Arthritis knee pain and function of the knee in overweight or obese adults with osteoarthritis of knee have a better outcome in persons who loose weight by combination of exercise and diet than with diet or exercise alone.
This has been brought out by research called Intensive Diet and Exercise for Arthritis (IDEA) and the study has been published in JAMA, on Sep 25.
The study found that the patients who had diet plus exercise had less inflammation, less arthritis knee pain, better function, improved health-related quality of life, and better mobility.
The diet-only group had greater reductions in knee joint loads.
The study was Single-blind, 18-month, randomized clinical trial at Wake Forest University between July 2006 and April 2011. It included 454 participants who were overweight/obese, older than 55 years with arthritis knee pain and radiographic knee osteoarthritis.
The participants were divided in three groups
- Intensive diet-induced weight loss plus exercise
- intensive diet-induced weight loss
- Exercise only
Main outcomes measures were knee joint compressive force and plasma IL-6 levels and secondary clinical outcomes were self-reported pain (range, 0-20), function (range, 0-68), mobility, and health-related quality of life (range, 0-100).
Eighty-eight percent of participants completed the 18-month follow-up.
The diet intervention was based on replacing up to 2 meals per day with nutritional shakes, plus a 500- to 750-kcal third meal that was low in fat and high in vegetables. The meal replacements were used for the first 6 months, and participants gradually replaced them with low-calorie meals for the remaining 12 months. The diet plan was designed to produce a daily energy-intake deficit of 800 to 1000 kcal/day.
The exercise intervention combined aerobic walking and strength training for 1 hour a day, 3 days a week.
Average weight loss was greater in the diet and exercise group and the diet group compared with the exercise group (?1.8 kg; 95% CI, ?5.7 to 1.8 kg at the 18-month follow-up.
Compared with the exercise group, the diet and exercise group had significantly 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 also had greater reductions in interleukin 6 levels than those in the exercise group.
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