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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

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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.


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).


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.


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.

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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).

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Correspondence to Sanam Dolati.

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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.

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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).

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