title: Effects of walking on low-grade inflammation and their implications for Type 2 Diabetes.
abstract: OBJECTIVE
  Inflammatory cytokines released by hypertrophic adipocytes contribute to low-grade inflammation, a characteristic of Type 2 Diabetes. Skeletal muscle contraction during physical activity stimulates the secretion of anti-inflammatory cytokines able to counteract this inflammatory status. The aim of this study was to review the evidence of the effectiveness of walking as a physical activity intervention to reduce inflammation. The interplay between adipose tissue and skeletal muscle contributions was also investigated.
  
  
  METHODS
  A structured literature review of papers available up to December 2014 was carried out within the PubMed, Scopus and ISI Web of Science databases using the keywords "walking" and "inflammation" in order to identify the studies involving healthy subjects and subjects diagnosed with, or at increased risk of, Type 2 Diabetes.
  
  
  RESULTS
  Thirty-two studies were reviewed, five investigating the acute effects of walking and twenty-seven its chronic effects (n = 21 interventional and n = 6 observational). Acute effects of walking bouts led to an increase of interleukin-6 in one study, although without any increase in the concentration of the anti-inflammatory marker interleukin-1 receptor antagonist. Eight interventional studies showed a significant reduction of inflammation. A reduction in tumour necrosis factor-α concentration was often associated with an adiposity reduction. The observational studies showed that individuals who walk more present a lower inflammatory status.
  
  
  CONCLUSIONS
  There is no consensus regarding the efficacy of walking in the reduction of low-grade systemic inflammation, even though a relationship cannot be excluded. In each walking bout, no anti-inflammatory effect due to the IL-6-stimulated myokine cascade can be demonstrated.
authors: Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome "Foro Italico", Rome, Italy.
authors: Micaela
authors: M
authors: Morettini
authors: Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK; INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.
authors: Fabio
authors: F
authors: Storm
authors: Department of Movement, Human and Health Sciences, University of Rome"Foro Italico", Rome, Italy.
authors: Massimo
authors: M
authors: Sacchetti
authors: Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, University of Rome "Foro Italico", Rome, Italy; Department of Movement, Human and Health Sciences, University of Rome"Foro Italico", Rome, Italy.
authors: Aurelio
authors: A
authors: Cappozzo
authors: Department of Mechanical Engineering, The University of Sheffield, Sheffield, UK; INSIGNEO Institute for in silico Medicine, The University of Sheffield, Sheffield, UK.
authors: Claudia
authors: C
authors: Mazzà
keywords: Adipokines; Diabetes mellitus, Type 2; Inflammation; Insulin resistance; Interleukin-6; Walking