Exercise attenuates high-fat diet-induced PVAT dysfunction through improved inflammatory response and BMP4-regulated adipose tissue browning.

Background: Perivascular adipose tissue (PVAT) dysfunction impairs vascular homeostasis. Impaired inflammation and bone morphogenetic protein-4 (BMP4) signaling are involved in thoracic PVAT dysfunction by regulating adipokine secretion and adipocyte phenotype transformation. We investigated whether aerobic exercise training could ameliorate high-fat diet (HFD)-induced PVAT dysfunction via improved inflammatory response and BMP4-mediated signaling pathways. Methods: Sprague-Dawley rats (n = 24) were divided into three groups, namely control, high-fat diet (HFD), and HFD plus exercise (HEx). After a 6-week intervention, PVAT functional efficiency and changes in inflammatory biomarkers (circulating concentrations in blood and mRNA expressions in thoracic PVAT) were assessed. Results: Chronic HFD feeding caused obesity and dyslipidemia in rats. HFD decreased the relaxation response of PVAT-containing vascular rings and impaired PVAT-regulated vasodilatation. However, exercise training effectively reversed these diet-induced pathological changes to PVAT. This was accompanied by significantly (p < 0.05) restoring the morphological structure and the decreased lipid droplet size in PVAT. Furthermore, HFD-induced impaired inflammatory response (both in circulation and PVAT) was notably ameliorated by exercise training (p < 0.05). Specifically, exercise training substantially reversed HFD-induced WAT-like characteristics to BAT-like characteristics as evidenced by increased UCP1 and decreased FABP4 protein levels in PVAT against HFD. Exercise training promoted transcriptional activation of BMP4 and associated signaling molecules (p38/MAPK, ATF2, PGC1α, and Smad5) that are involved in browning of adipose tissue. In conjunction with gene expressions, exercise training increased BMP4 protein content and activated downstream cascades, represented by upregulated p38/MAPK and PGC1α proteins in PVAT. Conclusion: Regular exercise training can reverse HFD-induced obesity, dyslipidemia, and thoracic PVAT dysfunction in rats. The browning of adipose tissue through exercise appears to be modulated through improved inflammatory response and/or BMP4-mediated signaling cascades in obese rats.

Assessment of the measurement properties of the Peabody Developmental Motor Scales-2 by applying the COSMIN methodology.

The Peabody Developmental Motor Scales-2 (PDMS-2) has been used to assess the gross and fine motor skills of children (0-6 years); however, the measurement properties of the PDMS-2 are inconclusive. Here, we aimed to systematically review the measurement properties of PDMS-2, and synthesize the quality of evidence using the Consensus-based Standards for the Selection of Health Measurements Instruments (COSMIN) methodology. Electronic databases, including PubMed, EMBASE, Web of Science, CINAHL and MEDLINE, were searched for relevant studies through January 2023; these studies used PDMS-2. The methodological quality of each study was assessed by the COSMIN risk-of-bias checklist, and the measurement properties of PDMS-2 were evaluated by the COSMIN quality criteria. Modified GRADE was used to evaluate the quality of the evidence. We included a total of 22 articles in the assessment. Among the assessed measurement properties, the content validity of PDMS-2 was found to be sufficient with moderate-quality evidence. The structural validity, internal consistency, test-retest reliability and interrater reliability of the PDMS-2 were sufficient for high-quality evidence, while the intrarater reliability was sufficient for moderate-quality evidence. Sufficient high-quality evidence was also found for the measurement error of PDMS-2. The overall construct validity of the PDMS-2 was sufficient but showed inconsistent quality of evidence. The responsiveness of PDMS-2 appears to be sufficient with low-quality evidence. Our findings demonstrate that the PDMS-2 has sufficient content validity, structural validity, internal consistency, reliability and measurement error with moderate to high-quality evidence. Therefore, PDMS-2 is graded as 'A' and can be used in motor development research and clinical settings.

Influence of different caregiving styles on fundamental movement skills among children.

