This systematic review and meta-analysis of controlled clinical trials was performed to evaluate the effects of weight-loss diets plus exercise compared with weight-loss diets alone on inflammatory biomarkers in adults. PubMed, Scopus, Embase, Web of Science (ISI), and Google Scholar were searched up to April 2021. Overall effects were derived using a random effects model. The overall quality of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Twenty-nine trials were included in this systematic review and meta-analysis. The meta-analysis showed no significant difference in serum high sensitivity C-reactive protein (hs-CRP) (weighted mean difference (WMD) -0.004 mg/l, 95% CI -0.140 to 0.132, p = 0.954), interleukin-6 (IL-6) (WMD -0.039 pg/ml, 95% CI -0.233 to 0.156, p = 0.696), and tumor necrosis factor-alpha (TNF-alpha) (WMD 0.405 ng/ml, 95% CI -1.036 to 0.226, p = 0.209) after adding exercise to a weight-loss diet compared with a weight-loss diet alone. Subgroup analysis revealed that exercise plus a weight-loss diet significantly reduced TNF-alpha in studies greater than 16 weeks in duration (WMD -0.742 ng/ml, 95% CI -1.384 to -0.1, p = 0.024). This systematic review and meta-analysis indicate that exercise in addition to a weight-loss diet does not have a significant effect on further reducing inflammatory markers compared to a weight loss diet alone.

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