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The positive effects of exercise on immune function are well-established. In moderate doses, exercise induces an immune response that may include protective effects against cancer [39] , immune senescence associated with the aging process [40-44] , rheumatoid arthritis [45,46] , cardiovascular disease [47] , diabetes [29,48] and all-cause mortality. [49]

Worried about over-training? Click here to learn about immune system response to excessive exercise.

A lifestyle including excessive amounts of refined foods and a lack of exercise is emerging as the main contributing factor to low-grade inflammation. Therefore treatment strategies should focus on exercise and diet modification. The information that follows summarizes the evidence for the positive effects of exercise on chronic inflammation.

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With physical activity, markers of systemic low-grade inflammation are reduced. [56-61] Typically, levels of proinflammatory markers (like C-reactive protein) are measured in the blood. Interestingly, one research group looked at levels within specific tissues and found that a treatment of caloric reduction and exercise changed levels of inflammatory markers in adipose tissue but not in skeletal muscle. [62]

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A strong link exists between elevated levels of C-reactive protein and cardiovascular disease. [38,63] There appears to be significant role for both diet and physical activity to improve the many factors associated with metabolic syndrome. [64] There does appear to be genetic variation that alters levels of C-reactive protein however exercise-induced changes in C-reactive protein do not appear to be dependent on genotype. [65]

When sedentary, but otherwise healthy individuals with high levels of C-reactive protein exercised for 20 weeks, levels reduced significantly. [66] A 12-week aerobic exercise program for patients with stable congestive heart failure showed a reduction in TNF-Alpha concentrations and improved fitness levels. [67] In addition, an exercise training program for people with intermittent claudication, which is associated with peripheral vascular disease, showed decreases in C-reactive protein concentrations. [68]


Lack of exercise is a strong predictor for the development diabetes. [71] Inflammatory markers, CRP and interleukin (IL)-6 predict the development of type 2 diabetes in women [29,48] and older adults. [72,73] The relationship between inflammatory markers and glucose utilization and insulin sensitivity in overweight and obese postmenopausal women was explored and researchers found that improvements in glucose metabolism were associated with decreases in cytokine concentrations during weight loss programs. [74] . There may be an association between low cardio respiratory fitness and C-reactive protein levels in women with type 2 diabetes. [75]

Post-menopausal Women:
Special Risk Factors with Hormone Replacement Therapy

Hormone replacement therapy (HRT) has a vascular inflammation effect and may lead to increased risk of adverse cardiovascular events. [69] Data fro the Women's Health Initiative showed that elevated levels of C-reactive protein and IL-6 were associated with HRT use, however data suggests that use or nonuse of HRT is less important as a predictor of cardiovascular risk than baseline levels of either C-reactive protein or IL-6. C-reactive protein levels were unchanged from normal values in women who exercised while taking hormone replacement therapy (HRT) but C-reactive protein levels were significantly higher in sedentary HRT users. [70] This study provides evidence that exercise may be beneficial to counteract the negative impacts of HRT.



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