Purpose: This study investigated the influence of parenting and grandparenting caregiving styles on fundamental motor skills (FMS) of preschool children. Method: A total of 1,326 preschool children (698 boys, 628 girls) aged 4-6 years were recruited from the kindergartens of Jinhua City, China. Locomotor skills (LM), ball skills (BS), and total fundamental movement skills (TS) of children were assessed by the Test of Gross Motor Development-3rd edition (TGMD-3). Results: There were 978 children in parenting and 348 children in grandparenting caregiving styles. The LM, BS and TS scores of children were considerably (p < 0.001) increased with age (irrespective of sex or caregiving style). For the sex comparisons, BS scores of boys were significantly higher than girls (p < 0.001), while LM and TS scores were not different between boys and girls. For the caregiving style comparison, parenting is superior to grandparenting in developing of children's FMS. Parenting boys of 4-, 5-, and 6-years old showed better BS compared to age-matched parenting girls, whereas boys of 5-years old in grandparenting only showed better BS compared to same-age grandparenting girls (p < 0.05). Furthermore, parenting boys of 6-years reported higher LM (p < 0.01), BS (p < 0.001), and TS (p < 0.001) scores compared to grandparenting boys, but girls' FMS at all ages were not significantly different between the caregiving styles. Conclusion: Parenting caregiving style is positively associated with proper development of FMS among children. Girl children with poor FMS in grandparenting may need a special care or intervention programs to promote their FMS.

Impact of Exercise in Hypoxia on Inflammatory Cytokines in Adults: A Systematic Review and Meta-analysis.

BACKGROUND: Both acute exercise and environmental hypoxia may elevate inflammatory cytokines, but the inflammatory response in the hypoxic exercise is remaining unknown. OBJECTIVE: We performed this systematic review and meta-analysis to examine the effect of exercise in hypoxia on inflammatory cytokines, including IL-6, TNF-α and IL-10. METHODS: PubMed, Scopus and Web of Science were searched to identify the original articles that compared the effect of exercise in hypoxia with normoxia on IL-6, TNF-α and IL-10 changes, published up to March 2023. Standardized mean differences and 95% confidence intervals (CIs) were calculated using a random effect model to (1) determine the effect of exercise in hypoxia, (2) determine the effect of exercise in normoxia and (3) compare the effect of exercise in hypoxia with normoxia on IL-6, TNF-α and IL-10 responses. RESULTS: Twenty-three studies involving 243 healthy, trained and athlete subjects with a mean age range from 19.8 to 41.0 years were included in our meta-analysis. On comparing exercise in hypoxia with normoxia, no differences were found in the response of IL-6 [0.17 (95% CI - 0.08 to 0.43), p = 0.17] and TNF-α [0.17 (95% CI - 0.10 to 0.46), p = 0.21] between the conditions. Exercise in hypoxia significantly increased IL-10 concentration [0.60 (95% CI 0.17 to 1.03), p = 0.006] compared with normoxia. In addition, exercise during both hypoxia and normoxia increased IL-6 and IL-10, whereas TNF-α was increased only in hypoxic exercise condition. CONCLUSION: Overall, exercise in both hypoxia and normoxia increased inflammatory cytokines; however, hypoxic exercise may lead to a greater inflammatory response in adults.

The effects of exercise training on body composition in postmenopausal women: a systematic review and meta-analysis.

