Shape Up America! Newsletter
Overweight and Activity – Effects on the Knee
by Stephen Messier, PhD
Dr. Stephen Messier, an expert in
biomechanics and a member of the Shape Up
America! Scientific Advisory Committee,
offers his thoughts on a study by David T.
Felson and colleagues, “Effects of
recreational physical activities on the
development of knee osteoarthritis in older
adults of different weights: the Framingham
Study.” It was published in the February 2007
issue of Arthritis & Rheumatism: Arthritis
Care & Research.
Moderate exercise has become a standard
component of care for older adults with knee
such as walking, improves self-reported
function and physical performance, and
decreases pain.1,3,4 However,
have examined the effects of chronic exercise
on the risk of developing knee OA, especially
in overweight individuals. Helping to fill
this gap is a study by Felson and colleagues
conducted on the offspring of a group of
people living in Framingham, MA who have been
studied extensively by researchers interested
in the relationship between diet, lifestyle
In this study, 1,279 individuals, with an
average age of 53, were followed for nine
years.2 X-rays of these adults
were taken at the beginning and the end of
the study. Results showed that walking for
not increase the risk of developing knee OA.
In 68 joggers and runners in the group, the
results were similar, although the authors
noted that the small number of runners
prevented any definitive conclusions about
running and the development of OA.
The benefits of long-term exercise are well
known.5 A physically active lifestyle
improves cardiovascular fitness, reduces
symptoms of mild to moderate depression, and
decreases the risk of illness and death.
The Felson study showed that middle-aged and
older adults who begin an exercise program
will not increase their risk of developing
knee OA. But the study also found that
moderate-intensity, long-term exercise did
not protect the knees from developing OA.
These results were independent of the level
of body weight. It is worth noting that in
clinical trials of older adults with knee OA
who were enrolled in long-term exercise
programs, joint space narrowing — a sign of
worsening OA — is no different than in
sedentary adults. 1,3
The results of the Felson study add to
existing research that supports including
moderate physical activity as part of a
healthy lifestyle. Exercise will not
increase the risk of developing knee
osteoarthritis and is beneficial for those
who already have the disease.
Stephen Messier has a PhD in biomechanics and
is a professor at Wake Forest University,
Healthy Knees For All
by Jimmy Smith, CSCS
Knee injuries are so common in daily life
that people accept the idea that they have to
live with knee pain. Some people have
undergone surgery to “repair” one of their
knees, but still suffer every day.
Knee pain is often the result of muscle
weakness and compensatory contraction of
other muscles, which pulls the kneecap in a
direction that causes pain. But the problem
often begins at a distance from the knee.
Since we are a computer-dominated society, we
often sit most hours of the day. This tends
to weaken our glutes (muscles in the butt),
compromising proper control of our hips.
Since our glutes are weak, muscles in our
hips have no choice but to get extremely
tight, which winds up causing problems in the
Here are two exercises that are good for knee
1) Glute Bridge. The glute bridge is a
movement that will help to strengthen your
glutes and decrease stress on the kneecap. To
perform this exercise, simply lie on your
back, with one knee pulled up to your chest
and the other knee bent with the foot flat on
the floor. From here, you are going to push
your foot down through the floor raising your
body up. Perform 2 sets of 10 to 15 reps. (If
you are a beginner, it is OK to perform only
3 or 4 reps and build up slowly over several
weeks or even months to this level.)
2) Hip Stretch. The hip stretch loosens up
several muscles in the hip and thigh area
that contribute to knee pain. It works your
hip flexors, quadriceps and even your
adductors. Begin by kneeling with one knee
on the ground while the other leg is
stretched forward and bent at the knee to a
90-degree angle with your foot on the floor.
From here, push the knee that is on the
ground into the ground and lean your upper
body backwards while twisting away from the
knee on the ground and toward the knee in the
air. You should feel the stretch in your
upper hip and the front of your thigh of the
leg on the ground. Perform 2 sets of 3 reps,
holding each rep for 10 seconds.
