***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Coronary heart disease ( CHD ) risk factors and the risk of CHD increase with increased adiposity . Fat loss induced by negative energy balance improves all metabolic CHD risk factors . To determine whether fat loss induced by long-term calorie restriction ( CR ) or increased energy expenditure induced by exercise ( EX ) has different effects on CHD risk factors in nonobese subjects , we conducted a 1-yr controlled trial involving 48 nonobese subjects who were r and omly assigned to one of three groups : CR , 20 % CR diet ( n = 18 ) ; EX , 20 % increase in energy expenditure through daily exercise with no increase in energy intake ( n = 18 ) ; or HL , healthy lifestyle guidelines ( n = 10 ) . Subjects were 29 women and 17 men aged 57 + /- 3 yr , with BMI 27.3 + /- 2.0 kg/m(2 ) . Assessment s included total body fat by DEXA , lipoproteins , blood pressure , HOMA-IR , C-reactive protein ( CRP ) , and estimated 10-yr CHD risk score . Body fat decreased by 6.3 + /- 3.8 kg in CR , 5.6 + /- 4.4 kg in EX , and 0.4 + /- 1.7 kg in HL , which corresponded to reductions of 24.9 , 22.3 , and 1.2 % of baseline body fat mass , respectively . These CR- and EX-induced energy deficits were accompanied by reductions in most of the major CHD risk factors , including plasma LDL-cholesterol , total cholesterol/HDL ratio , HOMA-IR index , and CRP concentrations that were similar in the two intervention groups . Data from the present study provide evidence that CR- and EX-induced negative energy balance result in substantial and similar improvements in the major risk factors for CHD in normal-weight and overweight middle-aged adults We studied the effect of exercise on circulating adipokine , high sensitivity C-reactive protein ( hs-CRP ) , and metabolic parameters in obese young women . Ninety-six healthy Japanese young female students aged 18 - 23 years were studied . The longitudinal intervention study of a 7-month exercise training program ( 30 - 60 min/day , 60 - 70 % HR-reserve , 200 - 400 kcal , 4 - 5 days/week ) was performed in eight obese female students ( BMI > or = 25 kg/m(2 ) ) . Eight control female students ( mean BMI = 22 kg/m(2 ) ) were included in the follow-up study . Body weight , body mass index ( BMI ) , percentage of body fat ( % Fat ) , body fat mass , lean body mass , health-promoting lifestyle profile-scale ( L-scale ) , VO(2)max ( maximal oxygen uptake ) , hs-CRP , lipids , insulin homeostasis model assessment ( HOMA-R ) , fasting levels for circulating adiponectin , leptin , and TNF-alpha , were measured before and after the exercise program . In obese subjects , body weight , BMI , % Fat , body fat mass , lean body mass , hs-CRP , leptin , and TNF-alpha were significantly higher , and L-scale and adiponectin were lower than those in control subjects . In obese subjects , exercise decreased body weight , BMI , % Fat , body fat mass , lean body mass , hs-CRP , leptin , and TNF-alpha , and increased L-scale , VO(2)max , HDL-cho , and adiponectin . It was concluded that changes in circulating adipokine levels are involved in the improvement of the metabolic state by exercise and may be useful markers for evaluation and prescription of exercise Background — Inflammatory processes are putative mechanisms underlying the cardioprotective effects of physical activity . An inverse association between physical activity and inflammation has been demonstrated , but no long-term prospect i ve data are available . We therefore examined the association between physical activity and inflammatory markers over a 10-year follow-up period . Methods and Results — Participants were 4289 men and women ( mean age , 49.2 years ) from the Whitehall II cohort study .  