Introduction: We conducted a systematic review and meta-analysis to investigate the effect of exercise training on body composition outcomes in postmenopausal women. Methods: PubMed, Web of Science, CINAHL, and Medline were searched to identify the randomized controlled trials which evaluated effect of exercise training versus control in postmenopausal women. Standardized mean differences (SMD), weighted mean differences (WMD) and 95% confidence intervals (95% CIs) were calculated using random effects model. Results: One hundred and one studies involving 5,697 postmenopausal women were included in the meta-analysis. Results indicated that exercise training effectively increased muscle mass/ volume, muscle and fiber cross-sectional area and fat-free mass, and decreased fat mass, body fat percentage, waist circumference and visceral fat. Furthermore, subgroup analyses results revealed that aerobic and combined training had greater beneficial effects on fat mass outcomes, whereas resistance and combined training had greater beneficial effects on muscle mass outcomes. Discussion: Overall, our results revealed that exercise training is effective for improving body composition in postmenopausal women. To be specific, aerobic training is effective on fat loss, whereas resistance training is effective on muscle gain. However, combination of aerobic and resistance trainings may be considered a viable strategy to improve body composition in postmenopausal women. Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42021283425.

Antioxidant Efficacy of Green-Synthesized Silver Nanoparticles Promotes Wound Healing in Mice.

Developing an efficient and cost-effective wound-healing substance to treat wounds and regenerate skin is desperately needed in the current world. Antioxidant substances are gaining interest in wound healing, and green-synthesized silver nanoparticles have drawn considerable attention in biomedical applications due to their efficient, cost-effective, and non-toxic nature. The present study evaluated in vivo wound healing and antioxidant activities of silver nanoparticles from Azadirachta indica (AAgNPs) and Catharanthus roseus (CAgNPs) leaf extracts in BALB/c mice. We found rapid wound healing, higher collagen deposition, and increased DNA and protein content in AAgNPs- and CAgNPs (1% w/w)-treated wounds than in control and vehicle control wounds. Skin antioxidant enzyme activities (SOD, catalase, GPx, GR) were significantly (p < 0.05) increased after 11 days CAgNPs and AAgNPs treatment. Furthermore, the topical application of CAgNPs and AAgNPs tends to suppress lipid peroxidation in wounded skin samples. Histopathological images evidenced decreased scar width, epithelium restoration, fine collagen deposition, and fewer inflammatory cells in CAgNPs and AAgNPs applied wounds. In vitro, the free radical scavenging activity of CAgNPs and AAgNPs was demonstrated by DPPH and ABTS radical scavenging assays. Our findings suggest that silver nanoparticles prepared from C. roseus and A. indica leaf extracts increased antioxidant status and improved the wound-healing process in mice. Therefore, these silver nanoparticles could be potential natural antioxidants to treat wounds.

Influence of exercise type and duration on cardiorespiratory fitness and muscular strength in post-menopausal women: a systematic review and meta-analysis.

Background and aim: Both cardiorespiratory fitness (CRF) and muscular strength are reported to decrease with age and menopause, which considered to be risk for cardiovascular diseases (CVDs). Previous relevant meta-analyses are inconclusive on the beneficial effects of exercise, particularly in post-menopausal women. In this systematic review and meta-analysis, we investigated the effects of exercise modalities on CRF and muscular strength in post-menopausal women, and identified the effective exercise type and duration. Methods: A comprehensive search was conducted on PubMed, Web of Science, CINAHL, and Medline to identify the randomized controlled trials, which evaluated exercise effect on CRF, lower- and upper-body muscular strength, and/or handgrip strength in post-menopausal women and compared the results with control. Standardized mean differences (SMD), weighted mean differences (WMD), and 95% confidence intervals (95% CIs) were calculated using random effects models. Results: A total of 129 studies comprising 7,141 post-menopausal women with mean age and BMI ranging from ∼53 to 90 years and 22 to 35 kg/m2, respectively, were included in the meta-analysis. Overall, exercise training effectively increased CRF (SMD: 1.15; 95% CI: 0.87, 1.42; p = 0.001), lower-body muscular strength (SMD: 1.06; 95% CI: 0.90, 1.22; p = 0.001), upper-body muscular strength (SMD: 1.11; 95% CI: 0.91, 1.31; p = 0.001), and handgrip strength (WMD: 1.78 kg; 95% CI: 1.24, 2.32; p = 0.001) in post-menopausal women. These increments were found to be irrespective of ages and intervention durations. Regarding exercise type, aerobic, resistance, and combined training significantly increased CRF and lower-body muscular strength, while resistance and combined training effectively increased handgrip strength. However, only resistance training increased the upper-body muscular strength in women. Conclusion: Our findings suggest that exercise training is effective in increasing CRF and muscular strength in post-menopausal women, which might be cardioprotective. Both aerobic and resistance training alone or in combination increased CRF and lower-body muscular strength, but only resistance training increased upper-body strength in women. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=283425, identifier: CRD42021283425.

