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Combined diet and exercise effective against knee osteoarthritis

Pain and function improve more with diet and exercise than with either alone

Louise Prime

Wednesday, 25 September 2013

People with knee osteoarthritis who combined intensive diet-induced weight loss with exercise had greater improvements in pain and function after 18 months than those who used either approach alone, research published today in JAMA has shown.

Researchers in the US recruited 454 overweight and obese people, aged at least 55 years, with pain and radiographic evidence of knee osteoarthritis. They randomly assigned them to one of three interventions: intensive diet designed to induce weight loss of 10%; exercise; or both combined. Both diet and exercise interventions were based centrally, but people in the exercise groups had the option of switching to a home-based programme.

In all, 399 patients completed the study and returned for the 18-month follow up.

People in the groups assigned to diet plus exercise, or to diet alone, lost more weight on average than those in the exercise group. They also had greater improvement in inflammation, measured by interleukin 6 levels.

People in the diet plus exercise group had less knee pain, better function, faster walking speed and better physical health-related quality of life than people in the exercise group. Patients in the diet group had better reductions in knee compressive force than patients in the exercise group.

The study’s authors said: “Osteoarthritis and other obesity-related diseases place an enormous physical and financial burden on the US health care system. 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%, with an associated improvement in symptoms greater than with either intervention alone.”

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