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Exercise training versus diet-induced weight-loss on metabolic risk factors and inflammatory markers in obese subjects: a 12-week randomized intervention study
Abstract
The purpose of this study was to investigate the effect of exercise training and diet-induced weight loss alone or in combination on inflammatory markers in circulation, in adipose tissue (AT) and in skeletal muscle (SM) in obese subjects. Seventy-nine obese subjects were randomized into a 12-wk intervention: 1) exercise only (EXO), 2) diet-induced weight loss using a very low energy diet (DIO), and 3) exercise and diet-induced weight-loss combined (DEX). Blood samples (metabolic and inflammatory markers) and AT and SM biopsies (mRNA expression) were collected at baseline and after 12 wk. In the EXO group the weight loss was 3.5 kg and in the DIO and DEX groups it was 12 kg in both. Vo(2max) was increased by 14-18% in the EXO and DEX groups with no changes in the DIO group. In the DIO and DEX groups, circulating levels of MCP-1, MIP-1alpha, IL-15, and IL-18 were decreased, and adiponectin was increased (P < 0.05 for all). In the EXO group, MCP-1 was decreased with 10% (P = 0.06). By combining the weight loss in all three groups, we found a correlation between the degree of weight loss and improvement in several of the inflammatory markers (P < 0.05). In AT biopsies, subjects in the DIO and DEX groups achieved a general beneficial but nonsignificant effect on the gene expression of inflammatory markers. In the EXO group, no changes in AT adipokine mRNA were found except for an increment of adiponectin (P < 0.05). In SM, the only observed change was that the gene expression of IL-6 was increased in all three groups (P < 0.05). In conclusion, rather large weight losses (>5-7%) were found to have beneficial effects on circulating inflammatory markers in these obese subjects. Aerobic exercise for 12 wk, which increased Vo(2max), was found to have no effects on circulating inflammatory markers in these obese patients. It is suggested that more intensive exercise may be necessary to affect systemic inflammation.
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“Therefore, in humans, when IL-10 is added to the culture medium of mononuclear cells and circulating neutrophils stimulated with lipopolysaccharide(LPS), the synthesis of proinflammatory cytokines (TNF-α, IL-1β, IL-6) is inhibited through post-transcriptional mechanisms, a direct consequence of a higher mRNA degradation rate of the corresponding genes (Christiansen et al., 2010).”
From Physical Exercise-Induced Myokines and Muscle-Adipose Tissue Crosstalk: A Review of Current Knowledge and the Implications for Health and Metabolic Diseases (2018) · cites this paper as Christiansen et al., 2010
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“Therefore, in humans, when IL-10 is added to the culture medium of mononuclear cells and circulating neutrophils stimulated with lipopolysaccharide(LPS), the synthesis of proinflammatory cytokines (TNF-α, IL-1β, IL-6) is inhibited through post-transcriptional mechanisms, a direct consequence of a higher mRNA degradati…”
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Kalinkovich, A., & Livshits, G. (2015) · Ageing Research Reviews · doi:10.1016/j.arr.2015.05.001 · Cited by 191
“In contrast, regular physical exercise has been shown to reduce basal levels of inflammatory markers (Christiansen et al., 2010), thus, protecting against a number of chronic diseases that are characterized by inflammation (Gleeson, 2007; Pedersen and Fischer, 2007).”
Metaflammation in obesity and its therapeutic targeting
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“Intensive exercise focused on structure and consistency may be necessary to produce a hypo-in-flammatory state, especially in persons with obesity ( 106 ).”
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(2015) · Progress in Molecular Biology and Translational Science · doi:10.1016/bs.pmbts.2015.07.002 · Cited by 168
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“Sample size was calculated based on prior studies [30,31] using a 6-kg clinically relevant difference in mean weight gain between the exercise and the control group, from baseline to delivery.”
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“Although in patients affected by metabolic syndrome exercise training improved some metabolic parameter [164,165], weight loss due to a restricted diet program determined superior effects [166].”
