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Preventing weight gain from young adulthood to late midlife could reduce knee replacements by almost 30%, enabling the health system to achieve annual savings of $373 million, according to a new study by Monash University.

Using data from 24,368 participants in the Melbourne Collaborative Cohort Study, the researchers examined links between weight gain patterns and the risk of total knee replacement for osteoarthritis.

While weight loss was recommended for people with osteoarthritis who were overweight or obese, this was often too little too late, said senior author and Monash University Professor Flavia Cicuttini, who also heads the School of Public Health and Preventive Medicine鈥檚 Musculoskeletal Epidemiology Unit.

鈥淔ocusing on prevention, with small average long-term changes in energy balance, can make a big difference. Reducing your caloric intake just slightly each day builds up to avoiding 8鈥�12 kg of weight gain over a couple of decades, saving money and avoiding surgery. This also has cardiac health benefits,鈥� Cicuttini said.

鈥淔or example, eating the average equivalent of two fewer pieces of chocolate per week, or adding 10 minutes of exercise, can prevent the insidious half to 0.5鈥�1 kg weight gain we see per person per year in Australia. This can result in tangible health gains, improving lives and saving money.鈥�

Professor Cicuttini said a 鈥渃all to action鈥� was needed for knee joint health. 鈥淲e also need to be sending out the message that it is important to make sure that people don鈥檛 continue to gain more weight,鈥� she said.

鈥淎lthough recommendations to lose weight are important if a person is carrying excess weight, this can be difficult to achieve for most people.

鈥淭oo often we see people with knee pain, advise them to lose weight, only for them to return five years later having gained a further 3鈥�5 kg. This is a missed opportunity because it is easier to prevent further weight gain than it is to lose it.

鈥淲e need to focus on preventing or slowing weight gain when people first present with any knee pain, even niggling knee pain. Australians tend to gain about 0.5鈥�1 kg per year over adult life. This slow, steady accumulation of weight adds up, resulting in the obesity we see.鈥�

Professor Cicuttini said that assuming we can 鈥榝ix鈥� obesity after it has occurred is not very effective and prevention has multiple health and cost benefits.

鈥淚f an approach doesn鈥檛 work, why don鈥檛 we change it?鈥� she said.

鈥淚f adults can be encouraged to consider preventing the slow creep in weight from a young age, this will have multiple health benefits including reducing the need for a knee replacement in the future.鈥�

Image caption: iStockphoto.com/Rungrudee