Wake Forest study: Treating knee osteoarthritis with intense weight loss and exercise
October 2, 2006
In 2004, researchers at Wake Forest University determined that modest weight loss through diet and exercise improves physical function and decreases pain in older, overweight adults suffering from knee osteoarthritis (OA).
Now, backed by more than $3 million from the National Institutes of Health (NIH), Wake Forest researchers will take their findings a step further through IDEA (Intensive Diet and Exercise for Arthritis), the first study to determine whether intensive weight loss, either alone or combined with exercise, can slow the progression of knee OA.
Beginning Oct. 2, the study is recruiting participants in the Piedmont Triad who are overweight, 60 years of age or older and have pain in one or both knees. Participation is free and limited transportation is available. Anyone interested in participating in the study should call the toll-free recruitment telephone line at 1-877-238-4825 (1-877-BE-VITAL).
The study is a collaboration of Wake Forest’s health and exercise science department on the university’s Reynolda Campus and the Wake Forest School of Medicine on the university’s Bowman Gray Campus. Stephen Messier, a professor of health and exercise science on the Reynolda Campus, is the study’s lead researcher.
“Being overweight is the most modifiable risk factor for knee OA,” Messier said. “Although participants in our earlier studies experienced some improvement, they remained overweight and so, their risk of disease progression stayed the same,” said Messier. “We hypothesize that a more intensive weight loss, a weight loss two to three times greater than that achieved in our prior study, administered either alone or combined with exercise, could reduce inflammation and joint loads to the point of potentially slowing disease progression.”
During the five-year IDEA study, 450 patients will randomly be divided into three groups: intensive dietary restriction and exercise; exercise only; and intensive dietary restriction only. Each group will engage in their prescribed behaviors for 18 months. Messier and his colleagues will then compare the three groups to see which benefited the most in terms of inflammation and joint-load reduction, pain, function, mobility and disease progression. They will also determine whether knee strength affects knee alignment, thereby affecting progression of knee OA.
Messier said he and his colleagues hope IDEA will change the way knee OA is treated.
“This study could make intensive weight loss the standard-of-care for overweight adults with the knee osteoarthritis,” said Messier.
Messier was also the lead researcher for the 2004 study, ADAPT (Arthritis, Diet and Activity Promotion Trial), as well as a 2005 study that determined each pound lost nets a 4-pound reduction in pressure placed on the knees. Both studies were published in the journal Arthritis & Rheumatism and ADAPT was named by the Arthritis Foundation as one of the top 10 arthritis advances in 2004.
Karen Richardson, Wake Forest University School of Medicine