Umbrella review: exercise and inflammatory biomarkers in older adults and adults with chronic disease
Across 21 reviews, exercise was linked to small reductions in TNF-alpha and CRP, but IL-6 results were inconsistent and certainty was very low. [1]
Automatic summary · not editorially reviewed
The key findings
The umbrella review included 21 reviews: 14 fully matching the population, intervention, comparator, outcome and design criteria, and seven used only for mapping and background. [1]
Exercise was associated with small reductions in TNF-alpha and CRP, while IL-6 estimates were inconsistent. [1]
Certainty of evidence was very low for every biomarker construct, and effects on immunosenescence and cellular-senescence markers remain an evidence gap. [1]
The source at a glance
- Study type / format
- Umbrella review (structured narrative synthesis of systematic reviews and meta-analyses).
- Population / context
- Older adults and adults with chronic diseases.
- Summary based on
- Study abstract
- Original publication
- September 29, 2026
Reviews on exercise and biomarkers in older and chronically ill adults
This umbrella review asked whether exercise or physical activity changes circulating biomarkers linked to chronic low-grade inflammation and immunosenescence. It covered older adults and adults with chronic diseases. The authors searched six databases through 1 March 2026 for systematic reviews, meta-analyses and overviews. They included 21 reviews: 14 fully matched the population, intervention, comparator, outcome and design criteria and fed the main synthesis; seven only partly matched and served for mapping and background.
Supporting source [1]
Small TNF-alpha and CRP reductions, inconsistent IL-6 results
Among the fully matching reviews that reported standardised mean differences, exercise was associated with small reductions in tumour necrosis factor-alpha (TNF-alpha; point estimates -1.42 to -0.05, two of five confidence intervals excluding the null) and C-reactive protein (CRP; -0.65 to -0.47, two of three excluding the null). Interleukin-6 (IL-6) estimates were inconsistent (-0.81 to +0.09, two of five excluding the null). Heterogeneity was often high. A sensitivity analysis excluding reviews rated critically low attenuated the apparent signal.
Supporting source [1]
Very low certainty and a gap for senescence markers
Methodological confidence was critically low in 11 reviews, low in nine and moderate in one; certainty of evidence was very low for every biomarker construct. Primary-study overlap was slight overall but very high within the multiple sclerosis cluster. Effects on immunosenescence and cellular-senescence markers remain an evidence gap. The authors state this biomarker evidence alone does not justify prescribing exercise specifically to lower inflammatory biomarkers and does not change broader activity recommendations based on clinical and functional outcomes.
Supporting source [1]
How to interpret this
Abstract only; the full text was not reviewed. This umbrella review is a structured narrative synthesis of review-level estimates, not a new meta-analysis. Certainty was very low for all biomarkers, and immunosenescence and cellular-senescence markers were not covered by findings.
Based on the study abstract; the full paper, tables and supplementary data were not reviewed.
Source & supporting passages
Chai G, Xue J, Xie B. · europepmc.org · September 29, 2026