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Obesity

Overweight women have nearly 4 times the risk of knee OA; for overweight men the risk is 5 times greater.

Being only 10 pounds overweight increases the force on the knee by 30-60 pounds with each step. It is estimated that persons in the highest quintile of body weight ( BMI 30 to 34.9) have up to 10 times the risk of knee OA than those in the lowest quintile ( BMI 18.5 to 24.9). The risk of knee OA increases 15% for each 1 unit increase in BMI.

Swimming has significant effects in loss weight, physical fitness, muscular endurance, flexibility, and cardiopulmonary endurance.

Obesity and OA are linked to heart disease, stroke, diabetes and depression.

Much of this increased risk is due to body-wide inflammation leading to metabolic syndrome: a group of conditions that include high blood pressure, high blood sugar, abnormal cholesterol levels, and excess fat around the waist. Obese people with OA are almost three times more likely than those in the general population to have metabolic syndrome.

OA is not simply a disease of ageing or metabolic stress of joints

OA is rather a metabolic disorder in which various interrelated lipid, metabolic, and humoral mediators contribute to initiation and progression of the disease.

There is strong association between metabolic factors (hypertension, hypercholesterolaemia, and blood glucose) and knee OA in women that is independent of obesity, which further supports the notion that OA has important systemic and metabolic contributing factors.

Metabolic syndrom disorder

It comprises a combination of risk factors for coronary heart disease, as well as for diabetes, fatty liver, and several cancers.

To be diagnosed with metabolic syndrome, you would have at least three of these risk factors.

Most of the metabolic risk factors have no obvious signs or symptoms, except for a large waistline.

It is very common. For example, in the US more than 40% of people above 50 years may have metabolic syndrome.

High blood pressure

A blood pressure of 130/85 mm Hg or higher, or those taking blood pressure medications

Large Waist Size "having an apple shape"

A waistline of 40 inches or more for men and 35 inches or more for women (measured across the belly)

Low Good Cholesterol (HDL)

A high density lipoprotein level (HDL) less than 40 mg/dl (men) or under 50 mg/dl (women)

High Triglycerides

A triglyceride level above 150 mg/dl

High Fasting Glucose Level

A fasting blood glucose (sugar) level greater than 100 mg/dl, or those taking glucose-lowering medications

The Benefits of Weight Loss

Decrease of 5 kg or more, or a 5% decrease in body mass, over 30 months decreased the incidence of structurally defined OA from 20% to 15%

However, such people find weight loss difficult to achieve and maintain [10]. Few studies have addressed the barriers to weight control among patients with knee OA [11,12,13]. For example, most obese knee-OA outpatients (89%) surveyed in the UK had tried to lose weight by changing their diet, trying to exercise more, and joining a support group [11]. Barriers to losing the desired amount of weight were lack of motivation, knee-joint pain, pain in other joints, and lack of time

Amount of initial weight loss

In contrast to weight loss among the general population, greater initial weight loss in obese people with OA is associated with better long-term prognoses, and can be associated with better compliance with treatment

muscle strength & weight loss

Decrease in lower extremity muscle mass and muscle strength following weight loss in obese patients with knee OA, suggesting that significant weight loss should be followed by an exercise regimen to restore or increase muscle mass

optimal method for weight loss

Opinions on the optimal method for weight loss are varied. While evidence supports a calorie-restricted diet, the evidence to support differences in diet composition is limited and inconclusive.

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