An anti-inflammatory diet intervention for knee osteoarthritis: a feasibility study.
An anti-inflammatory diet intervention for knee osteoarthritis: a feasibility study.
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DOI：
10.1186/s12891-022-05003-7
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发表时间：
2022-01-13
影响因子：
2.3
通讯作者：
Culvenor AG
中科院分区：
文献类型：
--
作者：
Cooper I;Brukner P;Devlin BL;Reddy AJ;Fulton M;Kemp JL;Culvenor AG
膝骨性关节炎有一种与疼痛和关节病理有关的炎症成分，但常见的非手术和非药物干预(如运动、限制卡路里饮食)通常不针对炎症。我们的目的是评估远程健康递送抗炎饮食干预膝骨性关节炎的可行性。这项为期9周的单臂可行性研究招募了年龄在40-85岁、患有症状性膝骨性关节炎的参与者(纳入标准：过去一周内平均疼痛指数 ≥为4/10或最大疼痛≥为5/10)。所有参与者都接受了远程健康提供的抗炎饮食教育干预，包括基线、3周和6周的1：1会诊。该饮食强调营养密集的全食和最少加工的消炎食品，不鼓励被认为是促炎的加工食品。可行性的主要结果通过以下方面进行评估：i)资格、招募和保留率；ii)自我报告的饮食依从性；iii)不良事件；以及iv)治疗满意度。干预后的访谈评估了通过远程保健提供的饮食干预的可接受性。次要结果包括自我报告的体重、膝关节损伤和骨关节炎结果评分(KOOS)、与健康相关的生活质量(EuroQol-5D)、止痛药的使用和全球变化评级的变化。有价值的效果是通过所有五个Koos子量表(疼痛、症状、日常生活活动、运动/娱乐、生活质量)的最小可检测变化(MDC)在95%的可信区间内确定的。在73人中，48人(66%)符合条件，其中28人在2个 月内登记(82%女性，平均年龄66 ± 8 年，体重指数30.7 ± 4.8kg.m −2)。6名参与者在最后一次随访前退出(21%退出)。在那些有最终随访数据的人中，参加预定远程医疗会诊的比例为99%。自我报告在9周干预期内坚持饮食：每天 = 为27%，大部分时间 = 为68%，部分时间 = 为5%。报告了两个轻微的不良反应。改变分数包含所有五个Koos分量表的MDC在95%的可信区间内。改进研究设计和限制辍学的建议包括最初的面对面咨询和更全面的习惯饮食摄入量数据收集。这项研究支持了一项全面随机对照试验的可行性，以确定主要由远程健康提供的抗炎饮食教育干预对患有症状性膝骨性关节炎的成年人的疗效。ACTRN12620000229976预期于2020年2月25日生效。网上版载有补充材料，可在10.1186/s12891-022-05003-7查阅。
Knee osteoarthritis has an inflammatory component that is linked to pain and joint pathology, yet common non-surgical and non-pharmacological interventions (e.g., exercise, calorie restricting diets) do not typically target inflammation. We aimed to evaluate the feasibility of a telehealth delivered anti-inflammatory diet intervention for knee osteoarthritis. This 9-week single-arm feasibility study recruited participants aged 40–85 years with symptomatic knee osteoarthritis (inclusion criteria: average pain ≥4/10 or maximal pain ≥5/10 during past week). All participants received a telehealth-delivered anti-inflammatory dietary education intervention involving 1:1 consultations at baseline, 3- and 6-week follow-up. The diet emphasised nutrient-dense wholefoods and minimally processed anti-inflammatory foods and discouraged processed foods considered to be pro-inflammatory. The primary outcome of feasibility was assessed via: i) eligibility, recruitment and retention rates; ii) self-reported dietary adherence; iii) adverse events; and iv) treatment satisfaction. Post-intervention interviews evaluated the acceptability of the dietary intervention delivered via telehealth. Secondary outcomes included changes in self-reported body mass, Knee injury and Osteoarthritis Outcome Score (KOOS), health-related quality of life (EuroQoL-5D), analgesic use and global rating of change. Worthwhile effects were determined by the minimal detectable change (MDC) for all five KOOS-subscales (pain, symptoms, activities of daily living, sport/recreation, quality of life) being contained within the 95% confidence interval. Forty-eight of seventy-three (66%) individuals screened were eligible and 28 enrolled over 2 months (82% female, mean age 66 ± 8 years, body mass index 30.7 ± 4.8 kg.m−2). Six participants withdrew prior to final follow-up (21% drop-out). Of those with final follow-up data, attendance at scheduled telehealth consultations was 99%. Self-reported adherence to diet during the 9-week intervention period: everyday = 27%, most of time = 68% and some of time = 5%. Two minor adverse events were reported. Change scores contained the MDC within the 95% confidence interval for all five KOOS subscales. Suggestions to improve study design and limit drop-out included an initial face-to-face consultation and more comprehensive habitual dietary intake data collection. This study supports the feasibility of a full-scale randomised controlled trial to determine the efficacy of a primarily telehealth-delivered anti-inflammatory dietary education intervention in adults with symptomatic knee osteoarthritis. ACTRN12620000229976 prospectively on 25/2/2020. The online version contains supplementary material available at 10.1186/s12891-022-05003-7.
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