Background

Osteoarthritis (OA) is one of the most common joint diseases worldwide. Typical symptoms are pain and swelling, which go hand in hand with functional limitations and a reduced quality of life (QoL). Until recently, OA has been regarded as a degenerative joint disease that results from bodily wear and tear only. The latest studies, however, show that inflammatory processes also play a key role in the development of OA.

Project content

Building on the latest international scientific findings on OA, the clinical guidelines of the Osteoarthritis Research Community recommend patient education, physiotherapy, exercise and weight reduction. The "Good Life with Arthritis in Denmark" (GLA:D®) program adopts and implements these recommendations. However, it neglects inflammatory processes, even though they have been revealed as an important factor in OA. More precisely, inflammations are triggered by local tissue destruction in and between the joints, by metabolic imbalances (e.g., higher level of proinflammatory cytokines and adipokines as usual), and by malnutrition and overeating. Medication can keep inflammatory processes at bay, but this does not come without side-effects and constitutes no viable long-term solution. An alternative and more effective therapeutic approach is switching to a diet that mitigates the negative impact of inflammation. In the present project, we pursue such an alternative approach and investigate whether a plant-based, anti-inflammatory and antioxidative diet (building on a modified version of the New Nordic Diet) can improve the quality of life of people with OA.       

Goals

Exercise therapy (ET) is an effective treatment method for reducing symptoms of knee osteoarthritis and as a consequence improving quality of life. Since inflammatory processes are a non-negligible factor in joint diseases, it is a plausible conclusion that an anti-oxidant and anti-inflammatory diet is an additional means of alleviating the pain caused by OA. In this project, we therefore aim to:

• evaluate how a combination of exercise therapy and nutritional therapy affects quality of life in patients with knee osteoarthritis.
• investigate how our therapeutic approach affects the nutritional and inflammatory status as well as the joint function in patients with knee osteoarthritis.

Method

60 subjects with knee osteoarthritis between 50 and 75 years of age are randomly assigned to an intervention or a control group. The intervention group participates in the GLA:D® program for six weeks and receives nutritional therapy for nine months. The control group participates in the GLA:D® program for six weeks and receives information on a healthy lifestyle for nine months. Biochemical, nutritive and oxidative stress parameters as well as inflammatory biomarkers are collected at the beginning of the study and at four additional time points. Also, anthropometric and clinical data are collected. The eating guidelines for our participants are based on the New Nordic Diet (NND). The NND is known for integrating food groups that are common in Central- and North European countries, thereby making it easier for patients to stick to their therapy goals (high adherence). For this reason, we also use the NND, modify it in accordance with the requirements of our project and adjust it to Austrian eating habits as far as possible.   

Result

The project underlines the importance of nutrition as a supporting element in the treatment of osteoarthritis and breaks new ground by combining exercise therapy with an adapted version of the New Nordic Diet. Patients with joint problems will benefit from the results, as we expect an increase in quality of life that goes beyond previous therapies. The project also gives us the opportunity to expand our topic-specific network on a national and international level and strengthen our research focus.