Physical Activity Decreases Inflammation Levels in Youth With Obesity

School children at break time playing on climbing frame
Researchers assessed the effect of a 6-month exercise training program on levels of inflammation markers.

Circulating inflammatory levels were found to be reduced among adolescents who were considered overweight or with obesity after a 6-month physical activity intervention, according to study findings were published in The Journal of Clinical Endocrinology & Metabolism.

The Exercise Training and Hepatic Metabolism in Overweight/Obese Adolescent study (HEPAFIT; Identifier: NCT02753231) included adolescents who were considered overweight or with obesity from the Colegio Instituto Técnico Internacional in Columbia.

Overweight and obese status was defined by body mass index (BMI) z-scores or excess body fat greater than 30%. The exercise intervention was conducted 3 days a week for 6 months. Participants were randomly assigned to receive standard physical education (control group), high-intensity physical education (HIPE group), low- to moderate-intensity physical education (LIPE group), and combined training (PLUS group). All participants received nutritional education and support throughout the study. Researchers collected blood samples to assess for changes in inflammatory markers.

Of 120 participants, 95 (control group, n=26; HIPE group, n=21, LIPE group, n=25, PLUS group, n=23) were included in the analysis. Mean age of participants was 13.5±1.6 years; 70% were girls; mean BMI z-score was 1.8±0.4, and mean body fat was 39.5%±4.7%.

Change in body fat was -2.88% (95% CI; -3.96% to -1.81%; P =.001) and -0.62% (95% CI, -1.68% to -0.45%; P =.014) for the HIPE and LIPE cohorts, respectively.

After the intervention, 22 of the 65 measured inflammatory markers and immune molecules differed from those at baseline. Stratified by intervention, significant changes were noted in 9 proteins for the LIPE and PLUS groups, 7 proteins for the HIPE group, and 6 proteins for the control group.

Insulin-like growth factor binding protein 4 (IGFBP-4) and C-X-C motif chemokine ligand 6 (CXCL6) were downregulated in both the LIPE and HIPE groups and BLC, eotaxin, fibroblast growth factor 6 (FGF-6), MCP-4, PARC, and RANTES were downregulated in both LIPE and PLUS cohorts.

Researchers found that exercise affected the chemokine-mediated signaling pathway (false discovery rate [FDR], 4.31e-23), inflammatory response (FDR, 2.91e-17), chemotaxis (FDR, 1.56e-15), and cellular response to stimulus (FDR, 3.16e-11).

Study findings may not be generalizable to youth without obesity.

Researchers concluded, “…interventions involving supervised physical exercise aimed at preventing metabolic dysfunction could help improve the effects of systemic low grade inflammation, thus preventing the development of obesity-related metabolic diseases in adolescents with overweight/obesity.”


Ramírez-Vélez R, García-Hermoso A, Correa-Rodríguez M, et al. Effects of different doses of exercise on inflammation markers among adolescents with overweight/obese: HEPAFIT study. J Clin Endocrinol Metab. Published online January 17, 2022. doi:10.1210/clinem/dgac021