Effects of diet type and supplementation of glucosamine, chondroitin, and MSM on body composition, functional status, and markers of health in women with knee osteoarthritis initiating a resistance-based exercise and weight loss program

Teresa Magrans-Courtney, Colin Wilborn, Christopher Rasmussen, Maria Ferreira, Lori Greenwood, Bill Campbell, Chad M Kerksick, Erica Nassar, Rui Li, Mike Iosia, Matt Cooke, Kristin Dugan, Darryn Willoughby, LuAnn Soliah, Richard B Kreider, Teresa Magrans-Courtney, Colin Wilborn, Christopher Rasmussen, Maria Ferreira, Lori Greenwood, Bill Campbell, Chad M Kerksick, Erica Nassar, Rui Li, Mike Iosia, Matt Cooke, Kristin Dugan, Darryn Willoughby, LuAnn Soliah, Richard B Kreider

Abstract

Background: The purpose of this study was to determine whether sedentary obese women with knee OA initiating an exercise and weight loss program may experience more beneficial changes in body composition, functional capacity, and/or markers of health following a higher protein diet compared to a higher carbohydrate diet with or without GCM supplementation.

Methods: Thirty sedentary women (54 ± 9 yrs, 163 ± 6 cm, 88.6 ± 13 kg, 46.1 ± 3% fat, 33.3 ± 5 kg/m2) with clinically diagnosed knee OA participated in a 14-week exercise and weight loss program. Participants followed an isoenergenic low fat higher carbohydrate (HC) or higher protein (HP) diet while participating in a supervised 30-minute circuit resistance-training program three times per week for 14-weeks. In a randomized and double blind manner, participants ingested supplements containing 1,500 mg/d of glucosamine (as d-glucosamine HCL), 1,200 mg/d of chondroitin sulfate (from chondroitin sulfate sodium), and 900 mg/d of methylsulfonylmethane or a placebo. At 0, 10, and 14-weeks, participants completed a battery of assessments. Data were analyzed by MANOVA with repeated measures.

Results: Participants in both groups experienced significant reductions in body mass (-2.4 ± 3%), fat mass (-6.0 ± 6%), and body fat (-3.5 ± 4%) with no significant changes in fat free mass or resting energy expenditure. Perception of knee pain (-49 ± 39%) and knee stiffness (-42 ± 37%) was decreased while maximal strength (12%), muscular endurance (20%), balance indices (7% to 20%), lipid levels (-8% to -12%), homeostasis model assessment for estimating insulin resistance (-17%), leptin (-30%), and measures of physical functioning (59%), vitality (120%), and social function (66%) were improved in both groups with no differences among groups. Functional aerobic capacity was increased to a greater degree for those in the HP and GCM groups while there were some trends suggesting that supplementation affected perceptions of knee pain (p < 0.08).

Conclusions: Circuit style resistance-training and weight loss improved functional capacity in women with knee OA. The type of diet and dietary supplementation of GCM provided marginal additive benefits.

Trial registration: ClinicalTrials.gov: NCT01271218.

Figures

Figure 1
Figure 1
Participant flow diagram.
Figure 2
Figure 2
Changes in body composition variables among groups after 10 and 14 weeks of dieting and training.

