Exercise Only Plan Yields Less Weight Loss in Obese, Overweight OA Adults

Intensive diet-induced weight loss with exercise leads to more weight loss and a greater reduction in interleukin (IL)-6, compared with exercise alone, according to research published September 25th in JAMA.

“[OA], a common cause of chronic pain and disability, has biomechanical and inflammatory origins and is exacerbated by obesity,” explained Stephen P. Messier, PhD, from the Department of Health and Exercise Science, Wake Forest University, Winston-Salem, North Carolina, and colleagues. “To determine where a ≥10% reduction in body weight induced by diet, with out without exercise, would improve mechanistic and clinical outcomes more than exercise alone.”

As part of an 18-month single blind, randomized clinical trial, the investigators included 399 overweight and obese adults with OA and evaluated knee joint compressive force and plasma IL-6 levels. Other outcomes of interest included self-reported pain, function, mobility, and health-related quality of life. The participants were included in one of three groups: intensive diet-induced weight loss plus exercise, intensive diet-induced weight loss, or exercise alone.

Overall, patients in the diet with exercise group had a mean weight loss of 10.6kg, patients in the diet weight loss group lost 8.9kg, and patients in the exercise group, 1.8kg. In addition, the authors observed that after 18 months, knee compressive forces were lower in patients in the diet weight loss group, compared with the exercise alone group. IL-6 was lower among patient in the diet with exercise group and diet weight loss group, compared with patients in the exercise only group.

“Among overweight and obese adults with knee OA, after 18 months, participants in the diet + exercise and diet groups had more weight loss and greater reductions in IL-6 levels than those in the exercise group,” Messier and colleagues concluded. “Those in the diet group had greater reductions in knee compressive force than those in the exercise group.”

Reference

Messier SP, Mihalko SL, Legault C, Miller GD, Nicklas BJ, DeVita P, Beavers DP, Hunter DJ, Lyles MF, Eckstein F, Williamson JD, Carr JJ, Guermazi A, Loeser RF. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA. 2013;310(12):1263-1273.