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Kong G, Wang J, Li R, Huang Z, Wang L. Ketogenic diet ameliorates inflammation by inhibiting the NLRP3 inflammasome in osteoarthritis. Arthritis Res Ther 2022; 24:113. [PMID: 35585627 PMCID: PMC9116003 DOI: 10.1186/s13075-022-02802-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 05/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The nucleotide-binding domain, leucine-rich repeat, and pyrin domain-containing protein 3 (NLRP3) inflammasome has been reported to be involved in the pathological process of osteoarthritis (OA) inflammation. Here, we investigated the ketogenic diet (KD), which has been previously demonstrated to inhibit NLRP3 inflammasome activation, to elucidate its protective mechanism against OA in rats. METHODS Anterior cruciate ligament transaction (ACLT) together with partial medial meniscectomy was used to create a rat knee joint OA model. After treatment with KD or standard diet (SD) for 8 weeks, the knee specimens were obtained for testing. RESULTS The KD significantly increased the content of β-hydroxybutyrate (βOHB) in rats. Compared to the SD group, the KD significantly reduced the damage caused by OA in the articular cartilage and subchondral bone. The NLRP3 inflammasome and inflammatory cytokines interleukin-1 β (IL-1β) and IL-18 were significantly increased in the SD group compared with the sham group, while their expression was significantly decreased in rats treated with the KD. In addition, MMP13 was significantly decreased in the KD group compared to that in the SD group, while COL2 was significantly increased. CONCLUSIONS KD can protect the articular cartilage and subchondral bone in a rat OA model by inhibiting NLRP3 inflammasome activation and reducing the OA inflammatory response.
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Affiliation(s)
- Ganggang Kong
- Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, Department of Spinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, No.58, Zhong Shan Er Lu, Guangzhou, 510080, China.
- Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
| | - Jinyang Wang
- Department of Pathology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Rong Li
- Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zhiping Huang
- Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Le Wang
- Guangdong Provincial Key Laboratory of Orthopedics and Traumatology, Department of Spinal Surgery, The First Affiliated Hospital of Sun Yat-sen University, No.58, Zhong Shan Er Lu, Guangzhou, 510080, China.
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2
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Martello E, Bigliati M, Adami R, Biasibetti E, Bisanzio D, Meineri G, Bruni N. Efficacy of a dietary supplement in dogs with osteoarthritis: A randomized placebo-controlled, double-blind clinical trial. PLoS One 2022; 17:e0263971. [PMID: 35171954 PMCID: PMC8849458 DOI: 10.1371/journal.pone.0263971] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 01/31/2022] [Indexed: 11/30/2022] Open
Abstract
This study is a randomized, placebo-controlled, double-blinded trial performed to investigate the effects of a dietary supplement containing a mixture of Boswellia serrata Roxb., chlorophyll, green tea extract, glucosamine, chondroitin sulfate, hyaluronic acid, and further in the manuscript: non-hydrolised type II collagen in dogs with osteoarthritis (OA). A total of 40 dogs were enrolled in the study, they were randomly divided in control (CTR) and treatment (TRT) groups. The TRT group received the dietary supplement for 60 days. The CTR group received a placebo for the same number of days. All the subjects had veterinary evaluations during the trial and owners were requested to fill in questionnaires on chronic pain using the Helsinki Chronic Pain Index. The product was easy to administer and no side effects were reported. Combining results from veterinarian and owner evaluations, the tested product proved to be significantly beneficial in alleviating pain and in reducing the clinical signs in dogs with OA.
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Affiliation(s)
- Elisa Martello
- Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- * E-mail:
| | | | | | - Elena Biasibetti
- Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d’Aosta, Torino, Italy
| | - Donal Bisanzio
- RTI International, Washington, DC, United States of America
| | - Giorgia Meineri
- Department of Veterinary Science, University of Turin, Grugliasco (TO), Italy
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Strath LJ, Jones CD, Philip George A, Lukens SL, Morrison SA, Soleymani T, Locher JL, Gower BA, Sorge RE. The Effect of Low-Carbohydrate and Low-Fat Diets on Pain in Individuals with Knee Osteoarthritis. Pain Med 2021; 21:150-160. [PMID: 30865775 DOI: 10.1093/pm/pnz022] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Osteoarthritis is the most prominent form of arthritis, affecting approximately 15% of the population in the United States. Knee osteoarthritis (KOA) has become one of the leading causes of disability in older adults. Besides knee replacement, there are no curative treatments for KOA, so persistent pain is commonly treated with opioids, acetaminophen, and nonsteroidal anti-inflammatory drugs. However, these drugs have many unpleasant side effects, so there is a need for alternative forms of pain management. We sought to test the efficacy of a dietary intervention to reduce KOA. DESIGN A randomized controlled pilot study to test the efficacy of two dietary interventions. SUBJECTS Adults 65-75 years of age with KOA. METHODS Participants were asked to follow one of two dietary interventions (low-carbohydrate [LCD], low-fat [LFD]) or continue to eat as usual (control [CTRL]) over 12 weeks. Functional pain, self-reported pain, quality of life, and depression were assessed every three weeks. Serum from before and after the diet intervention was analyzed for oxidative stress. RESULTS Over a period of 12 weeks, the LCD reduced pain intensity and unpleasantness in some functional pain tasks, as well as self-reported pain, compared with the LFD and CTRL. The LCD also significantly reduced oxidative stress and the adipokine leptin compared with the LFD and CTRL. Reduction in oxidative stress was related to reduced functional pain. CONCLUSIONS We present evidence suggesting that oxidative stress may be related to functional pain, and lowering it through our LCD intervention could provide relief from pain and be an opioid alternative.
