Prescribing optimal nutrition and physical activity as "first-line" interventions for best practice management of chronic low-grade inflammation associated with osteoarthritis: evidence synthesis.
Prescribing optimal nutrition and physical activity as "first-line" interventions for best practice management of chronic low-grade inflammation associated with osteoarthritis: evidence synthesis.
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DOI：
10.1155/2012/560634
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Gormsen Hansen R
中科院分区：
文献类型：
--
作者：
Dean E;Gormsen Hansen R
低度炎症和氧化应激是慢性骨关节炎的基础。尽管骨关节炎的最佳实践指南强调包括体重控制和锻炼在内的自我管理，但改变生活方式行为对解决慢性低度炎症的作用并不是一线管理的重点。本文综合了支持这一观点的文献，其中西方饮食和不活动是促炎的，而植物性饮食和活动是抗炎的，骨关节炎背后的低级别炎症和氧化应激通常与生活方式相关的危险因素和条件共存。我们就如何通过团队合作和有针对性的循证干预将生活方式行为的改变整合到骨关节炎治疗的“一线”中提供循证建议。健康的生活可以被用来减少炎症、氧化应激以及相关的疼痛和残疾，并改善患者的整体健康。这种方法符合循证最佳实践，有望消除或减少慢性低度炎症，减缓疾病进展，减轻体重，最大限度地减少患者的风险或以慢性低度炎症为特征的其他与生活方式有关的疾病的表现，并减少对药物和手术的需求。这种方法为慢性骨关节炎的预防、潜在逆转和体征和症状的管理提供了可靠的成本效益基础，并对骨关节炎的研究范式有影响。
Low-grade inflammation and oxidative stress underlie chronic osteoarthritis. Although best-practice guidelines for osteoarthritis emphasize self-management including weight control and exercise, the role of lifestyle behavior change to address chronic low-grade inflammation has not been a focus of first-line management. This paper synthesizes the literature that supports the idea in which the Western diet and inactivity are proinflammatory, whereas a plant-based diet and activity are anti-inflammatory, and that low-grade inflammation and oxidative stress underlying osteoarthritis often coexist with lifestyle-related risk factors and conditions. We provide evidence-informed recommendations on how lifestyle behavior change can be integrated into “first-line” osteoarthritis management through teamwork and targeted evidence-based interventions. Healthy living can be exploited to reduce inflammation, oxidative stress, and related pain and disability and improve patients' overall health. This approach aligns with evidence-based best practice and holds the promise of eliminating or reducing chronic low-grade inflammation, attenuating disease progression, reducing weight, maximizing health by minimizing a patient's risk or manifestations of other lifestyle-related conditions hallmarked by chronic low-grade inflammation, and reducing the need for medications and surgery. This approach provides an informed cost effective basis for prevention, potential reversal, and management of signs and symptoms of chronic osteoarthritis and has implications for research paradigms in osteoarthritis.