TOPLINE:

A narrative review identified key nutritional and metabolic biomarkers, including adipokines, inflammatory cytokines, insulin resistance indices, and gut microbiota-derived metabolites, that could improve early detection of obesity risk and enable more precise, personalized nutrition strategies for managing obesity.

METHODOLOGY:

• Obesity is a heterogeneous metabolic disorder with marked interindividual variability in metabolic, inflammatory, and hormonal profiles. Traditional anthropometric measures such as BMI fail to capture these differences, limiting precise risk stratification and individualized interventions.
• Researchers conducted a narrative review of original research articles, systematic reviews, and meta-analyses published from January 2000 to February 2026 to examine nutritional and metabolic biomarkers that underlie the physiologic dysregulation in obesity. They explored the mechanistic basis, clinical relevance, and nutritional modulation of each biomarker class.
• The reviewed markers included adipokines, inflammatory cytokines, insulin resistance indices, lipid metabolism indicators, liver enzymes, circulating microRNAs (miRNAs), gut microbiota-derived metabolites, and micronutrient biomarkers.
• The review also evaluated how dietary composition and overall dietary patterns influenced biomarker profiles and metabolic outcomes, providing a foundation for biomarker-guided individualized nutrition strategies.

TAKEAWAY:

• Elevated C-reactive protein (CRP), reduced adiponectin levels, and increased homeostatic model assessment of insulin resistance values (cutoff, ~2.3-2.5) were identified as reliable early indicators of metabolic risk in individuals with obesity. Higher levels of leptin, resistin, proinflammatory cytokines, low-density lipoprotein cholesterol, triglycerides, and apolipoprotein B, along with lower levels of high-density lipoprotein cholesterol, were linked to inflammation, insulin resistance, dyslipidemia, and an increased risk for cardiovascular disease.
• The Mediterranean diet, rich in monounsaturated fatty acids, fiber, and antioxidants, was associated with higher levels of adiponectin and lower levels of leptin, resistin, proinflammatory cytokines, and CRP, reflecting a favorable lipid and inflammatory profile. Conversely, the Western diet, rich in saturated fats, refined carbohydrates, and ultraprocessed foods, was linked to reduced levels of adiponectin and elevated levels of inflammatory and metabolic risk markers.
• The metabolically healthy obesity (MHO) phenotype describes people with excess weight but a favorable biomarker profile (eg, higher adiponectin levels, lower inflammation, a more favorable lipid profile, and better preserved insulin sensitivity) that distinguishes them from those with metabolically unhealthy obesity. However, MHO is often unstable, with about 30%-50% of individuals experiencing progression to metabolic dysfunction within 5-10 years, so repeat biomarker monitoring is advisable.
• Levels of circulating miRNAs (such as miR-122 and miR-126) were altered in obesity. Consumption of diets rich in unsaturated fats, omega-3 fatty acids, and carbohydrates with a low glycemic load could upregulate the expression of miR-126 and downregulate the expression of miR-103.
• The gut microbiota governs production of metabolites (including short-chain fatty acids, trimethylamine N-oxide, and lipopolysaccharides) that link diet to inflammation, insulin resistance, and lipid metabolism. These metabolites were found to be promising markers for early detection and monitoring of dietary responses in individuals with obesity.

IN PRACTICE:

“The critical clinical advance is to use these biomarker trajectories not merely as outcome measures but as real-time decision tools. Consider a patient adhering to a Mediterranean-pattern diet who fails to show the expected reductions in HOMA-IR [homeostatic model assessment of insulin resistance] or hs-CRP [high-sensitivity CRP] at the 12-week assessment. This nonresponse pattern defines a clinically distinct subphenotype that warrants mechanistic investigation,” the authors of the study wrote.

SOURCE:

The study, led by Girolamo Di Maio, Pegaso Telematic University, and Maria Giovanna Tafuri, Pegaso University, Naples, Italy, was published online in Nutrients.

LIMITATIONS:

No specific limitations were provided for the study.

DISCLOSURES:

The study received no external funding. The authors declared having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.