New research unveiled at this year’s European Congress on Obesity in Venice, Italy, sheds light on the anti-inflammatory benefits of moderate-to-vigorous aerobic exercise for adults experiencing mild obesity-related inflammation. This suggests promising avenues for preventing metabolic diseases such as type 2 diabetes and atherosclerosis (hardening of the arteries) associated with obesity.
Excessive accumulation of fat in adipose tissue (fat cells) causes chronic low-grade inflammation. It is characterized by chronically elevated levels of harmful compounds called proinflammatory cytokines, which contribute to the development of metabolic diseases.
“We know that exercise can reduce the risk of obesity-related complications and that new weight loss drugs, such as glucagon-like peptide-1 receptor agonist (GLP-1 RAs), originally developed for diabetes, are showing promise in reducing obesity. “We know that we can effectively reduce the risk of cancer and associated complications,” explains lead author Professor Signe Tolekov of the University of Copenhagen, Denmark.
“In this analysis, we wanted to investigate whether combining exercise and GLP-1 RAs could reduce chronic low-grade inflammation in obese patients, which underlies many chronic and age-related diseases. ”
The randomized, double-blind, placebo-controlled S-LITE study included 195 Danish adults (mean age 42 years, 63% female) who were obese (BMI 32-43 kg/m2) but had no history of diabetes. An 8-hour test was conducted. They consumed a low-calorie diet (800 kcal per day) and lost at least 5% of their body weight (average weight loss of 13.1 kg).
Participants were then given either a placebo (usual activity plus a placebo), exercise (at least 150/75 minutes of moderate/vigorous exercise per week as recommended by WHO guidelines plus a placebo), or liraglutide (3 mg per day). Patients were randomly assigned to receive either treatment for 1 year. in addition to assigned activities), or a combination of exercise and liraglutide treatment to maintain weight loss. Participants injected themselves with either a placebo or liraglutide daily (depending on the group they belonged to).
The exercise intervention consisted of two supervised sessions per week of primarily intense exercise (measured by heart rate) on a spinning bike. Participants were encouraged to complete two individual sessions per week to achieve at least 150 minutes of activity per week.
Blood samples were taken before and after the low-calorie diet and after a one-year treatment period to detect interleukins (inflammatory cytokines such as IL-2, IL-6, IL-8, and IL-2), which are known triggers of chronic inflammation. We measured changes in Ten). , IFN-γ) and tumor necrosis factor alpha (TNF-γ)
After one year, patients in the liraglutide-only group had lost an average of 0.7 kg more. The patient in the exercise group regained her 2.0 kg weight. Participants in the placebo group regained about half of the weight they lost (6.1 kg). However, participants in the group that combined exercise and liraglutide lost an additional 3.4 kg on average.
Changes in inflammatory markers
After a low-calorie diet, TNF-α levels increased by an average of 8.4% and IL-10 levels by 11.7%. Other cytokines showed no significant changes after dietary intervention. TNF-α is associated with apoptosis (cell death), and the authors speculate that rapid weight loss temporarily increases TNF-α as a stress marker.
At the end of the 1-year intervention period, the training group reduced IL-6 levels by an average of 31.9% and 18.9% compared to placebo. Chronically elevated IL-6 levels are associated with cardiovascular diseases such as atherosclerosis and insulin resistance. The training group also reduced IFN-γ levels by an average of 36.6% and 37.2% compared to placebo. IFN-γ in obesity is associated with insulin resistance.
The liraglutide and combination groups reduced IL-6 levels by an average of 17.3% and 19.9%, respectively, during the intervention period, but the difference was not significant compared to placebo. However, there was no change in his IFN-γ in the placebo, liraglutide or combination groups.
No significant differences were observed between groups in plasma concentrations of IL-2, IL-8, IL-10, and TNF-α.
“Our results show that performing exercise in accordance with guideline recommendations is the most effective strategy to reduce chronic low-grade inflammation,” says Professor Tolekov. “Treatment with liraglutide did not reduce inflammation more than placebo, and adding liraglutide to exercise did not further reduce inflammation. It highlights the benefits of vigorous exercise, which may help prevent problems associated with metabolic diseases.
The dropout rate was low. After 1 year, 41 of 49 randomized patients in the liraglutide group, 40 of 48 patients in the exercise group, 45 of 49 patients in the combination group, and 40 of 49 patients in the placebo group completed the study did.
Source:medicalxpress