Self-reported physical activity and inflammatory markers ( serum high-sensitivity C-reactive protein and interleukin-6 ) were measured at baseline ( 1991 ) and follow-up ( 2002 ) . Forty-nine percent of the participants adhered to st and ard physical activity recommendations for cardiovascular health ( 2.5 h/wk moderate to vigorous physical activity ) across all assessment s. Physically active participants at baseline had lower C-reactive protein and interleukin-6 levels , and this difference remained stable over time . Compared with participants who rarely adhered to physical activity guidelines over the 10-year follow-up , the high-adherence group displayed lower loge C-reactive protein ( & bgr;=−0.07 ; 95 % confidence interval , −0.12 to −0.02 ) and loge interleukin-6 ( & bgr;=−0.07 ; 95 % confidence interval , −0.10 to −0.03 ) at follow-up after adjustment for a range of covariates . Compared with participants who remained stable , those who reported an increase in physical activity  of at least 2.5 h/wk displayed lower loge C-reactive protein ( & bgr ; coefficient=−0.05 ; 95 % confidence interval , −0.10 to −0.001 ) and loge interleukin-6 ( & bgr ; coefficient=−0.06 ; 95 % confidence interval , −0.09 to −0.03 ) at follow-up . Conclusions — Regular physical activity is associated with lower markers of inflammation over 10 years of follow-up and thus may be important in preventing the proinflammatory state seen with aging Background Coronary heart disease as well as major cardiovascular risk factors are associated with elevated levels of proinflammatory markers . There is , however , limited information about how changes in lifestyle improving the cardiovascular risk profile influence these levels . The aim of the study was to evaluate whether changes in lifestyle measures with special attention to physical activity , were associated with the levels of such markers . Design Coronary heart disease patients ( n = 197 ) were r and omized to either a comprehensive lifestyle intervention programme comprising regular physical activity , low fat diet and smoking cessation , or usual care with routine follow-up in the outpatient clinic for 6 months . An exercise test and fasting blood sample s analysed for soluble cell adhesion molecules , C reactive protein and pro-inflammatory cytokines were evaluated before and at the end of the study . Results Improved diet , physical performance and reduction in smoking were obtained in the intervention programme when compared with usual care patients , but no significant group differences in levels of inflammatory markers were observed . In the total population , however , physical performance significantly and inversely predicted levels of soluble cell adhesion molecule 1 , ( P>0.001 ) , C-reactive protein ( P>0.001 ) and interleukin-6 ( P=0.01 ) at 6 months . Smokers had elevated levels of soluble cell adhesion molecule 1 when compared with non-smokers ( P=0.011 ) . Conclusions We demonstrated that physical performance is inversely correlated with levels of pro-inflammatory markers in coronary heart disease patients , possibly retarding the process of atherosclerosis . No effect on inflammatory markers was obtained with a 6-month lifestyle intervention programme when compared with patients who received usual care follow-up . Eur J Cardiovasc Prev Rehabil 13:356 - 362 © 2006 The European Society of The primary purpose of this study was to investigate the effects of high-intensity exercise training under relatively equal energy expenditure on whole body fat and abdominal fat loss , and cardiorespiratory fitness . Twenty-two untrained middle-aged Korean females were r and omized into one of the following groups : control , low-intensity training group ( LI ) , and high-intensity training group ( HI ) . Subjects completed 14 weeks of training at 50 % maximal oxygen consumption ( LI ) or 70 % maximal oxygen consumption ( HI ) with the volume of exercise equated relative to kilograms of body weight . Weekly exercise volumes were 13.5 METs⋅h/week for the first 4 weeks , 18 METs⋅h/week for next 5 weeks , and 22.5 METs⋅h/week for the final 5 weeks . Data were analyzed using 2-way repeated measures ANOVA with post hoc test , using Bonferroni 's correction . HI showed significant reductions in fat mass ( p < 0.05 ) , total abdominal fat ( p < 0.01 ) , and subcutaneous abdominal fat ( p < 0.01 ) . LI reduced total abdominal fat ( p < 0.05 ) , but there were no other significant changes found in the control or LI groups . Maximal oxygen consumption was enhanced in both HI and LI with no significant group difference . High-density lipoprotein cholesterol increased significantly in HI ( p < 0.05 ) . IL-6 , C-reactive protein , TNF-α , and other blood lipids were unaltered following training . Results indicate that high-intensity exercise training is more beneficial in whole body and abdominal fat loss ; however , cardiorespiratory enhancement shows a dose-response relationship with weekly exercise volume . It is suggested that 14 weeks of aerobic exercise training at either high- or low-intensity is not sufficient enough to induce changes in levels of inflammatory proteins PURPOSE To investigate the effect of a yearlong moderate-intensity aerobic exercise intervention on C-reactive protein ( CRP ) , serum amyloid A ( SAA ) , and interleukin 6 ( IL-6 ) among overweight or obese postmenopausal women . METHODS In a r and omized controlled trial , 115 postmenopausal , overweight or obese , sedentary women , aged 50 - 75 yr were r and omized to an aerobic exercise intervention of moderate-intensity ( 60%-75 % observed maximal HR ) , for > or = 45 min x d(-1 ) , 5 d x wk ( n = 53 ) , or to a 1-d x wk(-1 ) stretching control ( n = 62 ) , on an intent-to-treat basis . CRP , SAA , and IL-6 were measured at baseline , at 3 months , and at 12 months . RESULTS From baseline to 12 months , CRP decreased 10 % in exercisers and increased 12 % in controls ( P = 0.01 ) ; no effects were observed for SAA and IL-6 . Among participants at baseline who were obese ( body mass index ( BMI ) > or = 30 kg x m(-2 ) ) or had abdominal obesity ( waist circumference ( WC ) > or = 88 cm ) , exercise result ed in a more pronounced reduction in CRP ( BMI > or = 30 kg x m(-2 ) , P = 0.002 ; WC > or = 88 cm , P < 0.0001 ) , borderline for SAA ( BMI > or = 30 kg x m(-2 ) , P = 0.08 ; WC > or = 88 cm , P = 0.04 ) ; no intervention effects were observed among women who did not have these characteristics . Overall , weight loss was minimal in the exercise intervention ( approximately 1.8 kg ) . Linear trends were observed between CRP and 12-month changes in aerobic fitness ( Ptrend = 0.006 ) , exercise adherence ( Ptrend = 0.004 ) , percentage body fat ( Ptrend = 0.002 ) , body weight ( Ptrend = 0.002 ) , WC ( Ptrend = 0.02 ) , and intra-abdominal fat ( Ptrend = 0.03 ) . CONCLUSIONS A moderate-intensity exercise intervention reduced CRP for 12 months among women who were obese at baseline . These findings support the role of exercise in modulating inflammatory processes that are related to increased risk of chronic disease among obese women Background —C-reactive protein ( CRP ) has been proposed as an independent risk factor for cardiovascular disease and has been positively associated with body weight and body fatness . We examined the hypothesis that weight loss would reduce plasma CRP levels in obese postmenopausal women . Methods and Results —In a sample of 61 obese ( body mass index , 35.6±5.0 kg/m2 ) , postmenopausal women ( age , 56.4±5.2 years ) , we found that plasma CRP levels were positively associated with dual x-ray absorptiometry – measured total body fatness ( r = 0.36 , P < 0.005 ) and CT-measured intra-abdominal body fat area ( r = 0.30 , P < 0.02 ) . Significant correlations were also found between plasma CRP and triglyceride levels ( r = 0.33 , P < 0.009 ) and glucose disposal measured by the hyperinsulinemic-euglycemic clamp technique ( r = −0.29 , P < 0.03 ) . Twenty-five of the 61 women tested at baseline completed a weight loss protocol .  The average weight loss was 14.5±6.2 kg ( −15.6 % , P < 0.0001 ) , with losses of 10.4±5.4 kg fat mass ( −25.0 % , P < 0.0001 ) and 2.8±1.4 kg fat-free mass ( −6.0 % , P < 0.0 
    Output:
    
Heterogeneity between studies could not be attributed to age , gender , intervention length , intervention type , or inclusion of diet modification .
Exercise interventions  reduced hsCRP levels in adults irrespective of the presence of heart