Efficacy, Safety, and Tolerability of a Very Low-Calorie Ketogenic Diet in Women with Obesity and Symptomatic Knee Osteoarthritis: A Pilot Interventional Study.

Publisher: MDPI Publishing Country of Publication: Switzerland NLM ID: 101521595 Publication Model: Electronic Cited Medium: Internet ISSN: 2072-6643 (Electronic) Linking ISSN: 20726643 NLM ISO Abbreviation: Nutrients Subsets: MEDLINE

Original Publication: Basel, Switzerland : MDPI Publishing

Osteoarthritis, Knee*/diet therapy ; Diet, Ketogenic*/methods ; Obesity*/diet therapy ; Obesity*/complications ; Body Mass Index*; Humans ; Female ; Pilot Projects ; Middle Aged ; Treatment Outcome ; Caloric Restriction/methods ; Weight Loss ; Aged ; Quality of Life

Background/objectives: Obesity is a major risk factor for knee osteoarthritis (OA), and weight loss is crucial for its management. This pilot study explores the effects of a Very Low-Calorie Ketogenic Diet (VLCKD) in women with obesity and symptomatic knee OA.
Methods: Women with symptomatic knee OA and obesity, defined as a body mass index (BMI) ≥ 30 kg/m ² , were eligible for the VLCKD protocol. The intervention included a ketogenic phase from baseline (T0) to the 8th week (T8), followed by a progressive reintroduction of carbohydrates over the next 12 weeks, ending at the 20th week (T20). Body mass index (BMI), the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, the EuroQol 5D (EQ-5D), and the 36-item Short Form Health Survey (SF-36) were assessed at all time points. Generalized estimating equations were used to analyze the association between BMI and patient-reported outcomes across the study period.
Results: Twenty participants started the study, but four discontinued the intervention, with two of these being due to adverse effects. The mean age of the 16 patients who completed the 20-week program was 57.3 ± 5.5 years, and their mean BMI was 40.0 ± 4.8 kg/m ² . The mean BMI significantly decreased to 37.5 ± 4.5 at T4, 36.3 ± 4.6 at T8, and 34.8 ± 4.8 at T20 (all p < 0.001 compared to baseline). The total WOMAC score improved from a mean of 43.6 ± 16.9 at T0 to 30.2 ± 12.8 at T4 ( p = 0.005) and further to 24.7 ± 10.6 at T8 ( p = 0.001) and to 24.8 ± 15.9 at T20 ( p = 0.005). The reduction in BMI was significantly correlated with the improvements in WOMAC, EQ-5D, and SF-36 over time. No major adverse effects were observed.
Conclusions: A 20-week VLCKD in women with obesity and knee OA significantly reduced their weight and improved their outcomes, warranting further research. This trial is registered with number NCT05848544 on ClinicalTrials.gov.

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Keywords: WOMAC; ketogenic diet; ketone bodies; knee; obesity; osteoarthritis; pain

ClinicalTrials.gov NCT05848544

Date Created: 20241016 Date Completed: 20241016 Latest Revision: 20241019

20241019

PMC11479182

10.3390/nu16193236

39408203