Skip to main content
SpringerLink
Log in

The effect of an anti-inflammatory in comparison with a low caloric diet on physical and mental health in overweight and obese women with knee osteoarthritis: a randomized clinical trial

European Journal of Nutrition Aims and scope Submit manuscript

Cite this article

Abstract

Purpose

To evaluate the effect of an anti-inflammatory compared to a low-calorie diet on the physical and mental health of patients with knee OA.

Methods

In this randomized parallel clinical trial, participants were selected among overweight and obese women aged 40 years or older with mild to moderate OA. Sixty women with a ratio of 1:1 were randomly assigned to receive either low-calorie or anti-inflammatory accompanied by a low-calorie diet for two months. The dietary intake and weight of participants were measured. Study variables were assessed using the Western Ontario and McMaster Index (WOMAC), visual analog pain scale (VAS), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI-I), and the Short Form 36 Health Survey Questionnaire (SF-36) to indicate the quality of life (QoL).

Results

There was no statistically significant difference between the two groups in demographic and baseline variables except for the emotional well-being subscale of QoL. There was significant difference in anti-inflammatory compared to low-calorie diet in terms of weight (MD (95% CI): − 4.02 kg (− 6.77 to − 1.28); p = 0.005), VAS (MD (95% CI): − 0.97 (− 1.53 to − 0.41); p = 0.001), WOMAC-total score (MD (95% CI): − 9.91 (− 15.05 to − 4.78); p < 0.001), WOMAC-pain subscale (MD (95% CI): − 3.30 (− 5.30 to − 1.29); p = 0.002), WOMAC-physical function (MD(95% CI): − 5.48 (− 9.41 to − 1.53); p = 0.007), depression (p = 0.003), anxiety (p = 0.011), QoL-physical functioning (0.041), and QoL-pain (0.010) after the intervention.

Conclusion

An anti-inflammatory accompanied by a low-calorie diet resulted in greater weight loss and greater improvement in pain intensity, functional status, depression, anxiety, and some dimension of QoL in overweight and obese women with knee OA compared to the low-calorie diet.

Trial registration number and date of registration: IRCT201610220030424N2; 2018-04-23.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Hunter DJ, Bierma-Zeinstra S (2019) Osteoarthritis. Lancet 393:1745–1759. https://doi.org/10.1016/S0140-6736(19)30417-9

    Article  CAS  PubMed  Google Scholar 

  2. Deshpande BR, Katz JN, Solomon DH et al (2016) Number of persons with symptomatic knee osteoarthritis in the US: impact of race and ethnicity, age, sex, and obesity. Arthritis Care Res 68(12):1743–1750. https://doi.org/10.1002/acr.22897

    Article  Google Scholar 

  3. Bannuru RR, Schmid CH, Kent DM, Vaysbrot EE, Wong JB, McAlindon TE (2015) Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis. Ann Intern Med 162:46–54. https://doi.org/10.7326/M14-1231

    Article  PubMed  Google Scholar 

  4. Davatchi F, Tehrani Banihashemi A, Gholami J et al (2009) The prevalence of musculoskeletal complaints in a rural area in Iran: a WHO-ILAR COPCORD study (stage 1, rural study) in Iran. Clin Rheumatol 28:1267–1274. https://doi.org/10.1007/s10067-009-1234-8

    Article  PubMed  Google Scholar 

  5. Fotouhi A, Maleki A, Dolati S, Aghebati-Maleki A, Aghebati-Maleki L (2018) Platelet rich plasma, stromal vascular fraction and autologous conditioned serum in treatment of knee osteoarthritis. Biomed Pharmacother 104:652–660. https://doi.org/10.1016/j.biopha.2018.05.019

    Article  PubMed  Google Scholar 

  6. Park HM, Kim HS, Lee YJ (2020) Knee osteoarthritis and its association with mental health and health-related quality of life: a nationwide cross-sectional study. Geriatr Gerontol Int 20:379–383. https://doi.org/10.1111/ggi.13879

    Article  PubMed  Google Scholar 

  7. Chow YY, Chin KY (2020) The role of inflammation in the pathogenesis of osteoarthritis. Mediators Inflamm 2020:8293921. https://doi.org/10.1155/2020/8293921

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Robinson WH, Lepus CM, Wang Q et al (2016) Low-grade inflammation as a key mediator of the pathogenesis of osteoarthritis. Nat Rev Rheumatol 12:580–592. https://doi.org/10.1038/nrrheum.2016.136

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Mora JC, Przkora R, Cruz-Almeida Y (2018) Knee osteoarthritis: pathophysiology and current treatment modalities. J Pain Res 11:2189–2196. https://doi.org/10.2147/JPR.S154002

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Grässel S, Muschter D (2020) Recent advances in the treatment of osteoarthritis. F1000Res 9:F1000 Faculty Rev-325. https://doi.org/10.12688/f1000research.22115.1

