Can Weight Loss and Exercise Help Women Stave off Osteoarthritis?

Arthritis Foundation funds Wake Forest University research to test the preventive impact of diet and exercise in women over 50 at risk for osteoarthritis.

ATLANTA (February 26, 2024) — In an extensive clinical study spanning two continents, Wake Forest University researchers will determine whether the most common treatments for osteoarthritis (OA) – weight loss and exercise – also help prevent women from developing the degenerative joint disease.
The University’s Department of Health and Exercise Science has received $17.1 million in funding from the Arthritis Foundation (the largest private funder), the Centers for Disease Control and Prevention, and the National Institute of Arthritis and Musculoskeletal and Skin Diseases, among others, for The Osteoarthritis Prevention Study (TOPS).

TOPS is the first study in the United States to examine weight loss and exercise as preventatives for osteoarthritis. It also is another major step in fulfilling the vision of the Osteoarthritis Clinical Trial Network to accelerate the discovery of therapies for OA.  

“Clinical trials are critical to the development of new treatments for OA, a disease that affects women at nearly twice the rate of men,” said Steven Taylor, President & CEO of the Arthritis Foundation. “The Arthritis Foundation strongly supports this approach to testing diet and exercise as OA preventives in women at high risk for osteoarthritis, and we are proud to be the largest private funder of this best-in-class study.” 

Osteoarthritis is the most common type of arthritis, and the knee is the most often affected weight-bearing joint. OA occurs when the tissues in the joint become inflamed and the loads on the joint are excessive, resulting in degeneration of the cartilage and surrounding tissue. The result is pain, swelling and loss of motion. The condition is the leading cause of disability among adults and it affects nearly twice as many women as men, often targeting the knees.

“Finding interventions that effectively prevent arthritis can have a major impact on public health,” said Erica Odom, DrPH, MPH, CDC's Arthritis Management and Well-Being Program Lead. “CDC is proud to help support this unprecedented study."

Professor Stephen Messier, PhD, of Wake Forest’s Department of Health and Exercise Science, will lead the five-year study as principal investigator (PI). He has conducted more than 30 years of research into how diet and exercise can reduce pain and increase function in people who have developed osteoarthritis. As there is no cure for the condition, he has turned his attention to prevention – and whether proven treatments instead can be used to stop the disease from occurring.

“We know how to get people to lose weight and we know that it's an effective treatment,” he said. “But there is still no cure for osteoarthritis. It's the leading cause of disability in adults. So, we thought that maybe prevention is better treatment – that is, preventing people from actually getting the disease in the first place.”
Wake Forest University will serve as the coordinating center for four intervention sites: Brigham and Women’s Hospital in Boston, University of North Carolina at Chapel Hill, University of Sydney in Australia, and Wake Forest University.
TOPS is recruiting 1,230 women age 50 and older who are not diagnosed with osteoarthritis. Participants must have a BMI of more than 30 and report no or infrequent knee pain. The commitment for each participant is four years.
Study participants will be divided randomly into two groups, one will focus on diet and guided exercise, the other will focus on healthy lifestyle choices. 

Using MRI scans, the researchers will evaluate degenerative changes in the knee at month 48 for all participants. They also will track knee pain, mobility in terms of how far each woman can walk in six minutes and health-related quality of life.
Additional TOPS sponsors and collaborators include the National Center for Complementary and Integrative Health (NCCIH), Office of Disease Prevention, Office of Research on Women's Health (ORWH), Office of Behavioral and Social Sciences Research (OBSSR), and University of Missouri-Columbia. 
If you are interested in learning more about the study, Steve Messier and the esteemed TOPS investigative team will be presenting at the Arthritis Foundation's Pathways 2024 Conference on March 9 in Washington, D.C. Recruitment for TOPS is now open. To apply to participate, visit the Osteoarthritis Prevention Study page. 

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