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“inflammatory cytokines in relation to weight loss [10,17,21,31,53,69] indicating that the inflammatory process is dynamically regulated and”
Friedenreich, C. M., Neilson, H. K., Woolcott, C. G., McTiernan, A., Wang, Q., Ballard-Barbash, R., Jones, C. A., Stanczyk, F. Z., Brant, R. F., Yasui, Y., et al. (2011) · Endocrine Related Cancer · doi:10.1530/erc-10-0303 · Cited by 124
“…has been inconclusive (Simpson & Singh 2008), it is hypothesized that levels increase with sufficient weight loss (Kraemer & Castracane 2007, Christiansen et al. 2010), perhaps more than the 2.3 kg weight loss in our trial (Friedenreich et al. 2010b) and the others (Giannopoulou et al.…”
InfluentialJones, S. B., Thomas, G. A., Hesselsweet, S. D., Alvarez-Reeves, M., Yu, H., & Irwin, M. L. (2012) · Cancer Prevention Research · doi:10.1158/1940-6207.capr-12-0278 · Cited by 132
“In addition, TNF-a is a risk factor in cardiovascular disease and metabolic syndrome, as well as increased in obesity and aging (22, 23).”
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Ringseis, R., Eder, K., Mooren, F. C., & Krüger, K. (2026) · PubMed · doi:10.22029/eir.2015.1696 · Cited by 120
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“otherwise healthy adult (37 ± 7 y) men and women who participated in a supervised aerobic (60 to 75 min/session, three sessions/week at 500 to 600 kcal/session) exercise training regimen and/or reduced calorie diet for 12 weeks, only exhibited changes in adiponectin when the interventions were associated with weight l…”
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“In contrast, lifestyle interventions over 12 wk (16, 17) and 15 wk (12), incorporating exercise and a hypocaloric diet, found a decreased expression of IL-6, TNF- , and monocyte chemotactic protein-1 (MCP-1) mRNA in adipose tissue and an increase in adiponectin mRNA alongside a weight loss of 5–14% in obese individual…”
BackgroundMethodEnergy balance and gastrointestinal cancer: risk, interventions, outcomes and mechanisms
Ulrich, C. M., Himbert, C., Holowatyj, A. N., & Hursting, S. D. (2018) · Nature Reviews Gastroenterology & Hepatology · doi:10.1038/s41575-018-0053-2 · Cited by 111
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“This is in agreement with the two other sufficiently powered-randomized clinical trials that examined the independent effects of exercise and weight loss on MOI in a cohort of men and women (10,33).”
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“Lifestyle modification, physical activity and nutritional interventions [48,49], may reduce development of diabetes, but also the level of blood pressure and inflammation in patients with hypertension and T2D, which is important for the prevention of cardiovascular diseases [50].”
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Shanely, R. A., Nieman, D. C., Henson, D. A., Jin, F., Knab, A. M., & Sha, W. (2011) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/j.1600-0838.2011.01373.x · Cited by 93
Combined Training Reduces Subclinical Inflammation in Obese Middle-Age Men
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“However, 12 wk of AT associated with an extremely low-calorie diet (600– 800 kcalId) decreased the concentrations of IL-15 in the obese, probably owing to the loss of muscle mass due to the nature of the diet and AT (7).”
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“34,35 This might be due to behavioral lifestyle factors, such as psychological stressors, anxiety, and depression, also being able to substantially influence inflammation, and yoga being a well-known practice that reduces stress, anxiety, and depression through a positive psychoneuroimmune effects.”
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“Young and middleaged men [23,30,35,40–45] and women [25,26,30,33,38–40,43], older men and women [37] participated in a randomized control [23,26,33,35,37,42], randomized non-controlled [30,36,38,40,43] or a non-randomized non-controlled trial [24,25,39,41,44,45].”
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Interleukin-15 as a myokine: Mechanistic insight into its effect on skeletal muscle metabolism
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InfluentialLow back pain, obesity, and inflammatory markers: exercise as potential treatment
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“In addition, after 12 weeks of continuous moderate-intensity aerobic exercise intervention (energy expenditure of 500–600 kcal), 3 times/wk lasting 60–75 min, Christiansen et al. (2010) also found no change in circulating inflammatory proteins (IL-6, IL-15, IL-18, MCP-1, adiponectin and MIP1α).”