  11. Katz JN, Arant KR, Loeser RF (2021) Diagnosis and treatment of hip and knee osteoarthritis: a review. JAMA 325:568–578. https://doi.org/10.1001/jama.2020.22171

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Rayman MP (2015) Diet, nutrition and osteoarthritis. BMC Musculoskelet Disord 16:S7. https://doi.org/10.1186/1471-2474-16-S1-S7

    Article  PubMed Central  Google Scholar 

  13. Musumeci G, Mobasheri A, Trovato FM, Szychlinska MA, Imbesi R, Castrogiovanni P (2014) Post-operative rehabilitation and nutrition in osteoarthritis. F1000Res 3:116. https://doi.org/10.12688/f1000research

  14. Messina OD, Vidal Wilman M, Vidal Neira LF (2019) Nutrition, osteoarthritis and cartilage metabolism. Aging Clin Exp Res 31:807–813. https://doi.org/10.1007/s40520-019-01191-w

    Article  PubMed  Google Scholar 

  15. Raymond JL, Morrow K (2020) Krause and mahan’s food and the nutrition care process. e-book.: Elsevier Health Sciences

  16. Eftekhar-Sadat B, Niknejad-Hosseyni SH, Babaei-Ghazani A, Toopchizadeh V, Sadeghi H (2015) Reliability and validity of Persian version of Western Ontario and McMaster Universities Osteoarthritis index in knee osteoarthritis. J Anal Res Clin 3:170–177. https://doi.org/10.15171/jarcm.2015.027

    Article  Google Scholar 

  17. Ghassemzadeh H, Mojtabai R, Karamghadiri N, Ebrahimkhani N (2005) Psychometric properties of a Persian-language version of the Beck Depression Inventory-Second edition: BDI-II-PERSIAN. Depress Anxiety 21:185–192. https://doi.org/10.1002/da.20070

    Article  PubMed  Google Scholar 

  18. Kaviani H, Mousavi A (2008) Psychometric properties of the Persian version of Beck Anxiety Inventory (BAI). Tehran Univ Med J 66:136–140 ([In Persian])

    Google Scholar 

  19. Bunevicius A (2017) Reliability and validity of the SF-36 Health Survey Questionnaire in patients with brain tumors: a cross-sectional study. Health Qual Life Outcomes 15:92. https://doi.org/10.1186/s12955-017-0665-1

    Article  PubMed  PubMed Central  Google Scholar 

  20. Berenbaum F (2013) Osteoarthritis as an inflammatory disease (osteoarthritis is not osteoarthrosis!). Osteoarthr Cartil 21:16–21. https://doi.org/10.1016/j.joca.2012.11.012

    Article  CAS  Google Scholar 

  21. Hawker GA (2019) Osteoarthritis is a serious disease. Clin Exp Rheumatol 37(Suppl 120):3–6

    PubMed  Google Scholar 

  22. Johnson KA, Lee AH, Swanson KS (2020) Nutrition and nutraceuticals in the changing management of osteoarthritis for dogs and cats. J Am Vet Med Assoc 15(256):1335–1341. https://doi.org/10.2460/javma.256.12.1335

    Article  Google Scholar 

  23. Cooper I, Brukner P, Devlin BL, Reddy AJ, Fulton M, Kemp JL, Culvenor AG (2022) An anti-inflammatory diet intervention for knee osteoarthritis: a feasibility study. BMC Musculoskelet Disord 23:1–3

    Article  Google Scholar 

  24. Huebner JL, Hanes MA, Beekman B, TeKoppele JM, Kraus VB (2002) A comparative analysis of bone and cartilage metabolism in two strains of guinea-pig with varying degrees of naturally occurring osteoarthritis. Osteoarthr Cartil 10:758–767. https://doi.org/10.1053/joca.2002.0821

    Article  CAS  Google Scholar 

  25. Mirzaee N, Mohammadi-shahboulaghi F, Nowroozi K, Biglarian A, Rangin H (2016) The effect of self-management training on performance of elderly patients with knee osteoarthritis. Iran J Nurs 28:10–20

    Article  Google Scholar 

  26. Dyer J, Davison G, Marcora SM, Mauger AR (2017) Effect of a Mediterranean type diet on inflammatory and cartilage degradation biomarkers in patients with osteoarthritis. J Nutr Health Aging 21:562–566. https://doi.org/10.1007/s12603-016-0806-y

    Article  CAS  PubMed  Google Scholar 

  27. Vincent HK, Heywood K, Connelly J, Hurley RW (2012) Obesity and weight loss in the treatment and prevention of osteoarthritis. PM&R 4:S59-67. https://doi.org/10.1016/j.pmrj.2012.01.005

    Article  Google Scholar 

  28. Messier SP, Mihalko SL, Legault C et al (2013) Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial. JAMA 25(310):1263–1273. https://doi.org/10.1001/jama.2013.277669