References

    1. Felson DT, Zhang Y. An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum. 1998;41:1343–1355. doi: 10.1002/1529-0131(199808)41:8<1343::AID-ART3>;2-9.
    1. Murphy LB, Helmick CG, Schwartz TA, Renner JB, Tudor G, Koch GG, Dragomir AD, Kalsbeek WD, Luta G, Jordan JM. One in four people may develop symptomatic hip osteoarthritis in his or her lifetime. Osteoarthritis Cartilage. 2010;18:1372–1379. doi: 10.1016/j.joca.2010.08.005.
    1. Dillon CF, Rasch EK, Gu Q, Hirsch R. Prevalence of knee osteoarthritis in the United States: arthritis data from the Third National Health and Nutrition Examination Survey 1991-94. J Rheumatol. 2006;33:2271–2279.
    1. Oliveria SA, Felson DT, Reed JI, Cirillo PA, Walker AM. Incidence of symptomatic hand, hip, and knee osteoarthritis among patients in a health maintenance organization. Arthritis Rheum. 1995;38:1134–1141. doi: 10.1002/art.1780380817.
    1. Vad V, Hong HM, Zazzali M, Agi N, Basrai D. Exercise recommendations in athletes with early osteoarthritis of the knee. Sports Med. 2002;32:729–739. doi: 10.2165/00007256-200232110-00004.
    1. Felson DT, Niu J, Clancy M, Sack B, Aliabadi P, Zhang Y. Effect of recreational physical activities on the development of knee osteoarthritis in older adults of different weights: the Framingham Study. Arthritis Rheum. 2007;57:6–12. doi: 10.1002/art.22464.
    1. Felson DT, Zhang Y, Anthony JM, Naimark A, Anderson JJ. Weight loss reduces the risk for symptomatic knee osteoarthritis in women. The Framingham Study. Ann Intern Med. 1992;116:535–539.
    1. Messier SP, Loeser RF, Miller GD, Morgan TM, Rejeski WJ, Sevick MA, Ettinger WH, Pahor M, Williamson JD. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum. 2004;50:1501–1510. doi: 10.1002/art.20256.
    1. Miller GD, Nicklas BJ, Davis C, Loeser RF, Lenchik L, Messier SP. Intensive weight loss program improves physical function in older obese adults with knee osteoarthritis. Obesity (Silver Spring) 2006;14:1219–1230. doi: 10.1038/oby.2006.139.
    1. Christensen R, Astrup A, Bliddal H. Weight loss: the treatment of choice for knee osteoarthritis? A randomized trial. Osteoarthritis Cartilage. 2005;13:20–27. doi: 10.1016/j.joca.2004.10.008.
    1. Slemenda C, Heilman DK, Brandt KD, Katz BP, Mazzuca SA, Braunstein EM, Byrd D. Reduced quadriceps strength relative to body weight: a risk factor for knee osteoarthritis in women? Arthritis Rheum. 1998;41:1951–1959. doi: 10.1002/1529-0131(199811)41:11<1951::AID-ART9>;2-9.
    1. Hernandez-Molina G, Reichenbach S, Zhang B, Lavalley M, Felson DT. Effect of therapeutic exercise for hip osteoarthritis pain: results of a meta-analysis. Arthritis Rheum. 2008;59:1221–1228. doi: 10.1002/art.24010.
    1. Messier SP. Obesity and osteoarthritis: disease genesis and nonpharmacologic weight management. Rheum Dis Clin North Am. 2009;34:713–729.
    1. Devkota S, Layman DK. Protein metabolic roles in treatment of obesity. Curr Opin Clin Nutr Metab Care. 2010;13:403–407. doi: 10.1097/MCO.0b013e32833a7737.
    1. Acheson KJ. Carbohydrate for weight and metabolic control: where do we stand? Nutrition. 2010;26:141–145. doi: 10.1016/j.nut.2009.07.002.
    1. Wilborn C, Beckham J, Campbell B, Harvey T, Galbreath M, La Bounty P, Nassar E, Wismann J, Kreider R. Obesity: prevalence, theories, medical consequences, management, and research directions. J Int Soc Sports Nutr. 2005;2:4–31. doi: 10.1186/1550-2783-2-2-4.
    1. Te Morenga LA, Levers MT, Williams SM, Brown RC, Mann J. Comparison of high protein and high fiber weight-loss diets in women with risk factors for the metabolic syndrome: a randomized trial. Nutr J. 2011;10:40. doi: 10.1186/1475-2891-10-40.
    1. Wycherley TP, Noakes M, Clifton PM, Cleanthous X, Keogh JB, Brinkworth GD. A high-protein diet with resistance exercise training improves weight loss and body composition in overweight and obese patients with type 2 diabetes. Diabetes Care. 2010;33:969–976. doi: 10.2337/dc09-1974.
