How to Avoid Aching Knees

Exercise and healthy diet may prevent or decrease knee pain in some patients

(RxWiki News) Knee pain — a sign of arthritis, related to obesity or just the result of getting older? Whatever the reason, diet and exercise might be able to prevent or reduce knee pain in overweight older adults with diabetes.

A new study found that a healthy diet and exercise could reduce the short-term risk of knee pain in overweight type 2 diabetes patients.

The authors of this study knew that weight loss and exercise were often recommended for patients with knee pain but wanted to know whether the same regime could actually prevent knee pain. They found that the regime was effective up to a point.

“We found an intensive intervention program of weight loss and exercise reduced the short-term risk for developing knee pain among overweight adults with type 2 diabetes," the authors of this study wrote. "These findings suggest that diet and exercise may be effective for preventing the development of knee pain. Health care providers should consider recommending diet and exercise to their patients who are overweight or obese as a potentially effective means to prevent the development of knee pain."

Personal trainer and wellness coach Rusty Gregory told dailyRx News that scientists have known for some time that an unhealthy diet, including high sugar consumption, can have an inflammatory effect on the body. "This inflammation can lead to joint pain along with other health issues," said Gregory, who is also the author of "Self-Care Reform: How to Discover Your Own Path to Good Health" and "Living Wheat-Free For Dummies."

Gregory noted that sugar consumption is one of the leading causes of type 2 diabetes and weight gain. "Added weight is never easy on joints," he said. "Exercise, on the other hand, increases blood flow and synovium to joints and improves strength of the muscles that surround the joints, enhancing joint stability.

"Also, intestinal permeability, or leaky gut, as a result of non-steroidal anti-inflammatory drugs (NSAIDS), stress, an inflammatory diet and other issues, can lead to joint inflammation," he said. "Eliminating these factors can go a long way in healing your gut and getting rid of body aches and pains.”

Daniel K. White, PT, ScD, of the Department of Physical Therapy at the University of Delaware in Newark, used data from a past study called the Action for Health in Diabetes (Look AHEAD) study. Look AHEAD began in 2001.

The study patients were obese and had type 2 diabetes. Type 2 diabetes occurs in people who are resistant to insulin, the hormone that regulates blood sugar.

From this group, Dr. White and colleagues studied nearly 3,000 patients who did not report knee pain.

The patients were 45 to 76 years old, and because they were obese, they were at high risk to develop osteoarthritis in the knees. Osteoarthritis results from wear and tear on joints and bones. It can cause pain and stiffness.

The subjects were split into two groups. One group — called the intensive lifestyle intervention (ILI) group — was given a goal to lose at least 7 percent of their body weight and spend at least 175 minutes a week in an intensive exercise program.

Patients in the ILI group received extensive counseling and support, dietary education and one supervised exercise session each week. They could tailor their eating and exercise programs to their own preferences.

The second group was called the diabetes support and education (DSE) group. These patients attended three group sessions in the first year. At the group sessions, they were given general guidelines about healthy eating and exercise. They did not receive specific strategies or individual counseling.

At the end of one year, the ILI patients were 15 percent less likely to develop knee pain than those in the DSE group. After four years, the risk of knee pain dropped to 4 percent for those in the ILI group.

Dr. White and team noted that, although the ILI program did appear to protect patients from knee pain, the benefits disappeared over time. These researchers noted that, by year four, the ILI patients might have been less able to maintain diet and exercise recommendations.

These researchers also noted that they were unable to determine whether diet, exercise or the combination made the difference in the ILI patients. They also noted that their findings applied to patients with type 2 diabetes but might not apply to the general population.

This study was published in the February issue of Arthritis Care and Research.

Although the study itself did not receive outside funding, Drs. White, Tuhina Neogi and David T. Felson were funded through the ACR/RRF Rheumatology Investigator Award, ACR/RRF Bridge Funding Award, Boston Claude D. Pepper Older Americans Independence Center and the Foundation for Physical Therapy.

Conflict of interest disclosures were not available at the time of publication.

Review Date: 
February 20, 2015