Effects of exercise intensity and volume on systemic inflammation in overweight and obese postmenopausal women: a dose-response meta-analysis.

<h4>Objective</h4>This study evaluates the dose-response relationships between multiple exercise parameters (volume, duration, and intensity) and inflammatory modulation (C-reactive protein [CRP], interleukin-6 [IL-6], tumor necrosis factor-α [TNF-α], and adiponectin) exclusively in overweight and obese postmenopausal women.<h4>Methods</h4>Five databases were systematically searched for randomized controlled trials (RCTs) up to January 2026 (PROSPERO: CRD420261288134). Standardized Mean Differences (SMD) were estimated using random-effects models. Meta-regression analyses investigated the dose-response effects of total exercise volume (MET-minutes/week), intervention duration (weeks), and exercise intensity (systematically standardized to %HRmax).<h4>Results</h4>Analysis of 30 RCTs (N = 2,124) demonstrated that exercise interventions significantly reduced TNF-α (SMD = -0.47, p < 0.001) and CRP (SMD = -0.36, p = 0.001). Changes in IL-6 and adiponectin were not statistically significant. Leave-one-out sensitivity analyses confirmed the exceptional stability of the CRP (SMD range: -0.41 to -0.28) and TNF-α reductions. Meta-regression revealed no definitive linear dose-response relationships for total exercise volume or duration across any biomarkers. However, a borderline trend (p = 0.063) indicated that higher exercise intensity is associated with greater reductions in TNF-α.<h4>Conclusion</h4>Structured exercise functions as a potent therapeutic modality that reliably mitigates systemic and tissue-derived inflammation in postmenopausal obesity. The findings challenge the traditional reliance on total exercise volume or duration, pointing instead toward an "intensity threshold" where higher exercise intensities more effectively drive anti-inflammatory adaptations. Precision exercise prescriptions for this demographic should prioritize the optimization of exercise intensity.