24 and 25 These effects may be mediated in part through muscle-de

24 and 25 These effects may be mediated in part through muscle-derived peptides or myokines, but this proposed mechanism needs further testing.25 Contracting skeletal muscles release myokines (e.g., IL-6, IL-8, IL-15) that may exert both direct and chronic anti-inflammatory effects. The first identified and most

studied myokine is IL-6. During prolonged and intense exercise, IL-6 is produced by muscle fibers and stimulates the appearance in the circulation of other anti-inflammatory cytokines such as IL-1ra and IL-10.26 IL-6 also inhibits the production of the proinflammatory PD-0332991 supplier cytokine TNF-α and stimulates lipolysis and fat oxidation.26 With weight loss from energy restriction and exercise, plasma levels of IL-6 fall, skeletal muscle TNF-α decreases, and insulin sensitivity improves.27 and 28 Thus IL-6 release from the exercising muscle may help mediate some of the health

benefits of exercise including metabolic control of type 2 diabetes.27 and 28 Muscle IL-6 release, however, is very low during moderate physical activity. For example, during a 30-min LY294002 cost brisk walk on a treadmill, plasma IL-6 concentrations increased from1.3 pg/mL to 2.0 pg/mL in female subjects.29 The increase in IL-6 during brisk walking is probably insufficient to mediate anti-inflammatory and other beneficial health effects, and additional research is needed to determine the relative contribution of myokines compared to other exercise-induced factors. The acute exercise-induced increase in IL-6 after heavy exertion (e.g., typically above 5 pg/mL, 10 pg/mL, and 50 pg/mL following 1-h, 2-h, science and marathon race running bouts, respectively) may indeed orchestrate anti-inflammatory influences, lipolysis, and improved insulin sensitivity, but this amount of physical activity is beyond levels achievable by most overweight/obese individuals. A moderate exercise program of near daily 30-min walking bouts, without diet control, has small influences on visceral fat, even in long-term studies.30 This is further evidence that the myokine hypothesis does not

apply at the activity level attainable by most middle-aged and elderly individuals. Thus moderate physical activity training must be increased to the highest levels acceptable to an individual (e.g., 60 min a day) and combined with weight loss through tight control of energy intake and improved diet quality to achieve reductions in systemic inflammation. URTI is the most frequently occurring infectious disease in humans worldwide.31, 32 and 33 More than 200 different viruses cause the common cold, and rhinoviruses and coronaviruses are the culprits 25%–60% of the time. The National Institute of Allergy and Infectious Diseases reports that people in the USA suffer one billion colds each year with an incidence of 2–4 for the average adult and 6–10 for children.31 URTI imposes an estimated USD40 billion burden in direct and indirect costs on the U.S. economy.32 Low to high exercise workloads have a unique effect on URTI risk.

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