Every 1 pound of weight lost translates to nearly 4 pounds of stress relief on the knee.
Shannon Mihalko, Ph.D., professor of Health and Exercise Science at Wake Forest University
According to Shannon Mihalko, Ph.D., professor of Health and Exercise Science at Wake Forest University, knee osteoarthritis (OA) ranks as the third most common diagnosis for hospital inpatient stays. It’s also the leading cause of disability among adults, affecting women at nearly twice the rate as men. Plus, interventions designed to slow or stop knee OA progression have failed.
“The knee is the most commonly affected weight-bearing joint,” Mihalko said. “Once people have mobility problems from OA, that’s when they start to see a big decline in independent functioning — it limits the ability to get around the home and engage in the simple activities of daily living such as getting up from the chair, climbing stairs and just living and aging in their homes independently.”
Mihalko and her research team are interested in finding out how, by following a diet and exercise regimen, individuals could potentially prevent or help stave off the onset of OA.
“We’ve known through a number of studies we’ve conducted over the last 30 years that if we can help individuals lose 10% of their weight — and maintain that weight loss — that it will make a difference in the pain they experience,” Mihalko said. “Weight loss and diet do help with overall quality-of-life benefits. And very positive changes like these can slow the progression of OA, making it a possible preventive therapy for at-risk individuals.
“Right now, there is no cure for OA, and knee replacement surgery is expensive, does not last forever, and has health risks as any surgery does,” she said. “So we started talking about next steps. What if we could prevent OA or at least push it down the stream, so to speak, as far as possible?”
To that end, Mihalko is serving as the Wake Forest site principal investigator for a five-year clinical trial to establish the efficacy of diet and exercise and weight-loss management on women with little or no knee pain. Participants will be randomly divided into two healthy lifestyle groups, a diet and exercise group or a healthy living group. Those in the diet and exercise group will have a goal of losing 10% of their body weight. Through individual and group meetings, participants will learn diet education and behavioral strategies that can be incorporated into their daily lives. The healthy living group focuses on teaching participants how to make healthy lifestyle choices. Participants will attend quarterly face-to-face sessions that will cover various health topics on nutrition, health and wellness, and chronic diseases. Participants in this group will also receive quarterly newsletters and text messages.
Individuals interested in learning more about the study can contact tops@wfu.edu or call 336.713.8539, option 6. Study participants must be 50 years or older. Candidates who pass the initial screening will then undergo an X-ray and MRI to ensure they are not exhibiting signs of disease. The study, which began recruiting subjects January 8, will be conducted with 1,230 women throughout four locations: Wake Forest University in Winston Salem; the University of North Carolina at Chapel Hill; Brigham and Women’s Hospital in Boston; and the University of Sydney in Sydney, Australia.
“I absolutely love that this is a women’s health study,” Mihalko said. “We now have a reason for women to come together for the cultivation of our long-term health.”
Mihalko said this multi-site study, led by her Wake Forest colleague Stephen Messier, was developed over the past two years and includes the participation of leading experts around the world including top rheumatologists, biomechanists, psychologists and diet experts, among many others.
“The process has been very interdisciplinary and collaborative.”
Once the study is underway, Mihalko and her team at Wake Forest will coordinate the four clinical sites to ensure the fidelity of the work among the multiple sites. The university has built a clinical research facility on the campus specifically to conduct clinical trials such as this one.
“There hasn’t been a study on prevention on OA done to this extent, ever,” Mihalko said. “We all seem to think that OA is something that happens down the line as we age. But what if there are ways to delay that from happening or to even prevent it? That’s what we intend to find out.”
For more information on the study, please visit bump-enabling-research.org/wakeforest-tops-study.
