FIGURE 1.

Visual Summary. Atherosclerosis is an inflammatory disease that is regulated by systemic inflammation. Physical activity can have beneficial effects (green arrows) by regulating systemic inflammation directly, and through behavioral and environmental factors that cause inflammation, like sedentary behavior, obesity, hypertension, and the microbiome. These risk factors contribute to deleterious effects (red arrows) and promote atherosclerosis development. The impact of the microbiome on atherogenesis is an emerging field, and the mechanism of how physical activity regulates the microbiome is not completely understood. Inflammation may also regulate the microbiome (van den Elsen et al., 2017; Chen et al., 2018).