Chronic disease has been strongly correlated with
inflammation resulting from the body's release of inflammatory
cytokines as a result of injury or
infection. Specific interventions promoting
weight loss, exercise, or intake of
antioxidants have been used by several investigators in an effort to decrease inflammatory
cytokines.
C-reactive protein (CRP) is produced by the liver and its role in the development of
inflammation has been well established. However, the strong association between CRP and risk for
heart disease is a more recent discovery. During the
inflammation process, the transcriptional activity of
nuclear factor kappaB leads to the increased production of inflammatory
cytokines associated with
atherosclerosis, including
tumor necrosis factor-alpha (
TNFalpha). Increased concentrations of
TNFalpha have been reported in obese patients; thus,
weight loss is considered a key intervention to reduce the concentrations of this
cytokine. In contrast to CRP and
TNFalpha,
adiponectin increases during
weight loss and
insulin sensitivity. Additionally, lower concentrations of this
cytokine have been reported in
cardiovascular disease and type-2 diabetes. Recent epidemiological studies and clinical interventions have reported contradictory findings related to dietary or exercise interventions and the resulting alterations in plasma
cytokines. Part of the discrepancies may be due to the population studied, the time of the treatment, and the lack of
weight loss in some studies. Although it is clear from the literature that these
cytokines play a major role in the development of
chronic disease, the best strategy to favorably alter the inflammatory response is still debatable.