BackgroundExercise and diabetes: relevance and causes for response variability
Böhm, A., Weigert, C., Staiger, H., & Häring, H. (2015) · Endocrine · doi:10.1007/s12020-015-0792-6 · Cited by 83
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“This result might indicate that the additional effects of diet and exercise are difficult to anticipate, as suggested by the results of earlier studies [29–31].”
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“The most recent study randomized 79 obese men and women to 12 weeks of exercise only, diet-induced WL only, or exercise and diet-induced WL combined.(26) Exercise decreased monocyte chemotactic protein 1 (MCP-1) but did not alter IL-6, IL-18, IL-15, macrophage inflammatory protein 1 alpha (MIP-1a), or adiponectin, des…”
BackgroundHigh intensity interval training reduces systemic inflammation in post-PCI patients
Munk, P. S., Breland, U. M., Aukrust, P., Ueland, T., Kvaløy, J. T., & Larsen, A. I. (2011) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1177/1741826710397600 · Cited by 71
“Large weight loss has been shown to be associated with a reduction of inflammatory markers in obese individuals.(24) As visceral fat is a key regulator site for inflammation, the weight loss might have contributed to the reduction of inflammatory markers.”
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Effects of Exercise on ASC Methylation and IL-1 Cytokines in Heart Failure
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Exercise tolls the bell for key mediators of low-grade inflammation in dysmetabolic conditions
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Addition of Exercise Increases Plasma Adiponectin and Release from Adipose Tissue
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“Most studies do not show a change in adiponectin concentration with exercise training (1,10,16,17,24,34).”
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Weight-Loss Diets, Adiponectin, and Changes in Cardiometabolic Risk in the 2-Year POUNDS Lost Trial
Ma, W., Huang, T., Zheng, Y., Wang, M., Bray, G. A., Sacks, F. M., & Qi, L. (2016) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2016-1207 · Cited by 59
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Interpreting ‘anti‐inflammatory’ cytokine responses to exercise: focus on interleukin‐10
Islam, H., Neudorf, H., Mui, A. L., & Little, J. P. (2021) · The Journal of Physiology · doi:10.1113/jp281356 · Cited by 61
“In fact, several studies suggest that reduction in systemic inflammation following a lifestyle intervention are driven more strongly by weight loss than exercise per se (Nicklas et al. 2004; Christiansen et al. 2010; Fisher et al. 2011).”
BackgroundRosso, S. D., Baraquet, M. L., Barale, A., Defagó, M. D., Tortosa, F. G., Perovic, N. R., & Aoki, M. P. (2023) · Obesity Reviews · doi:10.1111/obr.13564 · Cited by 58
“Christiansen et al.(53) also looked at the effects on MIP1-α and found no significant impact.”
BackgroundInfluentialSnel, M., van Diepen, J. A., Stijnen, T., Pijl, H., Romijn, J. A., Meinders, A. E., Voshol, P. J., & Jazet, I. M. (2011) · Food and Chemical Toxicology · doi:10.1016/j.fct.2011.09.032 · Cited by 55
Zouhal, H., Abderrahman, A. B., Khodamoradi, A., Saeidi, A., Jayavel, A., Hackney, A. C., Laher, I., Algotar, A. M., & Jabbour, G. (2020) · Obesity Reviews · doi:10.1111/obr.13039 · Cited by 66
Hernández-Reyes, A., Cámara‐Martos, F., Molina‐Luque, R., Romero‐Saldaña, M., Molina‐Recio, G., & Moreno-Rojas, R. (2019) · BMC Women s Health · doi:10.1186/s12905-019-0864-5 · Cited by 63
Dadrass, A., Salamat, K. M., Hamidi, K., & Azizbeigi, K. (2019) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-019-00416-z · Cited by 52
Mendelson, M., Michallet, A. ‐., Monneret, D., Perrin, C., Estève, F., Lombard, P. R., Faure, P., Levy, P. A., Favre‐Juvin, A., Pépin, J., et al. (2014) · Pediatric Obesity · doi:10.1111/ijpo.255 · Cited by 56
“Some authors have shown an association between alteration of body weight and body composition and improvements of endothelial function and insulin resistance in obese adults (13) while others have found improved insulin sensibility independently of changes of body composition (11,14).”