Jimmy Smith, CSCS, is a certified strength
and conditioning specialist who has helped
individuals and athletes of all levels from
high school to college and national ranks
optimize their performance. He is a master’s
degree student in Human Movement.
Do More, Watch Less: TV-Turnoff Week 2007
April 23 through 29 is TV-Turnoff Week and we
want to encourage you to participate by
helping families to “Do More, Watch Less,”
which is this year’s slogan. When kids turn
off the TV, they have two choices: they can
do something active or do something
sedentary. If they choose activity, that is
terrific, and we particularly encourage
outdoor play. If kids choose to remain
sedentary, we hope you will encourage them to
read. Children who read at home are more
likely to succeed at school. So be sure to
have lots of ideas ready for activities
to do when the TV goes off, and use your
public library to find age-appropriate books
Aim for these TV reduction goals:
- Children under 2 years old: Do not watch
- Children 2 years and older: Watch no more
than 2 hours a day.
- Remove TV from children’s bedrooms.
For more information about TV-Turnoff Week,
go to http://www.tvturnoff.org/week.htm.
To download a copy of the Do More, Watch
Less! toolkit — a TV/screen reduction
tool for after school programs or youth
organizations that include 10-14 year olds
— go to
Share Your Story
We continue to offer our viewers some
inspirational stories submitted to Shape Up
America! If you would like to share your
personal story and be an inspiration to
others who desire to lose weight, simple use our
submission system on the SUA website.
Need a boost of motivation to lose weight?
Check out how Teresa did it. She took it one
step at a time — along with the help of a
pedometer. Her own success helped her to
motivate others to lose weight, too.
Although I was never what is considered to be
"obese", I was overweight and because of that
I was not happy with myself. After years of
yo-yo dieting, I finally reached a point in
my life where I wanted to lose weight for
myself. I decided one week before
Thanksgiving in 2005 that I was going to eat
more healthy and start exercising. My first
time exercising I only lasted five minutes.
The next night, I lasted ten and so on until
I built myself up to one hour a night. My
niece who is a Marine bought me a pedometer
and I set a goal for myself to walk 10,000
steps a day. That is not as easy as it sounds
and meant that most nights after I got home
from work I would stand in front of the TV
and walk in place until I reached my goal.
Eventually I ventured out to walks in the
park and doing things throughout the day to
increase my steps so that I would not have as
many to do at night. The exercise, along with
eating healthier, made a HUGE difference. I
went from 184 pounds and wearing a size 16 XL
to my present weight of 140 pounds and
wearing a size 6. Read
Recipe of the Month
This tasty, meatless entrée combines fruit, vegetables, whole grains and beans for a big boost of fiber and good nutrition.
PAPAYA BLACK BEANS AND RICE
Makes 6 servings
- 2 tsp. olive oil
- 1 cup chopped red onion
- ½ cup orange juice
- ¼ cup lemon juice
- 2 Tbsp. fresh chopped cilantro
- ½ tsp. cayenne pepper
- 1 cup finely chopped green bell pepper
- 1 medium papaya, peeled, seeded, and
- 2 garlic cloves, minced
- 2 15-oz. cans black beans, rinsed and
- 6 cups hot cooked brown rice
- Heat oil in large skillet over medium
heat. Add all ingredients except beans and rice.
- Cook for 5 minutes, stirring occasionally
until bell peppers are crisp-tender.
- Stir in beans. Cook about 5 minutes or
until heated through. Serve over rice.
Nutritional analysis per serving: 410
calories, 13 grams protein, 78 grams
carbohydrate, 5 grams fat, 1 gram saturated
fat, 0 milligrams cholesterol, 13 grams
fiber, 440 milligrams sodium, 114 milligrams
vitamin C (190% DV*), 1500 IU (30% DV*)
vitamin A, 5 milligrams iron (25% DV*).
* DV = Daily Value
Source: Centers for Disease Control and
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Editor: Adrienne Forman, MS, RD