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Blueberries Improve Pain, Gait Performance, and Inflammation in Individuals with Symptomatic Knee Osteoarthritis.
Du, C, Smith, A, Avalos, M, South, S, Crabtree, K, Wang, W, Kwon, YH, Vijayagopal, P, Juma, S
Nutrients. 2019;11(2)
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Plain language summary
Osteoarthritis (OA) is the most common joint disorder in the world. Inflammation is one of the major drivers of the progression of OA, which typically involves progressive loss of the structure and function of joint cartilage. Polyphenols, which are compounds found in plant foods such as spices, tea, dark chocolate and dark-coloured berries, have been studied for their anti-inflammatory properties. Blueberries are high in dietary polyphenols, so researchers proposed that the regular consumption of blueberries may help improve OA. The purpose of this randomised, double-blind trial was to examine the effect of freeze-dried whole blueberries on pain, inflammation and walking ability in people with knee OA. A group of adults aged 45 to 79 with knee OA, consumed either 40g freeze-dried blueberry powder or maltodextrin powder (placebo) daily for four months. Blood draws and assessment of pain and walking were conducted at baseline, two months, and four months. Pain, stiffness, and difficulty to perform daily activities improved significantly in the blueberry treatment group, with no change in the placebo group. Some measures of walking ability improved in the blueberry group. No statistically significant changes were observed in blood levels of inflammatory markers in either of the groups. However, an increasing trend for interleukin (IL)-13 concentration and a decreasing trend in monocyte chemoattractant protein-1 (MCP-1) concentration were seen 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 walking ability, and would therefore improve quality of life in individuals with knee OA.
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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Advanced Glycation End Products, Inflammation, and Chronic Metabolic Diseases: Links in a Chain?
Davis, KE, Prasad, C, Vijayagopal, P, Juma, S, Imrhan, V
Critical reviews in food science and nutrition. 2016;(6):989-98
Abstract
Advanced glycation end products (AGEs) are a diverse group of compounds produced when reducing sugars react with proteins or other compounds to form glycosylated molecules. AGEs may form endogenously, and glycation of molecules may negatively affect their function. AGEs may also be consumed in food form with dietary AGEs reported to be particularly high in foods treated with high heat: baked, broiled, grilled, and fried foods. Whether dietary AGEs are absorbed in significant quantities and whether they are harmful if absorbed is a question under current debate. The American Diabetes Association makes no recommendation regarding avoidance of these foods, but many researchers are concerned that they may be pro-inflammatory and way worsen cardiac function, kidney function, diabetes and its complications and may even contribute to obesity.
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Contribution of dietary advanced glycation end products (AGE) to circulating AGE: role of dietary fat.
Davis, KE, Prasad, C, Vijayagopal, P, Juma, S, Adams-Huet, B, Imrhan, V
The British journal of nutrition. 2015;(11):1797-806
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Abstract
The purpose of this pilot study was to determine whether macronutrient content (low-fat v. high-fat diet) influences an indicator of advanced glycation end products (AGE), N(ε) carboxymethyl-lysine (CML), in the context of a 1-d, high-AGE diet. The effect of the diets on inflammatory markers was also assessed. A total of nineteen overweight and obese adults (nine men and ten women) without known disease were recruited to participate in a crossover challenge of a high-fat, high-AGE (HFHA) and low-fat, high-AGE (LFHA) diet. In each phase patients had fasting blood drawn, followed by consumption of a high-fat or low-fat breakfast test meal, then three postprandial blood draws at 1, 2 and 3 h after consuming the test meal. After consuming high-AGE meals for the remainder of the day, participants returned the next day for a follow-up analysis. A different pattern in the 3-h post-meal CML and soluble receptor for AGE response to the two diets was observed (P=0·01 and 0·05, respectively). No change in serum CML was observed following consumption of a LFHA breakfast (535 (25th-75th percentile 451-790) to 495 (25th-75th percentile 391-682) ng/ml; P=0·36), whereas a rise in CML occurred after the HFHA breakfast (463 (25th-75th percentile 428-664) to 578 (25th-75th percentile 474-865) ng/ml; P=0·05). High sensitivity C-reactive protein and high molecular weight adiponectin were not affected by either diet. These findings suggest that dietary CML may not be as important in influencing serum CML as other dietary factors. In addition, acute exposure to dietary CML may not influence inflammation in adults without diabetes or kidney disease. This is contrary to previous findings.
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Bioactive Plant Metabolites in the Management of Non-Communicable Metabolic Diseases: Looking at Opportunities beyond the Horizon.