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Affiliation(s)
- Larissa J Strath
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Catherine D Jones
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Alan Philip George
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Shannon L Lukens
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Shannon A Morrison
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Taraneh Soleymani
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Julie L Locher
- Division of Gerontology, Geriatrics and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Barbara A Gower
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Robert E Sorge
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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4
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Veronese N, La Tegola L, Caruso MG, Maggi S, Guglielmi G. The Association between Dietary Magnesium Intake and Magnetic Resonance Parameters for Knee Osteoarthritis. Nutrients 2019; 11:nu11061387. [PMID: 31226792 PMCID: PMC6628041 DOI: 10.3390/nu11061387] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 06/14/2019] [Accepted: 06/18/2019] [Indexed: 02/02/2023] Open
Abstract
The aim of the study was to evaluate the relationship between dietary magnesium (Mg) intake and prevalence of knee osteoarthritis (OA), a topic poorly explored in the literature. Overall, 783 people participating in the Osteoarthritis Initiative (59.8% females; mean age: 62.3 years) and having an MRI assessment were enrolled in this cross-sectional study. Mg intake was measured with a semi-quantitative food frequency questionnaire, and its association with knee OA was evaluated for an increased intake of 100 mg/day. Using an adjusted linear regression analysis, a higher Mg intake (i.e., increase of 100 mg/day) corresponded to a significant increase in mean cartilage thickness, cartilage volume at medial tibia, cartilage volume and mean cartilage thickness at central medial femur, and cartilage volume and mean cartilage thickness in the central medial tibiofemoral compartment. In conclusion, an increased Mg dietary intake is associated with a better knee cartilage architecture, also when adjusting for potential confounders, suggesting a potential role of Mg in the prevention and treatment of knee OA.
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Affiliation(s)
- Nicola Veronese
- National Research Council, Neuroscience Institute, Aging Branch, 35128 Padova, Italy.
- Research Hospital, National Institute of Gastroenterology, IRCCS De Bellis, BA 70077 Castellana Grotte, Italy.
| | - Luciana La Tegola
- Università degli Studi di Foggia, Scuola di Specializzazione di Area Medica, Department of Radiology, 71100 Foggia, Italy.
| | - Maria Gabriella Caruso
- Research Hospital, National Institute of Gastroenterology, IRCCS De Bellis, BA 70077 Castellana Grotte, Italy.
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Aging Branch, 35128 Padova, Italy.
| | - Giuseppe Guglielmi
- Università degli Studi di Foggia, Scuola di Specializzazione di Area Medica, Department of Radiology, 71100 Foggia, Italy.
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Radakovich LB, Marolf AJ, Culver LA, Santangelo KS. Calorie restriction with regular chow, but not a high-fat diet, delays onset of spontaneous osteoarthritis in the Hartley guinea pig model. Arthritis Res Ther 2019; 21:145. [PMID: 31196172 PMCID: PMC6567638 DOI: 10.1186/s13075-019-1925-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 05/23/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity is a leading risk factor for osteoarthritis (OA). In contrast, calorie restriction (CR) may lessen OA due to improved systemic inflammatory status and reduced weight-bearing. The aim of this study was to determine how CR with regular chow versus a high-fat diet (HFD) alters OA progression using the Hartley guinea pig model of disease. METHODS Twenty-four male guinea pigs were allocated to four groups at 2 months of age: (1) ad libitum regular chow (obese), (2) CR regular chow (lean), (3) ad libitum HFD, and (4) CR HFD. Animals in both HFD groups ate identical amounts and were combined into one HFD group for analyses. At 5 months, hind limbs were harvested for microcomputed tomography (microCT) and histopathologic evaluation of knee OA. Total body, gonad fat, and infrapatellar fat pad (IFP) masses were recorded. IFPs were collected for gene expression analysis. Immunohistochemistry for monocyte chemoattractant protein-1 (MCP-1) was performed on intact joints. Serum was utilized for protein C3 measurement. All data were compared using ordinary one-way ANOVA analyses with Tukey's post-hoc tests. RESULTS Body mass in the lean and HFD groups were similar and lower than the obese group. Despite this, gonad fat pads in the HFD group were comparable to the obese group. MicroCT and histologic OA scores were similar in obese and HFD groups; both scores were significantly lower in the lean group. Obese and HFD groups displayed increased gene expression of pro-inflammatory and catabolic mediators in IFPs relative to lean animals. Consistent with this, immunohistochemistry for MCP-1 in knee joints demonstrated strong positive staining in obese and HFD groups but was minimally detected in lean animals. Serum protein C3 levels were also statistically higher. CONCLUSIONS This study demonstrated that CR with a regular chow diet lessened knee OA in the Hartley guinea pig and was associated with decreased local and systemic inflammation compared to obese animals. HFD animals, although under CR conditions, had OA scores and inflammatory markers similar to obese animals. Thus, diet composition, and not solely body weight, may be a key factor in development of OA.
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Affiliation(s)
- Lauren B. Radakovich
- Department of Microbiology, Immunology, Pathology, Colorado State University, 200 West Lake Street, Fort Collins, CO 80521 USA
| | - Angela J. Marolf
- Department of Environmental and Radiological Health Sciences, Colorado State University, 123 Flint Cancer Center, Fort Collins, CO 80523 USA
| | - Lauren A. Culver
- Department of Microbiology, Immunology, Pathology, Colorado State University, 200 West Lake Street, Fort Collins, CO 80521 USA
| | - Kelly S. Santangelo
- Department of Microbiology, Immunology, Pathology, Colorado State University, 200 West Lake Street, Fort Collins, CO 80521 USA
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Du C, Smith A, Avalos M, South S, Crabtree K, Wang W, Kwon YH, Vijayagopal P, Juma S. Blueberries Improve Pain, Gait Performance, and Inflammation in Individuals with Symptomatic Knee Osteoarthritis. Nutrients 2019; 11:nu11020290. [PMID: 30699971 PMCID: PMC6413191 DOI: 10.3390/nu11020290] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 01/17/2019] [Accepted: 01/23/2019] [Indexed: 01/11/2023] Open
Abstract
Osteoarthritis (OA) is the most common joint disorder in the world and is the most frequent cause of walking related disability among older adults in the US, which brings a significant economic burden and reduces quality of life. The initiation and development of OA typically involves degeneration or progressive loss of the structure and function of articular cartilage. Inflammation is one of the major drives of the progression of OA. Dietary polyphenols have been studied for their anti-inflammatory properties and potential anabolic effects on the cartilage cells. Blueberries are widely consumed and are high in dietary polyphenols, therefore regular consumption of blueberries may help improve OA. The purpose of the present study was to examine the effect of freeze dried whole blueberries on pain, gait performance, and inflammation in individuals with symptomatic knee OA. In a randomized, double-blind trial, adults age 45 to 79 with symptomatic knee OA, were randomized to either consume 40 g freeze-dried blueberry powder (n = 33) or placebo powder (n = 30) daily for four months. Blood draws and assessment of pain and gait were conducted at baseline, two months, and four months. Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaires were used to assess pain and GAITRite® electronic walkway was used to evaluate gait spatiotemporal parameters. WOMAC total score and sub-groups, including pain, stiffness, and difficulty to perform daily activities decreased significantly in the blueberry treatment group (p < 0.05), but improvement of WOMAC total score and difficulty to perform daily activities were not observed in the placebo group. Normal walking pace single support percentage for both limbs increased (p = or < 0.007), while double support percentage for both limbs decreased in the blueberry treatment group (p = or < 0.003). No significant changes were observed in plasma concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-10, IL-13, matrix metalloproteinases (MMP)-3, MMP-13, and monocyte chemoattractant protein-1 (MCP-1) in both treatment groups. However, an increasing trend for IL-13 concentration and a decreasing trend in MCP-1 concentration were noted in the blueberry group. The findings of this study suggest that daily incorporation of whole blueberries may reduce pain, stiffness, and difficulty to perform daily activities, while improving gait performance, and would therefore improve quality of life in individuals with symptomatic knee OA.
