Background:
The objective of this study was to investigate the effect of a low calorie low inflammatory diet (LCID) on inflammation markers, body weight, metabolic syndrome parameters, mitochondrial DNA copy number (mtDNA-CN) and relative telomere length (RTL) in obese adults.

Methods:
This is a randomized controlled trial among Indonesian adults with obesity. Participants (n=61) were divided into 2 groups: low-calorie diet (LCD) (n=30) and low calorie low inflammatory diet (LCID) (n=31). The LCID was an adaptation of the Mediterranean diet principle to a low calorie diet regime. The length of the weight loss program was 8 weeks, and participants were followed for 8 weeks of the weight maintenance period.

Results:
Subjects in the LCID group had a lower hs-CRP (p=0.03) compared to those in the LCD group, but no difference was seen in plasma levels of TNF- α (p=0.32) and IL-6 (p=0.63). Subjects in both groups had a significant reduction in body weight, body fat, lipid profile and blood pressure (all p<0.05) with no differences between groups (all p>0.05). The mtDNA-CN was unchanged (p=0.96) after weight loss while RTL was shown to be increased (p=0.002). Changes in RTL were higher in LCID than those in the LCD group (p=0.036), while mtDNA-CN showed no difference. Weight changes after weight loss and maintenance period were not associated with inflammation markers, mtDNA-CN or RTL (all p>0.05).

Conclusion:
This study showed that the LCID had a beneficial effect on hs-CRP during a weight loss intervention compared to the LCD, but not on TNF- α and IL-6. The weight loss program was associated with the elongation of telomere length and those in LCID responded with significantly longer telomeres as compared to LCD despite a similar degree of weight loss.