Prasad, C, Imrhan, V, Juma, S, Maziarz, M, Prasad, A, Tiernan, C, Vijayagopal, P
Metabolites. 2015;(4):733-65
Abstract
There has been an unprecedented worldwide rise in non-communicable metabolic diseases (NCDs), particularly cardiovascular diseases (CVD) and diabetes. While modern pharmacotherapy has decreased the mortality in the existing population, it has failed to stem the rise. Furthermore, a large segment of the world population cannot afford expensive pharmacotherapy. Therefore, there is an urgent need for inexpensive preventive measures to control the rise in CVD and diabetes and associated co-morbidities. The purpose of this review is to explore the role of food bioactives in prevention of NCDs. To this end, we have critically analyzed the possible utility of three classes of food bioactives: (a) resistant starch, a metabolically resistant carbohydrate known to favorably modulate insulin secretion and glucose metabolism; (b) cyclo (His-Pro), a food-derived cyclic dipeptides; and (c) polyphenol-rich berries. Finally, we have also briefly outlined the strategies needed to prepare these food-bioactives for human use.
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Women with osteoarthritis have elevated synovial fluid levels of insulin-like growth factor (IGF)-1 and IGF-binding protein-3.
Hooshmand, S, Juma, S, Khalil, DA, Shamloufard, P, Arjmandi, BH
Journal of immunoassay & immunochemistry. 2015;(3):284-94
Abstract
The present study explores the possible connection between synovial fluid concentrations of insulin like growth factor (IGF-1), IGF-binding protein (IGFBP-3), leptin, and C-reactive protein (CRP) in osteoarthritis (OA). Synovial fluid specimens were obtained from a total of thirty-four individuals with and without OA. Protein-normalized measurements of IGF-1, IGFBP-3, and leptin concentrations in synovial fluid showed significantly (P < 0.05) elevated levels in women with knee OA but not in men. This study provides initial evidence that protein normalized IGF-1 and IGFBP-3 and leptin levels increase in synovial fluid of women but not in men with OA versus those without OA.
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Prescribing personalized nutrition for cardiovascular health: are we ready?
Juma, S, Imrhan, V, Vijayagopal, P, Prasad, C
Journal of nutrigenetics and nutrigenomics. 2014;(3):153-60
Abstract
Of all chronic metabolic diseases, cardiovascular disease (CVD) is the leading cause of death worldwide. Most research over the past 100 years show a link between CVD and lifestyle, including diet; thus, public health messages have focused on modifications of the diet to better manage this disease. Despite this effort, the CVD mortality rate continues to rise. Therefore, is it possible that this failure may be due to individual variability in response to dietary recommendations? The elucidation of the structure of the human genome combined with the knowledge that nutrients are capable of modifying gene expression and genetic variability regulates how individuals respond to a diet have led to the possibility of personalized nutrition for disease prevention. While this possibility is real for the future, our current understanding of nutrient-gene interactions for CVD is limited, making personalized nutrition therapy difficult at this time. With advances in nutritional genomics, in the near future, dietitians and nutritionists will be able to give personalized nutritional advice based on a combination of lifestyle factors and genetics.
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Lifestyle and Advanced Glycation End Products (AGEs) Burden: Its Relevance to Healthy Aging.
Prasad, C, Imrhan, V, Marotta, F, Juma, S, Vijayagopal, P
Aging and disease. 2014;(3):212-7
Abstract
Uncontrolled continued exposure to oxidative stress is a precursor to many chronic diseases including cancer, diabetes, degenerative disorders and cardiovascular diseases. Of the many known mediators of oxidative stress, reactive oxygen species (ROS) and advanced glycation end products (AGEs) are the most studied. In the present review, we have summarized current data on the origin of circulating AGEs, discussed issues associated with reliable assessment of its steady state level, and changes in its level with age and select metabolic diseases. Lastly, we have made recommendations about life style changes that may decrease AGEs burden to promote healthy aging.
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Soy protein may alleviate osteoarthritis symptoms.