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Affiliation(s)
- Chen Du
- Department of Nutrition and Food Science, Texas Woman's University, Denton, TX 76204, USA.
| | - Amy Smith
- Department of Nutrition and Food Science, Texas Woman's University, Denton, TX 76204, USA.
| | - Marco Avalos
- School of Health Promotion and Kinesiology, Texas Woman's University, Denton, TX 76204, USA.
| | - Sanique South
- Department of Nutrition and Food Science, Texas Woman's University, Denton, TX 76204, USA.
| | - Keith Crabtree
- Department of Nutrition and Food Science, Texas Woman's University, Denton, TX 76204, USA.
| | - Wanyi Wang
- Center for Research Design and Analysis, Texas Woman's University, Houston, TX 77030, USA.
| | - Young-Hoo Kwon
- School of Health Promotion and Kinesiology, Texas Woman's University, Denton, TX 76204, USA.
| | - Parakat Vijayagopal
- Department of Nutrition and Food Science, Texas Woman's University, Denton, TX 76204, USA.
| | - Shanil Juma
- Department of Nutrition and Food Science, Texas Woman's University, Denton, TX 76204, USA.
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Schell J, Scofield RH, Barrett JR, Kurien BT, Betts N, Lyons TJ, Zhao YD, Basu A. Strawberries Improve Pain and Inflammation in Obese Adults with Radiographic Evidence of Knee Osteoarthritis. Nutrients 2017; 9:nu9090949. [PMID: 28846633 PMCID: PMC5622709 DOI: 10.3390/nu9090949] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 08/20/2017] [Accepted: 08/25/2017] [Indexed: 02/06/2023] Open
Abstract
Osteoarthritis (OA), the most common form of arthritis, is a significant public health burden in U.S. adults. Among its many risk factors, obesity is a key player, causing inflammation, pain, impaired joint function, and reduced quality of life. Dietary polyphenols and other bioactive compounds in berries, curcumin, and tea have shown effects in ameliorating pain and inflammation in OA, but few clinical studies have been reported. The purpose of the present study was to examine the effects of dietary strawberries on pain, markers of inflammation, and quality of life indicators in obese adults with OA of the knee. In a randomized, double-blind cross-over trial, adults with radiographic evidence of knee OA (n = 17; body mass index (BMI): (mean ± SD) 39.1 ± 1.5; age (years): 57 ± 7) were randomized to a reconstituted freeze-dried strawberry beverage (50 g/day) or control beverage daily, each for 12 weeks, separated by a 2-week washout phase (total duration, 26 weeks). Blood draws and assessments of pain and quality of life indicators were conducted using the Visual Analog Scale for Pain (VAS Pain), Measures of Intermittent and Constant Osteoarthritis Pain (ICOAP), and Health Assessment Questionnaire-Disability Index (HAQ-DI) questionnaires, which were completed at baseline and at weeks 12, 14, and 26 of the study. Among the serum biomarkers of inflammation and cartilage degradation, interleukin (IL)-6, IL-1β, and matrix metalloproteinase (MMP)-3 were significantly decreased after strawberry vs. control treatment (all p < 0.05). Strawberry supplementation also significantly reduced constant, intermittent, and total pain as evaluated by the ICOAP questionnaire as well as the HAQ-DI scores (all p < 0.05). No effects of treatment were noted on serum C-reactive protein (CRP), nitrite, glucose, and lipid profiles. Dietary strawberries may have significant analgesic and anti-inflammatory effects in obese adults with established knee OA.
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Affiliation(s)
- Jace Schell
- Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA.
| | - R Hal Scofield
- Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
- Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA.
- Medical Service, US Department of Veterans Affairs Medical Center, Oklahoma City, OK 73102, USA.
| | - James R Barrett
- Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
| | - Biji T Kurien
- Section of Endocrinology and Diabetes, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
| | - Nancy Betts
- Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA.
| | - Timothy J Lyons
- Division of Endocrinology, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Yan Daniel Zhao
- Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA.
| | - Arpita Basu
- Nutritional Sciences, Oklahoma State University, Stillwater, OK 74078, USA.
- Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV 89154, USA.
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Hung M, Bounsanga J, Voss MW, Gu Y, Crum AB, Tang P. Dietary and Supplemental Vitamin C and D on Symptom Severity and Physical Function in Knee Osteoarthritis. J Nutr Gerontol Geriatr 2017; 36:121-133. [PMID: 28557644 PMCID: PMC6088727 DOI: 10.1080/21551197.2017.1317315] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Vitamins C and D have been associated with decreasing pain and increasing function but these associations are not definitive. This cross-sectional study explores what relationships supplemental and dietary intake of vitamins C and D have on pain severity and physical function in patients with knee osteoarthritis. Using data from the Osteoarthritis Initiative, we performed regression analyses to examine relationships between vitamins C and D, pain, and function. Dietary vitamin D and dietary vitamin C were divided into >90th, 50th-90th, and <50th percentile. The high percentile group for supplemental vitamin D was divided into >85th percentile, whereas the high percentile group for supplemental vitamin C was divided into >90th percentile. We found the 90th/85th percentile levels of dietary and supplemental vitamin D to be positively associated with pain (β = 0.180; p = 0.028) and inversely related to physical function (β = -0.150, p = 0.028), respectively. Daily intake of vitamin C showed no statistical significance. We found that supplementary vitamin D was strongly associated with lessened disability for knee OA patients. The unexpected finding that associated dietary vitamin D with greater knee pain merits further study.
