Anti‐inflammatory effects of exercise: role in diabetes and cardiovascular disease

Abstract Background Persistent inflammation is involved in the pathogenesis of chronic diseases such as type 2 diabetes mellitus (T2 DM ) and cardiovascular disease ( CVD ). Aims The aim of this review was to provide the reader with an update of the mechanisms whereby exercise‐induced cytokines may impact cardiometabolic diseases. Results Evidence exists that interleukin ( IL )‐1β is involved in pancreatic β‐cell damage, whereas TNF ‐α is a key molecule in peripheral insulin resistance. In addition, TNF ‐α appears to be involved in the pathogenesis of atherosclerosis and heart failure. A marked increase in IL ‐6 and IL ‐10 is provoked by exercise and exerts direct anti‐inflammatory effects by an inhibition of TNF ‐α and by stimulating IL ‐1ra, thereby limiting IL ‐1β signalling. Moreover, muscle‐derived IL ‐6 appears to have direct anti‐inflammatory effects and serves as a mechanism to improve glucose tolerance. In addition, indirect anti‐inflammatory effects of long‐term exercise are mediated via improvements in body composition. Conclusion Physical activity represents a natural, strong anti‐inflammatory strategy with minor side effects and should be integrated in the management of patients with cardiometabolic diseases.