Arjmandi, BH, Khalil, DA, Lucas, EA, Smith, BJ, Sinichi, N, Hodges, SB, Juma, S, Munson, ME, Payton, ME, Tivis, RD, et al
Phytomedicine : international journal of phytotherapy and phytopharmacology. 2004;(7-8):567-75
Abstract
Alternative and complementary therapeutic approaches, such as the use of a wide array of herbal, nutritional, and physical manipulations, are becoming popular for relieving symptoms of osteoarthritis (OA). The present study evaluated the efficacy of soy protein (SP) supplementation in relieving the pain and discomfort associated with OA. One hundred and thirty-five free-living individuals (64 men and 71 women) with diagnosed OA or with self-reported chronic knee joint pain not attributed to injury or rheumatoid arthritis were recruited for this double-blind, placebo-controlled, parallel design study. Study participants were assigned randomly to consume 40 g of either supplemental SP or milk-based protein (MP) daily for 3 months. Pain, knee range of motion, and overall physical activity were evaluated prior to the start of treatment and monthly thereafter. Serum levels of glycoprotein 39 (YKL-40), a marker of cartilage degradation, and insulin-like growth factor-I (IGF-I), a growth factor associated with cartilage synthesis, were assessed at baseline and at the end of the study. Overall, SP improved OA-associated symptoms such as range of motion and several factors associated with pain and quality of life in comparison to MP. However, these beneficial effects were mainly due to the effect of SP in men rather than women. Biochemical markers of cartilage metabolism further support the efficacy of SP in men as indicated by a significant increase in serum level of IGF-I and a significant decrease in serum level of YKL-40 compared to MP. This study is the first to provide evidence of possible beneficial effects of SP in the management of OA. Examining and verifying the long-term effects of SP on improving symptoms of OA, particularly in men, is warranted.
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Soy protein has a greater effect on bone in postmenopausal women not on hormone replacement therapy, as evidenced by reducing bone resorption and urinary calcium excretion.
Arjmandi, BH, Khalil, DA, Smith, BJ, Lucas, EA, Juma, S, Payton, ME, Wild, RA
The Journal of clinical endocrinology and metabolism. 2003;(3):1048-54
Abstract
Recent reports suggest that soy protein may reduce the risk of osteoporosis in peri- and postmenopausal women. The objective of this study was to examine whether soy supplementation exerts beneficial effects on serum and urinary biomarkers of bone metabolism in postmenopausal women, regardless of whether or not they are on hormone replacement therapy (HRT). A total of 71 women were randomly assigned to either soy protein (SP) or milk-based protein (MBP), 40 g daily for 3 months, in a double-blind parallel design. Forty-two women completed the study (20 on SP and 22 on MBP). Overall, both protein supplements positively influenced serum IGF-I, known to correlate with bone formation. However, SP had a more pronounced effect on IGF-I than MBP. Urinary deoxypyridinoline (Dpd) excretion, a specific biomarker of bone resorption, was significantly reduced by SP, but not by MBP when all women were included. Furthermore, women on MBP experienced a 33% increase in urinary calcium excretion, whereas SP did not have such an effect. To evaluate whether SP affects women differently on the basis of their HRT status, data from women on HRT (n = 22) and those not on HRT (n = 20) were analyzed separately. The subanalysis of the data indicated that SP had the greatest impact on serum IGF-I (an increase of 97%) in the women not on HRT. The changes in urinary Dpd due to SP were only observed in women not on HRT, indicating that the overall decrease in Dpd occurred with SP in the absence of HRT. These results indicate that soy protein may positively influence bone and calcium homeostasis in postmenopausal women, particularly those not on HRT.
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Soy protein supplementation increases serum insulin-like growth factor-I in young and old men but does not affect markers of bone metabolism.
Khalil, DA, Lucas, EA, Juma, S, Smith, BJ, Payton, ME, Arjmandi, BH
The Journal of nutrition. 2002;(9):2605-8
Abstract
Recent studies suggest that soy protein (SP) protects bone in women; however, its effects on bone metabolism in men have not been investigated. Healthy men (59.2 +/- 17.6 y) were assigned to consume 40 g of either SP or milk-based protein (MP) daily for 3 mo in a double-blind, randomized, controlled, parallel design. Serum insulin-like growth factor-I (IGF-I), which is associated with higher rates of bone formation, was greater (P < 0.01) in men supplemented with SP than in those consuming MP. Serum alkaline phosphatase and bone-specific alkaline phosphatase activities, markers of bone formation, and urinary deoxypyridinoline excretion, a specific marker of bone resorption, were not different between the SP and MP groups. Furthermore, because substantial reductions in bone density occur in men at approximately 65 y of age, data were analyzed separately for men ≥65 y and those <65 y of age. The response to protein supplementation was consistent in the two age groups. The effects of SP on serum IGF-I levels suggest that SP may positively influence bone in men. Longer-duration studies examining the effects of SP or its isoflavones on bone turnover and bone mineral density and content in men are warranted.