BackgroundClark, J. (2016) · Biology of Sport · doi:10.5604/20831862.1212974 · Cited by 50
“6), 9-15 weeks (29-studies [46-73], group size: 19±22, age: 47±10.”
Lira, F. S., Neto, J. C. R., Antunes, B. M., & Fernandes, R. A. (2014) · Current Diabetes Reviews · doi:10.2174/1573399810666141122210135 · Cited by 50
Möller, K., Ostermann, A. I., Rund, K. M., Thoms, S., Blume, C. A., Stahl, F., Hahn, A., Schebb, N. H., & Schuchardt, J. P. (2015) · Prostaglandins Leukotrienes and Essential Fatty Acids · doi:10.1016/j.plefa.2015.12.001 · Cited by 50
“This result is consistent with previous studies that observed a decreasing effect of body weight reduction on the inflammation markers hsCRP, IL-6 and TNF-α [38–43].”
ResultAkbarpour, M. (2013) · Biology of Sport · doi:10.5604/20831862.1029817 · Cited by 48
Yoshimura, E., Kumahara, H., Tobina, T., Matsuda, T., Watabe, K., Matono, S., Ayabe, M., Kiyonaga, A., Anzai, K., Higaki, Y., et al. (2014) · Obesity Facts · doi:10.1159/000358576 · Cited by 48
Stelmach-Mardas, M., & Walkowiak, J. (2016) · Nutrients · doi:10.3390/nu8080455 · Cited by 48
“Other longitudinal studies [29,30] with shorter follow-up (6–8.”
BackgroundJung, D. Y., Ko, H. J., Lichtman, E. I., Lee, E., Lawton, E., Ong, H., Yu, K., Azuma, Y., Friedline, R. H., Lee, K. W., et al. (2013) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00462.2012 · Cited by 48
Lacraz, G., Rakotoarivelo, V., Labbé, S. M., Vernier, M., Noll, C., Mayhue, M., Staňková, J., Schwertani, A. G., Grenier, G., Carpentier, A. C., et al. (2016) · PLoS ONE · doi:10.1371/journal.pone.0162995 · Cited by 47
“Different studies have shown elevated levels of circulating IL-15, IL-6, CRP and IL-1Rα have been observed in obese individuals [21, 54, 55].”
BackgroundClinical implications of exercise immunology
Nieman, D. C. (2012) · Journal of sport and health science/Journal of Sport and Health Science · doi:10.1016/j.jshs.2012.04.004 · Cited by 47
“Nonetheless, data from both study formats support that in order for reductions in chronic inflammation to be experienced, a large change in a combination of lifestyle factors is needed including weight loss, near-daily moderate-tovigorous physical activity of 30e60-min duration, avoidance of cigarette smoking, and inc…”
BackgroundPredictors of Improvement in Cardiometabolic Risk Factors With Weight Loss in Women
Dow, C. A., Thomson, C. A., Flatt, S. W., Sherwood, N. E., Pakiz, B., & Rock, C. L. (2013) · Journal of the American Heart Association · doi:10.1161/jaha.113.000152 · Cited by 47
“≥130 154 (17) 139 133 (35)** 127 132 (38)**”
Exercise Training Effects on Inflammatory Gene Expression in White Adipose Tissue of Young Mice
Baynard, T., Vieira‐Potter, V. J., Valentine, R. J., & Woods, J. A. (2012) · Mediators of Inflammation · doi:10.1155/2012/767953 · Cited by 46
Castela, I., Rodrigues, C., Ismael, S., Barreiros-Mota, I., Morais, J., Araújo, J. R., Marques, C., Silvestre, M. P., Ângelo‐Dias, M., Martins, C. G., et al. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.06.021 · Cited by 46
Saeidi, A., Haghighi, M. M., Kolahdouzi, S., Daraei, A., Abderrahman, A. B., Essop, M. F., Laher, I., Hackney, A. C., & Zouhal, H. (2020) · Obesity Reviews · doi:10.1111/obr.13090 · Cited by 50
“sion and release of MCP-1 are increased by obesity-associated lowgrade inflammation(367) and reversed by weight loss.(144,152) Chronic exercise training modulates immune function and induces antiinflammatory effects(368) either directly by anti-inflammatory modula-”
BackgroundA therapeutic role for vitamin D on obesity-associated inflammation and weight-loss intervention
Slusher, A. L., McAllister, M. J., & Huang, C. (2015) · Inflammation Research · doi:10.1007/s00011-015-0847-4 · Cited by 47
“Interestingly, diet coupled with exercise demonstrates a synergistic relationship in response to weight-loss intervention studies when supplemented with vitamin D [15, 115].”
