New research led by Monash University has found preventing weight gain from young adulthood to late midlife to reduce obesity could reduce knee replacements in Australian adults by nearly 30 per cent.
The study, published in Osteoarthritis and Cartilage, examined the “association between patterns of weight gain (body mass index (BMI) trajectories) from early adulthood to late midlife and the risk of total knee replacement for osteoarthritis”.
Monash University Professor Flavia Cicuttini, senior author of the study, said the results underlined “the importance of prevention in improving health and reducing health costs”.
“Preventing weight gain is feasible and effective in improving osteoarthritis health outcomes,” she said.
“Focussing on prevention, with small average long-term changes in energy balance, can make a big difference. Reducing your caloric intake just slightly each day builds up to avoiding eight to 12 kilograms of weight gain over a couple of decades, saving money and avoiding surgery. This also has cardiac health benefits.
“For example, eating the average equivalent of two fewer pieces of chocolate per week, or adding 10 minutes of exercise, can prevent the insidious half to 0.5 to one kilogram weight gain we see per person per year in Australia. This can result in tangible health gains, improving lives and saving money.”
She put out a “call to action” for knee joint health.
“We also need to be sending out the message that it is important to make sure that people don’t continue to gain more weight,” she said.
“Although recommendations to lose weight are important if a person is carrying excess weight, this can be difficult to achieve for most people.
“Too often we see people with knee pain, advise them to lose weight, only for them to return five years later having gained a further three to five kilograms. This is a missed opportunity because it is easier to prevent further weight gain than it is to lose it.
“We need to focus on preventing or slowing weight gain when people first present with any knee pain, even niggling knee pain. Australians tend to gain about 0.5-1 kg per year over adult life. This slow, steady accumulation of weight adds up, resulting in the obesity we see.”
Using data from 24,368 participants, the study found six distinct trajectories of BMI from early adulthood, from 18 to 21 years, to late midlife, about 62 years:
– Group 1: lower normal to normal BMI (19.7%)
– Group 2: normal BMI to borderline overweight (36.7%)
– Group 3: normal BMI to overweight (26.8%)
– Group 4: overweight to borderline obese (3.5%)
– Group 5: normal BMI to class 1 obesity (10.1%)
– Group 6: overweight to class 2 obesity (3.2%).
“Over 12.4 years, 1328 (5.4 per cent) of subjects had a total knee replacement. The risk of requiring one increased in all groups where someone progressed into a higher weight group,” a Monash University statement said.
“In total, 28.4 per cent of knee replacements could be prevented if people moved to one group lower, with an average eight to 12 kilogram weight loss from early adulthood to late midlife. This could save $373 million in annual health costs.”
Professor Cicuttini said if adults can be encouraged to consider preventing the slow creep in weight gain, it would have “multiple health benefits including reducing the need for a knee replacement in the future”.
Details: www.monash.edu/news/articles/preventing-weight-gain-can-help-avoid-total-knee-replacement-study.
