New research finds that an intensive exercise and healthy eating regime can reduce the knee pain caused by osteoarthritis in overweight adults with type 2 diabetes.
Osteoarthritis is a common complication for overweight people with type 2 diabetes. The added weight places extra strain on the joints. Osteoarthritis can also develop as a result of natural wear-and-tear, so it tends to affect older people more often. Being overweight and over the age of 50 are also conditions that increase the likelihood of type 2 diabetes.
The researchers hypothesised that the right diet and the right exercise regime could prevent knee pain caused by osteoarthritis
“Prior to this study, we did not have empirical data to support the claim that diet and exercise actually worked to prevent knee pain,” said study leader Daniel White, Assistant Professor of Physical Therapy at the University of Delaware.
“Now we do have a study.”
How was the study conducted?
The researchers compared two groups: the first received intensive lifestyle intervention (ILI); the second received standard diabetes mellitus support and education (DSE). After one-year and four-year periods, the participants were questioned about any knee pain they experienced.
“The analysis involved a subcohort of 2,889 subjects who reported no knee pain at baseline, but were at high risk due to obesity.”
The intensive lifestyle intervention mainly involved restricting calories. Moreover, at least 10 per cent of the participants’ calories had to come from protein. Exercise intervention was based on gradual progression of home-based exercise, culminating in 175 minutes of vigorous exercise a week. In most cases, the particularly activities included brisk walking.
White explained that the research only focused on people with type 2 diabetes who were overweight, because the excess weight increased the strain on their joints. People with type 2 diabetes triggered by other causes, such as polycystic ovary syndrome and genetics, do not have a heightened risk of osteoarthritis.
“We did not study people in the general population, but only adults who were diabetic and overweight,” said White.
The results
White found the results reassuring. People who received the intense lifestyle intervention were 15 per cent less likely to report knee pain than those who received the standard diabetes mellitus support and education.
“Among these we studied who were randomised to the diet and exercise interventio, it was found that they were 15 per cent less likely to develop knee pain compared with their counterparts randomised to the control condition.
“These findings are very important. They demonstrate that the recommendations to exercise and diet to make a difference for preventing the development of knee pain among those who are at high risk.”
Knee pain is responsible for more disability among people of middle or older age than any other condition. These findings could lead to more effective methods of knee pain prevention.
“I study physical activity among people with knee arthritis,” White said. “I felt it was important to investigate whether exercise combined with diet did in fact protect against the development of knee pain.”
The findings were published in Arthritis Care and Research.

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