BackgroundWright, C. S., Zhou, J., Sayer, R. D., Kim, J. E., & Campbell, W. W. (2018) · Nutrients · doi:10.3390/nu10070946 · Cited by 43
Adolphe, J. L., Silver, T. I., Childs, H., Drew, M. D., & Weber, L. P. (2014) · British Journal Of Nutrition · doi:10.1017/s0007114514001214 · Cited by 44
“in human weight-loss trials have also found conflicting findings((53)), with some studies demonstrating increases in plasma adiponectin concentrations after weight loss((54,55)) and some studies demonstrating no effects.”
ResultNishida, Y., Higaki, Y., Taguchi, N., Hara, M., Nakamura, K., Nanri, H., Imaizumi, T., Sakamoto, T., Horita, M., Shinchi, K., et al. (2014) · Preventive Medicine · doi:10.1016/j.ypmed.2014.04.004 · Cited by 43
“IL-15 level in the exercise- and diet-induced weight-loss group decreased by 33% (baseline: 116.4; 12 weeks: 78 pg/mL) (Christiansen et al., 2010).”
InfluentialKhalafi, M., Symonds, M. E., & Akbari, A. M. (2021) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2021.1873732 · Cited by 46
Garnæs, K. K., Nyrnes, S. A., Salvesen, K. Å., Salvesen, Ø. O., Mørkved, S., & Moholdt, T. T. (2017) · PLoS ONE · doi:10.1371/journal.pone.0173937 · Cited by 43
Serum IL ‐15 and IL ‐15Rα levels are decreased in lean and obese physically active humans
Pérez‐López, A., Valadés, D., Martínez, C. V., Blanco, A. I. D. C., Buján, J., & García‐Honduvilla, N. (2017) · Scandinavian Journal of Medicine and Science in Sports · doi:10.1111/sms.12983 · Cited by 40
Exercise-induced myokines: a brief review of controversial issues of this decade
Son, J. S., Chae, S. A., Testroet, E. D., Du, ., & Jun, H.-P. (2017) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2018.1416290 · Cited by 38
“Apelin HFD rats/mice AT ↓[49] ↑[49] ↑[49] T1DM rats AT ↓[4] ↔[5] T2DM rats AT ↑[45] ↔[45] ↓[45] Obese adults AT ↓[6] ↔[52] T2DM patients AT ↑[7,8] RT ↔[8] CT ↑[8,9] Elderly adults AT ↑[10] BDNF T2DM rats RT ↓[11]↔[11] ↓[11] SCT rats AT ↑[12] NR mice AT ↔[53] ↑[53] Post-MI rats AT ↔[54] ↑[54] ↑[54] NSE/PS2m mice AT ↑[1…”
Moholdt, T. T., Salvesen, K. Å., Ingul, C. B., Vik, T., Oken, E., & Mørkved, S. (2011) · Trials · doi:10.1186/1745-6215-12-154 · Cited by 37
“Based on prior studies [37,38], the power calculation has taken into account a 6 kg expected and clinically relevant difference between mean weight increases in the control group compared to the training group (between baseline and delivery).”
MethodCooper, J. H. F., Collins, B. E. G., Adams, D. R., Robergs, R. A., & Donges, C. E. (2016) · Journal of Obesity · doi:10.1155/2016/2479597 · Cited by 38
“Some studies report no change in CRP or inflammatory cytokines following exercise intervention [20, 21, 26, 36, 37], while other studies report significant reductions [18–21, 38, 39].”
