Studies Spotlight Diet, Supplements For Knee Pain

Fiber helps lower cholesterol, stabilize blood sugar levels and keep the bowels running smoothly, but a new study suggests it can also reduce knee pain from arthritis.

Research has shown that fiber intake can reduce osteoarthritis pain in the knees by as much as 60%. However, Xrays showed no difference between those who ate the most fiber and those who had less.

Another study examined the impact of chondroitin dietary supplement on knee pain. Sponsored by the manufacturer of the supplements, this study found that chondroitin was associated with less pain in the knees and better function.

Two bone experts noted, however that the powerful type of chondroitin in the study is not available in the United States and it is uncertain if the supplement can be safely taken long term.

Both studies were published online May 23 in the Annals of the Rheumatic Diseases.

"With both of these studies, the danger is that people are thinking they're making a change in their arthritis, but they may only be masking the pain. Neither study has proven a change in the natural history of osteoarthritis," explained Dr. Victor Khabie, who was not involved with the studies. He co-directs the Orthopedic and Spine Institute of Northern Westchester Hospital in Mount Kisco (N.Y.).

Fruits, vegetables and whole grains are rich in fiber. Fiber helps people feel satisfied and decreases calorie intake. The researchers also found fiber to lower inflammation.

The fiber study looked at data from two other studies. The first included almost 5,000 people with osteoarthritis or at high risk. Since 2006 when the average age of these people was 61, their health status has been closely monitored.

Framingham Offspring Study, which included more than 1,200 participants, provided the second set. This study was started in 1971 and covers data between 1993-94, at which time the participants were on average 54 years old. These participants were then followed up until 2005.

The median fiber intake in the first group ranged between 21g per day and 9g daily. The Framingham group had the highest intake of fiber at 26 grams per day. Fast 14 grams was the daily average for those in the lowest groups.

According to the study, people with the highest intake of fiber had a lower chance of suffering from osteoarthritis. The risk of developing osteoarthritis knee pain was lower for those who consumed the highest fiber diet. Framingham participants who ate more fiber had a risk of 61% less than those who did not.

Research also showed that those who consumed more fiber had less chance of experiencing worsening pain in their knees.

Zhaoli Dai (postdoctoral researcher, Boston University) said that there is an obvious link between obesity and inflammation. It is believed that more fiber can increase satiety, reduce total calories and lower body weight.

Dai said that the observational study cannot prove cause-and effect relationships because it is not conclusive.

Matthew Hepinstall, associate director at the Lenox Hill Hospital Center for Joint Preservation & Reconstruction is New York City.

He also agreed with the conclusion that there was no causal connection.

Hepinstall explained that mixed with recent data showing lower osteoarthritis rates in those who are overweight, a picture emerges suggesting healthy lifestyles can have significant effects on osteoarthritis risk.

However, he pointed out that painful osteoarthritis is common in people who lead active lives and are healthy. Hepinstall stated that high fiber diets are not proven to be effective in preventing the development of arthritis.

Dai explained that Americans average about 15g fiber daily. The Dietary Guidelines For Americans 2015-2020 recommends that women consume 22.4g per day and men, 51 and older, should consume 28 grams.

A typical meal of high-fiber cereals contains at least 9g of fiber, according to Dietary Guidelines for Americans 2015 - 2020. About 10 grams are found in a cup of navy beans, and 5 grams is contained in an apple.

Second, we looked at chondroitin-sulfate. The U.S. National Library of Medicine says it is a chemical naturally present in the cartilage of your knee.

More than 600 patients with osteoarthritis of the knee were included in this study. They came from five European countries. Patients were randomly allocated to one of three treatment programs.

A group received 800 mg (mg) each of "pharmaceutical-grade" chondroitin and one placebo to simulate 200 mg of pain relief celecoxib (Celebrex). A second group was provided with a Celecoxib tablet of 200mg and a placebo that mimics the chondroitin pill. A third group received two placebo pills.

It lasted for six months. Participants were assessed by physicians at six, three, and six month intervals.

Celecoxib or chondroitin were more effective in reducing pain and improving joint function in patients who received treatment for three to six months. According to the researchers, chondroitin was comparable in providing relief to celecoxib.

Khabie stated, "It seems like there's an inflammatory or pain-relieving efect when chondroitin's taken in a very pure, well-controlled state but it's likely not what's on-the-shelf (in the United States)." Khabie pointed out that chondroitin was a supplement. Supplements aren't subject to the same regulations as drugs in the United States.

Khabie said, "The safety of long-term chondroitin use is not known."

Hepinstall echoed Khabies concerns regarding the chondroitin studies, but said that chondroitin could be "especially well-suited to patients who are unable to take NSAID medicines." NSAIDs are non-steroidal anti-inflammatory drug (also known as NSAIDs) that include ibuprofen, Motrin Advil, naproxen, Aleve, and aspirin .