Abstract Body (Do not enter title and authors here): Introduction:
Overweight and obesity are associated with chronic low-grade inflammation, and exercise has been shown to lower levels of inflammatory markers. In this study, we examined the relationship between various exercise intensities and systemic inflammatory levels in overweight and obese adults using a nationally representative database of the United States population.

Methods:
Analysis was performed on 4,385 adults aged 18 years and older with a BMI of 25 or higher from the 2017-2018 National Health and Nutrition Examination Survey (NHANES), by comparing participant self-reported physical activity categorized as mild/moderate (M/M) and vigorous (V). Systemic inflammation was assessed using high-sensitivity C-reactive protein levels (CRP) and Systemic Inflammatory Index (SII). SII was calculated using platelet count, neutrophil, and lymphocyte count. Chi square and multivariable logistic regression were performed.

Result:
CRP was normal in 68.3% of people reporting V physical activity compared with 54.2% of people with M/M physical activity (p = 0.00). Similarly, 54.3% of people with V physical activity had lower SII compared with 43.7% of participants with M/M physical activity (p = 0.00). While controlling for sex, age group, race, and medical comorbidity, V physical activity was associated with lower odds of having elevated CRP (OR: 0.60, P = 0.00, 95% CI 0.42 –0.73) and SII (OR: 0.70, P = 0.00, 95% CI 0.56 – 0.90). Males (P = 0.00) have lower odds for elevated CRP and SII. Increasing comorbidity was associated with a higher odd of elevated CRP whereas was not significantly associated with SII. Non-Hispanic white males had higher odds of elevated SII. However, race was not significantly associated with CRP.

Conclusion:
For overweight and obese adults, the intensity of exercise matters. Compared with moderate/mild physical activity, vigorous physical activity is associated with lower systemic inflammatory markers, namely CRP and SII.