Interleukin-15 responses to acute and chronic exercise in adults: a systematic review and meta-analysis.

Purpose: Interlukin-15 (IL-15) is an inflammatory cytokine that plays a vital role in immunology and obesity-associated metabolic syndrome. We performed this systematic review and meta-analysis to investigate whether exercise promotes circulating IL-15 concentrations in adults. Methods: We searched PubMed, Web of Science, and Scopus from inception to May, 2023 and identified original studies that investigated the effectiveness of acute and/or chronic exercise on serum/plasma IL-15 levels in adults. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated using random effect models. Subgroup analyses were performed based on type of exercise, and training status, health status and body mass indexes (BMI) of participants. Results: Fifteen studies involving 411 participants and 12 studies involving 899 participants were included in the acute and chronic exercise analyses, respectively. Our findings showed that acute exercise increased circulating IL-15 concentrations immediately after exercise compared with baseline [SMD=0.90 (95% CI: 0.47 to 1.32), p=0.001], regardless of exercise type and participants' training status. Similarly, acute exercise was also associated with increased IL-15 concentrations even one-hour after exercise [SMD=0.50 (95% CI: 0.00 to 0.99), p=0.04]. Nevertheless, chronic exercise did not have a significant effect on IL-15 concentrations [SMD=0.40 (95% CI: -0.08 to 0.88), p=0.10]. Conclusion: Our results confirm that acute exercise is effective in increasing the IL-15 concentrations immediately and one-hour after exercise intervention, and thereby playing a potential role in improving metabolism in adults. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=445634, identifier CRD42023445634.

Cardioprotective Effects of 6-Gingerol against Alcohol-Induced ROS-Mediated Tissue Injury and Apoptosis in Rats.

The present study investigated the cardioprotective properties of 6-gingerol against alcohol-induced ROS-mediated cardiac tissue damage in rats. Experiments were conducted on 4 groups of rats, orally treated with control, 6-gingerol (10 mg/kg body weight), alcohol (6 g/kg body weight) and combination of 6-gingerol plus alcohol for two-month. In the results, we found 6-ginger treatment to alcohol-fed rats substantially suppressed ROS production in cardiac tissue. Alcohol-induced elevated 8-OHDG and protein carbonyls which represent oxidative modification of DNA and proteins were completely reversed by 6-gingerol. This was further endorsed by restored superoxide dismutase and catalase activities with 6-gingerol against alcohol-induced loss. The elevated cardiac biomarkers (CK-MB, cTn-T, cTn-I) and dyslipidemia in alcohol-intoxicated rats was significantly reversed by 6-gingerol. Furthermore, alcohol-induced apoptosis characterized by overexpression of cytochrome C, caspase-8 and caspase-9 was diminished with 6-gingerol treatment. Transmission electron microscope images conferred the cardioprotective properties of 6-gingerol as we have seen less structural derangements in mitochondria and reappearance of myofilaments. Our findings conclude that 6-ginger effectively protect alcohol-induced ROS-mediated cardiac tissue damage, which may be due to its potent antioxidant efficacy. Therefore, 6-gingerol could be a potential therapeutic molecule that can be used in the treatment of alcohol-induced myocardial injury.

Gender Differences in Fundamental Motor Skills Proficiency in Children Aged 3-6 Years: A Systematic Review and Meta-Analysis.

