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Background  Rheumatoid arthritis (RA) is a disease characterized by a chronic inflammatory state. High pro-inflammatory cytokine levels are associated with disease activity. Exercise and the Mediterranean diet (MD) exert anti-inflammatory effects; however, their impacts on inflammation in RA patients remains unknown. This study aimed to compare the effects of six-months of dynamic exercise program (DEP) vs. MD on pro- and anti-inflammatory cytokine serum concentrations.    Methods  Secondary analysis of a randomized clinical trial in which 90 women with RA were randomly assigned to the DEP ( n  = 30), MD ( n  = 30), or control group ( n  = 30). All patients received pharmacological treatment. Serum concentrations of pro-inflammatory (TNF-α, TNF-β, IL-1β, IL-6 pg/mL) and anti-inflammatory (IL-10, IL-Ra pg/mL) cytokines were measured at baseline and after 6 months using the Luminex technique.    Results  After 6 months of follow-up, we found an improvement of the median percentages changes concentrations of TNF-α (DEP, −12.3; MD, −13.3; control, 73.2;  p  = 0.01), TNF-β (DEP, −67.4; MD, −54.9; control, 0;  p  = 0.04), and IL-6 (DEP, −19.9; MD, −37.7; control, 45.5;  p  = 0.04) in the DEP and MED groups in comparison with control group. IL-1Ra concentrations increased only in the MD group (13.8) compared to levels in the control group (−31.7),  p  = 0.04. There were no statistically significant differences between DEP and MD groups. Only  n  = 27 participants in the DEP group,  n  = 26 in the MD group, and  n  = 21 in the control group completed the follow-up.    Conclusion  The DEP and the MD have potential effects in the concentrations of pro-inflammatory cytokines compared with those in a control group. Only the MD elevated the concentration of IL-Ra.    Clinical Trial Registration  [ ClinicalTrials.gov ], identifier [NCT02900898].

frontiers in nutrition

Comparison of the Impacts of a Dynamic Exercise Program vs. a Mediterranean Diet on Serum Cytokine Concentrations in Women With Rheumatoid Arthritis. A Secondary Analysis of a Randomized Clinical Trial