-  University of Hohenheim [NORA names: Germany; Europe, EU; OECD]
-  Department of Nutritional Medicine and Prevention, University of Hohenheim, 70599 Stuttgart, Germany;, email@example.com, (L.K.);, firstname.lastname@example.org, (A.S.);, email@example.com, (V.F.);, firstname.lastname@example.org, (T.J.);, email@example.com, (A.R.)
-  Division of Inflammation and Infection, Department of Biomedical and Clinical Sciences, Linköping University, 72076 Tübingen, Germany
-  Nutrition-Gut-Brain Interactions Research Centre, School of Medical Sciences, Örebro University, 70362 Örebro, Sweden;, firstname.lastname@example.org, (L.T.);, email@example.com, (A.N.H.);, firstname.lastname@example.org, (R.J.B.)
-  Örebro University [NORA names: Sweden; Europe, EU; Nordic; OECD]
-  Institute of Food Chemistry (170b), University of Hohenheim, 70593 Stuttgart, Germany;, email@example.com, (K.L.);, firstname.lastname@example.org, (W.V.)
-  Haleon, 2665 Vallensbæk Strand, Denmark;, email@example.com
Obesity is characterized by low-grade inflammation and increased gut permeability. Here, we aim to evaluate the effect of a nutritional supplement on these parameters in subjects with overweight and obesity. A double-blinded, randomized clinical trial was conducted in 76 adults with overweight or obesity (BMI 28 to 40) and low-grade inflammation (high-sensitivity C-reactive protein (hs-CRP) between 2 and 10 mg/L). The intervention consisted of a daily intake of a multi-strain probiotic of Lactobacillus and Bifidobacterium, 640 mg of omega-3 fatty acids (n-3 FAs), and 200 IU of vitamin D (n = 37) or placebo (n = 39), administered for 8 weeks. hs-CRP levels did not change post-intervention, other than an unexpected slight increase observed in the treatment group. Interleukin (IL)-6 levels decreased in the treatment group (p = 0.018). The plasma fatty acid (FA) levels of the arachidonic acid (AA)/eicosapentaenoic acid (EPA) ratio and n-6/n-3 ratio (p < 0.001) decreased, and physical function and mobility improved in the treatment group (p = 0.006). The results suggest that hs-CRP may not be the most useful inflammatory marker, but probiotics, n-3 FAs, and vitamin D, as non-pharmaceutical supplements, may exert modest effects on inflammation, plasma FA levels, and physical function in patients with overweight and obesity and associated low-grade inflammation.