The age range of 3−6 years is considered as a critical period in developing and learning fundamental motor skills (FMS). To make the formulation of future FMS guidance programs more targeted, we examined gender differences in children's FMS proficiency using a meta-analysis. Structured electronic databases including PubMed, Scopus and Web of Science were systematically searched using key terms, and the Joanna Briggs Institute (JBI) was used to assess the quality of included literature. Finally, 38 articles (39 studies) met the pre-specified inclusion criteria. The results showed that boys had higher proficiency in total FMS and object control skills than girls (SMD = 0.17 (95% CI 0.03, 0.31), p = 0.02; SMD = 0.48 (95% CI 0.38, 0.58), p < 0.00001), and gender differences in locomotor skill proficiency approached significance, trending in favor of girls (SMD = −0.07 (95 % CI −0.15, 0.01), p = 0.09, I2 = 66%). Meta-regression shows that age is associated with gender differences in object control skills (p < 0.05). In addition, through subgroup analysis, we found that boys' advantage in object control skills increased with age (3 years: SMD = 0.27 (95% CI 0.00, 0.54), p < 0.00001; 4 years: SMD = 0.58 (95% CI 0.38, 0.77), p < 0.00001; 5 years: SMD = 0.59 (95% CI 0.31, 0.88), p < 0.00001; 6 years: SMD = 0.81 (95% CI 0.61, 1.01), p < 0.00001). In this meta-analysis, we found gender differences in FMS levels in children aged 3−6 years. Notably, gender differences in skill proficiency in object control were influenced by age. We recommend focusing on and developing girls' object control skills starting at age 3.

Effects of Variable-Resistance Training Versus Constant-Resistance Training on Maximum Strength: A Systematic Review and Meta-Analysis.

Greater muscular strength is generally associated with superior sports performance, for example, in jumping, sprinting, and throwing. This meta-analysis aims to compare the effects of variable-resistance training (VRT) and constant-resistance training (CRT) on the maximum strength of trained and untrained subjects. PubMed, Web of Science, and Google Scholar were comprehensively searched to identify relevant studies published up to January 2022. Fourteen studies that met the inclusion criteria were used for the systematic review and meta-analysis. Data regarding training status, training modality, and type of outcome measure were extracted for the analyses. The Cochrane Collaboration tool was used to assess the risk of bias. The pooled outcome showed improved maximum strength with VRT, which was significantly higher than that with CRT (ES = 0.80; 95% CI: 0.42−1.19) for all the subjects. In addition, trained subjects experienced greater maximum-strength improvements with VRT than with CRT (ES = 0.57; 95% CI: 0.22−0.93). Based on subgroup analyses, maximum-strength improvement with a VRT load of ≥80% of 1 repetition maximum (1RM) was significantly higher than that with CRT (ES = 0.76; 95% CI: 0.37−1.16) in trained subjects, while no significant differences were found between VRT and CRT for maximum-strength improvement when the load was <80% (ES = 0.00; 95% CI: −0.55−0.55). The untrained subjects also achieved greater maximum strength with VRT than with CRT (ES = 1.34; 95% CI: 0.28−2.40). Interestingly, the improved maximum strength of untrained subjects with a VRT load of <80% of 1RM was significantly higher than that with CRT (ES = 2.38; 95% CI: 1.39−3.36); however, no significant differences were noted between VRT and CRT when the load was ≥80% of 1RM (ES = −0.04; 95% CI: −0.89−0.81). Our findings show that subjects with resistance training experience could use a load of ≥80% of 1RM and subjects without resistance training experience could use a load of <80% of 1RM to obtain greater VRT benefits.

Effect of Exercise Training on Serum Transaminases in Patients With Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-Analysis.

