Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training. CMAJ

Sticht Center on Aging, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Canadian Medical Association Journal (Impact Factor: 5.81). 05/2005; 172(9):1199-209. DOI: 10.1503/cmaj.1040769
Source: PubMed

ABSTRACT Persistent low-grade inflammation, as indicated by higher circulating levels of inflammatory mediators such as C-reactive protein, interleukin-6 and tumour necrosis factor-alpha, is a strong risk factor for several chronic diseases. There are data indicating that decreasing energy intake and increasing physical activity may be effective therapies for reducing overall inflammation. Evidence is strong that circulating levels of inflammatory markers are elevated with total and abdominal obesity, possibly owing to a higher secretion rate of cytokines by adipose tissue in obese people. Moreover, very-low-energy dietary weight loss reduces both circulating markers of inflammation and adipose-tissue cytokine production. Data from several large population-based cohorts show an inverse association between markers of systemic inflammation and physical activity or fitness status; small-scale intervention studies support that exercise training diminishes inflammation. Dietary weight loss plus exercise is likely more effective than weight reduction alone in reducing inflammation. To date, data from randomized, controlled trails designed to definitively test the effects of weight loss or exercise training, or both, on inflammation are limited. Future studies are required to define the amount of weight loss needed for clinically meaningful reductions of inflammation; in addition, fully powered and controlled studies are necessary to clarify the effect of exercise training on chronic, systemic inflammation.

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    • "Drastic changes in daily life over the past century are fueling the growing burden of chronic diseases, including atherosclerosis, hormone-related and gastrointestinal cancers, osteoporosis, and type 2 diabetes mellitus (Beckman et al., 2002; Eaton and III, 2004; Mokdad et al., 2001; Omenn, 2010; Smith, 2002). These diseases share a high-degree of co-morbidity and behavioral risk factors, are endemic to industrialized nations, and have been associated with a similar physiologic profile of metabolic and inflammatory dysregulation (Beckman et al., 2002; Coussens and Werb, 2002; Libby et al., 2002; Moussavi et al., 2007; Mundy, 2007; Must et al., 1999; Nicklas et al., 2005; Shoelson et al., 2007). Though there is evidence of some human evolution since the advent of agriculture ~10,000 years ago (Perry et al., 2007), Homo sapiens are considered to be most adapted to the diverse array of hunter–gatherer lifestyles characteristic of past evolutionary environments, collectively referred to as the environment of evolutionary adaptedness (EEA) (Barkow et al., 1992; Irons, 1998). "
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    • "Sedentary lifestyle and physical inactivity are associated with an increase of inflammatory markers [17]. Also it has been suggested by several data that an increase of PA and a decrease of energy intake could effectively diminish overall inflammation [18]. Consistent with the anti-inflammatory role of PA it has been shown that plasma concentrations of anti-inflammatory cytokines like IL-1ra, IL-4, IL-10, IL-12p40 and MCP-1 increase after different types of exercise [19]. "
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    International immunopharmacology 09/2009; 9(13-14):1504-8. DOI:10.1016/j.intimp.2009.08.025 · 2.71 Impact Factor
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    • "Among studies of weight loss, a consistent reduction in circulating IL-6, TNF-α and sTNF- Rs and CRP has been observed (for reviews, see You and Nicklas, 2006; Nicklas et al., 2005), regardless of whether weight loss was achieved through hypocaloric dietary intake, exercise, or liposuction. The magnitude of decrease of BMI correlated with decreases in IL-6, TNF-α, sTNF-Rs and CRP (Esposito et al., 2003; Heilbronn et al., 2001; Marfella et al., 2004; Nicklas et al., 2004; Xydakis et al., 2004; Ziccardi et al., 2002). "
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