Can intermittent fasting help manage knee osteoarthritis? Study sheds light

New Delhi: Intermittent fasting is to be considered in weight loss programs and its benefits extended for the non-surgical management of osteoarthritis, more so for the metabolic Knee osteoarthritis.Therefore the choice of intermittent fasting should be offered for weight loss to obese patients with knee osteoarthritis (KOA), concludes a recent study published in the Journal of Clinical Orthopaedics and Trauma. 

Explaining their findings, Dr Suresh Babu, Dr Raju Vaishya and colleagues from Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India, and colleagues wrote, "Intermittent fasting regimens practiced across cultures and geographies have been effective for weight reduction. Intermittent fasting is to be considered in weight loss programs and its benefits extend to the non-surgical management of osteoarthritis, including KOA." 

Dr Raju Vaishya told Medical Dialogues "Obesity and Knee Osteoarthritis have a proven association. Obese individuals are likely to have early and more severe arthritis, and the complications and overall results of surgery are also inferior. Hence, weight reduction is of paramount importance for these people. Due to the inability to do intense physical activities, they are unable to lose weight and instead perpetually kept gaining weight. Hence, intermittent fasting as a non-operative means of weight reduction is an attractive and viable option and should be offered to obese patients with Knee Arthritis for weight reduction."

"Intermittent fasting (time-related fasting of 16 hours or more in a day), has additional benefits of helping in weight reduction, protecting against neurodegenerative disease, boosting the metabolism of fat loss, Insulin and glucose levels drop, and human growth hormone increases, reducing blood pressure, and may extend the life span by reducing oxidative stress, inflammation, and promoting autophagy" he further added.

Previous studies have shown an association between obesity and knee osteoarthritis. Obese patients are likely to have early and more severe KOA, and surgery complications and overall results are also inferior. Hence, weight reduction becomes important in these patients. Also, these individuals cannot lose weight owing to their inability to perform physical activities and keep gaining weight perpetually. Hence, for such patients, intermittent fasting as a non-operative means of weight reduction is an attractive and viable option. 

The review article by Dr. Babu and the team explored the effectiveness of intermittent fasting and its possible benefit in the non-medical management of KOA. 

"From the available literature, a narrative can be drawn on obesity with OA, be it through the metabolic or mechanical pathway," wrote the authors. "Obesity caused metabolic inflammation and mechanical stress causing accelerated cartilage damage and ultimately premature and severe OA." Considering this, it becomes clear that tackling obesity could lessen the adverse effects that cause OA, the authors note. 

Weight loss programs should, therefore, inculcate intermittent fasting and its benefits extended for the non-surgical management of OA, more so for the metabolic KOA

"Intermittent fasting regimes as an effective instrument of weight reduction can be explored as a surrogate management strategy for KOA," they concluded. 

Reference:

The study titled, "Can intermittent fasting be helpful for knee osteoarthritis?" was published in the Journal of Clinical Orthopaedics and Trauma.

DOI: https://doi.org/10.1016/j.jcot.2020.12.020