Background/Purpose: Nonalcoholic fatty liver disease (NAFLD) constitutes a spectrum of liver diseases associated with various metabolic disorders. Exercise interventions reportedly manage the clinical outcomes of NAFLD, but their efficacy depends on exercise as well as characteristics of patient. We hypothesized that exercise could alleviate the elevated transaminases level, which may be associated with the characteristics of patients (age/bodyweight/sex) or exercise variables (frequency/intensity/duration). Therefore, we examined the effect of exercise on serum transaminases, and identified the variables influencing transaminases in NAFLD patients. Methods: Article search was conducted using electronic databases (PubMed, Web of Science, EMBASE, ScienceDirect, Google Scholar) until December 2021. Studies that involved examination and comparison of the effect of an exercise intervention on alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels in NAFLD/nonalcoholic steatohepatitis patients were included. We calculated pooled effect upon a meta-analysis, determined correlations (between transaminases and characteristics of patients/exercise) by meta-regression, and assessed the influencing variable through subgroup analysis. Results: A total of 18 studies (22 trials) with 1098 NAFLD patients (exercise = 568; control = 530) were included. The pooled outcomes revealed that exercise intervention significantly decreased both ALT (p = 0.004) and AST (p = 0.001) levels in NAFLD patients. Meta-regression analysis showed decreased ALT (coef. = 1.138, p < 0.01) and AST (coef. = 0.459, p = 0.041) after intervention was correlated with the age of patients. Particularly, patients aged 30-39 years (MD: -25.89 U/L, 95% CI: -36.40 to -15.37, p < 0.00001) and 40-49 years (MD: -12.17 U/L, 95% CI: -20.38 to -3.96, p = 0.004) represented a substantial decrease in ALT levels. Additionally, the 50-59 years age group tended to have decreased ALT levels (MD: -3.94 U/L, 95% CI: -8.19 to 0.31, p = 0.07); however, patients above 60 years did not respond (p = 0.92) to exercise intervention. In contrast, exercise-induced AST reduction was found in only the 30-39 years age group (MD: -11.92 U/L, 95% CI: -16.78 to -7.06, p < 0.00001) and not in patients under the 40-49 (p = 0.19), and 50-59 groups (p = 0.12) and above 60 years (p = 0.15). Conclusion: Our findings suggest that the age of NAFLD patients may be an important variable in improving the levels of serum transaminases, and clinically young patients may have greater benefits from exercise than older patients.

Status of Sedentary Time and Physical Activity of Rural Residents: A Cross-Sectional Population-Based Study in Eastern China.

Background: The urbanization process may affect the lifestyle of rural residents in China. Limited information exists on the extent of sedentarism and physical activity (PA) level of rural residents in middle-income countries. This is the first survey on sedentary time (ST) and PA among rural residents in eastern China. Methods: This cross-sectional observational study randomly samples rural adults from Zhejiang Province in eastern China (n = 1,320). Participants' ST and PA levels were determined from the International Physical Activity Questionnaire Short Form through face-to-face interviews, and the influencing factors of PA levels were assessed through multi-class logistic regression analysis. Results: The findings showed that the daily ST of the participants ranged from 30 to 660 min, with a median of 240 min (P25, P75:120, 240 min), and 54.6% of participants were sedentary for 240 min or above. The daily ST in men, people aged 18 to 44 years, people with bachelors' degree and above, people working for government agencies or institutions, people with unmarried status, and people with an average income of < 2,000 Yuan was longer than that of other respective groups (p < 0.01). In contrast, the daily ST of people with hypertension or with patients with osteoporosis or osteopenia was less than that of normal people (p < 0.01). Additionally, 69.4% of participants generally had a low level of PA (LPA). Compared with those living in northern Zhejiang, people living in southern Zhejiang who were aged 18-44 years, had bachelor's degree or above, were farmers, and had household incomes below 10,000 Yuan per month were more likely to engage in LPA compared to people > 60 years, with high school or technical education levels or with junior college degrees, working in government agencies and institutions, and with household income above 10,000 Yuan per month (p < 0.05). Furthermore, there was no correlation between ST and PA levels. Conclusion: Most rural residents in the Zhejiang Province of eastern China had longer daily ST and a LPA. This was predominant in men, young people, highly educated people, unmarried people, and middle to high-income people. Health education programs should be targeted toward specific population groups to decrease the ST and increase PA.

