Effects of heavy endurance physical exercise on inflammatory markers in non-athletes



      Physical activity has beneficial effects on cardiovascular disease but the mechanisms are still somewhat unclear. One possible pathway may be through the anti-inflammatory effects attributed to regular physical activity. Our primary aim was to study the effects of endurance physical exercise on C-reactive protein (CRP), Interleukin-6 (IL-6), Tumor Necrosis Factor-alpha (TNFα) during the acute and recovery phases. Secondarily, we studied the impact of diet on these inflammatory markers.


      Twenty men, aged 18–55 years, participated in a 14 days cross-country skiing tour. They traveled 12–30 km per day corresponding to about 10 h of heavy physical activity. The participants were randomized to a diet with either 30 or 40% of energy derived from fat. Inflammatory variables were analysed at week 0, after 1 and 2 weeks and during the recovery phase at week 6 and 8.


      CRP and TNFα increased significantly during the two weeks of exercise (1.4–5.0 mg/l, p = 0.00 and 6.8–8.4 pg/ml, p = 0.00). CRP levels were significantly lower during recovery (median 0.7 mg/l) compared to baseline (median 1.4 mg/l) and did not correlate to metabolic variables. There were no significant changes in IL-6 levels during the study period. For dietary groups significant CRP changes were observed only in the high fat group during recovery.


      CRP and TNFα increased significantly but reacted differently during heavy physical activity while there seemed to be no significant changes in IL-6. No significant differences regarding inflammatory variables were found between the dietary groups.


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        • Paffenbarger R.S.J.
        • Hyde R.T.
        • Wing A.L.
        • et al.
        The association of changes in physical-activity level and other lifestyle characteristics with mortality among men.
        N Engl J Med. 1993; 328: 538-545
        • Pate R.R.
        • Pratt M.
        • Blair S.N.
        • et al.
        Physical activity and public health. A recommendation from the centers for disease control and prevention and the American college of sports medicine.
        JAMA. 1995; 273: 402-407
        • Cesari M.
        • Penninx B.W.
        • Newman A.B.
        • et al.
        Inflammatory markers and onset of cardiovascular events: results from the health abc study.
        Circulation. 2003; 108: 2317-2322
        • Tuomisto K.
        • Jousilahti P.
        • Sundvall J.
        • Pajunen P.
        • Salomaa V.
        C-reactive protein, interleukin-6 and tumor necrosis factor alpha as predictors of incident coronary and cardiovascular events and total mortality. A population-based, prospective study.
        Thromb Haemost. 2006; 95: 511-518
        • Abramson J.L.
        • Vaccarino V.
        Relationship between physical activity and inflammation among apparently healthy middle-aged and older us adults.
        Arch Intern Med. 2002; 162: 1286-1292
        • Ford E.S.
        Does exercise reduce inflammation? Physical activity and c-reactive protein among U.S. adults.
        Epidemiology. 2002; 13: 561-568
        • Mora S.
        • Cook N.
        • Buring J.E.
        • Ridker P.M.
        • Lee I.M.
        Physical activity and reduced risk of cardiovascular events: potential mediating mechanisms.
        Circulation. 2007; 116: 2110-2118
        • Kasapis C.
        • Thompson P.D.
        The effects of physical activity on serum c-reactive protein and inflammatory markers: a systematic review.
        J Am Coll Cardiol. 2005; 45: 1563-1569
        • Kelley G.A.
        • Kelley K.S.
        Effects of aerobic exercise on c-reactive protein, body composition, and maximum oxygen consumption in adults: a meta-analysis of randomized controlled trials.
        Metabolism. 2006; 55: 1500-1507
        • Boman K.
        • Hellsten G.
        • Bruce A.
        • Hallmans G.
        • Nilsson T.K.
        Endurance physical activity, diet and fibrinolysis.
        Atherosclerosis. 1994; 106: 65-74
        • Weinehall L.
        • Westman G.
        • Hellsten G.
        • et al.
        Shifting the distribution of risk: results of a community intervention in a Swedish programme for the prevention of cardiovascular disease.
        J Epidemiol Community Health. 1999; 53: 243-250
        • Livsmedelsverket
        Livsmedelsverkets menybok.
        Elanders Gotab, Stockholm2004
        • Lakka T.A.
        • Lakka H.M.
        • Rankinen T.
        • et al.
        Effect of exercise training on plasma levels of c-reactive protein in healthy adults: the heritage family study.
        Eur Heart J. 2005; 26: 2018-2025
        • Mattusch F.
        • Dufaux B.
        • Heine O.
        • Mertens I.
        • Rost R.
        Reduction of the plasma concentration of c-reactive protein following nine months of endurance training.
        Int J Sports Med. 2000; 21: 21-24
        • Fischer C.P.
        • Berntsen A.
        • Perstrup L.B.
        • Eskildsen P.
        • Pedersen B.K.
        Plasma levels of interleukin-6 and c-reactive protein are associated with physical inactivity independent of obesity.
        Scand J Med Sci Sports. 2007; 17: 580-587
        • Fischer C.P.
        Interleukin-6 in acute exercise and training: what is the biological relevance?.
        Exerc Immunol Rev. 2006; 12: 6-33
        • Bastard J.P.
        • Maachi M.
        • Nhieu J.T.V.
        • et al.
        Adipose tissue il-6 content correlates with resistance to insulin activation of glucose uptake both in vivo and in vitro.
        J Clin Endocrinol Metab. 2002; 87: 2084-2089
        • Petersen A.M.
        • Pedersen P.K.
        The anti-inflammatory effect of exercise.
        J Appl Physiol. 2005; 98: 1154-1162
        • Pedersen B.K.
        • Hoffman-Goetz L.
        Exercise and the immune system: regulation, integration, and adaptation.
        Physiol Rev. 2000; 80: 1055-1081
        • Pedersen B.K.
        • Steensberg A.
        • Schjerling P.
        Muscle-derived interleukin-6: possible biological effects.
        J Physiol. 2001; 536: 329-337
        • Ross R.
        Mechanisms of disease: atherosclerosis—an inflammatory disease.
        N Engl J Med. 1999; 340: 115-126
        • Tamakoshi K.
        • Yatsuya H.
        • Kondo T.
        • et al.
        The metabolic syndrome is associated with elevated circulating c-reactive protein in healthy reference range, a systemic low-grade inflammatory state.
        Int J Obes Relat Metab Disord. 2003; 27: 443-449
        • Genser B.
        • Grammer T.
        • Stojakovic T.
        • Siekmeier R.
        • Maerz W.
        Effect of hmg coa reductase inhibitors on low-density lipoprotein cholesterol and c-reactive protein: systematic review and meta-analysis.
        Int J Clin Pharmacol Ther. 2008; 46: 497-510
        • Kinlay S.
        Low-density lipoprotein-dependent and -independent effects of cholesterol-lowering therapies on c-reactive protein: a meta-analysis.
        J Am Coll Cardiol. 2007; 49: 2003-2009