Cited by 255Adipokines, Inflammation, and Metabolic DiseasesExercise and Physiological ResponsesAdipose Tissue and Metabolism

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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

Christiansen, Tore, Paulsen, Søren K., Bruun, Jens M., Pedersen, Steen B., Richelsen, Bjørn·2010·American Journal of Physiology-Endocrinology and Metabolism

DOI 10.1152/ajpendo.00574.2009

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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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Background
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BackgroundMethodInfluential
Genomic Signatures of a Global Fitness Index in a Multi‐Ethnic Cohort of Women
Rampersaud, E., Nathanson, L., Farmer, J., Meshbane, K., Belton, R. L., Dressen, A., Cuccaro, M. L., Musto, A. A., Daunert, S., Deo, S. K., et al. (2013) · Annals of Human Genetics · doi:10.1111/ahg.12006 · Cited by 11
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Dairy Attenuates Weight Gain to a Similar Extent as Exercise in Rats Fed a High‐Fat, High‐Sugar Diet
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BackgroundMethod
The effect of a combined lifestyle intervention with and without protein drink on inflammation in older adults with obesity and type 2 diabetes
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“The authors also suggested that “ more intensive exercise may be necessary to affect systemic inflammation ” (Christiansen et al., 2010).”
Changes in Inflammatory Markers Following Bariatric Surgery and the Impact of the Surgical Procedure: A 12-Month Longitudinal Study
Jensen, R. T., Thuesen, A. C. B., Huang, Y., Stinson, S. E., Juel, H. B., Madsbad, S., Bendtsen, F., Hansen, T. F., & Pedersen, J. S. (2025) · Obesity Surgery · doi:10.1007/s11695-024-07629-z · Cited by 12
“And our findings correspond well with studies of diet-induced weight-loss, which report reduced plasma levels of inflammatory markers after a reduction in weight [19–21].”
Aerobic Exercise Does Not Predict Brain Derived Neurotrophic Factor And Cortisol Alterations in Depressed Patients
Lamego, M. K., Moura, A. D. S., Paes, F., Rocha, N., Filho, A. S. S., Lattari, E., Rimes, R., Manochio, J., Budde, H., Wegner, M., et al. (2015) · CNS & Neurological Disorders - Drug Targets · doi:10.2174/1871527315666151111125402 · Cited by 11
Meta-inflammatory state and insulin resistance can improve after 10 weeks of combined all-extremity high-intensity interval training in sedentary overweight/obese females: a quasi-experimental study
Soltani, N., Marandi, S. M., Kazemi, M., & Esmaeil, N. (2020) · Journal of Diabetes & Metabolic Disorders · doi:10.1007/s40200-020-00550-z · Cited by 11
Changes in body weight, C-reactive protein, and total adiponectin in non-obese women after 12 months of a small-volume, home-based exercise program
Mediano, M. F. F., Neves, F. A., Rodrigues-Cunha, A. C. D. S., Souza, É. P. G., Moura, A. S., & Sichieri, R. (2013) · Clinics · doi:10.6061/clinics/2013(08)10 · Cited by 10
“It is noteworthy that most of these results were observed in obese individuals with high inflammatory levels at baseline (19-23).”
Result
Plasma Apelin Unchanged With Acute Exercise Insulin Sensitization.
Waller, J. D., McNeill, E., Zhong, F. Y., Vervaecke, L. S., & Goldfarb, A. H. (2019) · Europe PMC (PubMed Central) · Cited by 11
Application of cryolipolysis in adipose tissue: A systematic review
Resende, L., Noites, A., & Amorim, M. (2022) · Journal of Cosmetic Dermatology · doi:10.1111/jocd.15265 · Cited by 10
Optimized RNA sequencing deconvolution illustrates the impact of obesity and weight loss on cell composition of human adipose tissue
Ahn, C., Divoux, A., Zhou, M., Seldin, M. M., Sparks, L. M., & Whytock, K. L. (2025) · Obesity · doi:10.1002/oby.24264 · Cited by 10
“Although DIWL-mediated attenuation of systemic inflammation has been commonly reported in individuals with overweight and obesity [55,56], the CALERIE study was the first to reveal reduced markers of systemic inflammation after 1 to 2 years of CR in individuals without obesity [ 57].”
