Abstract
Introduction: In the context of the obesity pandemic, an estimated 3.0 billion patients have excessive reserves of adipose tissue and calories. These patients with excess energy are not classified as overweight or obese. Increasing evidence suggests that obesity promotes the activation of resident T cells and macrophages. MicroRNAs contribute to the maintenance of the immune response and obesity in adipose tissue, and enteral nutritional therapy is essential for the treatment of obesity, as it works as triggers to modulate gene expression through microRNAs. Objective: This study aimed to present the main considerations of enteral nutritional therapy in patients with obesity, in controlling the gene expression of microRNAs in the gut microbiota, adipose tissue, and circulatory systems to reduce inflammatory processes, and metabolic disorders. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from May to July 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found. A total of 38 articles were fully evaluated and 17 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with high risk of bias and 23 studies that did not meet the GRADE. Most studies showed homogeneity in their results, with X2=73.5% >50%. It was concluded that certain miRNAs have been implicated in the control of body weight gain, glucose homeostasis, insulin resistance and lipid metabolism. A single dose of dietary protein has acute effects on hormonal and metabolic regulation and increases the expression of exosomal miRNA in individuals with obesity and insulin resistance. Enteral feeding is an effective and safe treatment in the regulation of these microRNAs. Ketogenic enteral nutrition may lead to better clinical outcomes than hypocaloric enteral nutritional protocols in glycemic and lipid profiles. A diverse range of nutritional interventions have been shown to be effective in the treatment of obesity and its comorbidities, mainly through the modulation of nutritherapy on microRNAs in adipose tissue, intestinal microbiota and circulatory systems.