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Evidence-based nutritional and pharmacological interventions targeting chronic low-grade inflammation in middle-age and older adults: A systematic review and meta-analysis.

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29803716
PMC6235673
Ageing research reviews
Sept. 1, 2018
C Custodero4, R T Mankowski1, S A Lee1, Z Chen2, S Wu2, T M Manini1, J Hincapie Echeverri1, C Sabbà8, D P Beavers5, J A Cauley6, M A Espeland5, R A Fielding10, S B Kritchevsky5, C K Liu10, M M McDermott9, M E Miller5, R P Tracy7, A B Newman6, W T Ambrosius5, M Pahor1, S D Anton3
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  • 1
    Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States.
  • 2
    Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States; Department of Biostatistics, University of Florida, Gainesville, FL, United States.
  • 3
    Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States; Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, United States.
  • 4
    Department of Aging and Geriatric Research, University of Florida, Gainesville, FL, United States; Dipartimento Interdisciplinare di Medicina, Clinica Medica Cesare Frugoni, University of Bari Aldo Moro, Bari, Italy. Electronic address: c.custodero@ufl.edu.
  • 5
    Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States.
  • 6
    Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, United States.
  • 7
    Department of Pathology & Laboratory Medicine, Larner College of Medicine, University of Vermont, Burlington, VT, United States.
  • 8
    Dipartimento Interdisciplinare di Medicina, Clinica Medica Cesare Frugoni, University of Bari Aldo Moro, Bari, Italy.
  • 9
    Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
  • 10
    Nutrition, Exercise Physiology, and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States.
Drug Delivery Systems, Diet Therapy, Evidence-Based Medicine, Nutritional Status, Inflammation, Aging, Middle Aged, Humans, Aged, Aged, 80 and over
P30 AG049638, P30 AG021332, P30 AG028740
Custodero C, Mankowski RT, Lee SA, Chen Z, Wu S, Manini TM, Hincapie Echeverri J, Sabbà C, Beavers DP, Cauley JA, Espeland MA, Fielding RA, Kritchevsky SB, Liu CK, McDermott MM, Miller ME, Tracy RP, Newman AB, Ambrosius WT, Pahor M, Anton SD. Evidence-based nutritional and pharmacological interventions targeting chronic low-grade inflammation in middle-age and older adults: A systematic review and meta-analysis. Ageing research reviews 2018 Sep.

Abstract

Growing evidence suggests chronic low-grade inflammation (LGI) as a possible mechanism underlying the aging process. Some biological and pharmaceutical compounds may reduce systemic inflammation and potentially avert functional decline occurring with aging. The aim of the present meta-analysis was to examine the association of pre-selected interventions on two established biomarkers of inflammation, interleukin-6 (IL-6), and C-reactive protein (CRP) in middle-age and older adults with chronic LGI. We reviewed the literature on potential anti-inflammatory compounds, selecting them based on safety, tolerability, acceptability, innovation, affordability, and evidence from randomized controlled trials. Six compounds met all five inclusion criteria for our systematic review and meta-analysis: angiotensin II receptor blockers (ARBs), metformin, omega-3, probiotics, resveratrol and vitamin D. We searched in MEDLINE, PubMed and EMBASE database until January 2017. A total of 49 articles fulfilled the selection criteria. Effect size of each study and pooled effect size for each compound were measured by the standardized mean difference. I2 was computed to measure heterogeneity of effects across studies. The following compounds showed a significant small to large effect in reducing IL-6 levels: probiotics (-0.68 pg/ml), ARBs (-0.37 pg/ml) and omega-3 (-0.19 pg/ml). For CRP, a significant small to medium effect was observed with probiotics (-0.43 mg/L), ARBs (-0.2 mg/L), omega-3 (-0.17 mg/L) and metformin (-0.16 mg/L). Resveratrol and vitamin D were not associated with any significant reductions in either biomarker. These results suggest that nutritional and pharmaceutical compounds can significantly reduce established biomarkers of systemic inflammation in middle-age and older adults. The findings should be interpreted with caution, however, due to the evidence of heterogeneity across the studies.