Effects of weight loss on bone turnover, inflammatory cytokines, and adipokines in Chinese overweight and obese adults
Yu, D., Chen, W., Zhang, J., Wei, L., Qin, J., Lei, M., Tang, H., Wang, Y., Xue, S., Dong, J., et al. (2022) · Journal of Endocrinological Investigation · doi:10.1007/s40618-022-01815-5 · Cited by 12
Proof of Concept of a 6-Month Person-Oriented Exercise Intervention ‘MultiPill-Exercise’ among Patients at Risk of or with Multiple Chronic Diseases: Results of a One-Group Pilot Trial
Schweda, S., Munz, B., Burgstahler, C., Niess, A. M., Roesel, I., Sudeck, G., & Krauß, I. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19159469 · Cited by 12
“Moreover, a significant increase in HDL was only found in the combination group [65].”
Background
Effects of a Walking Intervention Using Mobile Technology and Interactive Voice Response on Serum Adipokines Among Postmenopausal Women at Increased Breast Cancer Risk
Llanos, A. A. M., Krok, J. L., Peng, J., Pennell, M. L., Vitolins, M. Z., DeGraffinreid, C. R., & Paskett, E. D. (2014) · Hormones and Cancer · doi:10.1007/s12672-013-0168-4 · Cited by 11
Effect of Exercise Training on Signaling of Interleukin-6 in Skeletal Muscles of Type 2 Diabetic Rats
Pattamaprapanont, P., Muanprasat, C., Soodvilai, S., Srimaroeng, C., & Chatsudthipong, V. (2016) · The Review of Diabetic Studies · doi:10.1900/rds.2016.13.197 · Cited by 10
Exercise to spot the differences: a framework for the effect of exercise on hippocampal pattern separation in humans
Jennen, L., Mazereel, V., Lecei, A., Samaey, C., Vancampfort, D., & van Winkel, R. (2022) · Reviews in the Neurosciences · doi:10.1515/revneuro-2021-0156 · Cited by 13
Exercise, Weight Loss, and Effects on Inflammation
Nicklas, B. J., & Beavers, K. M. (2010) · Current Cardiovascular Risk Reports · doi:10.1007/s12170-010-0106-8 · Cited by 9
Interdisciplinary therapy improves cardiorespiratory fitness and inflammatory markers in obese adult women
Sanches, R. B., Andrade-Silva, S. G., Fidalgo, J. P. N., Moraes, A. D. S., Poli, V. F. S., Oyama, L. M., dos Santos, R. V. T., & Caranti, D. A. (2016) · Obesity Medicine · doi:10.1016/j.obmed.2015.12.004 · Cited by 9
Caloric restriction-induced weight loss with a high-fat diet does not fully recover visceral adipose tissue inflammation in previously obese C57BL/6 mice
Rodrigues, M. O. M., Evangelista-Silva, P. H., Neves, N. N., Moreno, L. G., Santos, C. S., Rocha, K. L. S., Ottone, V. O., Batista-da-Silva, B., Dias‐Peixoto, M. F., Magalhães, F. D. C., et al. (2020) · Applied Physiology, Nutrition, and Metabolism · doi:10.1139/apnm-2020-0220 · Cited by 11
“…from studies that have examined the effects of weight loss on tissue inflammation are Page 4 of 19 https://mc06.manuscriptcentral.com/apnm-pubs Applied Physiology, Nutrition, and Metabolism Draft 4 inconsistent (Christiansen et al. 2010; Esposito et al. 2003; Jung et al. 2013; Nicklas et al. 2004).”