    1. Clifton PM, Bastiaans K, Keogh JB. High protein diets decrease total and abdominal fat and improve CVD risk profile in overweight and obese men and women with elevated triacylglycerol. Nutr Metab Cardiovasc Dis. 2009;19:548–554. doi: 10.1016/j.numecd.2008.10.006.
    1. Kerksick C, Thomas A, Campbell B, Taylor L, Wilborn C, Marcello B, Roberts M, Pfau E, Grimstvedt M, Opusunju J, Magrans-Courtney T, Rasmussen C, Wilson R, Kreider RB. Effects of a popular exercise and weight loss program on weight loss, body composition, energy expenditure and health in obese women. Nutr Metab (Lond) 2009;6:23. doi: 10.1186/1743-7075-6-23.
    1. Kerksick CM, Wismann-Bunn J, Fogt D, Thomas AR, Taylor L, Campbell BI, Wilborn CD, Harvey T, Roberts MD, La Bounty P, Galbreath M, Marcello B, Rasmussen CJ, Kreider RB. Changes in weight loss, body composition and cardiovascular disease risk after altering macronutrient distributions during a regular exercise program in obese women. Nutr J. 2010;9:59. doi: 10.1186/1475-2891-9-59.
    1. Kreider RB, Serra M, Beavers KM, Moreillon J, Kresta JY, Byrd M, Oliver JM, Gutierrez J, Hudson G, Deike E, Shelmadine B, Leeke P, Rasmussen C, Greenwood M, Cooke M, Kerksick C, Campbell JK, Beiseigal J, Jonnalagadda SS. A structured diet and exercise program promotes favorable changes in weight loss, body composition, and weight maintenance. Journal of the American Dietetic Association. 2011;111:828–843. doi: 10.1016/j.jada.2011.03.013.
    1. Kreider RB, Rasmussen C, Kerksick CM, Wilborn C, Taylor L, Campbell B, Magrans-Courtney T, Fogt D, Ferreira M, Li R, Galbreath M, Iosia M, Cooke M, Serra M, Gutierrez J, Byrd M, Kresta JY, Simbo S, Oliver J, Greenwood M. A carbohydrate-restricted diet during resistance training promotes more favorable changes in body composition and markers of health in obese women with and without insulin resistance. Physician Sportsmed. 2011;39:1–14.
    1. Qiu GX, Gao SN, Giacovelli G, Rovati L, Setnikar I. Efficacy and safety of glucosamine sulfate versus ibuprofen in patients with knee osteoarthritis. Arzneimittelforschung. 1998;48:469–474.
    1. Pavelka K, Gatterova J, Olejarova M, Machacek S, Giacovelli G, Rovati LC. Glucosamine sulfate use and delay of progression of knee osteoarthritis: a 3-year, randomized, placebo-controlled, double-blind study. Arch Intern Med. 2002;162:2113–2123. doi: 10.1001/archinte.162.18.2113.
    1. Usha PR, Naidu MU. Randomised, Double-Blind, Parallel, Placebo-Controlled Study of Oral Glucosamine, Methylsulfonylmethane and their Combination in Osteoarthritis. Clin Drug Investig. 2004;24:353–363. doi: 10.2165/00044011-200424060-00005.
    1. Petersen SG, Saxne T, Heinegard D, Hansen M, Holm L, Koskinen S, Stordal C, Christensen H, Aagaard P, Kjaer M. Glucosamine but not ibuprofen alters cartilage turnover in osteoarthritis patients in response to physical training. Osteoarthritis Cartilage. 2010;18:34–40. doi: 10.1016/j.joca.2009.07.004.
    1. Ostojic SM, Arsic M, Prodanovic S, Vukovic J, Zlatanovic M. Glucosamine administration in athletes: effects on recovery of acute knee injury. Res Sports Med. 2007;15:113–124. doi: 10.1080/15438620701405248.
    1. Hespel P, Maughan RJ, Greenhaff PL. Dietary supplements for football. J Sports Sci. 2006;24:749–761. doi: 10.1080/02640410500482974.
    1. Heavin G. Permanent Results Without Permanent Dieting: The Curves for Women Wight Loss Method. Waco, TX: Curves Interational Inc; 1999.
    1. Almada A, Kreider R. Comparison of the reliability of repeated whole body DEXA scans to repeated spine and hip scans. J Bone Miner Res. 1999;14:S369.
    1. Kaminsky LA, Bryant CX, Mahler DA, Durstine JL, Humphrey RH. ACSM's Guidelines for Exercise Testing and Prescription. 8. Baltimore, MD: Lippincott, Williams & Wilkins; 2009.
    1. Wessel J. Isometric strength measurements of knee extensors in women with osteoarthritis of the knee. J Rheumatol. 1996;23:328–331.
    1. Carter ND, Khan KM, Petit MA, Heinonen A, Waterman C, Donaldson MG, Janssen PA, Mallinson A, Riddell L, Kruse K, Prior JC, Flicker L, McKay HA. Results of a 10 week community based strength and balance training programme to reduce fall risk factors: a randomised controlled trial in 65-75 year old women with osteoporosis. Br J Sports Med. 2001;35:348–351. doi: 10.1136/bjsm.35.5.348.
