Knee osteoarthritis and diet: Ketogenic meal replacements and exercise lead to reduced pain and weight loss
More than 400 individuals with knee osteoarthritis participated in the Better Knee, Better Me trial, developed by the University of Melbourne in partnership with Medibank and Austin Health.
Published in the Annals of Internal Medicine, the study shows researchers evaluated two six-month telehealth-delivered exercise programs, one with and one without a weight-loss dietary program, compared with an information-only control group.
During the trial, participants in the intervention groups were provided support from physiotherapists and dietitians via Zoom and a suite of resources. Those in the exercise plus diet group also received meal replacements so they could undertake a ketogenic low energy diet.
This included two formulated meal replacements and a low-carbohydrate meal daily.
Compared to the group that only received information, both intervention programmes resulted in benefits for pain, function and quality of life. Compared to the exercise-only program, the combined exercise and diet programme led to additional benefits – including a greater reduction in pain, greater improvements in physical function, lower use of pain medications, and significant weight loss.
After both programmes, participants were also less willing to undergo knee joint replacement surgery.
Significant improvement
Lead researcher and Director of the Centre for Health, Exercise and Sports Medicine at the University of Melbourne Professor Kim Bennell, said participants lost on average 10.2 kilograms over a six-month period with four out of five participants achieving significant improvement in pain. She said 30 per cent of participants lived in regional and rural Australia.
“We are proud to have developed a program that has a strong regional and rural representation and is based on a trial which made a real difference in the lives of participants. Particularly during these times of pandemic-related travel restrictions, it is crucial Australians are able to access home-based treatments to manage their osteoarthritis symptoms, no matter where they live or what COVID restrictions are in place.”
The researchers wrote: “A total of 379 participants (91%) provided 6-month primary outcomes, and 372 (90%) provided 12-month primary outcomes. At 6 months, both programmes were superior to control for pain and function. The diet and exercise program was superior to exercise. Findings were similar at 12 months.
They concluded: “Telehealth-delivered exercise and diet programs improved pain and function in people with knee osteoarthritis and overweight or obesity. A dietary intervention conferred modest additional pain and function benefits over exercise.”
Around 2.1 million Australians are currently living with osteoarthritis. The prevalence of osteoarthritis is expected to increase by 58 per cent by 2032 due to an ageing population and rising obesity rates.
Medibank Head of Member Health Service and Design Catherine Keating said Medibank wants to provide its customers with healthcare that gives them more choice and control in how they receive their care.
“It’s part of our focus on taking the lead on driving preventative health because we know our customers want personalised support to improve their health and wellbeing.”
Source: Annals of Internal Medicine
https://doi.org/10.7326/M21-2388
“Comparing Video-Based, Telehealth-Delivered Exercise and Weight Loss Programs With Online Education on Outcomes of Knee Osteoarthritis”
Authors: Kim L Bennell, et al.
