Dane baker Nutrition

THE BURDEN

Knee Osteoarthritis [OA] is the most common and persistent cause of mobility dependency and disability; its prevalence is estimated at over 250 million, or 3.6% of the world’s population [1,2]. Its prevalence is also rapidly growing and has doubled since the mid-20th century [3].

OBESITY / OVERWEIGHT

Being overweight or obese increases the risk of knee OA onset [4] and can significantly increase pain for those with OA. During gait, body weight is transferred to the knee with substantial leverage such that with each additional 1 kg of body mass increases the compressive load over the knee by roughly 4 kg [5].

Obesity is the most modifiable risk factor for knee OA and weight loss is a safe, effective non-pharmacologic intervention to improve clinical outcomes [6, 7].Clinical guidelines strongly encourage the use of non-pharmacologic exercise and diet to relieve pain and improve function [8, 9]. However, unfortunately, only 25% of the patients requiring advice concerning these treatments (BMI ≥ 27 kg/m2 with diagnosed knee OA) receive the necessary care [10].

Multiple studies have now demonstrated  an improvement in clinical performance through weight loss. [11,12]. Weight loss of >10% in combination with exercise has been shown to successfully reduce pain after 18 months [13] with a 51% decrease in pain from baseline as well improvements in clinical measures such as physical function and walking speed.

Weight loss has also shown significant improvements in structural outcomes in OA. Serebrakian et al [14] demonstrated that T2 relaxation times progress less in subjects with >10% weight loss of their baseline BMI over four years. Teichtahl [15] and colleagues found that percentage weight change was significantly associated with change in medial tibial cartilage volume. Recently it has been demonstrated that weight change was significantly associated with change in cartilage composition in the medial tibia and in WOMAC subscales for pain and disability in obese and overweight individuals [16].

 

Nutrition Services Summary

• Dane Baker Nutrition aims to provide individualised education and information to promote weight loss in a safe and evidenced based manner to assist in the management of Osteoarthritis.

• The best practise program is tailored around an intensive 12 week block with the overall aim of assisting patients to achieve between 5-10% body mass loss to aid in improvements of pain and symptoms.