Effect of Aerobic Exercise on Inflammatory Markers in Healthy Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Abstract

Background: Chronic inflammation plays a significant role in accelerating the aging process and is closely associated with the initiation and progression of a broad range of age-related diseases. Physical exercise is considered beneficial in alleviating these conditions, but the effects of aerobic exercise on inflammatory markers in a healthy population should be furtherly clarified. Objective: The purpose of this systematic review and meta-analysis was to evaluate the effect of aerobic exercise on inflammatory markers in middle-aged and older adults. Methods: The literature search was conducted utilizing PubMed, Web of Science, Embase, and the Cochrane Library from their inception through April 2018, and the reference lists were screened to identify appropriate studies. Only randomized controlled trials that investigated the effect of aerobic exercise on inflammatory markers in middle-aged and older adults were eligible for this review. Results: Eleven studies involving 1,250 participants were retrieved from the databases for analysis. The pooled results showed that aerobic exercise significantly reduced inflammatory markers (C-reactive protein (CRP): SMD = 0.53, 95% CI 0.26–0.11, p = 0.0002; tumor necrosis factor-alpha (TNF-α): SMD = 0.75, 95% CI 0.31–1.19, p = 0.0007; interleukin 6 (IL-6): SMD = 0.75, 95% CI 0.31–1.19, p = 0.0007). No significant improvement was found in relation to interleukin 4 (IL-4). Conclusions: Aerobic exercise may have a positive effect on reduction of CRP, TNF-α, and IL-6 in middle-aged and older adults. Further randomized controlled trials (RCTs) need to be conducted to determine the effect of aerobic exercise on additional inflammatory markers in the population of middle-aged and older adults.

The Role of Exercise in the Interplay between Myokines, Hepatokines, Osteokines, Adipokines, and Modulation of Inflammation for Energy Substrate Redistribution and Fat Mass Loss: A Review

“…Although acute exercise was found to trigger a transient increase in oxidative stress and proinflammatory cytokines, chronic exercise was shown to induce a systemic anti-inflammatory response not only in the recovery period but also in the long term, an effect hypothesized to partially mediate its health benefits [ 9 , 238 ]. In healthy individuals subjected to aerobic exercise interventions, systematic reviews and meta-analyses have found decreased circulating levels of TNF-α, IL-6, and CRP [ 249 ], as well as increased levels of the anti-inflammatory cytokine IL-10 [ 250 ]. A meta-analysis focusing specifically on individuals with T2DM has also described decreased levels of IL-6 and CRP with aerobic exercise interventions [ 227 ], which emphasizes that the anti-inflammatory properties of exercise are strong regardless of preexisting metabolic status.…”

Role of increasing the aerobic capacity on improving the function of immune and respiratory systems in patients with coronavirus (COVID-19): A review

“…Secondly, it can increase the level of immunoglobulins (IgA, IgM, IgG), particularly IgA because of its vital role against lung infections [12e15]. Lastly, it can regulate the level of C-reactive proteins (CRP), through inducing a short-term small increase [16e18] to fight lung infections and a longeterm decrease to inhibit any decrease in lung functions [19,20], and lowering anxiety and depression to improve the immunity by re-balancing T-helper-1/T-helper-2 21À27 .…”

“…Patients with COVID-19 have very high levels of CRP [1,74]. Increasing the aerobic capacity plays an interesting role in regulating the CRP levels by producing a short-term small increase in CRP levels [16e18] to fight lung infections and a long-term decrease in CRP levels [19,20] to prevent the decrease in lung functions.…”

Exercise, Cardiovascular Health, and Risk Factors for Atherosclerosis: A Narrative Review on These Complex Relationships and Caveats of Literature

“…Exercise interventions have been shown as potential mediators of improved inflammatory profiles. A recent meta-analysis of randomized controlled trials, evaluating 1,138 healthy middle-aged and older patients, showed improvements in tumoral necrosis factor α, IL-6, and CRP levels in individuals exposed to aerobic exercise training, when compared with those in non-exercising controls ( Zheng et al, 2019 ). These results are following a previous meta-analysis evaluating the effects of exercise on CRP levels that, in sensitivity analyses, also showed reduced concentrations of this inflammatory marker in patients with established CVD and type 2 diabetes ( Fedewa et al, 2017 ).…”