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Affiliation(s)
- Man Hung
- University of Utah Department of Orthopaedics
- University of Utah Division of Public Health
- Huntsman Cancer Institute
| | | | | | - Yushan Gu
- University of Utah Department of Orthopaedics
- University of Utah Department of Mathematics
| | | | - Philip Tang
- University of Utah Department of Orthopaedics
- Touro University California College of Osteopathic Medicine
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9
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Rasheed Z, Rasheed N, Al-Shaya O. Epigallocatechin-3-O-gallate modulates global microRNA expression in interleukin-1β-stimulated human osteoarthritis chondrocytes: potential role of EGCG on negative co-regulation of microRNA-140-3p and ADAMTS5. Eur J Nutr 2017; 57:917-928. [PMID: 28110479 DOI: 10.1007/s00394-016-1375-x] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 12/22/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE MicroRNAs (miRNAs) are short, non-coding RNAs involved in almost all cellular processes. Epigallocatechin-3-O-gallate (EGCG) is a green tea polyphenol and is known to exert anti-arthritic effects by inhibiting genes associated with osteoarthritis (OA). This study was undertaken to investigate the global effect of EGCG on interleukin-1β (IL-1β)-induced expression of miRNAs in human chondrocytes. METHODS Human chondrocytes were derived from OA cartilage and then treated with EGCG and IL-1β. Human miRNA microarray technology was used to determine the expression profile of 1347 miRNAs. Microarray results were verified by taqman assays and transfection of chondrocytes with miRNA inhibitors. RESULTS Out of 1347 miRNAs, EGCG up-regulated expression of 19 miRNAs and down-regulated expression of 17 miRNAs, whereas expression of 1311 miRNAs remains unchanged in IL-1β-stimulated human OA chondrocytes. Bioinformatics approach showed that 3`UTR of ADAMTS5 mRNA contains the 'seed-matched-sequence' for hsa-miR-140-3p. IL-1β-induced expression of ADAMTS5 correlated with down-regulation of hsa-miR-140-3p. Importantly, EGCG inhibited IL-1β-induced ADAMTS5 expression and up-regulated the expression of hsa-miR-140-3p. This EGCG-induced co-regulation between ADAMTS5 and hsa-miR-140-3p becomes reversed in OA chondrocytes transfected with anti-miR-140-3p. CONCLUSIONS This study provides an important insight into the molecular basis of the reported anti-arthritic effects of EGCG. Our data indicate that the potential of EGCG in OA chondrocytes may be related to its ability to globally inhibit inflammatory response via modulation of miRNAs expressions.
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MESH Headings
- 3' Untranslated Regions
- ADAMTS5 Protein/antagonists & inhibitors
- ADAMTS5 Protein/chemistry
- ADAMTS5 Protein/genetics
- ADAMTS5 Protein/metabolism
- Anti-Inflammatory Agents, Non-Steroidal/metabolism
- Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
- Base Sequence
- Cartilage, Articular/immunology
- Cartilage, Articular/metabolism
- Cartilage, Articular/pathology
- Catechin/analogs & derivatives
- Catechin/metabolism
- Catechin/therapeutic use
- Cells, Cultured
- Chondrocytes/immunology
- Chondrocytes/metabolism
- Chondrocytes/pathology
- Computational Biology
- Conserved Sequence
- Dietary Supplements
- Gene Expression Profiling
- Gene Expression Regulation
- Humans
- Interleukin-1beta/metabolism
- MicroRNAs/antagonists & inhibitors
- MicroRNAs/chemistry
- MicroRNAs/metabolism
- Oligonucleotide Array Sequence Analysis
- Osteoarthritis, Knee/diet therapy
- Osteoarthritis, Knee/immunology
- Osteoarthritis, Knee/metabolism
- Osteoarthritis, Knee/pathology
- RNA Interference
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Affiliation(s)
- Zafar Rasheed
- Department of Medical Biochemistry, College of Medicine, Qassim University, P.O. Box 6655, Buraidah, 51452, Saudi Arabia.
| | - Naila Rasheed
- Department of Medical Biochemistry, College of Medicine, Qassim University, P.O. Box 6655, Buraidah, 51452, Saudi Arabia
| | - Osama Al-Shaya
- Department of Orthopedics, King Fahd Medical City, Riyadh, Saudi Arabia
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10
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Dyer J, Davison G, Marcora SM, Mauger AR. Effect of a Mediterranean Type Diet on Inflammatory and Cartilage Degradation Biomarkers in Patients with Osteoarthritis. J Nutr Health Aging 2017; 21:562-566. [PMID: 28448087 PMCID: PMC5405095 DOI: 10.1007/s12603-016-0806-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 04/13/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVES To investigate the effects of a Mediterranean type diet on patients with osteoarthritis (OA). PARTICIPANTS Ninety-nine volunteers with OA (aged 31 - 90 years) completed the study (83% female). SETTING Southeast of England, UK. DESIGN Participants were randomly allocated to the dietary intervention (DIET, n = 50) or control (CON, n = 49). The DIET group were asked to follow a Mediterranean type diet for 16 weeks whereas the CON group were asked to follow their normal diet. MEASUREMENTS All participants completed an Arthritis Impact Measurement Scale (AIMS2) pre-, mid- and post- study period. A subset of participants attended a clinic at the start and end of the study for assessment of joint range of motion, ROM (DIET = 33, CON = 28), and to provide blood samples (DIET = 29, CON = 25) for biomarker analysis (including serum cartilage oligomeric matrix protein (sCOMP) (a marker of cartilage degradation) and a panel of other relevant biomarkers including pro- and anti-inflammatory cytokines). RESULTS There were no differences between groups in the response of any AIMS2 components and most biomarkers (p > 0.05), except the pro-inflammatory cytokine IL-1α, which decreased in the DIET group (~47%, p = 0.010). sCOMP decreased in the DIET group by 1 U/L (~8%, p = 0.014). There was a significant improvement in knee flexion and hip rotation ROM in the DIET group (p < 0.05). CONCLUSIONS The average reduction in sCOMP in the DIET group (1 U/L) represents a meaningful change, but the longer term effects require further study.