Background
The effects of exercise and low-calorie diets compared with low-calorie diets alone on health: a protocol for systematic reviews and meta-analyses of controlled clinical trials
Beigrezaei, S., Yazdanpanah, Z., Soltani, S., Rajaie, S. H., Mohseni‐Takalloo, S., Zohrabi, T., Kaviani, M., Forbes, S. C., Baker, J. S., & Salehi‐Abargouei, A. (2021) · Systematic Reviews · doi:10.1186/s13643-021-01669-7 · Cited by 9
“However, controlled clinical trials have led to inconsistent results [25–29], with some studies demonstrating no additive effects of exercise [25, 26], while others found a greater effect with exercise for improving multiple cardiometabolic risk factors in obese adults [27, 28].”
Result
The relationship between adiposopathy and glucose-insulin homeostasis is not affected by moderate-intensity aerobic training in healthy women with obesity
Clément, A., Riesco, É., Tessier, S., Lacaille, M., Pérusse, F., Côté, M., Després, J., Weisnagel, J., Doré, J., Joanisse, D. R., et al. (2018) · Journal of Physiology and Biochemistry · doi:10.1007/s13105-018-0630-4 · Cited by 8
Twelve-week treadmill endurance training in mice is associated with upregulation of interleukin-15 and natural killer cell activation and increases apoptosis rate in Hepa1-6 cell-derived mouse hepatomas
Wang, Z., Cui, Y., Zhang, Y., Wang, X., Li, J., Li, J.-L., & Jiang, N. (2023) · Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas · doi:10.1590/1414-431x2023e12296 · Cited by 7
Effectiveness of diet versus exercise intervention on weight reduction in local Japanese residents
Toji, C., Okamoto, N., Kobayashi, T., Furukawa, Y., Tanaka, S., Ueji, K., Fukui, M., & Date, C. (2012) · Environmental Health and Preventive Medicine · doi:10.1007/s12199-011-0258-2 · Cited by 7
The Effect of an Eight-week Pilates Training on Interleukine-18 Level, Fatigue, and Balance in Women With Multiple Sclerosis
Asvar, S., & Taghian, F. (2020) · Journal of Research and Health · doi:10.32598/jrh.10.6.552.4 · Cited by 6
The addition of exercise to a weight loss diet on inflammatory markers: a systematic review and Meta-analysis of controlled clinical trials
Beigrezaei, S., Yazdanpanah, Z., Soltani, S., Rajaie, S. H., Mohseni‐Takalloo, S., Zohrabi, T., Kaviani, M., Forbes, S. C., Baker, J. S., & Salehi‐Abargouei, A. (2021) · Critical Reviews in Food Science and Nutrition · doi:10.1080/10408398.2021.1999201 · Cited by 6
Baseline Characteristics in the Remote Diet Intervention to REduce long-COVID Symptoms Trial (ReDIRECT)
Haag, L., Richardson, J., Haig, C. E., Cunningham, Y., Fraser, H., Brosnahan, N., Ibbotson, T. R., Ormerod, J. A., White, C., McIntosh, E., et al. (2024) · NIHR Open Research · doi:10.3310/nihropenres.13522.1 · Cited by 6
UP-TO-DATE VIEW AT THE ROLE OF ASEPTIC INFLAMMATION OF ADIPOSE TISSUE IN THE GENESIS OF OBESITY AND METABOLIC SYNDROME
Kryukov, N. N., Гинзбург, M. М., & Kiseleva, E., V (2013) · Arterial’naya Gipertenziya (Arterial Hypertension) · doi:10.18705/1607-419x-2013-19-4- · Cited by 6
Visceral obesity and chronic pain: effect of a 4-week rehabilitation program on adipokines and insulin resistance
Doury-Panchout, F., Métivier, J.-C., Nardoux, J., & Fouquet, B. (2017) · Journal of Exercise Rehabilitation · doi:10.12965/jer.1734920.460 · Cited by 5
“…2009; Boudou et al., 2003; Coker et al., 2009; Hulver et al., 2002; Yokoyama et al., 2004), whereas some found increases and others decreases of adiponectin concentrations (Christiansen et al., 2010; Kriketos et al., 2004; Lim et al., 2008; Oberbach et al., 2006; Rokling-Andersen et al., 2007).”
