In MetS or obesity-associated inflammation, elevated proinflammatory cytokines such as TNF-α, ROS, and insulin resistance lowers endothelial nitric oxide production, leukocyte adhesion, and platelet aggregation, further increasing inflammatory response, which is ameliorated by dietary nitrate or arginine administration in rodent HFD models [403, 404]. Here, TNF is linked to obesity due to melanocortin 4 receptor deficiency.