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Affiliation(s)
- J Dyer
- Dr. Alexis R. Mauger, School of Sport and Exercise Sciences, The Medway Campus, University of Kent, KENT, ME4 4AG, United Kingdom, Telephone: +44 (0)1634 888997, Fax: +44 (0)1634 888890,
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Ghoochani N, Karandish M, Mowla K, Haghighizadeh MH, Jalali MT. The effect of pomegranate juice on clinical signs, matrix metalloproteinases and antioxidant status in patients with knee osteoarthritis. J Sci Food Agric 2016; 96:4377-4381. [PMID: 26804926 DOI: 10.1002/jsfa.7647] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Revised: 01/18/2016] [Accepted: 01/19/2016] [Indexed: 06/05/2023]
Abstract
BACKGROUND Osteoarthritis (OA) is one of the commonest forms of musculoskeletal disorders that leads to joint degeneration and has a major impact on patients' quality of life. Experimental and in vitro studies have suggested the protective roles of pomegranate juice (PJ) as a rich antioxidant source for mitigating cartilage inflammation. In this interventional study, 38 patients with knee OA were randomly divided into two groups: PJ or control for 6 weeks to evaluate the effect of this intervention on clinical signs, inflammation and antioxidant status. RESULTS Significant decreases in Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) total score (P = 0.01), stiffness score (P = 0.00) and physical function score (P = 0.01) were observed in PJ group after the intervention. The means of serum levels of matrix metalloproteinase (MMP)-13 was significantly decreased (P = 0.02) and glutathione peroxidase was increased in the intervention group compared with the control group after the study period (P = 0.02). CONCLUSIONS According to the findings of this clinical trial, PJ consumption can improve physical function and stiffness, decrease breakdown cartilage enzymes and increase antioxidant status in patients with knee OA. © 2016 Society of Chemical Industry.
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Affiliation(s)
- Nasrin Ghoochani
- Nutrition and Metabolic Diseases Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid Karandish
- Nutrition and Metabolic Diseases Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Karim Mowla
- Department of Internal Medicine, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Hossein Haghighizadeh
- Department of Biostatics and Epidemiology, Faculty of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Taha Jalali
- Hyperlipidemia Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Hofstede SN, Marang-van de Mheen PJ, Vliet Vlieland TPM, van den Ende CHM, Nelissen RGHH, van Bodegom-Vos L. Barriers and Facilitators Associated with Non-Surgical Treatment Use for Osteoarthritis Patients in Orthopaedic Practice. PLoS One 2016; 11:e0147406. [PMID: 26799974 PMCID: PMC4723077 DOI: 10.1371/journal.pone.0147406] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 01/04/2016] [Indexed: 11/29/2022] Open
Abstract
Introduction International evidence-based guidelines for the management of patients with hip and knee osteoarthritis (OA) recommend to start with (a combination of) non-surgical treatments, and using surgical intervention only if a patient does not respond sufficiently to non-surgical treatment options. Despite these recommendations, there are strong indications that non-surgical treatments are not optimally used in orthopaedic practice. To improve the adoption of non-surgical treatments, more insight is needed into barriers and facilitators of these treatments. Therefore, this study assessed which barriers and facilitators are associated with the use and prescription of different non-surgical treatments before hip and knee OA in orthopaedic practice among patients and orthopaedic surgeons in the Netherlands. Materials and Methods We performed two internet-based surveys among 172 orthopaedic surgeons and 174 OA patients. Univariate association and multivariable regression techniques are used to identify barriers and facilitators associated with the use of non-surgical treatments. Results Most barriers and facilitators among patients were associated with the use of physical therapy, lifestyle advice and dietary therapy. Among orthopaedic surgeons, most were associated with prescription of acetaminophen, dietary therapy and physical therapy. Examples of barriers and facilitators among patients included “People in my environment had positive experiences with a surgery” (facilitator for education about OA), and “Advice of people in my environment to keep on moving” (facilitator for lifestyle and dietary advice). For orthopaedic surgeons, examples were “Lack of knowledge about guideline” (barrier for lifestyle advice), “Agreements/ deliberations with primary care” and “Easy communication with a dietician” (facilitators for dietary therapy). Also the belief in the efficacy of these treatments was associated with increased prescription. Conclusions Strategies to improve non-surgical treatment use in orthopaedic practice should be targeted at changing the beliefs of orthopedic surgeons, communication with other OA care providers and involving patient’s environment in OA treatment.
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Affiliation(s)
- Stefanie N. Hofstede
- Department of Medical Decision Making, Leiden University Medical Center, RC Leiden, The Netherlands
| | | | | | | | - Rob G. H. H. Nelissen
- Department of Orthopaedics, Leiden University Medical Center, RC Leiden, The Netherlands
| | - Leti van Bodegom-Vos
- Department of Medical Decision Making, Leiden University Medical Center, RC Leiden, The Netherlands
- * E-mail:
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Kumar S, Sugihara F, Suzuki K, Inoue N, Venkateswarathirukumara S. A double-blind, placebo-controlled, randomised, clinical study on the effectiveness of collagen peptide on osteoarthritis. J Sci Food Agric 2015; 95:702-707. [PMID: 24852756 DOI: 10.1002/jsfa.6752] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 04/29/2014] [Accepted: 05/18/2014] [Indexed: 06/03/2023]
Abstract
BACKGROUND Recent studies show that enzymatically hydrolysed collagen, the collagen peptide, is absorbed and distributed to joint tissues and has analgesic and anti-inflammatory properties. A double-blind, placebo-controlled, randomised trial with collagen peptides isolated from pork skin (PCP) and bovine bone (BCP) sources was carried out to study the effectiveness of orally supplemented collagen peptide to control the progression of osteoarthritis in patients diagnosed with knee osteoarthritis. Improvement in treatment was assessed with reduction in Western Ontario McMaster Universities (WOMAC), visual analogue scale (VAS) and quality of life (QOL) scores from baseline to 13 weeks (Visit 7). Safety and tolerability were also evaluated. RESULTS There was significant reduction from baseline to Visit 7 in the primary end points of WOMAC and VAS scores and in the secondary end point of QOL score in subjects with PCP and BCP groups, while in subjects with placebo group the end point indices remained unaltered. Furthermore, all the score levels of WOMAC, VAS and QOL decreased significantly (P < 0.01) in the study group compared to placebo group in Visit 7. CONCLUSION The study demonstrated that collagen peptides are potential therapeutic agents as nutritional supplements for the management of osteoarthritis and maintenance of joint health.