Background
The Role of Brown Adipose Tissue in the Development and Treatment of Nonalcoholic Steatohepatitis: An Exploratory Gene Expression Study in Mice
Munck, T. J. I. D., Xu, P., Vanderfeesten, B. L. J., Elizalde, M., Masclee, A., Nevens, F., Cassiman, D. M., Schaap, F. G., Jonkers, D. M. A. E., & Verbeek, J. (2020) · Hormone and Metabolic Research · doi:10.1055/a-1301-2378 · Cited by 5
“observed a significantly decreased Nrg4 expression in cultured adipocytes with Tnf-α [41], suggesting a rate-limiting role of inflammatory stimuli [42, 43].”
Background
Nutritional status and energy expenditure after a programme of nutrition education and combined aerobic/resistance training in obese women
de Melo, C. M., Tirapegui, J., Cohen, D. D., Marchini, J. S., & Ribeiro, S. M. L. (2010) · e-SPEN the European e-Journal of Clinical Nutrition and Metabolism · doi:10.1016/j.eclnm.2010.04.001 · Cited by 5
Very low calorie diets
(2012) · Drug and Therapeutics Bulletin · doi:10.1136/dtb.2012.05.0104 · Cited by 5
Exercise training and spexin ameliorate thyroid changes in obese type 2 diabetic rats: the possible interlaying mechanisms
Rizk, F. H., Barhoma, R. A., El‐Saka, M. H., Ibrahim, H. A., El‐Gohary, R. M., Ismail, R., Motawea, S. M., Salem, O., & Hegab, I. I. (2024) · American Journal of Physiology-Endocrinology and Metabolism · doi:10.1152/ajpendo.00213.2024 · Cited by 4
Regular walking improves plasma protein concentrations that promote blood hyperviscosity in women 65–74 yr with type 2 diabetes
Simmonds, M. J., Sabapathy, S., Serre, K. R., Haseler, L. J., Gass, G. C., Marshall‐Gradisnik, S., & MINAHAN, C. L. (2016) · Clinical Hemorheology and Microcirculation · doi:10.3233/ch-162061 · Cited by 4
“Paradoxically, given that acute exercise is associated with increased concentrations of inﬂammatory cytokines and acute-phase reactants [29], lifestyle modiﬁcation including chronic exercise has been demonstrated to reduce markers of inﬂammation in some [12, 15, 21, 40], but not all studies [9].”
Diet or exercise: The role of diet and/or exercise on changes of pro-inflammatory markers during a weight loss program in adult women with overweight
Muhammad, H. F. L., Pahdarina, D., Zahara, N. P., Nugraheni, F., Hanny, T. A., Ermamilia, A., & Huriyati, E. (2021) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2021.05.022 · Cited by 4
Circulating adiponectin expression is elevated and associated with the IL-15/IL-15Rα complex in obese physically active humans
Pérez‐López, A., Valadés, D., Blanco, A. I. D. C., García‐Honduvilla, N., & Martínez, C. V. (2019) · The Journal of Sports Medicine and Physical Fitness · doi:10.23736/s0022-4707.18.09030-8 · Cited by 6
Diet and diet combined with chronic aerobic exercise decreases body fat mass and alters plasma and adipose tissue inflammatory markers in obese women
Lakhdar, N., Denguezli, M., Zaouali, M., Zbidi, A., Tabka, Z., & Bouassida, A. (2015) · Pediatric Rheumatology · doi:10.1186/1546-0096-13-s1-p194 · Cited by 4
Effect of a Cross-Training and Resistance Exercise Routine on IL-15 in Adults with Type B Acute Lymphoblastic Leukemia during the Induction Phase: Randomized Pilot Study
Gallardo-Rodríguez, A. G., Carrillo, I. O., Tovar, A. M., Maldonado, R. C., Moreno, E. M., & Peñafiel, C. O. R. (2023) · Journal of Functional Morphology and Kinesiology · doi:10.3390/jfmk9010004 · Cited by 3
“Christiansen et al. described a close relationship between the decrease in IL-15 post training intervention and the loss of fat mass in obese patients [31]; however, in our population, fat mass increased in patients.”
