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Abstract
Background
The purpose of this study was to determine whether sedentary obese women with knee OA initiating an exercise and weight loss program may experience more beneficial changes in body composition, functional capacity, and/or markers of health following a higher protein diet compared to a higher carbohydrate diet with or without GCM supplementation.
Methods
Thirty sedentary women (54 ± 9 yrs, 163 ± 6 cm, 88.6 ± 13 kg, 46.1 ± 3% fat, 33.3 ± 5 kg/m2) with clinically diagnosed knee OA participated in a 14-week exercise and weight loss program. Participants followed an isoenergenic low fat higher carbohydrate (HC) or higher protein (HP) diet while participating in a supervised 30-minute circuit resistance-training program three times per week for 14-weeks. In a randomized and double blind manner, participants ingested supplements containing 1,500 mg/d of glucosamine (as d-glucosamine HCL), 1,200 mg/d of chondroitin sulfate (from chondroitin sulfate sodium), and 900 mg/d of methylsulfonylmethane or a placebo. At 0, 10, and 14-weeks, participants completed a battery of assessments. Data were analyzed by MANOVA with repeated measures.
Results
Participants in both groups experienced significant reductions in body mass (-2.4 ± 3%), fat mass (-6.0 ± 6%), and body fat (-3.5 ± 4%) with no significant changes in fat free mass or resting energy expenditure. Perception of knee pain (-49 ± 39%) and knee stiffness (-42 ± 37%) was decreased while maximal strength (12%), muscular endurance (20%), balance indices (7% to 20%), lipid levels (-8% to -12%), homeostasis model assessment for estimating insulin resistance (-17%), leptin (-30%), and measures of physical functioning (59%), vitality (120%), and social function (66%) were improved in both groups with no differences among groups. Functional aerobic capacity was increased to a greater degree for those in the HP and GCM groups while there were some trends suggesting that supplementation affected perceptions of knee pain (p < 0.08).
Conclusions
Circuit style resistance-training and weight loss improved functional capacity in women with knee OA. The type of diet and dietary supplementation of GCM provided marginal additive benefits.
Trial Registration
ClinicalTrials.gov: NCT01271218
Electronic supplementary material
The online version of this article (doi:10.1186/1550-2783-8-8) contains supplementary material, which is available to authorized users.
Teresa Magrans-Courtney, Colin Wilborn, Christopher Rasmussen, Maria Ferreira, Lori Greenwood, Bill Campbell, Chad M Kerksick, Erica Nassar, Rui Li, Mike Iosia, Matt Cooke, Kristin Dugan, Darryn Willoughby, LuAnn Soliah and Richard B Kreider contributed equally to this work.
Copyright comment
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Electronic supplementary material
The online version of this article (doi:10.1186/1550-2783-8-8) contains supplementary material, which is available to authorized users.
Teresa Magrans-Courtney, Colin Wilborn, Christopher Rasmussen, Maria Ferreira, Lori Greenwood, Bill Campbell, Chad M Kerksick, Erica Nassar, Rui Li, Mike Iosia, Matt Cooke, Kristin Dugan, Darryn Willoughby, LuAnn Soliah and Richard B Kreider contributed equally to this work.
Copyright comment
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Acknowledgements
We would like to thank the individuals who participated in this study as well as all of the students and administrative support staff's at Baylor University and Texas A&M University that assisted in conducting this study. We would also like thank Rodney Bowden and Beth Lanning for their input on selecting the QOL questionnaire used in this study; Mike Greenwood for his assistance in overseeing the study and mentoring doctoral students who assisted in this study; and, Dr. Ron Wilson for providing medical supervision for this study.
Competing interests
Curves International (Waco, TX, USA) provided funding for this project through an unrestricted research grant to Baylor University when the Principal Investigator and the Exercise & Sport Nutrition Lab were affiliated with that institution and currently provides funding to Texas A&M University to conduct exercise and nutrition related research. All researchers involved independently collected, analyzed, and interpreted the results from this study and have no financial interests concerning the outcome of this investigation. Data from this study have been presented at the Federation of American Societies of Experimental Biology annual meeting. Publication of these findings should not be viewed as endorsement by the investigators or their institutions of the programs or materials investigated.
Authors' contributions
TMC served as the study supervisor, oversaw all testing, and assisted in writing of the manuscript. CW assisted in data collection and manuscript preparation. CR, MF, LG, BC, CMK, KD, RL, EN, MI and MC assisted in data collection, data analysis, and/or manuscript preparation. DW oversaw analysis of blood work. LS provided input on study design and results. RBK served as Principal Investigator and contributed to the design of the study, statistical analysis, manuscript preparation, and procurement of external funding. All authors read and approved the final manuscript.