(Press-News.org) Among overweight and obese adults with knee osteoarthritis, combining intensive diet and exercise led to less knee pain and better function after 18 months than diet-alone and exercise-alone, according to a study in the September 25 issue of JAMA.
"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. Current treatments for knee OA are inadequate; of patients treated pharmacologically, only about half experience a 30 percent pain reduction, usually without improved function," according to background information in the article.
Stephen P. Messier, Ph.D., of Wake Forest University, Winston-Salem, N.C., 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 randomized trial was conducted between July 2006 and April 2011. The diet and exercise interventions were center-based with options for the exercise groups to transition to a home-based program. The study included 454 overweight and obese older community-dwelling adults (age 55 years or older with a body mass index of 27-41) with pain and radiographic knee OA. The interventions consisted of intensive diet-induced weight loss plus exercise, intensive diet-induced weight loss, or exercise.
Of the participants, 399 (88 percent) completed the study (returned for 18-month follow-up). Retention did not differ between groups. Among the findings of the study:
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 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," the authors write.
###
(doi:10.l001/jama.2013.277669; Available pre-embargo to the media at http://media.jamanetwork.com)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Diet and exercise for knee osteoarthritis produces greater improvement in knee pain, function
2013-09-25
ELSE PRESS RELEASES FROM THIS DATE:
Study findings question frequency of bone mineral density testing for predicting fracture risk
2013-09-25
A second bone mineral density (BMD) screening four years after a baseline measurement provided little additional value when assessing risk for hip or other major osteoporotic fracture among older men and women untreated for osteoporosis, and resulted in little change in risk classification used in clinical management, findings that question the common clinical practice of repeating a BMD test every 2 years, according to a study in the September 25 issue of JAMA.
Bone mineral density testing is important in the management of osteoporosis. Guidelines for initiating pharmacologic ...
Sensor-augmented insulin pump therapy reduces rate of severe hypoglycemic events
2013-09-25
Use of an insulin pump with a sensor that suspends insulin delivery when blood glucose falls below a set threshold reduced the rate of severe and moderate hypoglycemia among patients with type 1 diabetes and impaired awareness of hypoglycemia, according to a study in the September 25 issue of JAMA.
Hypoglycemia is a critical obstacle to the care of patients with type 1 diabetes. Sensor-augmented pump therapy with an automated insulin suspension or low glucose suspension function is a technology has the potential to reduce the duration and frequency of significant hypoglycemia, ...
Decision-making tool may help rule out brain hemorrhage for patients in emergency department
2013-09-25
Researchers have developed a simple clinical decision rule that may help doctors identify patients with headache in the emergency department who have subarachnoid hemorrhage (bleeding in a certain area of the brain), according to a study in the September 25 issue of JAMA.
"Headache accounts for approximately 2 percent of all emergency department visits, and subarachnoid hemorrhage is one of the most serious diagnoses, accounting for only 1 percent to 3 percent of these headaches. Although the decision to evaluate patients with new neurologic deficits is relatively straightforward, ...
Prevalence of poorer kidney function increases among adults 80 years of age and older
2013-09-25
Recent studies have shown that older adults with chronic kidney disease (CKD; defined as an estimated glomerular filtration rate [GFR; a measure of kidney function] of less than 60 mL/min/1.73 m2) have a high prevalence of concurrent complications and increased risk for adverse outcomes including mortality, cardiovascular disease, and kidney failure. A prior study demonstrated an increase in CKD prevalence between 1988-1994 and 1999-2004 for the general U.S. population. However, trends in CKD prevalence have not been reported for the oldest old [defined as 80 years of age ...
Acupuncture & care may help depression; Pneumococcal infection vaccine; A disruptive medical journal
2013-09-25
Everything published by PLOS Medicine is open access: freely available for anyone to read, download, redistribute and otherwise use, as long as the authorship is properly attributed.
Please mention PLOS Medicine in your report and use the links below to take your readers straight to the online articles:
Acupuncture or counselling plus usual care may improve depression symptoms
Vaccine against pneumococcal infections has led to widespread reduction in serious disease
The importance of a medical journal being disruptive
Improved strategies are needed to assess ...
Vitamin D alone does little to protect bone health in postmenopausal women
2013-09-25
Chevy Chase, MD—While calcium supplements noticeably improved bone health in postmenopausal women, vitamin D supplements did not reduce bone turnover, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
Bone turnover is the body's natural process for breaking down old bone. In young people, the body forms enough new bone to replace what is lost. After age 30, however, bone mass in women begins to decline and the process speeds up after menopause. Osteoporosis develops when the body cannot ...
Low testosterone may be linked to heart problems
2013-09-25
Chevy Chase, MD—Men who have low testosterone levels may have a slightly elevated risk of developing or dying from heart disease, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
Testosterone is a key male sex hormone that helps maintain sex drive, sperm production and bone health. Over time, low testosterone may contribute to an increase in body fat, loss of body hair and muscle bulk.
"When we reviewed the existing research into testosterone and cardiovascular disease, a growing ...
Study findings may explain delayed onset of heart disease in women
2013-09-25
Chevy Chase, MD—A biological ability to compensate for the body's reduced response to insulin may explain why women typically develop heart disease 10 years later than men, according to a recent study accepted for publication in The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
Insulin is a hormone that takes glucose from the bloodstream and carries it into cells, where it is used for energy. When the body doesn't use insulin properly, a condition known as insulin resistance, it raises the risk a person will develop diabetes and cardiovascular ...
NYU Steinhardt researcher pinpoints biological risk factor in obesity-related cancers
2013-09-25
It is estimated that over a third of the new cancer cases expected to occur in the U.S. in 2013 will be related to overweight or obesity, physical inactivity, and poor nutrition. Thanks to the work of one NYU Steinhardt researcher, we may better understand why.
Nutritional epidemiologist Niyati Parekh's latest research study, which appears in the journal Cancer Epidemiology, Biomarkers, and Prevention, concludes that disturbances in body insulin and glucose levels, specifically exposures to longer periods, are associated with an increased risk of obesity-related cancers ...
Link between antidepressants and diabetes risk is real
2013-09-25
Clinicians should be extra vigilant when prescribing antidepressants as they could pose a risk of type 2 diabetes, researchers at the University of Southampton have warned.
A systematic review, carried out by the University, showed that people taking antidepressants are at a higher risk of type 2 diabetes; however it is not certain whether the medication is responsible.
The use of antidepressant medication has risen sharply over recent years reaching 46.7 million prescriptions issued in the UK in 2011.
A number of studies have been carried out to establish whether ...