Effects of Long-term Aerobic or Resistance Exercise on Chronic Inflammatory Markers in Overweight or Obese Postmenopausal Women: A Systematic Review of Controlled Clinical Trials

Abstract

Background: Chronic low-grade inflammation is a key contributor to cardiometabolic disease risk, marked by elevated C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Overweight and obese postmenopausal women are particularly vulnerable due to hormonal changes exacerbating inflammatory pathways. Exercise (aerobic and resistance) has been shown to have anti-inflammatory effects. However, prior reviews focused on short-term interventions or heterogeneous populations, leaving the long-term impact in this specific group unclear.

Objective: This study evaluated the long-term effects (≥ 6 months) of structured aerobic and/or resistance exercise on circulating CRP, IL-6, and TNF-α in overweight/obese postmenopausal women.

Methods: We searched PubMed, Web of Science, and Cochrane between April 18 and May 1, 2025, for literature published from inception through April 2025. Eligible studies were randomized or controlled trials lasting ≥ 6 months that involved overweight/obese postmenopausal women. Two reviewers independently screened articles, extracted data, and assessed risk of bias. A third reviewer resolved disagreements.

Results: Seven trials (n = 1,278 participants) were included. Five showed some concerns, and two were judged to have high risk of bias. Six trials assessed CRP, four IL-6, and three TNF-α.  Between-groupanalyses showed no significant reductions in CRP or TNF-α.Only one study reported a significant reduction in IL-6.. Significant within-group decreases were observed in two CRP trials and one IL-6 trial, but these occurred exclusively in interventions combining exercise with dietary modification. Exercise-only interventions generally did not produce significant reductions in inflammatory markers.

Conclusions: Exercise alone does not consistently reduce CRP, IL-6, or TNF-α in overweight and obese postmenopausal women. Observed effects may be confounded by dietary co-interventions, methodological limitations, and heterogeneity across trials. Further well-designed long-term studies isolating the independent effects of exercise are warranted.