Exercise, Alone, Didn’t Cut It

Which is better—diet or exercise—in the treatment of knee osteoarthritis? Diet came out better than did either alone for obese patients, according to an 18 month trial conducted by Stephen P. Messier, Ph.D. of Wake Forest University, Winston-Salem, North Carolina. However, joint inflammation, pain, function, and quality of life all significantly favored those who followed the combined approach of diet and exercise.

According to Crystal Phend, Senior Staff Writer, MedPage Today the trial included 454 community-living participants ages 55 and older who had mild or moderate knee osteoarthritis and a body mass index in the 27 to 41 kg/m² range. The analysis included the 399 participants (88%) who stuck out the program to month 18.

The mean weight loss of the participants was 11.4% of body weight in the combined diet and exercise group compared with 9.5% in the diet-alone group and 2% in the exercise-alone group, Phend reported. The goal for all groups was a weight loss of 10% or more. All of the patients had a sedentary lifestyle at the beginning of the trial.

Amanda E. Nelson, M.D., MSCR, a rheumatologist at the University of North Carolina at Chapel Hill, told MedPage Today “This gives us some real guidelines for what kind of change needs to happen to be meaningful. We can tell patients if they’re going to lose 10% of their body weight, they can expect these kinds of benefits and in order to do that the kind of diet restrictions and the kind of exercise regimens that are required.”

Most of the patients in the trial had relatively mild pain at baseline (a mean of 6.5 on a 20-point scale), which left little room for improvement. However the pain was sufficient to lead the researchers to believe it helped the participants adhere to the exercise regimen.