A combination of diet and exercise is more effective than medication is in reducing pain in overweight patients who suffer from knee osteoarthritis, according to new research published in JAMA.
Nearly 40 percent of the patients enrolled in an intensive weight loss and exercise program had little or no knee pain after 18 months. They also had better mobility, joint function and quality of life.
About a third of adults over the age of 65 suffer from osteoarthritis, a progressive disorder of the joints caused by inflammation of the soft tissue, which worsens over time and leads to thinning of cartilage.
“Osteoarthritis (OA) is the leading cause of chronic disability among older adults. 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,” wrote Stephen Messier, PhD, of Wake Forest University.
“Current treatments for knee OA are inadequate; of patients treated pharmacologically, only about half experience a 30 percent pain reduction, usually without improved function.”
Messier and his colleagues enrolled 454 overweight or obese osteoarthritis patients in an Intensive Diet and Exercise for Arthritis program (IDEA). Participants were assigned to one of three groups; exercise-alone, diet-alone, or a combination of diet and exercise.
The diet was designed to help the patients lose at least 10 percent of their body weight. Initially up to two meals per day were replaced with a high protein shake. The third meal was low in calories, low in fat, and high in vegetables. Adjustments to the diet were made as patients lost weight.
Patients who exercised did so for one hour, three times a week. The program consisted of walking, aerobic exercise, and strength training.
After 18 months, patients who dieted and exercised had lost an average of 23 pounds. About 38 percent reported little or no pain in their knees, compared to 20% of the diet group and 22% of the exercise group. They also walked faster, had more mobility and had fewer inflammatory markers in their blood compared to the patients who dieted or exercised alone.
“The findings from the IDEA trial data 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,” said Messier.
Osteoarthritis is the most common form of arthritis, affecting over 27 million people in the United States.
About 97 million Americans are overweight or obese, making them at higher risk for osteoarthritis.