High-intensity interval exercise versus moderate-intensity continuous exercise on postprandial glucose and insulin responses: A systematic review and meta-analysis.

We performed a meta-analysis to investigate the effects of high-intensity interval exercise (HIIE) as compared to moderate-intensity exercise (MIE) and a control condition (CON) on postprandial glucose (PPG) and insulin (PPI) responses. PubMed, Web of Science, and Scopus were comprehensively searched to identify relevant studies until October 2021. Separate analyses were conducted for HIIE versus MIE and HIIE versus CON. A total of 30 studies comprising 36 intervention arms and involving 467 participants (350 adults) were included in the meta-analysis. HIIE reduced PPG and PPI when compared with CON. Based on subgroup analyses, reductions in PPG and PPI were significant for both children and adult participants, as well as for healthy participants and participants with metabolic disorders, with larger effects in those with metabolic disorders. There were no significant differences between HIIE and MIE for PPG or PPI. However, when comparing studies matched for total work performed, HIIE was more effective for decreasing PPG as compared with MIE. HIIE is effective for reducing PPG and PPI in both children and adult participants, particularly in those with metabolic disorders. In addition, HIIE has superior effects for reducing PPG as compared with MIE, when equivalent work was performed at both intensity levels.

Calorie Restriction With Exercise Intervention Improves Inflammatory Response in Overweight and Obese Adults: A Systematic Review and Meta-Analysis.

Background/Purpose: In this systematic review and meta-analysis, we assessed the effects of exercise (EX) combined with calorie restriction (CR) intervention on inflammatory biomarkers, and correlations between biomarkers and participants' characteristics were calculated in overweight and obese adults. Methods: An article search was conducted through PubMed, Web of Science, EMBASE, the Cochrane database, Scopus, and Google Scholar to identify articles published up to April 2021. Studies that examined the effect of EX + CR intervention on inflammatory biomarkers, including C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α), and compared them with a CR trial in overweight and obese adults were included. We calculated the pooled effect by meta-analysis, identified the correlations (between inflammatory biomarkers and participants' characteristics) through meta-regression, and explored the beneficial variable through subgroup analysis. The Cochrane risk of bias tool and Methodological Index for Non-randomized Studies were used to assess the risk of bias for the included trials. Results: A total of 23 trials, including 1196 overweight and obese adults, were included in the meta-analysis. The pooled effect showed that EX + CR intervention significantly decreased CRP levels (P = 0.02), but had no effect on IL-6 (P = 0.62) and TNF-α (P = 0.11). Meta-regression analysis showed that the effect of EX + CR on CRP, IL-6, and TNF-α changes was correlated with lifestyle behavior of adults (Coef. = -0.380, P = 0.018; Coef. = -0.359, P = 0.031; Coef. = -0.424, P = 0.041, respectively), but not with age and BMI. The subgroup analysis results revealed that participants with sedentary lifestyle behavior did not respond to EX + CR intervention, as we found no changes in CRP, IL-6, and TNF-α concentrations (P = 0.84, P = 0.16, P = 0.92, respectively). However, EX + CR intervention significantly decreased CRP (P = 0.0003; SMD = -0.39; 95%CI: -0.60 to -0.18), IL-6 (P = 0.04; SMD = -0.21; 95%CI: -0.40 to -0.01) and TNF-α (P = 0.006; SMD = -0.40, 95%CI: -0.68 to -0.12) in adults without a sedentary lifestyle or with a normal lifestyle. Furthermore, the values between sedentary and normal lifestyle subgroups were statistically significant for CRP, IL-6, and TNF-α. Conclusion: Our findings showed that combination EX + CR intervention effectively decreased CRP, IL-6, and TNF-α in overweight and obese adults with active lifestyles, but not with sedentary lifestyle behavior. We suggest that 'lifestyle behavior' is a considerable factor when designing new intervention programs for overweight or obese adults to improve their inflammatory response.