Effect of a multidisciplinary lifestyle intervention on body composition in people with osteoarthritis: Secondary analysis of the “Plants for Joints” randomized controlled trial

• Published in: Osteoarthritis and cartilage open 2024-12, Vol.6 (4), p.100524, Article 100524
• Main Authors: Wagenaar, C.A., Walrabenstein, W., de Jonge, C.S., Bisschops, M., van der Leeden, M., van der Esch, M., Weijs, P.J.M., Troelstra, M.A., Korteweg, M.A., Nederveen, A.J., van Schaardenburg, D.
• Format: Article
• Language: English
• Subjects: Body composition; Clinical Trial; Diet; Lifestyle intervention; Magnetic resonance imaging; Metabolic syndrome; Osteoarthritis
• ISSN: 2665-9131; 2665-9131
• DOI: 10.1016/j.ocarto.2024.100524

The Plants for Joints (PFJ) intervention significantly improved pain, stiffness, and physical function, and metabolic outcomes, in people with metabolic syndrome-associated osteoarthritis (MSOA). This secondary analysis investigated its effects on body composition. In the randomized PFJ study, people with MSOA followed a 16-week intervention based on a whole-food plant-based diet, physical activity, and stress management, or usual care. For this secondary analysis, fat mass, muscle mass, and bone mineral density were measured using dual-energy X-ray absorptiometry (DEXA) for all participants. Additionally, in a subgroup (n ​= ​32), hepatocellular lipid (HCL) content and composition of visceral adipose tissue (VAT) were measured using magnetic resonance spectroscopy (MRS). An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyse between-group differences. Of 66 people randomized, 64 (97%) completed the study. The PFJ group experienced significant weight loss (−5.2 ​kg; 95% CI –6.9, −3.6) compared to controls, primarily from fat mass reduction (−3.9 ​kg; 95% CI –5.3 to −2.5). No significant differences were found in lean mass, muscle strength, or bone mineral density between groups. In the subgroup who underwent MRI scans, the PFJ group had a greater reduction in HCL (−6.5%; 95% CI –9.9, 3.0) compared to controls, with no observed differences in VAT composition. The PFJ multidisciplinary intervention positively impacted clinical and metabolic outcomes, and appears to significantly reduce body fat, including liver fat, while preserving muscle mass and strength.