ResultKhalafi, M., Sakhaei, M. H., Kazeminasab, F., Rosenkranz, S. K., & Symonds, M. E. (2023) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2023.05.024 · Cited by 45
Sloan, R. P., Shapiro, P. A., McKinley, P. S., Bartels, M. N., Shimbo, D., Lauriola, V., Karmally, W., Pavlicová, M., Choi, C. J., Choo, T.-H. J., et al. (2018) · Journal of the American Heart Association · doi:10.1161/jaha.118.010201 · Cited by 35
Little evidence of systemic and adipose tissue inflammation in overweight individuals
Redman, L. M. (2012) · Frontiers in Genetics · doi:10.3389/fgene.2012.00058 · Cited by 35
Improving Adiponectin Levels in Individuals With Diabetes and Obesity: Insights From Look AHEAD
Belalcazar, L. M., Lang, W., Haffner, S. M., Schwenke, D. C., Kriska, A. M., Balasubramanyam, A., Hoogeveen, R. C., Pi‐Sunyer, F. X., Tracy, R. P., & Ballantyne, C. M. (2015) · Diabetes Care · doi:10.2337/dc14-2775 · Cited by 36
El-Kader, S. M. A., & Al-Dahr, M. H. S. (2016) · African Health Sciences · doi:10.4314/ahs.v16i3.12 · Cited by 34
Hovanloo, F., Arefirad, T., & Ahmadizad, S. (2013) · Journal of Diabetes & Metabolic Disorders · doi:10.1186/2251-6581-12-22 · Cited by 35
MicroRNAs in Obesity-Associated Disorders: The Role of Exercise Training
Silveira, A. C., Gomes, J. L. P., Roque, F. R., Fernandes, T., & de Oliveira, E. M. (2022) · Obesity Facts · doi:10.1159/000517849 · Cited by 33
Garnæs, K. K., Helvik, A., Stafne, S. N., Mørkved, S., Salvesen, K. Å., Salvesen, Ø. O., & Moholdt, T. T. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-028252 · Cited by 36
Nascimento, H., Costa, E. M., Rocha, S., Lucena, C., Rocha‐Pereira, P., Rêgo, C., Mansilha, H. F., Quintanilha, A. T., Aires, L., Mota, J. A. P. S., et al. (2014) · Pediatric Research · doi:10.1038/pr.2014.73 · Cited by 30
Exercise and Estrogen Make Fat Cells “Fit”
Vieira‐Potter, V. J., Zidon, T. M., & Padilla, J. (2015) · Exercise and Sport Sciences Reviews · doi:10.1249/jes.0000000000000046 · Cited by 30
Metadata
- Authors
- Christiansen, T., Paulsen, S. K., Bruun, J. M., Pedersen, S. B., & Richelsen, B.
- Affiliations
- Aarhus University Hospital (DK)
- Corresponding author
- Christiansen, Tore
- Venue
- American Journal of Physiology-Endocrinology and Metabolism
- Publisher
- American Physiological Society
- Published
- 2010-04
- Volume
- 298
- Issue
- 4
- Pages
- E824-E831
- ISSN
- 0193-1849 (ISSN-L)
- 1522-1555
- OpenAlex
- W2111106822
- Cited by
- 255
- References
- 55
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 12 · 2023: 13 · 2022: 14 · 2021: 19 · 2020: 15 · 2019: 11 · 2018: 18 · 2017: 18 · 2016: 19 · 2015: 22 · 2014: 21 · 2013: 25 · 2012: 18
- FWCI
- 14.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physiology-Endocrinology and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Physiology (medical) › Exercise and Physiological Responses
- Health Sciences › Medicine › Physiology (medical) › Adipose Tissue and Metabolism
- Keywords
- obesity, exercise training, diet-induced weight loss, very low calorie diet, inflammatory markers, adipose tissue inflammation, skeletal muscle inflammation, adiponectin, MCP-1, MIP-1α, IL-15, IL-18, interleukin-6, aerobic exercise, VO2max, metabolic risk factors
- MeSH terms
- Adipose Tissue, Adolescent, Adult, Blood Glucose, Blood Pressure, Blood Proteins, Body Weight, Diet, Reducing, Female, Humans, Inflammation, Insulin, Lipids, Male, Middle Aged, Obesity, Physical Education and Training, Risk Factors, Anaerobic Threshold, Biomarkers, Weight Loss, Exercise, Gene Expression, Muscle, Skeletal, Young Adult
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