    1. Cuka S, Dvornik S, Drazenovic K, Mihic J. Evaluation of the Dade Behring Dimension RxL clinical chemistry analyzer. Clin Lab. 2001;47:35–40.
    1. McAuley KA, Williams SM, Mann JI, Walker RJ, Lewis-Barned NJ, Temple LA, Duncan AW. Diagnosing insulin resistance in the general population. Diabetes Care. 2001;24:460–464. doi: 10.2337/diacare.24.3.460.
    1. Ware JE, Kosinski M, Bayliss MS, McHorney CA, Rogers WH, Raczek A. Comparison of methods for the scoring and statistical analysis of SF-36 health profile and summary measures: summary of results from the Medical Outcomes Study. Med Care. 1995;33:AS264–279.
    1. Denegar CR, Perrin DH. Effect of transcutaneous electrical nerve stimulation, cold, and a combination treatment on pain, decreased range of motion, and strength loss associated with delayed onset muscle soreness. J Athl Train. 1992;27:200–206.
    1. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.
    1. Black C, Clar C, Henderson R, MacEachern C, McNamee P, Quayyum Z, Royle P, Thomas S. The clinical effectiveness of glucosamine and chondroitin supplements in slowing or arresting progression of osteoarthritis of the knee: a systematic review and economic evaluation. Health Technol Assess. 2009;13:1–148.
    1. Frech TM, Clegg DO. The utility of nutraceuticals in the treatment of osteoarthritis. Curr Rheumatol Rep. 2007;9:25–30. doi: 10.1007/s11926-007-0018-x.
    1. Messier SP, Gutekunst DJ, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 2005;52:2026–2032. doi: 10.1002/art.21139.
    1. Felson DT. Nonmedicinal therapies for osteoarthritis. Bull Rheum Dis. 1998;47:5–7.
    1. Baker KR, Nelson ME, Felson DT, Layne JE, Sarno R, Roubenoff R. The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial. J Rheumatol. 2001;28:1655–1665.
    1. Minor MA, Brown JD. Exercise maintenance of persons with arthritis after participation in a class experience. Health Educ Q. 1993;20:83–95.
    1. Minor MA, Key DR. ACSM's exercise management for persons with chronic diseases and disabilities: Arthritis. Champaign, IL: Human Kinetics; 1997.
    1. Penninx BW, Messier SP, Rejeski WJ, Williamson JD, DiBari M, Cavazzini C, Applegate WB, Pahor M. Physical exercise and the prevention of disability in activities of daily living in older persons with osteoarthritis. Arch Intern Med. 2001;161:2309–2316. doi: 10.1001/archinte.161.19.2309.
    1. Miller GD, Nicklas BJ, Davis CC, Ambrosius WT, Loeser RF, Messier SP. Is serum leptin related to physical function and is it modifiable through weight loss and exercise in older adults with knee osteoarthritis? Int J Obes Relat Metab Disord. 2004;28:1383–1390. doi: 10.1038/sj.ijo.0802737.
    1. Foster GD, Wyatt HR, Hill JO, McGuckin BG, Brill C, Mohammed BS, Szapary PO, Rader DJ, Edman JS, Klein S. A randomized trial of a low-carbohydrate diet for obesity. N Engl J Med. 2003;348:2082–2090. doi: 10.1056/NEJMoa022207.
    1. Reginster JY, Deroisy R, Rovati LC, Lee RL, Lejeune E, Bruyere O, Giacovelli G, Henrotin Y, Dacre JE, Gossett C. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet. 2001;357:251–256. doi: 10.1016/S0140-6736(00)03610-2.
    1. Braham R, Dawson B, Goodman C. The effect of glucosamine supplementation on people experiencing regular knee pain. Br J Sports Med. 2003;37:45–49. doi: 10.1136/bjsm.37.1.45. discussion 49.
    1. Matsuno H, Nakamura H, Katayama K, Hayashi S, Kano S, Yudoh K, Kiso Y. Effects of an oral administration of glucosamine-chondroitin-quercetin glucoside on the synovial fluid properties in patients with osteoarthritis and rheumatoid arthritis. Biosci Biotechnol Biochem. 2009;73:288–292. doi: 10.1271/bbb.80418.
    1. Ng NT, Heesch KC, Brown WJ. Efficacy of a progressive walking program and glucosamine sulphate supplementation on osteoarthritic symptoms of the hip and knee: a feasibility trial. Arthritis Res Ther. 2010;12:R25. doi: 10.1186/ar2932.

Source: PubMed

3
Sottoscrivi