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Affiliation(s)
- Suresh Kumar
- Nitta Gelatin India Ltd, Kinfra Parks Ltd, Kakkanad, Cochin - 682030, India
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Gudbergsen H. MRI in knee osteoarthritis. Application in diet intervention. Dan Med J 2013; 60:B4594. [PMID: 23484617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This thesis examines two main hypotheses: 1. Obese knee osteoarthritis (KOA) patients can achieve symptomatic improvements following diet intervention regardless of their level of structural damage and overall joint malfunctioning: 2. Rapid weight-loss in obese patients with KOA will lead to improvements in KOA related pathology that can be assessed and evaluated by MRI. Data for the studies were obtained from obese KOA patients who were recruited for a 16 week diet intervention trial, the CAROT-trial (ClinicalTrials.gov identification no.: NCT00655941). Inclusion criteria were age ≥ 50 years, BMI ≥ 30 kg/square metro plus symptomatic and verified KOA. Patients underwent a 16 weeks dietary programme with formula products and counselling. Baseline and week 16 assessments included clinical examinations, MRI and CR of the most symptomatic knee, muscle strength tests, gait analyses, blood samples and collection of patient-reported outcomes with a variety of generic and specific health status questionnaires. MRI scans were graded by the BLOKS and CR was analysed by measuring the mJSW and grading the knee as described by KL. 388 possible subjects were pre-screened, 192 were enrolled. Following the 16 weeks diet intervention 175 patients remained in the study. 187 (97%) MRI scans were completed at baseline, 172 (98 %) MRI scans obtained at week 16 and this left the study with 169 (97%) patients with complete MRI datasets at week 16. No statistical significant differences were detected between baseline characteristics of all the initially included patients (n = 192) and the 169 patients included in the per protocol analyses performed in study III (p < 0.05). In order to apply BLOKS, an extensive MRI scoring system, in study II and III we examined the inter- and intra-observer reliability of the various BLOKS items in study I. Results showed that our assessment team performed as described in the original study defining BLOKS and that the patients in the CAROT-trial were graded as expected. In study II we investigated the impact of diet intervention on KOA symptoms whatever the patient's individual level of joint damage and malfunctioning, and the explanatory variables included high-field MRI, radiographs, and muscle strength in m. quadriceps as well as measurements of the knee-joint alignment axis. Results showed that diet intervention resulted in a symptomatic relief in obese KOA patients, irrespective of their level of structural damage, measures of joint malfunctioning and general pre-study patient characteristics. The final study examined whether or not weight-loss had an immediate impact on MRI assessed BMLs. The results showed that changes seen in the total TF sum of BML scores and maximal BML scores did not differ between patients achieving a major weight loss (> 10%) and those who did not. Furthermore, changes in clinical symptoms and BML scores were not associated. The limitations of this thesis were that the MRI analyses were based on single determinations of MRI variables and that the studies did not assess between scan reliability. The MRI protocol for this study did not include all the recommended sequences for BLOKS. Analysing BMLs with the use of only coronal STIR and T1w sequences is considered adequate for a reasonable assessment of the tibial and femoral bones. However, we recognize the limitations this strategy withholds in terms of correctly assessing BMLs located at the margins of our slices when only having a single plane view included in our MRI protocol. Due to an inadequate coverage we did not analyse BMLs in patella, and this confined the thesis to only study changes in the tibial and femoral bones. BLOKS contains separate scores for effusion and synovitis and we have assessed all MRI scans according to this discrimination well knowing that this procedure is biased and that a recent paper has proposed the combination of the two scores. MRI technology allows for an excellent discrimination and delineation of synovitis and synovial effusion by performing MRI with I.V. gadolinium and post-contrast T1 FS images, but due to extensive requirements and longer scans times for such examinations we proceeded with our, in this matter, suboptimal MRI protocol. The optimal assessment of KOA would be achieved by performing three radiographic views, posteroanterior, lateral and skyline, but for this study we chose a radiographic protocol only including the first two mentioned as this procedure was somewhat similar to the routine examination for KOA applied on a daily basis at our Department of Radiology. The results of this thesis support existing guidelines suggesting that diet intervention in obese KOA patients is beneficial for symptomatic improvements. The new information from the thesis is that improvement in clinical symptoms is possible for the majority of patients, independent of their pre-study level of structural damage and measures of joint malfunctioning. The present results also demonstrated that a rapid weight-loss had no association to changes in BML scores and established that changes observed in symptoms and BML scores, following a 16 weeks diet intervention, were not related.
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Affiliation(s)
- Henrik Gudbergsen
- Department of Rheumatology, The Parker Institute, Frederiksberg, Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark.
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Kanzaki N, Saito K, Maeda A, Kitagawa Y, Kiso Y, Watanabe K, Tomonaga A, Nagaoka I, Yamaguchi H. Effect of a dietary supplement containing glucosamine hydrochloride, chondroitin sulfate and quercetin glycosides on symptomatic knee osteoarthritis: a randomized, double-blind, placebo-controlled study. J Sci Food Agric 2012; 92:862-869. [PMID: 21969261 DOI: 10.1002/jsfa.4660] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Revised: 08/09/2011] [Accepted: 08/19/2011] [Indexed: 05/31/2023]
Abstract
BACKGROUND Oral glucosamine and chondroitin sulfate, alone and in combination, have been used worldwide for the treatment of osteoarthritis (OA), but their efficacy is controversial. This clinical study was aimed at investigating the potential of a dietary supplement containing glucosamine and chondroitin sulfate in combination with derivatives of quercetin, a naturally occurring flavonoid, (GCQ supplement) for knee OA care. RESULTS A randomized, double-blind, placebo-controlled study was conducted in 40 Japanese subjects with symptomatic knee OA. Subjects were randomly assigned to GCQ supplement (1200 mg glucosamine hydrochloride, 60 mg chondroitin sulfate and 45 mg quercetin glycosides per day) or placebo and the treatment and follow-up were continued for 16 weeks. The results of symptomatic efficacy assessment based on Japanese Orthopaedic Association criteria showed that scores for two of the four symptom/function subscales, as well as the aggregate scores, were significantly improved at week 16 or earlier in the GCQ group compared to the placebo group. Moreover, analyses of cartilage metabolism biomarkers showed a trend of improvement in type II collagen synthesis/degradation balance in the GCQ group during follow-up. CONCLUSION GCQ supplement was thought to be more effective than placebo in decreasing the intensity of knee OA-associated clinical symptoms.
