Wendy Walrabenstein, Carlijn A Wagenaar, Marieke van de Put, Marike van der Leeden, Martijn Gerritsen, Jos W R Twisk, Martin van der Esch, Henriët van Middendorp, Peter J M Weijs, Leo D Roorda, Dirkjan van Schaardenburg
Journal: Osteoarthritis and cartilage 2023;31(11):1491-1500
PMID: 37328047
Osteoarthritis (OA) is a chronic condition that mostly affects the hands, hips and knees. Having OA is associated with a 2-fold higher risk of metabolic syndrome and obesity. Metabolic syndrome-associated osteoarthritis (MSOA) is a distinct phenotype of OA, based on studies showing associations between OA and the components of metabolic syndrome. The aim of this study was to determine the effectiveness of the “Plants for Joints” programme, which integrates a whole food plant-based diet, physical activity, and stress management, in patients with MSOA. This study was a 16-week open label randomised controlled trial that involved patients with hip or knee MSOA who were allocated to either the intervention group or the control group. Results showed that after 16 weeks, the intervention group showed a significant improvement in the Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) score, with an 11-point larger improvement compared to the control group. Additionally, the intervention group experienced weight loss, reduced fat mass, and decreased waist circumference Authors concluded that the “Plants for Joints” lifestyle programme was found to be effective in reducing stiffness, alleviating pain, and enhancing physical function in individuals with hip or knee MSOA, offering a promising approach to managing this condition.
OBJECTIVE
To determine the effectiveness of the "Plants for Joints" multidisciplinary lifestyle program in patients with metabolic syndrome-associated osteoarthritis (MSOA).
DESIGN
Patients with hip or knee MSOA were randomized to the intervention or control group. The intervention group followed a 16-week program in addition to usual care based on a whole food plant-based diet, physical activity, and stress management. The control group received usual care. The patient-reported Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) total score (range 0-96) was the primary outcome. Secondary outcomes included other patient-reported, anthropometric, and metabolic measures. An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyze between-group differences.
RESULTS
Of the 66 people randomized, 64 completed the study. Participants (84% female) had a mean (SD) age of 63 (6) years and body mass index of 33 (5) kg/m. After 16 weeks, the intervention group (n = 32) had a mean 11-point larger improvement in WOMAC-score (95% CI 6-16; p = 0.0001) compared to the control group. The intervention group also lost more weight (-5 kg), fat mass (-4 kg), and waist circumference (-6 cm) compared to the control group. Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue, pain interference, C-reactive protein, hemoglobin A1c, fasting glucose, and low-density lipoproteins improved in the intervention versus the control group, while other PROMIS measures, blood pressure, high-density lipoproteins, and triglycerides did not differ significantly between the groups.
CONCLUSION
The "Plants for Joints" lifestyle program reduced stiffness, relieved pain, and improved physical function in people with hip or knee MSOA compared to usual care.
Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.
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