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Cited by 1,065Osteoarthritis Treatment and MechanismsMusculoskeletal pain and rehabilitationPhysical Activity and Health

Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: The arthritis, diet, and activity promotion trial

Messier, Stephen P., Loeser, Richard F., Miller, Gary D., Morgan, Timothy M., Rejeski, W. Jack, Sevick, Mary Ann, Ettinger, Walter H., Pahor, Marco +1 more·2004·Arthritis & Rheumatism
DOI 10.1002/art.20256
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Abstract

Objective The Arthritis, Diet, and Activity Promotion Trial (ADAPT) was a randomized, single-blind clinical trial lasting 18 months that was designed to determine whether long-term exercise and dietary weight loss are more effective, either separately or in combination, than usual care in improving physical function, pain, and mobility in older overweight and obese adults with knee osteoarthritis (OA). Methods Three hundred sixteen community-dwelling overweight and obese adults ages 60 years and older, with a body mass index of > or =28 kg/m(2), knee pain, radiographic evidence of knee OA, and self-reported physical disability, were randomized into healthy lifestyle (control), diet only, exercise only, and diet plus exercise groups. The primary outcome was self-reported physical function as measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included weight loss, 6-minute walk distance, stair-climb time, WOMAC pain and stiffness scores, and joint space width. Results Of the 316 randomized participants, 252 (80%) completed the study. Adherence was as follows: for healthy lifestyle, 73%; for diet only, 72%; for exercise only, 60%; and for diet plus exercise, 64%. In the diet plus exercise group, significant improvements in self-reported physical function (P Conclusion The combination of modest weight loss plus moderate exercise provides better overall improvements in self-reported measures of function and pain and in perf…

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Crossref · 10.1002/art.20256

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  • Twelve RCTs compared the effects of a dietary weight loss intervention alone to a combination of the same dietary intervention with an exercise intervention in older persons.

    “Twelve RCTs were identified that compared the effects of a dietary weight loss intervention alone to a combination of the same dietary intervention with an exercise intervention in older persons (288)(289)(290)(291)(292)(293)(294)(295)(296)(297)(298)(299).”

    From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [288]

  • For several physical and strength-performance measures, greater improvements were observed in the combined groups than in the diet-only groups.

    “Moreover, for several physical and strengthperformance measures, greater improvements were observed in the combined groups than in the diet-only groups (288-291, 293-297, 299).”

    From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [288]

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Authors
Messier, S. P., Loeser, R. F., Miller, G. D., Morgan, T. M., Rejeski, W. J., Sevick, M. A., Ettinger, W. H., Pahor, M., & Williamson, J. D.
Affiliations
Wake Forest University (US)
ORCID
Venue
Arthritis & Rheumatism
Publisher
Wiley
Published
2004-05
Volume
50
Issue
5
Pages
1501-1510
ISSN
  • 0004-3591 (ISSN-L)
  • 1529-0131
DOI
10.1002/art.20256
OpenAlex
W2078769393
Cited by
1,065
References
1
Citations by year
2026: 20 · 2025: 32 · 2024: 28 · 2023: 35 · 2022: 37 · 2021: 48 · 2020: 44 · 2019: 45 · 2018: 46 · 2017: 57 · 2016: 54 · 2015: 64 · 2014: 71 · 2013: 73 · 2012: 75
FWCI
22.18
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor, 5 d)
Locations
  • Arthritis & Rheumatism (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • National Institute on Aging (5P60 AG10484-07, P60AG010484)
  • National Center for Research Resources (M01RR-00211, M01RR000211)
Topics
  • Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Physiology › Physical Activity and Health
Keywords
knee osteoarthritis, overweight, obesity, older adults, physical activity, dietary weight loss, combined diet and exercise intervention, physical function, knee pain, mobility (physical function), 6-minute walk distance, joint space width
MeSH terms
Aged, Diet, Reducing, Disability Evaluation, Female, Humans, Life Style, Male, Obesity, Patient Compliance, Radiography, Weight Loss, Exercise, Treatment Outcome, Osteoarthritis, Knee

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