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Peer-reviewedCC BY 4.0European Journal of Applied Physiology

Exercise-induced compensation and C-reactive protein change in adults with elevated C-reactive protein: analysis of a randomised controlled trial

  • James L. Dorling1
  • John W. Apolzan2
  • Diana M. Thomas3
  • Christoph Höchsmann4
  • Neil M. Johannsen2,5
  • Robert Ross6
  • Tim S. Church2,7
  • Corby K. Martin2
7 affiliations
  1. 1Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow, G31 2ER UK
  2. 2Pennington Biomedical Research Center, Baton Rouge, LA USA
  3. 3United States Military Academy, West Point, NY USA
  4. 4Department of Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
  5. 5Louisiana State University, Baton Rouge, LA USA
  6. 6School of Kinesiology and Health Sciences, Queen’s University, Kingston, ON Canada
  7. 7Wondr Health, Inc., Dallas, TX USA
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Abstract

Purpose: Exercise can reduce C-reactive protein (CRP), but heterogeneity exists and it is unclear whether exercise-induced weight compensation occurs or relates to CRP change. We examined whether compensation occurs in adults with elevated CRP during exercise and whether compensation and compensatory behaviours are associated with CRP change.

Methods: In this 4-month randomised controlled trial, 124 sedentary adults with elevated CRP (mean ± SD: 4.3 ± 2.5 mg/L) were randomised to a control group or a supervised aerobic exercise group expending 16 kcal/kg/week. Predicted weight change was estimated, and weight compensation (weight change – predicted weight change) was calculated. CRP was measured, and energy intake and non-exercise step count were assessed using questionnaires and pedometers, respectively.

Results: Weight compensation was greater in the exercise group than the control group (1.3 [95% CI, 0.6, 2.1] vs. 0.1 [95% CI, -0.6, 0.9] kg; P = 0.029). In response to exercise, compensation did not differ between participants with moderately higher (≤ 3 mg/L) and higher (> 3 mg/L) CRP (P = 0.977). Exercisers who did not compensate exhibited a 1.2 (95% CI, 0.2, 2.2) mg/L reduction in CRP versus those who did compensate (P = 0.016). Higher energy intake was associated with CRP change in exercisers, with each 100 kcal/day elevation in energy intake associated with a 0.1 (95% CI, 0.0, 0.2) mg/L increase in CRP (P = 0.022).

Conclusion: Exercise-induced weight compensation occurs in adults with elevated CRP and is associated with attenuated improvements in CRP. Increased energy intake was associated with higher CRP in exercisers, suggesting that limiting increases in energy intake may enhance exercise-induced anti-inflammatory benefits.

Clinical trials registration: NCT00113061.

Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00421-026-06405-4.

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Cite

BibTeXRIS
BibTeX
@article{dorling2026exerciseinduced,
  title = {{Exercise-induced compensation and C-reactive protein change in adults with elevated C-reactive protein: analysis of a randomised controlled trial}},
  author = {James L. Dorling and John W. Apolzan and Diana M. Thomas and Christoph Höchsmann and Neil M. Johannsen and Robert Ross and Tim S. Church and Corby K. Martin},
  journal = {European Journal of Applied Physiology},
  year = {2026},
  month = aug,
  doi = {10.1007/s00421-026-06405-4},
  url = {https://doi.org/10.1007/s00421-026-06405-4},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Exercise-induced compensation and C-reactive protein change in adults with elevated C-reactive protein: analysis of a randomised controlled trial
AU  - James L. Dorling
AU  - John W. Apolzan
AU  - Diana M. Thomas
AU  - Christoph Höchsmann
AU  - Neil M. Johannsen
AU  - Robert Ross
AU  - Tim S. Church
AU  - Corby K. Martin
PY  - 2026
DA  - 2026/08/27
JO  - European Journal of Applied Physiology
DO  - 10.1007/s00421-026-06405-4
UR  - https://doi.org/10.1007/s00421-026-06405-4
AB  - Purpose: Exercise can reduce C-reactive protein (CRP), but heterogeneity exists and it is unclear whether exercise-induced weight compensation occurs or relates to CRP change. We examined whether compensation occurs in adults with elevated CRP during exercise and whether compensation and compensatory behaviours are associated with CRP change.  Methods: In this 4-month randomised controlled trial, 124 sedentary adults with elevated CRP (mean ± SD: 4.3 ± 2.5 mg/L) were randomised to a control group or a supervised aerobic exercise group expending 16 kcal/kg/week. Predicted weight change was estimated, and weight compensation (weight change – predicted weight change) was calculated. CRP was measured, and energy intake and non-exercise step count were assessed using questionnaires and pedometers, respectively.  Results: Weight compensation was greater in the exercise group than the control group (1.3 [95% CI, 0.6, 2.1] vs. 0.1 [95% CI, -0.6, 0.9] kg; P = 0.029). In response to exercise, compensation did not differ between participants with moderately higher (≤ 3 mg/L) and higher (> 3 mg/L) CRP (P = 0.977). Exercisers who did not compensate exhibited a 1.2 (95% CI, 0.2, 2.2) mg/L reduction in CRP versus those who did compensate (P = 0.016). Higher energy intake was associated with CRP change in exercisers, with each 100 kcal/day elevation in energy intake associated with a 0.1 (95% CI, 0.0, 0.2) mg/L increase in CRP (P = 0.022).  Conclusion: Exercise-induced weight compensation occurs in adults with elevated CRP and is associated with attenuated improvements in CRP. Increased energy intake was associated with higher CRP in exercisers, suggesting that limiting increases in energy intake may enhance exercise-induced anti-inflammatory benefits.  Clinical trials registration: NCT00113061.  Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00421-026-06405-4.
SN  - 1439-6319
SN  - 1439-6327
ER  -