New research set to turn treatment of osteoarthritis on its head, lives could be “transformed”, say researchers.
A solution for England’s heart age problem: Danish study shows 10% weight loss can take 5 years off heart age and ease the pain of osteoarthritis.
Overweight elderly sufferers of osteoarthritis could have their lives “transformed” a leading scientist will today claim at a national conference on obesity.
Speaking at the UK conference on obesity in Newcastle, England on Thursday 6th September, Professor Henning Bliddal, director of the Parker arthritis Institute at Frederiksberg Hospital, Copenhagen will describe how his research team had shown weight loss with TDR (total diet replacement formula diet) and weight maintenance for four years improved symptoms in obese people with osteoarthritis and reduced their heart age by 5 years.
‘Elderly obese people with osteoarthritis have a very high risk of heart attack and stroke’ he said. ‘Our series of published clinical trials shows that an initial 12 to 13% weight loss over 16 weeks with total diet replacement reduces the pain of arthritis and that reduction of pain can be maintained over four years by careful weight maintenance’.
‘This amount of change in so short a time transformed their lives,’ said Professor Anthony Leeds, a bariatric physician at the Central Middlesex Hospital, London and a visiting senior research fellow at the Parker Institute. ‘Although weight loss is a core component in management of KOA, as recommended by the UK’s National Institute of Health and Care Excellence, in practice it is almost impossible to achieve by conventional diet in this type of patient. However, the team at the Parker has shown that a big weight loss with reduction of pain and blood pressure is possible’, he said.
Following the initial weight loss and one-year maintenance phase the Parker research team published the results of a three-year weight maintenance trial using the same participants, in effect showing that a 10% weight loss can be achieved and maintained for four years, with no significant deterioration of symptoms, and with maintained lower blood pressure. Professor Henning Bliddal said ‘These remarkable results should turn osteoarthritis treatment upside down. ‘We should now start with weight loss if the patient with knee osteoarthritis is heavy. ‘We know that most patients can do the programme with well over half getting good results after a total of four years. ‘Pain of osteoarthritis is due to a number of factors including inflammation and a sufficiently restricted diet will reduce the inflammation and hence reduce pain. ‘Pain causes misery for millions of OA patients across the globe, and this diet reduces pain, and the reduction of weight makes moving easier.’
Using the UK’s QRisk2 algorithm Professor Bliddal will present preliminary data showing that heart age before weight loss was on average 6 years greater than chronological age, while four years later heart age had been reduced by 5 years, in the two/thirds of participants who stayed in the programme. The maintenance of reduced blood pressure and reduced weight were probably the important factors contributing to this effect. Use of medications for blood pressure was also slightly reduced reflecting similar findings in other recent weight loss trials.
Prof Bliddal will refer to Public Health England’s announcement on Tuesday expressing concern about excessive heart age in the English population and remind his audience that obesity is linked to a vast portfolio of co-morbidities, the most significant of which are diabetes, vascular disease and osteoarthritis, adding ‘With ageing and heavier populations both Denmark and England are seeing increasing numbers of people with osteoarthritis and diabetes and the healthcare costs are rising rapidly. Achieving weight reduction in those who are overweight and obese is recognised as a ‘core’ feature of osteoarthritis management in European and UK guidelines’.