    Article  CAS  Google Scholar 

  29. Tolkien K, Bradburn S, Murgatroyd C (2019) An anti-inflammatory diet as a potential intervention for depressive disorders: a systematic review and meta-analysis. Clin Nutr 38:2045–2052. https://doi.org/10.1016/j.clnu.2018.11.007

    Article  CAS  PubMed  Google Scholar 

  30. Kheirouri S, Alizadeh M (2019) Dietary inflammatory potential and the risk of incident depression in adults: a systematic review. Adv Nutr 1(10):9–18. https://doi.org/10.1093/advances/nmy100

    Article  Google Scholar 

  31. Wang J, Zhou Y, Chen K, Jing Y, He J, Sun H, Hu X (2018) Dietary inflammatory index and depression: a meta-analysis. Public Health Nutr 15:1–7. https://doi.org/10.1017/S1368980018002628

    Article  Google Scholar 

  32. Firth J, Marx W, Dash S et al (2019) The effects of dietary improvement on symptoms of depression and anxiety: a meta-analysis of randomized controlled trials. Psychosom Med 81:265–280. https://doi.org/10.1097/PSY.0000000000000673

    Article  PubMed  PubMed Central  Google Scholar 

  33. Barrouin-Melo SM, Anturaniemi J, Sankari S et al (2016) Evaluating oxidative stress, serological- and haematological status of dogs suffering from osteoarthritis, after supplementing their diet with fish or corn oil. Lipids Health Dis 15:139. https://doi.org/10.1186/s12944-016-0304-6

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Calder PC (2013) Omega-3 polyunsaturated fatty acids and inflammatory processes: nutrition or pharmacology? Br J Clin Pharmacol 75:645–662. https://doi.org/10.1111/j.1365-2125.2012.04374.x

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Baker KR, Matthan NR, Lichtenstein AH et al (2012) Association of plasma n-6 and n-3 polyunsaturated fatty acids with synovitis in the knee: the MOST study. Osteoarthr Cartil 20:382–387. https://doi.org/10.1016/j.joca.2012.01.021

    Article  CAS  Google Scholar 

  36. Thomas S, Browne H, Mobasheri A, Rayman MP (2018) What is the evidence for a role for diet and nutrition in osteoarthritis? Rheumatology (Oxford) 57:iv61–iv74. https://doi.org/10.1093/rheumatology/key011

    Article  CAS  PubMed  Google Scholar 

  37. Farnaghi S, Crawford R, Xiao Y, Prasadam I (2017) Cholesterol metabolism in pathogenesis of osteoarthritis disease. Int J Rheum Dis 20:131–140. https://doi.org/10.1111/1756-185X.13061

    Article  CAS  PubMed  Google Scholar 

  38. Chen QJ, Ou L, Li K, Ou FR (2020) Meta-analysis of the relationship between Dietary Inflammatory Index and esophageal cancer risk. Medicine (Baltimore) 99:e23539. https://doi.org/10.1097/MD.0000000000023539

    Article  CAS  PubMed  Google Scholar 

  39. Lopez-Garcia E, Schulze MB, Manson JE et al (2004) Consumption of (n-3) fatty acids is related to plasma biomarkers of inflammation and endothelial activation in women. J Nutr 134:1806–1811. https://doi.org/10.1093/jn/134.7.1806

    Article  CAS  PubMed  Google Scholar 

  40. Jarosz M, Olbert M, Wyszogrodzka G, Młyniec K, Librowski T (2017) Antioxidant and anti-inflammatory effects of zinc. Zinc-dependent NF-κB signaling. Inflammopharmacology 25:11–24. https://doi.org/10.1007/s10787-017-0309-4

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran for supporting this work (Grant Number: 58560).

Author information

Authors and Affiliations

  1. Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran

    Neda Dolatkhah, Vahideh Toopchizadeh, Sahel Barmaki, Yagoub Salekzamani, Afsaneh Najjari, Azizeh Farshbaf-Khalili & Sanam Dolati

Authors
  1. Neda Dolatkhah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vahideh Toopchizadeh
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sahel Barmaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yagoub Salekzamani
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Afsaneh Najjari
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Azizeh Farshbaf-Khalili
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Sanam Dolati
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sanam Dolati.

Ethics declarations

Conflict of interest

The authors declare that there is no conflict of interests regarding the publication of this paper.

Ethical approval

Written informed consent was obtained from all participants after a full explanation of the objectives and method of study prior to intervention. All research stages were approved by the Research Ethics Committee of Tabriz University of Medical Science (IR.TBZMED.REC.1396.1117).The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dolatkhah, N., Toopchizadeh, V., Barmaki, S. et al. The effect of an anti-inflammatory in comparison with a low caloric diet on physical and mental health in overweight and obese women with knee osteoarthritis: a randomized clinical trial. Eur J Nutr 62, 659–672 (2023). https://doi.org/10.1007/s00394-022-03017-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00394-022-03017-4

Keywords

search

Navigation