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Reducing Inflammation?

Apart from following your anti-inflammatory diet, is there anything the average person can to do reduce levels of inflammation in the body? Does weight make a difference? How about exercise?

Andrew Weil, M.D. | April 2, 2024

Reducing Inflammation? | Exercise & Fitness | Andrew Weil, M.D.
4 min

We have known for decades that chronic, low-grade systemic inflammation is associated with heart disease, Type 2 diabetes, metabolic syndrome, and some cancers. That’s why it’s so important to reduce excessive inflammation in the body, and the anti-inflammatory diet is an excellent start. Yes, there are other lifestyle changes that can help, and regular exercise and weight management can make a significant difference.

We measure inflammation by looking for substances in blood that increase when it is present. The best known of these markers of inflammation is C-reactive protein (CRP). Another is the cytokine interleukin-6 (IL-6). More than a decade ago, a long-term study from England found that the more exercise mid-life men and women perform, the lower their levels of both CRP and IL-6. That study, which followed 4,289 men and women for ten years, found that those who increased their activity levels to meet recommendations (at least 2.5 hours a week of moderate to vigorous exercise) had significantly lower levels of both markers.

At the study’s outset, the participants reported on the duration, frequency, and intensity of their exercise. Later, they responded to 20 questions on the frequency and duration of their activities, which included walking, cycling, sports, gardening, housework, and home maintenance. The researchers measured inflammatory markers in each participant at the beginning of the study and again when it ended. They reported that those who were physically active when the study started had lower CRP and IL-6 levels compared to those who weren’t active. This held true after adjustment for age, sex, whether or not they smoked, their employment grade, body mass index, and chronic illness. At timed assessments during the investigation the investigators recorded that the participants who always met the physical activity guidelines had lower levels of CRP and IL-6 than those who reported rarely following the guidelines. The research team also discovered that study participants who increased their activity to meet the exercise guidelines between the second and third assessments showed lower levels of the two inflammatory markers.

More recently, a 2018 study investigated the effects of exercise on mental health, looking at the correlation between inflammatory markers and depression, anxiety, and stress. Moderate exercise was shown to be the most effective at reducing levels of a pro-inflammatory cytokine, and investigators concluded that exercise may reduce depression by reducing inflammation. I was impressed by the additional evidence that exercise so effectively combats inflammation; the resulting alleviation of the symptoms of depression and anxiety is an added benefit.

You also ask about weight in relation to inflammation. It does appear to play a key role. A 2021 paper reported that as adipose (fat) tissue expands during weight gain, it stops secreting anti-inflammatory cytokines and instead begins producing pro-inflammatory ones associated with insulin resistance.

These findings are consistent with a 2012 study at the Fred Hutchinson Cancer Research Center in Seattle, which found that overweight or obese postmenopausal women who lost at least five percent of their body weight had measurable reductions in the markers of inflammation. The researchers first measured levels of CRP, IL-6, and other markers of inflammation in the study’s 439 participants. After one year, CRP had dropped by 36.1 percent in women who lost weight by dieting alone and by 41.7 percent in those who also exercised; IL-6 dropped by 23.1 percent in the diet group and by 24.3 percent in the diet and exercise group. (Interestingly, this study showed little effect for exercise alone as a means of reducing inflammatory markers.)

The evidence is strong that inflammation has serious implications, and that reducing it – through diet, exercise, and weight loss – is a reliable and effective way of improving your health.

Andrew Weil, M.D.

Sources
Kawai T, Autieri MV, Scalia R. “Adipose tissue inflammation and metabolic dysfunction in obesity.” Am J Physiol Cell Physiol. 2021 Mar 1;320(3):C375-C391. doi: 10.1152/ajpcell.00379.2020. Epub 2020 Dec 23. PMID: 33356944; PMCID: PMC8294624.  pubmed.ncbi.nlm.nih/33356944/

Paolucci EM, Loukov D, Bowdish DME, Heisz JJ. “Exercise reduces depression and inflammation but intensity matters.” Biol Psychol. 2018 Mar;133:79-84. doi: 10.1016/j.biopsycho.2018.01.015. Epub 2018 Feb 3. PMID: 29408464. pubmed.ncbi.nlm.nih/29408464/

Hamer M, Sabia S, Batty GD, Shipley MJ, Tabák AG, Singh-Manoux A, Kivimaki M. “Physical activity and inflammatory markers over 10 years: Follow-up in men and women from the Whitehall II cohort study.” Circulation. 2012 Aug 21;126(8):928-33. doi: 10.1161/CIRCULATIONAHA.112.103879. Epub 2012 Aug 13. PMID: 22891048; PMCID: PMC3890998. pubmed.ncbi.nlm.nih/22891048/

Imayama I, Ulrich CM, Alfano CM, Wang C, Xiao L, Wener MH, Campbell KL, Duggan C, Foster-Schubert KE, Kong A, Mason CE, Wang CY, Blackburn GL, Bain CE, Thompson HJ, McTiernan A. “Effects of a caloric restriction weight loss diet and exercise on inflammatory biomarkers in overweight/obese postmenopausal women: a randomized controlled trial.” Cancer Res. 2012 May 1;72(9):2314-26. doi: 10.1158/0008-5472.CAN-11-3092. PMID: 22549948; PMCID: PMC3342840. pubmed.ncbi.nlm.nih/22549948/

Petersen AM, Pedersen BK. “The anti-inflammatory effect of exercise.” J Appl Physiol (1985). 2005 Apr;98(4):1154-62. doi: 10.1152/japplphysiol.00164.2004. PMID: 15772055. pubmed.ncbi.nlm.nih/15772055/

Dandona P, Aljada A, Bandyopadhyay A. “Inflammation: the link between insulin resistance, obesity and diabetes.” Trends Immunol. 2004 Jan;25(1):4-7. doi: 10.1016/j.it.2003.10.013. PMID: 14698276. pubmed.ncbi.nlm.nih/14698276/

Ross R. “Atherosclerosis–an inflammatory disease.” N Engl J Med. 1999 Jan 14;340(2):115-26. doi: 10.1056/NEJM199901143400207. PMID: 9887164. pubmed.ncbi.nlm.nih/9887164/

Originally Posted October 2012. Updated April 2024. 

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