Diet and exercise intervention better for pain in knee osteoarthritis

For overweight or obese patients with knee osteoarthritis, diet and exercise result in a small but statistically significant difference in knee pain over 18 months compared with an attention control, according to a study published in the Dec. 13 issue of the Journal of the American Medical Association.

Stephen P. Messier, Ph.D., from Wake Forest University in Winston-Salem, North Carolina, and colleagues conducted a randomized clinical trial among patients aged 50 years or older with knee osteoarthritis and overweight or obesity. A total of 823 patients were enrolled and randomly assigned to a diet and exercise intervention or an attention control group (414 and 409 participants, respectively) for 18 months.

The researchers found the adjusted mean Western Ontario and McMaster Universities Osteoarthritis Index pain score was 5.0 and 5.5 in the diet and exercise and attention control groups, respectively at 18-month follow-up (adjusted difference, −0.6). Five of seven secondary outcomes were significantly better in the intervention group versus the control group. The mean change in unadjusted 18-month body weight was −7.7 and −1.7 kg (8 and 2 percent) in the diet and exercise and attention control groups, respectively. Overall, there were 169 serious adverse events, none of which were definitely related to the study.

"The 7.7-kg (8 percent) weight loss combined with a 9-cm reduction in waist circumference in the diet and exercise group has the potential for health benefits for older adults with knee osteoarthritis," the authors write.

One author disclosed financial ties to the biopharmaceutical industry.

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