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Affiliation(s)
- Noriyuki Kanzaki
- Institute for Health Care Science, Suntory Wellness Ltd, Mishima-gun, Osaka, Japan.
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Fazelipour S, Tootian Z, Matini E, Hadipour-Jahromy M. Histomorphometric alteration of knee articular cartilage and serum alkaline phosphatase in young female mice by chronic supplementation with soybean. Phytother Res 2010; 25:886-91. [PMID: 21110395 DOI: 10.1002/ptr.3327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2010] [Revised: 09/21/2010] [Accepted: 09/21/2010] [Indexed: 11/07/2022]
Abstract
The purpose of the present study was to examine the effect of soybean supplementation on cartilage thickness in the knee joint and serum levels of alkaline phosphatase (ALP) in mice. Forty female mice were fed for 6 months on one of four regimens: low protein, complete protein without soybean, and complete protein containing either 20% or 40% soybean. Body weight differences, histological and histomorphometric analysis, and ALP levels were determined and compared after 6 months. The results showed a significant increase in serum ALP activity and cartilage thickness in both groups fed on soybean-containing diets, compared with the other groups. Additionally, the number of chondrocytes was significantly increased (p < 0.001) in the group taking the 40% soybean regimen, and the proteoglycan content of the intracellular fluid in the tibia was higher in those groups taking soybean. In conclusion, the present study suggests that soybean supplementation is capable of stimulating ALP production and reducing cartilage loss in young female mice. Soybean supplementation during childhood may therefore be potentially useful in protecting joints.
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Affiliation(s)
- S Fazelipour
- Department of Anatomy, Tehran Medical Branch Islamic Azad University, Tehran, Iran.
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Diet + exercise best for knee OA. Health News 2006; 12:4. [PMID: 16453933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
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Khodyrev VN, Beketova NA, Kodentsova VM, Vrzhesinskaia OA, Kosheleva OV, Pereverzeva OG, Rzhanikov EB, Spirichev VB. [The influence of the vitamin-mineral complex upon the blood vitamin, calcium and phosphorus of patients with ostreoarthrosis]. Vopr Pitan 2006; 75:44-7. [PMID: 16729761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
In research in which 11 osteoarthrosis patients with osteoarthrosis of the knee-joint of II-III degree and 18 healthy people took part, it has been shown that sufficiency with vitamin C, carotinoids and calcium of osteoarthrosis patients was worse than that of healthy people. These micronutrients blood plasma level in both groups was less than the lower border of normal sufficiency. Whereas patients from both groups were adequately supplied with vitamins A, E, B2 and phosphorus. Addition of vitamin-mineral complex to patients ration course 30 days resulted in eliminating insufficiently of vitamin C, carotinoids, beta-carotin, calcium and in hardly noticable changes of initial high levels of vitamin A, E, B and phosphoris. These nutrients deficit disappeared while there was no noticeable change in the initial optimal provision with vitamins B2, A and E. Thus, there is no doubt in arguments in favour of additional enrichment with vitamins and calcium of osteoarthrosis patients diet.
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Focht BC, Rejeski WJ, Ambrosius WT, Katula JA, Messier SP. Exercise, self-efficacy, and mobility performance in overweight and obese older adults with knee osteoarthritis. ACTA ACUST UNITED AC 2005; 53:659-65. [PMID: 16208674 DOI: 10.1002/art.21466] [Citation(s) in RCA: 121] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine changes in mobility-related self efficacy following exercise and dietary weight loss interventions in overweight and obese older adults with knee osteoarthritis (OA), and to determine if self efficacy and pain mediate the effects of the interventions on mobility task performance. METHODS The Arthritis, Diet, and Activity Promotion Trial was an 18-month, single-blind, randomized, controlled trial comparing the effects of exercise alone, dietary weight loss alone, a combination of exercise plus dietary weight loss, and a healthy lifestyle control intervention in the treatment of 316 overweight or obese older adults with symptomatic knee OA. Participants completed measures of stair-climb time and 6-minute walk distance, self efficacy for completing each mobility task, and self-reported pain at baseline, 6 months, and 18 months during the trial. RESULTS Mixed model analyses of covariance of baseline adjusted change in the outcomes demonstrated that the exercise + dietary weight loss intervention produced greater improvements in mobility-related self efficacy (P = 0.0035), stair climb (P = 0.0249) and 6-minute walk performance (P = 0.00031), and pain (P = 0.09) when compared with the healthy lifestyle control intervention. Mediation analyses revealed that self efficacy and pain served as partial mediators of the beneficial effect of exercise + dietary weight loss on stair-climb time. CONCLUSION Exercise + dietary weight loss results in improved mobility-related self efficacy; changes in these task-specific control beliefs and self-reported pain serve as independent partial mediators of the beneficial effect of exercise + dietary weight loss on stair-climb performance.
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Christensen R, Stigsgaard L, Astrup AV, Bliddal H. [Weight loss as therapy of knee osteoarthritis in obese patients--secondary publication]. Ugeskr Laeger 2005; 167:2522-6. [PMID: 16008009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
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Christensen R, Astrup A, Bliddal H. Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial. Osteoarthritis Cartilage 2005; 13:20-7. [PMID: 15639633 DOI: 10.1016/j.joca.2004.10.008] [Citation(s) in RCA: 196] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2004] [Accepted: 10/05/2004] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We wanted to assess the effect of rapid diet-induced weight loss on the function of obese, knee osteoarthritis (OA) patients. METHODS Eighty patients with knee OA, 89% women (n=71), were recruited. Mean (SD) body-mass index (BMI) was 35.9 (5.1) kg/m(2) and age 62.6 (11.1) years. Patients were randomized to either a low-energy diet (LED 3.4MJ/day), or a control diet (5MJ/day). The LED group had weekly dietary sessions, whereas the control group was given a booklet describing weight loss practices. Changes in body weight and body composition were examined as independent predictors of changes in knee OA symptoms. Symptoms were monitored by the Western Ontario and McMaster Universities' (WOMAC) OA index. RESULTS The LED and control group lost a mean (SE) of 11.1 (0.6)% and 4.3 (0.6)%, respectively, with a mean difference being 6.8% (95% confidence interval (CI): 5.5 to 8.1%; P<0.0001). The decrease in body fat percent was higher in the LED group, 2.2% (1.5 to 3.0%; P<0.0001). The total WOMAC index improved in the LED group (P<0.0001), but not in the control group (P=0.12), mean difference: -219.3mm (-369.2 to -69.4mm; P=0.005). The 'Number Needed to Treat (NNT)' to ensure an improvement in WOMAC>/=50% was 3.4 (2.1 to 8.8) patients. Changes in total WOMAC index were best predicted by the reduction of body fat percent, with a 9.4% (4.8 to 13.9%) improvement in WOMAC for each percent of body fat reduced (P=0.0005). CONCLUSIONS In our patients with knee OA, a weight reduction of 10% improved function by 28%. LED might be of advantage to control diet because of the rapidity of weight loss and a more significant loss of body fat.
