D, Klobučar Majanović S. The Efficacy of an Energy-Restricted Anti-Inflammatory Diet for the Management of Obesity in Younger Adults. Nutrients [Internet]. 2020 Nov 22;12(11):3583. DOI: 10.3390/nu12113583.Availablefrom:https://www.mdpi.com/2072-6643/12/11/3583
  26. Gholamalizadeh M, Ahmadzadeh M, BourBour F, Vahid F, Ajami M, Majidi N, et al. Associations between the dietary inflammatory index with obesity and body fat in male adolescents. BMC Endocr Disord [Internet]. 2022 Dec 2;22(1):115. DOI: 10.1186/s12902-022-01001–x.Availablefrom:https://bmcendocrdisord.biomedcentral.com/articles/10.1186/s12902-022-01001-x
  27. Wardhana IMW, Wangko S. Interaksi Antara Makrofag Dan Jaringan Adiposa Pada Obesitas. J Biomedik. 2013;3(2):DOI: 10.35790/jbm.3.2.2011.866
  28. Schlecht I, Fischer B, Behrens G, Leitzmann MF. Relations of Visceral and Abdominal Subcutaneous Adipose Tissue, Body Mass Index, and Waist Circumference to Serum Concentrations of Parameters of Chronic Inflammation. Obes Facts [Internet]. 2016;9(3):144-157. DOI: 10.1159/000443691.Availablefrom:https://karger.com/OFA/article/doi/10.1159/000443691
  29. Zheng X, Ge YZ, Ruan GT, Lin SQ, Chen Y, Liu CA, et al. Association between the Dietary Inflammatory Index and All-Cause Mortality in Adults with Obesity. Ann Nutr Metab [Internet]. 2023;79(5):434-447. DOI: 10.1159/000533380.Availablefrom:https://karger.com/ANM/article/doi/10.1159/000533380
  30. Collier B, Dossett L, Shipman J, Day M, Lawson G, Sawyer R, et al. Visceral Adiposity Is Not Associated With Inflammatory Markers in Trauma Patients. J Trauma Inj Infect Crit Care [Internet]. 2010 Jan;68(1):57-61. DOI: 10.1097/TA.0b013e3181c40262.Availablefrom:https://journals.lww.com/00005373-201001000-00011
  31. Polak-Szczybyło E, Tabarkiewicz J. Influence of dietary and lifestyle factors on levels of inflammatory markers (IL-6, IFN-γ and TNF-α) in obese subjects. Cent Eur J Immunol [Internet]. 2024;49(1):19-25. DOI: 10.5114/ceji.2024.138748.Availablefrom:https://www.termedia.pl/doi/10.5114/ceji.2024.138748
  32. Bai Y, Sun Q. Macrophage recruitment in obese adipose tissue. Obes Rev [Internet]. 2015 Feb 13;16(2):127-136. DOI: 10.1111/obr.12242.Availablefrom:https://onlinelibrary.wiley.com/doi/10.1111/obr.12242
  33. Martins LB, Oliveira MC de, Menezes-Garcia Z, Rodrigues DF, Lana JP, Vieira LQ, et al. Paradoxical role of tumor necrosis factor on metabolic dysfunction and adipose tissue expansion in mice. Nutrition [Internet]. 2018 Jun;50:1-7. DOI: 10.1016/j.nut.2017.07.006.Availablefrom:https://linkinghub.elsevier.com/retrieve/pii/S0899900717301521
  34. Okada S, Kozuka C, Masuzaki H, Yasue S, Ishii-Yonemoto T, Tanaka T, et al. Adipose tissue–specific dysregulation of angiotensinogen by oxidative stress in obesity. Metabolism [Internet]. 2010 Sep;59(9):1241-1251. DOI: 10.1016/j.metabol.2009.11.016.Availablefrom:https://linkinghub.elsevier.com/retrieve/pii/S0026049509004910
  35. Zhang L, Peng H, Wang Y, Ba H. Association of dietary inflammatory index with obesity among children and adolescents in the United States NHANES cohort: a population-based study. Ital J Pediatr [Internet]. 2024 Jan 25;50(1):14. DOI: 10.1186/s13052-024-01586–0.Availablefrom:https://ijponline.biomedcentral.com/articles/10.1186/s13052-024-01586-0
  36. Cantero I, Abete I, Babio N, Arós F, Corella D, Estruch R, et al. Dietary Inflammatory Index and liver status in subjects with different adiposity levels within the PREDIMED trial. Clin Nutr [Internet]. 2018 Oct;37(5):1736-1743. DOI: 10.1016/j.clnu.2017.06.027.Availablefrom:https://linkinghub.elsevier.com/retrieve/pii/S0261561417302388
  37. Li C, Qu L, Farragher C, Vella A, Zhou B. MicroRNA regulated macrophage activation in obesity. J Transl Intern Med [Internet]. 2019 Jul 11;7(2):46-52. DOI: 10.2478/jtim-2019–0011.Availablefrom:https://www.degruyter.com/document/doi/10.2478/jtim-2019-0011/html
  38. Galland L. Diet and Inflammation. Nutr Clin Pract [Internet]. 2010 Dec 7;25(6):634-640. DOI: 10.1177/0884533610385703.Availablefrom:https://aspenjournals.onlinelibrary.wiley.com/doi/10.1177/0884533610385703
  39. Sears B. Anti-inflammatory Diets. J Am Coll Nutr [Internet]. 2015 Sep 15;34(sup1):14-21. DOI: 10.1080/07315724.2015.1080105.Availablefrom:http://www.tandfonline.com/doi/full/10.1080/07315724.2015.1080105
  40. Marlina U, Maulitanti SD, Annisa Y, Masitha D. Pengaruh Penerapan Diet Anti Inflamasi Pada Perubahan Manifestasi Klinis Dan Penanda Inflamasi Wanita Dengan Polycystic Ovary Syndrome (PCOS). J Pendidik Indones [Internet]. 2023 May 25;4(05):475-488. DOI: 10.59141/japendi.v4i05.1821.Availablefrom:https://japendi.publikasiindonesia.id/index.php/japendi/article/view/1821
  41. KRÁLOVÁ A, KRÁLOVÁ LESNÁ I, FRONĚK J, ČEJKOVÁ S, SEKERKOVÁ A, JANOUŠEK L, et al. Macrophage Phenotypes in the Adipose Tissue of Postmenopausal Women. Physiol Res [Internet]. 2015 Nov 30;S427-S433. DOI: 10.33549/physiolres.933150.Availablefrom:http://www.biomed.cas.cz/physiolres/pdf/64Suppl3/64_S427.pdf

Last update:

No citation recorded.

Last update:

No citation recorded.