Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training
Open accessAbstract
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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Weight loss through reduced dietary intake and possibly bariatric surgery is associated with reductions in primary pro-inflammatory markers, partly due to normalized expression of inflammation-related genes in white adipose tissue and downregulation of the NLRP3 inflammasome.
“Weight loss through reduced dietary intake and possibly bariatric surgery is associated with reductions in primary pro-inflammatory markers, in part owing to normalized expression of inflammation-related genes in white adipose tissue and to downregulation of the NLRP3 inflammasome58–61.”
From Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty (2018) · cites this paper as [60]
Cross-sectional studies in humans show an inverse relation between markers of inflammation and physical activity levels and fitness.
“These findings complement data from several cross-sectional studies in humans that show an inverse relation between markers of inflammation and physical activity levels and fitness (34).”
From Exercise Counters the Age-Related Accumulation of Senescent Cells (2022) · cites this paper as [34]
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Low Carbohydrate, High Fat Diet Increases C-Reactive Protein during Weight Loss
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RetractedEggs modulate the inflammatory response to carbohydrate restricted diets in overweight men
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Review of the potential health impact of β-casomorphins and related peptides 1
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- Authors
- Nicklas, B. J.
- Affiliations
- Wake Forest University Health Sciences (US)
- Corresponding author
- Nicklas, B. J.
- Venue
- Canadian Medical Association Journal
- Publisher
- CMA Impact Inc.
- Published
- 2005-04-26
- Volume
- 172
- Issue
- 9
- Pages
- 1199-1209
- ISSN
- 0820-3946 (ISSN-L)
- 1488-2329
- PMC
- PMC557073
- OpenAlex
- W2113657976
- Cited by
- 259
- References
- 149
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 7 · 2023: 10 · 2022: 8 · 2021: 11 · 2020: 12 · 2019: 11 · 2018: 17 · 2017: 14 · 2016: 8 · 2015: 10 · 2014: 19 · 2013: 12 · 2012: 13
- FWCI
- 2.18
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Canadian Medical Association Journal (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wake Forest University
- University of Florida
- National Institute on Aging (R01-AG/DK20583, R01AG020583, P30AG021332)
- Topics
- Health Sciences › Medicine › Epidemiology › Adipokines, Inflammation, and Metabolic Diseases
- Health Sciences › Medicine › Rehabilitation › Exercise and Physiological Responses
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- chronic systemic inflammation, low-grade inflammation, dietary weight loss, very low calorie diet, exercise training, physical activity, obesity, adipose tissue cytokines, C-reactive protein, interleukin-6, TNF-α, energy intake, anti-inflammatory therapy
- MeSH terms
- C-Reactive Protein, Humans, Inflammation, Obesity, Weight Loss, Health Behavior, Exercise, Cytokines
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