When it comes to knee osteoarthritis, losing weight through diet and exercise may be one of the most effective ways to reduce pain, a new study shows.
Researchers found that people who struggle with being overweight or obese had less knee pain and better function after 18 months when they combined an intensive diet and exercise regimen. Their results were compared to people who either exercised without dieting or strictly changed their diet but didn’t work out. The study was published in the Sept. 25 issue of JAMA.
“Osteoarthritis is the leading cause of chronic disability among older adults,” according to background information in the article. “Knee OA is the most frequent cause of mobility dependency and diminished quality of life, and obesity is a major risk factor for knee OA. Current treatments for knee OA are inadequate; of patients treated pharmacologically, only about half experience a 30 percent pain reduction, usually without improved function.”
Stephen P. Messier, Ph.D., of Wake Forest University and colleagues conducted a study to determine whether a 10 percent or greater reduction in body weight induced by diet, with or without exercise, would reduce joint loading and inflammation and improve clinical outcomes more than exercise alone.
The study included 454 adults who were overweight or obese. All were 55 years or older with a body mass index of 27-41. They also had pain and radiographic knee OA. The three interventions consisted of intensive diet-induced weight loss plus exercise, intensive diet-induced weight loss, or exercise.
Nearly 88 percent of the adults completed the study and returned for their 18-month follow-up. Retention did not differ between groups.
Some of the study’s findings include:
- Average weight loss was greater in the diet and exercise group and the diet group compared with the exercise group;
- When compared with the exercise group, the diet and exercise group had less knee pain, better function, faster walking speed, and better physical health-related quality of life;
- Participants in the diet and exercise and diet groups had greater reductions in Interleukin 6 (a measure of inflammation) levels than those in the exercise group.
- Those in the diet group had greater reductions in knee compressive force than those in the exercise group.
“Osteoarthritis and other obesity-related diseases place an enormous physical and financial burden on the U.S. health care system,” the autors wrote. “The estimated 97 million overweight and obese Americans are at substantially higher risk for many life-threatening and disabling diseases, including OA.
“The findings from [this trial] suggest that intensive weight loss may have both anti-inflammatory and biomechanical benefits; when combining weight loss with exercise, patients can safely achieve a mean long-term weight loss of more than 10 percent, with an associated improvement in symptoms greater than with either intervention alone.”
Source: JAMA news release
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