The intensity of exercise and inflammation markers in women with overweight & obesity: a systematic review and network meta-analysis

Abstract

Objectives: The purpose of this network meta-analysis (NMA) of randomized controlled trials (RCT) was to examine the effects of different exercise intensities on inflammatory markers in women with overweight/obesity.

Methods: A systematic search for RCTs that met the inclusion criteria for the period up to October 2024. random effects NMA was performed within a frequency-based framework.

Results: A total of 75 RCTs were included (3989 participants). High-intensity exercise significantly modulated leptin and adiponectin levels, but had a nonsignificant effect on TNF-α, CRP, and IL-6 levels. Moderate-intensity exercise significantly modulated TNF-α, CRP, IL-6, leptin, and adiponectin levels. Surface under the cumulative ranking curve (SUCRA) probability ranking showed that moderate-intensity exercise was the most recommended exercise intensity for reducing TNF-α, CRP, IL-6, and leptin levels, and for modulating adiponectin levels, moderate-intensity exercise also had a SUCRA value of 65.4%, so we believe that moderate-intensity exercise may be the most robust type of exercise intensity in terms of the breadth of effects. Subgroup analysis showed that moderate-intensity aerobic exercise (MAE) significantly reduced TNF-α levels. Moderate-intensity resistance training (MRT) is the most recommended type for decreasing IL-6 and leptin levels. Moderate-intensity combined exercise (MCE) is the best type of exercise for managing CRP and adiponectin levels.

Conclusions: There were significant differences in the effects of different exercise intensities on specific inflammatory markers in women living with overweight and obesity. Moderate-intensity exercise may be the most robust type of exercise intensity. Future studies should consider the importance of exercise duration and volume (e.g., in MET* minutes/week) to better understand the relationship between exercise intensity and inflammatory markers. The effects of combining exercise and diet on inflammatory markers in women with overweight and obesity should also be explored in greater depth.