Objective To determine whether dietary intervention or knee strengthening exercise, or both, can reduce knee pain and improve knee function in overweight and obese adults in the community. Design Pragmatic factorial randomised controlled trial. Setting Five general practices in Nottingham. Participants 389 men and women aged 45 and over with a body mass index (BMI) of ≥28.0 and self reported knee pain. Interventions Participants were randomised to dietary intervention plus quadriceps strengthening exercises; dietary intervention alone; quadriceps strengthening exercises alone; advice leaflet only (control group). Dietary intervention consisted of individualised healthy eating advice that would reduce normal intake by 2.5 MJ (600 kcal) a day. Interventions were delivered at home visits over a two year period. Main outcome measures The primary outcome was severity of knee pain scored with the Western Ontario McMaster (WOMAC) osteoarthritis index at 6, 12, and 24 months. Secondary outcomes (all at 24 months) included WOMAC knee physical function and stiffness scores and selected domains on the SF-36 and the hospital anxiety and depression index.

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XIA/D-receptors were consistent with a1A affinities determined with chlorethylclonidine-treated rat cortical membranes. Affinities at cloned XIB-receptors were consistent with m affinities determined with rat liver membranes.6 Using the epididymal rat vas deferens as a functional measure of aIA affinity, prazosin (pA2 9.23 ± 0.28), WB 4101 (pA2 9.58 0.12), phentolamine (pKB 7.90 ± 0.16), benoxathian (pKB 9.21 ± 0.21) and 5-methyl-urapadil (pKB 8.51 0.16) were potent antagonists of noradrenaline-induced contractions.7 At present, evidence from cloning studies suggests the existence of at least three a,-adrenoceptor subtypes. In contrast to the recent proposal for al-adrenoceptor classification, the pharmacology of the cloned a1A/D (or alD)-adrenoceptor is more consistent with that of an XIA-adrenoceptor characterized in rat cerebral cortex and vas deferens.

BackgroundA low Glycaemic Index (GI) diet may decrease some long-term health risks in Polycystic Ovary Syndrome (PCOS) such as endometrial cancer. This study was performed to assess compliance to a low GI diet in women with PCOS. Food diaries prospectively collected over 6 months from women on a low GI diet or healthy eating diet were analysed retrospectively. The women were recruited for a pilot randomised control trial investigating whether a low GI diet decreased the risk of Endometrial Cancer. Nine women with PCOS completed 33 food diaries (17 from women on a low GI diet and 16 from women on a healthy eating diet) recording 3023 food items (low GI group:n = 1457; healthy eating group:n = 1566). Data was analysed using Foster-Powell international values inserted into an SPSS database as no scientifically valid established nutrition software was found. The main outcome measures were mean item GI and Glyacemic Load (GL), mean meal GL, percentage high GI foods and mean weight loss.FindingsWomen allocated the low GI diet had a statistically significant lower GI of food items (33.67 vs 36.91, p < 0.05), lower percentage of high GI foods (4.3% vs 12.1%, p < 0.05) and lower GL of food items and meals.ConclusionWomen with PCOS on a low GI diet consumed food items with a significantly lower mean GI and GL compared to the healthy eating diet group. Longer term compliance needs evaluation in subsequent studies to ascertain that this translates to reduced long term health risks.Trial RegistrationISRCTN: ISRCTN86420258