Abstract
BackgroundThe purpose of this study was to determine whether sedentary obese women with knee OA initiating an exercise and weight loss program may experience more beneficial changes in body composition, functional capacity, and/or markers of health following a higher protein diet compared to a higher carbohydrate diet with or without GCM supplementation.MethodsThirty sedentary women (54 ± 9 yrs, 163 ± 6 cm, 88.6 ± 13 kg, 46.1 ± 3% fat, 33.3 ± 5 kg/m2) with clinically diagnosed knee OA participated in a 14-week exercise and weight loss program. Participants followed an isoenergenic low fat higher carbohydrate (HC) or higher protein (HP) diet while participating in a supervised 30-minute circuit resistance-training program three times per week for 14-weeks. In a randomized and double blind manner, participants ingested supplements containing 1,500 mg/d of glucosamine (as d-glucosamine HCL), 1,200 mg/d of chondroitin sulfate (from chondroitin sulfate sodium), and 900 mg/d of methylsulfonylmethane or a placebo. At 0, 10, and 14-weeks, participants completed a battery of assessments. Data were analyzed by MANOVA with repeated measures.ResultsParticipants in both groups experienced significant reductions in body mass (-2.4 ± 3%), fat mass (-6.0 ± 6%), and body fat (-3.5 ± 4%) with no significant changes in fat free mass or resting energy expenditure. Perception of knee pain (-49 ± 39%) and knee stiffness (-42 ± 37%) was decreased while maximal strength (12%), muscular endurance (20%), balance indices (7% to 20%), lipid levels (-8% to -12%), homeostasis model assessment for estimating insulin resistance (-17%), leptin (-30%), and measures of physical functioning (59%), vitality (120%), and social function (66%) were improved in both groups with no differences among groups. Functional aerobic capacity was increased to a greater degree for those in the HP and GCM groups while there were some trends suggesting that supplementation affected perceptions of knee pain (p < 0.08).ConclusionsCircuit style resistance-training and weight loss improved functional capacity in women with knee OA. The type of diet and dietary supplementation of GCM provided marginal additive benefits.Trial RegistrationClinicalTrials.gov: NCT01271218
Highlights
The purpose of this study was to determine whether sedentary obese women with knee OA initiating an exercise and weight loss program may experience more beneficial changes in body composition, functional capacity, and/or markers of health following a higher protein diet compared to a higher carbohydrate diet with or without GCM supplementation
The purpose of this study was 1) to determine whether sedentary obese women with knee OA initiating an exercise and weight loss program will experience more favorable changes in body composition, functional status, and/ or markers of health when following a higher protein diet compared to a higher carbohydrate-based diet; 2) to determine whether dietary supplementation of glucosamine, chondroitin, and MSM during a weight loss and exercise program lessens symptoms of pain, improves functional capacity, and/or promotes greater health benefits in women with knee OA; and, 3) to determine whether there are any additive benefits of combining these strategies
Participants with physician diagnosed OA participated in the Curves® (Curves International, Waco, TX) fitness and weight management program for 14-weeks [30]. This program was selected because it offers higher carbohydrate and higher protein diets; incorporates circuit-style resistance training as the primary exercise modality; it has been found to be effective in promoting weight loss and improving markers of health and fitness in sedentary obese women [20,21,22,23]; it offers a joint support supplement containing GCM to its members; and, the program is widely available
Summary
The purpose of this study was to determine whether sedentary obese women with knee OA initiating an exercise and weight loss program may experience more beneficial changes in body composition, functional capacity, and/or markers of health following a higher protein diet compared to a higher carbohydrate diet with or without GCM supplementation. Research from the Framingham Knee Osteoarthritis Study indicated that overweight men and women have a higher risk for developing OA than those who are not overweight [6]. These researchers reported that weight loss helped decrease pain associated with OA [7]. Interventions that strengthen the muscles and reduce body fat have been suggested to reduce pain and enhance functional capacity in individuals with OA [10,12,13]
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