School of Health Sciences, Faculty of Health and Medicine, University of Newcastle, Newcastle2308, NSW, Australia.
Public Health Nutr. 2021 Feb;24(2):338-353. doi: 10.1017/S1368980020002529. Epub 2020 Sep 10.
Osteoarthritis (OA) is associated with functional limitations that can impair mobility and reduce quality of life in affected individuals. Excess body weight in OA can exacerbate impaired physical function, highlighting the importance of weight management in this population. The aim of this systematic review was to compare the effects of different dietary interventions for weight loss on physical function in overweight and obese individuals with OA.
A comprehensive search of five databases was conducted to identify relevant articles for inclusion. Studies were included that examined the effect of dietary weight loss interventions, with or without exercise, on physical function in adults with OA who were overweight or obese. Quality and risk of bias were assessed using the Quality Criteria Checklist for primary research. Primary and secondary outcomes were extracted, including change in weight and physical function which included performance-based and self-report measures.
Nineteen relevant studies were included, which incorporated lifestyle interventions (n 8), diet in combination with meal replacements (DMR; n 5) and very low-energy diets (VLED; n 6) using meal replacements only. Pooled data for eight RCT indicated a mean difference in Western Ontario and McMaster Universities Arthritis Index (WOMAC) physical function of 12·4 and 12·5 % following DMR or VLED interventions, respectively; however, no statistically significant change was detected for lifestyle interventions.
Our findings suggest that partial use of meal replacements is as effective as their sole use in the more restrictive VLED. Both dietary interventions are more effective than lifestyle programmes to induce significant weight loss and improvements in physical function.
骨关节炎（OA）与功能障碍相关，这些功能障碍会影响患者的活动能力并降低其生活质量。OA 患者的超重会加重身体功能受损，这突出了该人群体重管理的重要性。本系统评价的目的是比较不同的减肥饮食干预措施对超重和肥胖 OA 患者身体功能的影响。
全面检索了五个数据库，以确定纳入的相关文章。纳入的研究考察了饮食减肥干预措施（包括或不包括运动）对超重或肥胖 OA 成年人身体功能的影响。使用主要研究质量标准检查表评估了质量和偏倚风险。提取了主要和次要结局，包括体重和身体功能的变化，其中包括基于表现的和自我报告的测量。
纳入了 19 项相关研究，其中包括生活方式干预（n=8）、饮食与代餐结合（DMR；n=5）和仅使用代餐的极低能量饮食（VLED；n=6）。8 项 RCT 的汇总数据表明，DMR 或 VLED 干预后，WOMAC 身体功能的平均差异分别为 12.4%和 12.5%；然而，生活方式干预没有检测到统计学上的显著变化。
我们的研究结果表明，代餐的部分使用与更严格的 VLED 中单独使用一样有效。这两种饮食干预措施在诱导显著体重减轻和身体功能改善方面比生活方式方案更有效。