The association between plasma IL-6 levels and several thalassemia-related clinical features in Iraqi patients
Abd-AlKareem, D., Lafta, F. M., & Alwan, Y. F. (2022) · International Journal of Health Sciences · doi:10.53730/ijhs.v6ns6.10343 · Cited by 3
Precision Nutrition in Female Reproductive Health
Dumesic, D. A., Chazenbalk, G. D., & Heber, D. (2023) · Elsevier eBooks · doi:10.1016/b978-0-443-15315-0.00002-x · Cited by 3
Effects of acute and chronic resistance exercise training on IL-15 expression in rat skeletal muscle
오승렬, Kyung, S. J., Song, W. J., 김희재, & 김용안 (2013) · IJASS(International Journal of Applied Sports Sciences) · doi:10.24985/ijass.2013.25.2.85 · Cited by 3
Effects of low-glycemic index diet on plasma adipokines in obese children
Visuthranukul, C., Hurst, C. P., & Chomtho, S. (2021) · Pediatric Research · doi:10.1038/s41390-021-01463-0 · Cited by 3
Distinct transcriptomic effects of intermittent and chronic caloric restriction in mammary fat pad of a breast cancer mouse model
Tuna, B. G., Keles, N. A., Cicekdal, M. B., Doğan, S., & Kõks, S. (2025) · PLoS ONE · doi:10.1371/journal.pone.0331898 · Cited by 1
“Earlier studies also reported increased adiponectin/leptin ratio in serum and plasma with CR [65,66] and their role in breast cancer incidence [21].”
Plasma adiponectin as a predictor of the effectiveness of coronary heart disease therapy in patients with metabolic syndrome
Firova, E. M., & Tanyanskiy, D. A. (2023) · Reviews on Clinical Pharmacology and Drug Therapy · doi:10.17816/rcf321745 · Cited by 2
Effect of resistance training on serum interleukin-18 and C-reactive protein in obese men
Kouhi, F., Moradi, F., & Absazadegan, M. (2014) · DOAJ (DOAJ: Directory of Open Access Journals) · Cited by 2
Physical Activity Levels and Cardiometabolic Risks in Obese African American Adults: A Pilot Intervention Study
Zhou, Y., Buchowski, M. S., Akatue, R. A., Wu, J., Liu, J., & Hargreaves, M. K. (2018) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.2018.0077 · Cited by 2
Serological Study of Human Cytomegalovirus in Thalassemia Patients and Blood Donors and its Relation to IL-6 in Kirkuk City
Abbas, N. A., & Zaman, N. A. (2019) · Mağallaẗ ʻulūm al-rāfidayn · doi:10.33899/rjs.2019.159397 · Cited by 2
“…of IL-6, a pro- inflammatory factor, and the loss of adipose tissue caused by the reduction of body weight, Body Mass Index (BMI) and body fat percentage affected the gene expression and the consequent production of circulating in flammatory (Christiansen et al., 2010; Oberbach et al., 2008).”
Background
Secretory Malfunction
Eckel, J. (2018) · Elsevier eBooks · doi:10.1016/b978-0-12-809518-8.00005-2 · Cited by 1
The impact of moderate-intensity interval training on the NLR family pyrin domain-containing protein-3 inflammasome pathway in the liver tissue of male rats with type 2 diabetes
Sheikh, R., Tabandeh, M. R., Abolfathi, F., Tabatabaei, S. R. F., & Shakerian, S. (2025) · Sport Sciences for Health · doi:10.1007/s11332-025-01477-9 · Cited by 1

Authors: Christiansen, T., Paulsen, S. K., Bruun, J. M., Pedersen, S. B., & Richelsen, B.
Affiliations: Aarhus University Hospital (DK)
Corresponding author: Christiansen, Tore
ORCID: Bruun, Jens M.
Pedersen, Steen B.
Richelsen, Bjørn
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
DOI: 10.1152/ajpendo.00574.2009
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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Exercise training versus diet-induced weight-loss on metabolic risk factors and inflammatory markers in obese subjects: a 12-week randomized intervention study

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