Mode
Text Size
Log in / Sign up

Calorie restriction plus exercise reduced IL-6 and knee pain more than diet alone in knee OASmall study finds adding exercise to calorie restriction may reduce knee pain and inflammation

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Consider that adding exercise to calorie restriction may offer short-term benefits for inflammation and pain in knee OA, but evidence is from a very small, brief trial.

This 4-week randomized controlled trial enrolled 23 overweight or obese individuals with knee osteoarthritis who completed the study. Participants were assigned to either dietary calorie restriction alone (5000 kcal/week reduction) or the same calorie restriction combined with five 30-minute sessions of moderate cycling per week. The primary outcome was not explicitly stated.

At the 4-week post-intervention assessment, the combined calorie restriction and exercise group showed significantly lower IL-6 levels (1.36 mg/dL vs. 2.98 mg/dL; p<0.01), lower self-reported knee pain on a visual analogue scale (median 2 vs. 4; p<0.01), and a faster time to complete a stair climb test (p=0.016) compared to the calorie restriction alone group. There was no statistically significant difference between groups in C-reactive protein levels (p=0.517).

Safety, tolerability, and adverse event data were not reported. The study has significant limitations, including a very small sample size (n=23 completers), a short 4-week duration, and the lack of a specified primary outcome. Funding sources and conflicts of interest were also not reported.

For practice, the findings suggest that adding structured aerobic exercise to a short-term calorie restriction plan may provide greater short-term improvements in a specific inflammatory marker and pain/function for this population than diet alone. However, the evidence is preliminary due to the study's scale and brevity, and the clinical durability and safety of this approach remain unknown.

Researchers wanted to see if adding exercise to a reduced-calorie diet could help with inflammation and knee pain in people who are overweight or obese and have knee osteoarthritis. They studied 23 people for four weeks. One group cut calories, while another group cut calories and also did moderate cycling five times a week.

After four weeks, the group that did both diet and exercise had lower levels of a specific inflammation marker called IL-6 and reported less knee pain than the group that only cut calories. They were also faster on a stair-climbing test. However, there was no difference between the groups for another common inflammation marker called CRP.

The main reason to be careful with these results is the study's size. With only 23 people finishing the trial, it's a very small study. The program also lasted just four weeks, so we don't know if the benefits would continue. The study did not report on safety or if people found the program easy to stick with.

For now, this research suggests a promising direction. It hints that combining exercise with dietary changes might offer more immediate relief for knee pain and some types of inflammation than diet changes alone. However, much larger and longer studies are needed to confirm these early findings.

What this means for you:
A small, short study suggests adding exercise to a diet may help knee pain more than diet alone, but more research is needed.

Study Details

Study typeRct
EvidenceLevel 2
Follow-up0.9 mo
PublishedApr 2026
View Original Abstract ↓
PURPOSE: The purpose of this study is to determine the effects of 4-weeks dietary calorie restriction alone (CR) compared to CR with aerobic exercise (CR + E) on systemic inflammation and index knee pain in overweight and obese individuals with knee osteoarthritis (OA). METHODS: Twenty-three individuals with knee OA completed a randomised controlled trial. Participants in the CR group (n = 9, BMI: 30.0 ± 2.4 kg/m, 56 ± 5 years) were asked to reduce their habitual energy intake by 5000 kcal/week for 4 weeks, and those randomised to the CR + E group (n = 14, BMI: 32.3 ± 4.8 kg/m, 57 ± 5 years) were asked to follow the same dietary CR and perform five, 30-min bouts of moderate intensity cycling per week. Blood markers of inflammation, body composition, function, and pain were compared after a 4-week intervention period by ANCOVA, using pre-intervention value as a covariate. RESULTS: There was no difference in CRP between groups at post-intervention (p = 0.517, d = 0.31). IL-6 was lower (p < 0.01; d = 1.69) at post-intervention in the CR + E group (1.36 mg/dL, 0.72 to 2.00) compared to CR group (2.98 mg/dL, 2.22-3.73). Visual analogue scale (VAS) knee pain was lower (p < 0.01; d = 1.29) at post-intervention in the CR + E group (2, 1-3) compared to the CR group (4, 3-5). The time to complete the stair climb test was lower at post-intervention in the CR + E group compared to the CR group (p = 0.016, d = 1.17). CONCLUSIONS: Four weeks of moderate-intensity aerobic exercise training combined with CR led to a greater reduction in IL-6, but not CRP, compared to CR alone. The addition of exercise to CR led to greater reduction in knee pain compared to CR alone. TRIAL REGISTRATION: ClinicalTrials.gov (ID: NCT05518890).
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.