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Affiliation(s)
- R Christensen
- The Parker Institute, H:S Frederiksberg Hospital, Denmark
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Messier SP, Loeser RF, Miller GD, Morgan TM, Rejeski WJ, Sevick MA, Ettinger WH, Pahor M, Williamson JD. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. ACTA ACUST UNITED AC 2004; 50:1501-10. [PMID: 15146420 DOI: 10.1002/art.20256] [Citation(s) in RCA: 673] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The Arthritis, Diet, and Activity Promotion Trial (ADAPT) was a randomized, single-blind clinical trial lasting 18 months that was designed to determine whether long-term exercise and dietary weight loss are more effective, either separately or in combination, than usual care in improving physical function, pain, and mobility in older overweight and obese adults with knee osteoarthritis (OA). METHODS Three hundred sixteen community-dwelling overweight and obese adults ages 60 years and older, with a body mass index of > or =28 kg/m(2), knee pain, radiographic evidence of knee OA, and self-reported physical disability, were randomized into healthy lifestyle (control), diet only, exercise only, and diet plus exercise groups. The primary outcome was self-reported physical function as measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included weight loss, 6-minute walk distance, stair-climb time, WOMAC pain and stiffness scores, and joint space width. RESULTS Of the 316 randomized participants, 252 (80%) completed the study. Adherence was as follows: for healthy lifestyle, 73%; for diet only, 72%; for exercise only, 60%; and for diet plus exercise, 64%. In the diet plus exercise group, significant improvements in self-reported physical function (P < 0.05), 6-minute walk distance (P < 0.05), stair-climb time (P < 0.05), and knee pain (P < 0.05) relative to the healthy lifestyle group were observed. In the exercise group, a significant improvement in the 6-minute walk distance (P < 0.05) was observed. The diet-only group was not significantly different from the healthy lifestyle group for any of the functional or mobility measures. The weight-loss groups lost significantly (P < 0.05) more body weight (for diet, 4.9%; for diet plus exercise, 5.7%) than did the healthy lifestyle group (1.2%). Finally, changes in joint space width were not different between the groups. CONCLUSION The combination of modest weight loss plus moderate exercise provides better overall improvements in self-reported measures of function and pain and in performance measures of mobility in older overweight and obese adults with knee OA compared with either intervention alone.
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Affiliation(s)
- Stephen P Messier
- Claude D. Pepper Older Americans Independence Center, Wake Forest University, Winston-Salem, NC 27109, USA.
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Fransen M. Dietary weight loss and exercise for obese adults with knee osteoarthritis: modest weight loss targets, mild exercise, modest effects. ACTA ACUST UNITED AC 2004; 50:1366-9. [PMID: 15146405 DOI: 10.1002/art.20257] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Wluka AE, Stuckey S, Brand C, Cicuttini FM. Supplementary vitamin E does not affect the loss of cartilage volume in knee osteoarthritis: a 2 year double blind randomized placebo controlled study. J Rheumatol 2002; 29:2585-91. [PMID: 12465157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
Abstract
OBJECTIVE To determine whether vitamin E affects change in cartilage volume in patients with knee osteoarthritis (OA). METHODS In a double blind, placebo controlled trial, 136 patients with knee OA (American College of Rheumatology clinical and radiographic criteria) were randomized to receive vitamin E (500 IU) or placebo for 2 years. Tibial cartilage volume was measured by magnetic resonance imaging at the beginning and end of the study. RESULTS Baseline characteristics were similar in the 2 groups (67 vitamin E, 69 placebo); there were more women in the vitamin E group, 42 (63%) vs 33 (48%) in the placebo group. One hundred seventeen subjects (59 vitamin E, 58 placebo) completed the study. Loss of medial and lateral tibial cartilage was similar in subjects treated with vitamin E and placebo (mean +/- SD: medial 157 +/- 209 vs 187 +/- 220 micro m3 placebo, p = 0.51; lateral 186 +/- 258 vs 251 +/- 216 micro m3, p = 0.19). There were no significant differences between the vitamin E and placebo treated groups in improvement of symptoms from baseline. Dietary levels of antioxidants (vitamin C, beta carotene, retinol equivalents) had no effect on cartilage volume loss. CONCLUSION Vitamin E does not appear to have a beneficial effect in the management of knee OA: it does not affect cartilage volume loss or symptoms.
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Affiliation(s)
- Anita E Wluka
- Department of Epidemiology and Preventive Medicine, Monash University Medical School, Prahran, Victoria, Australia
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Hesslink R, Armstrong D, Nagendran MV, Sreevatsan S, Barathur R. Cetylated fatty acids improve knee function in patients with osteoarthritis. J Rheumatol 2002; 29:1708-12. [PMID: 12180734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
OBJECTIVE To determine the benefit of cetylated fatty acids (CFA) on knee range of motion and function in patients with osteoarthritis (OA). METHODS Sixty-four patients with chronic knee OA were evaluated at baseline and at 30 and 68 days after consuming either placebo (vegetable oil; n = 31) or CFA (Celadrin; n = 33). Evaluations included physician assessment, knee range of motion with goniometry, and the Lequesne Algofunctional Index (LAI). RESULTS After 68 days, patients treated with CFA exhibited significant (p < 0.001) increase in knee flexion (10.1 degrees) compared to patients given placebo (1.1 degrees). Neither group reported improvement in knee extension. Patient responses to the LAI indicated a significant (p < 0.001) shift towards functional improvement for the CFA group (-5.4 points) after 68 days compared to a modest improvement in the placebo group (-2.1 points). CONCLUSION Compared to placebo, CFA provides an improvement in knee range of motion and overall function in patients with OA of the knee. CFA may be an alternative to the use of nonsteroidal antiinflammatory drugs for the treatment of OA.
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