Background Osteoarthritis (OA) is one of the leading causes of pain and disability among older adults, particularly women. Pain and mobility disability are major consequences of knee OA which and can interfere with the functional autonomy of elderly and thus, making it difficult to perform activities of daily living. Evidence suggests that obesity is strongly linked to knee OA and that non-pharmacological therapy should be based on physical activity and weight loss in case of overweight and obesity. A positive relationship between adherence to the Mediterranean diet and health outcomes has been widely discussed in scientific literature, including its potential benefits in weight loss.
Objectives To determine whether a Mediterranean diet-based weight loss intervention is effective in promoting weight loss, improving physical function and reducing pain in older overweight older women with knee OA.
Methods Twelve community-dwelling physically active (enrolled in senior exercise classes 2x/week) overweight (BMI>27) older women (aged ≥60), with clinical symptoms of knee OA, participated in a dietary weight loss programme during 12 months. The weight loss programme was conducted by a trained dietitian and aimed to promote healthy eating (adherence to the Mediterranean diet) and weight loss using behavioural strategies (goal setting, problem solving, self-monitoring). It included individual sessions (individualised diet plan), group sessions (food education and problem solving) and workshops in healthy cooking. The following data was collected at baseline and after 12 months of dietary intervention: weight, body circumferences (waist and hip), adherence to the Mediterranean diet (MEDAS - Mediterranean Diet Adherence Screener), knee pain (only question “How often do you experience knee pain?”) and physical functional parameters (30s Chair Stand Test, Stair Climb Test, Timed up & Go Test and 6 Minute Walk Test).
Results Mean (SD) baseline descriptive characteristics included: age, 69 (6.3) years and BMI, 32.9 (5.5) kg/m2. After 12 months, a higher adherence (p=0.012) to the Mediterranean diet was observed. Mean weight loss was 5,5kg (6.7%; p=0.003). A significant reduction in waist (11.4 cm; p=0,003) and hip (2.4cm; p=0,033) circumferences was observed. Knee pain was significantly (p=0,010) less and physical function was significantly better (p=0.005) in the 6 Minute Walk Test. No significant difference was observed in the following physical function parameters: Timed up & Go, 30s Chair Stand Test and Stair Climb Test.
Conclusions The results of the present pilot study showed significant improvements in knee pain, physical function (6 Minute Walk Test) together with significant reduction in weight loss and waist and hips circumferences. These findings suggest that a Mediterranean diet-based weight loss intervention may be an important non-pharmacological strategy in improving health outcomes in overweight older adults with knee osteoarthritis.
Disclosure of Interest None declared
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