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Effect of exercise training on C reactive protein: a systematic review and meta-analysis of randomised and non-randomised controlled trials
  1. Michael V Fedewa1,
  2. Elizabeth D Hathaway2,
  3. Christie L Ward-Ritacco3
  1. 1Department of Kinesiology, The University of Alabama, Tuscaloosa, Alabama, USA
  2. 2Department of Kinesiology, The University of Georgia, Athens, Georgia, USA
  3. 3Department of Kinesiology, The University of Rhode Island, Kingston, Rhode Island, USA
  1. Correspondence to Dr Michael V Fedewa, The University of Alabama, Department of Kinesiology, 2003 Moore Hall, Box 870312, Tuscaloosa, AL 35487-0231, USA; mvfedewa{at}


Purpose C-reactive protein (CRP) is a marker of chronic systemic inflammation frequently used in cardiovascular disease risk assessment. The purpose of this meta-analysis was to provide a quantitative estimate of the magnitude of change in CRP following participation in physical exercise interventions.

Methods All studies included in the meta-analysis were peer reviewed and published in English. Human participants were assigned to a non-exercise comparison group or exercise training group, with the intervention lasting ≥2 weeks. CRP levels were measured at baseline, during and/or after completion of the exercise training programme. Random-effects models were used to aggregate a mean effect size (ES), 95% CIs and potential moderators.

Results 83 randomised and non-randomised controlled trials met the inclusion criteria and resulted in 143 effects (n=3769). The mean ES of 0.26 (95% CI 0.18 to 0.34, p<0.001) indicated a decrease in CRP following exercise training. A decrease in body mass index (BMI; β=1.20, SE=0.25, p<0.0001) and %Fat (β=0.76, SE=0.21, p=0.0002) were associated with a decrease in CRP, independently accounting for 11.1% and 6.6% of the variation in response, respectively. Exercise training led to a greater reduction in CRP when accompanied by a decrease in BMI (ES=0.38, 95% CI 0.26 to 0.50); however, a significant improvement in CRP occurred in the absence of weight loss (ES=0.19, 95% CI 0.10 to 0.28; both p<0.001).

Conclusions These results suggest that engaging in exercise training is associated with a decrease in CRP levels regardless of the age or sex of the individual; however, greater improvements in CRP level occur with a decrease in BMI or %Fat.

  • Meta-analysis
  • Exercise training

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