Multiple Interventions for Treating Chronic Inflammation in Older Adults

Dear Editor-in-Chief: We read with interest the recent review article entitled "Exercise Training as a Treatment for Chronic Inflammation" (3). This is a very timely review, and as such, we feel the research done to date is only beginning to reveal the relationship between exercise and chronic low-grade inflammation. We have recently completed a clinical trial using 12 wk of strength training and α-linolenic acid (ALA) supplementation in older adults while evaluating changes to interleukin 6 (IL-6) and tumor necrosis factor (TNF) (1). Although our study did not have a "true" nonexercise control group, we did make some interesting observations. First, it seems that ALA combined with strength training was able to decrease IL-6 and increase knee flexor thickness in the older men in our study, although it had no effect in the women or in the men taking placebo. Further, the study revealed different responses in males and females, with females increasing and males decreasing TNF concentrations during the 12 wk. These two results seem to indicate specific sex differences on inflammatory markers that need to be addressed with further research. The result also suggests that combined interventions for reducing inflammation may be needed to produce clinical effects. The authors also mention that antiinflammatory medication (presumable nonsteroidal antiinflammatory drugs (NSAID)) will reduce inflammation but go on to suggest that "… none of the pharmaceutical agents with antiinflammatory effects are approved for the treatment of sarcopenia or aging-related loss of function." Although this is true, it is premature to suggest that antiinflammatory medication will have either a negative or a positive effect on skeletal muscle because of its antiinflammatory effect, especially in older adults. High-dose NSAID use (1200 mg·d−1) inhibits muscle protein synthesis (4), but our group has recently demonstrated that a moderate dose (400 mg·d−1) had no effect on muscle hypertrophy, strength, or muscle thickness during a strength-training regimen (2). This study was done in younger adults, and so the results cannot be extrapolated to older adults, but we suggest that further research is needed on NSAID medication before making solid conclusions about its possible benefit or detriment to muscle hypertrophy or strength, especially in older adults. Stephen M. Cornish, Ph.D. Human Performance Research Lab National Defence Medical Centre Ottawa, Ontario, Canada Philip D. Chilibeck, Ph.D.