{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T14:11:45Z","timestamp":1789567905461,"version":"build-2803163510"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:00:00Z","timestamp":1789516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Objective<\/jats:title>\n Exercise is a well-established strategy for promoting healthy aging and reducing cardiometabolic risk; however, its effects on epicardial adipose volume (EAV) and associated inflammatory pathways in older adults remain insufficiently understood. This randomized controlled trial examined whether a 12-month structured exercise program reduces EAV in community-dwelling older adults, and secondarily explored changes in serum pro-inflammatory cytokines.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This single-center pragmatic randomized controlled trial incorporated a Zelen design. A total of 156 older adults (\u226560\u202fyears) were evenly allocated to a structured exercise (STE) group or a control group. The control group received health education only; the STE group performed one supervised center-based session plus at least two home-based sessions per week, with matched intensity and duration. EAV, body fat parameters, and circulating pro-inflammatory factors were measured at baseline and after 12\u202fmonths.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among the randomized participants, 57 individuals in the control group and 61 individuals in the STE group completed the 12-month follow-up (55 men, 46.6%; mean age 69.17\u202f\u00b1\u202f4.41\u202fyears). The absolute EAV change differed significantly between groups (STE vs. control: \u221215.15\u202fmL, 95% CI \u201322.61 to \u22127.69,\n p<\/jats:italic>\n \u202f&lt;\u202f0.0001). After adjusting for baseline values, only serum macrophage colony-stimulating factor (M-CSF) showed a significant between-group difference (\u22121.75\u202fpg\/mL, 95% CI \u20133.34 to \u22120.16,\n p<\/jats:italic>\n \u202f=\u202f0.032). Univariate linear regression indicated that each additional weekly exercise session was associated with a 3.156\u202fmL greater EAV reduction (\n R<\/jats:italic>\n 2<\/jats:sup>\n \u202f=\u202f0.084).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n A 12-month structured exercise intervention was associated with reduced EAV and lower circulating M-CSF levels in community-dwelling older adults, with greater reductions observed among participants engaging in more frequent weekly exercise sessions. These findings support regular supervised exercise as a non-pharmacological strategy to reduce cardiac adiposity and modulate inflammation in aging populations.<\/jats:p>\n <\/jats:sec>\n \n Clinical trial registration<\/jats:title>\n \n https:\/\/www.chictr.org.cn\/indexEN.html<\/jats:ext-link>\n , ChiCTR2400081824.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1938784","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T13:57:01Z","timestamp":1789567021000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A 12-month structured exercise reduces epicardial adipose volume in a frequency-dependent manner and lowers serum M-CSF in community-dwelling older adults: a randomized controlled trial"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiaojing","family":"Xue","sequence":"first","affiliation":[{"name":"Shengli Clinical Medical College of Fujian Medical University","place":["Fuzhou, China"]},{"name":"Department of Neurology, Fuzhou University Affiliated Provincial Hospital","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simiao","family":"Chen","sequence":"additional","affiliation":[{"name":"Shengli Clinical Medical College of Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanling","family":"Cheng","sequence":"additional","affiliation":[{"name":"Shengli Clinical Medical College of Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiaowei","family":"Li","sequence":"additional","affiliation":[{"name":"Shengli Clinical Medical College of Fujian Medical University","place":["Fuzhou, China"]},{"name":"Institute of Clinical Geriatrics, Fuzhou University Affiliated Provincial Hospital","place":["Fuzhou, China"]},{"name":"Fujian Key Laboratory of Geriatrics","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Ye","sequence":"additional","affiliation":[{"name":"Shengli Clinical Medical College of Fujian Medical University","place":["Fuzhou, China"]},{"name":"Institute of Clinical Geriatrics, Fuzhou University Affiliated Provincial Hospital","place":["Fuzhou, China"]},{"name":"Fujian Key Laboratory of Geriatrics","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haowen","family":"Li","sequence":"additional","affiliation":[{"name":"School of Nursing, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Huang","sequence":"additional","affiliation":[{"name":"Shengli Clinical Medical College of Fujian Medical University","place":["Fuzhou, China"]},{"name":"Institute of Clinical Geriatrics, Fuzhou University Affiliated Provincial Hospital","place":["Fuzhou, China"]},{"name":"Fujian Key Laboratory of Geriatrics","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fang","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute of Clinical Geriatrics, Fuzhou University Affiliated Provincial Hospital","place":["Fuzhou, China"]},{"name":"School of Nursing, Fujian University of Traditional Chinese Medicine","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e158451","DOI":"10.1172\/JCI158451","article-title":"Metabolic changes in aging humans: current evidence and therapeutic strategies","volume":"132","author":"Palmer","year":"2022","journal-title":"J Clin Invest"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"114723","DOI":"10.1016\/j.bcp.2021.114723","article-title":"White adipose tissue 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