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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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    • "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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