Changes in Body Weight and Knee Pain in Adults With Knee Osteoarthritis <scp>Three‐and‐a‐Half</scp> Years After Completing Diet and Exercise Interventions: Follow‐Up Study for a <scp>Single‐Blind</scp>, <scp>Single‐Center</scp>, Randomized Controlled Trial
Stephen P. Messier, Jovita J. Newman, Matthew J. Scarlett, Shannon L. Mihalko, Gary D. Miller, Barbara J. Nicklas, Paul DeVita, David J. Hunter, Mary F. Lyles, F. Eckstein, Ali Guermazi, Richard F. Loeser, Daniel P. Beavers
Abstract
Objective To determine whether long‐term diet (D) and exercise (E) interventions, alone or in combination (D+E), have beneficial effects for older adults with knee osteoarthritis (OA) 3.5 years after the interventions end. Methods This is a secondary analysis of a subset (n = 94) of the first 184 participants who had successfully completed the Intensive Diet and Exercise in Arthritis (IDEA) trial (n = 399) and who consented to follow‐up testing. Participants were older (age ≥55 years), overweight, and obese adults with radiographic and symptomatic knee OA in at least 1 knee who completed 1.5‐year D+E (n = 27), D (n = 35), or E (n = 32) interventions and returned for 5‐year follow‐up testing an average of 3.5 years later. Results During the 3.5‐years following the interventions, weight regain in D+E and D was 5.9 kg (7%) and 3.1 kg (4%), respectively, with a 1‐kg (1%) weight loss in E. Compared to baseline, weight (D+E –3.7 kg [ P = 0.0007], D –5.8 kg [ P < 0.0001], E –2.9 kg [ P = 0.003]) and Western Ontario and McMaster Universities Osteoarthritis Index pain subscale scores (D+E –1.2 [ P = 0.03], D –1.5 [ P = 0.001], E –1.6 [ P = 0.0008]) were lower in each group at the 5‐year follow‐up. The effect of group assignment at the 5‐year follow‐up was significant for body weight, with D being less than E (–3.5 kg; P = 0.04). Conclusion Older adults with knee OA who completed 1.5‐year D or D+E interventions experienced partial weight regain 3.5 years later; yet, relative to baseline, they preserved statistically significant changes in weight loss and reductions in knee pain.