A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the “Plants for Joints” randomized controlled trial

Wendy Walrabenstein; Carlijn A. Wagenaar; Marieke van de Put; Marike van der Leeden; Martijn Gerritsen; Jos W.R. Twisk; Martin van der Esch; Henriët van Middendorp; Peter J.M. Weijs; Leo D. Roorda; Dirkjan van Schaardenburg

doi:10.1016/j.joca.2023.05.014

A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the “Plants for Joints” randomized controlled trial

Wendy Walrabenstein, Carlijn A. Wagenaar, Marieke van de Put, Marike van der Leeden, Martijn Gerritsen, Jos W.R. Twisk, Martin van der Esch, Henriët van Middendorp, Peter J.M. Weijs, Leo D. Roorda, Dirkjan van Schaardenburg

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Abstract

Objective

To determine the effectiveness of the “Plants for Joints” multidisciplinary lifestyle program in patients with metabolic syndrome-associated osteoarthritis (MSOA).

Design

Patients with hip or knee MSOA were randomized to the intervention or control group. The intervention group followed a 16-week program in addition to usual care based on a whole food plant-based diet, physical activity, and stress management. The control group received usual care. The patient-reported Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) total score (range 0–96) was the primary outcome. Secondary outcomes included other patient-reported, anthropometric, and metabolic measures. An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyze between-group differences.

Results

Of the 66 people randomized, 64 completed the study. Participants (84% female) had a mean (SD) age of 63 (6) years and body mass index of 33 (5) kg/m2. After 16 weeks, the intervention group (n = 32) had a mean 11-point larger improvement in WOMAC-score (95% CI 6–16; p = 0.0001) compared to the control group. The intervention group also lost more weight (–5 kg), fat mass (–4 kg), and waist circumference (–6 cm) compared to the control group. Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue, pain interference, C-reactive protein, hemoglobin A1c, fasting glucose, and low-density lipoproteins improved in the intervention versus the control group, while other PROMIS measures, blood pressure, high-density lipoproteins, and triglycerides did not differ significantly between the groups.

Conclusion

The “Plants for Joints” lifestyle program reduced stiffness, relieved pain, and improved physical function in people with hip or knee MSOA compared to usual care.

Original language	English
Pages (from-to)	1491-1500
Journal	Osteoarthritis and Cartilage
Volume	31
Issue number	11
DOIs	https://doi.org/10.1016/j.joca.2023.05.014
Publication status	Published - Nov 2023

Funding

Study participants of the “Plants for Joints” trial, patient partners of “Plants for Joints,” employees of the Reade Biobank (Toni de Jong-de Boer and Corrie Verdoold), registered dietitians Pauline Kortbeek, Anna Kretova, Melissa Dijkshoorn, Michelle Bisschops, and Dana Hofland, exercise coaches Sietske de Weers, Tom van Iersel, and Jobjan Blonk, physical therapist Boke Dekker and relaxation/sleep coaches Nelleke Doornebal and Marieke Rinkema. We thank Mies Korteweg and Bart Bartels for scoring radiographs. The RCT is funded by Reade (Amsterdam, the Netherlands), Reade Foundation (Amsterdam, the Netherlands), Stichting Vermeer 14 (private foundation, Amsterdam, the Netherlands), and W.M. de Hoop Stichting (private foundation, Bussum, the Netherlands). The position of Carlijn Wagenaar is funded by The Netherlands Organisation for Health Research and Development (ZonMw) no. 555003210.

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Walrabenstein, W., Wagenaar, C. A., van de Put, M., van der Leeden, M., Gerritsen, M., Twisk, J. W. R., van der Esch, M., van Middendorp, H., Weijs, P. J. M., Roorda, L. D., & van Schaardenburg, D. (2023). A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the “Plants for Joints” randomized controlled trial. Osteoarthritis and Cartilage, 31(11), 1491-1500. https://doi.org/10.1016/j.joca.2023.05.014

@article{264f9864cdb54884aa21603279543bfb,

title = "A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the “Plants for Joints” randomized controlled trial",

abstract = "ObjectiveTo determine the effectiveness of the “Plants for Joints” multidisciplinary lifestyle program in patients with metabolic syndrome-associated osteoarthritis (MSOA).DesignPatients with hip or knee MSOA were randomized to the intervention or control group. The intervention group followed a 16-week program in addition to usual care based on a whole food plant-based diet, physical activity, and stress management. The control group received usual care. The patient-reported Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) total score (range 0–96) was the primary outcome. Secondary outcomes included other patient-reported, anthropometric, and metabolic measures. An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyze between-group differences.ResultsOf the 66 people randomized, 64 completed the study. Participants (84% female) had a mean (SD) age of 63 (6) years and body mass index of 33 (5) kg/m2. After 16 weeks, the intervention group (n = 32) had a mean 11-point larger improvement in WOMAC-score (95% CI 6–16; p = 0.0001) compared to the control group. The intervention group also lost more weight (–5 kg), fat mass (–4 kg), and waist circumference (–6 cm) compared to the control group. Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue, pain interference, C-reactive protein, hemoglobin A1c, fasting glucose, and low-density lipoproteins improved in the intervention versus the control group, while other PROMIS measures, blood pressure, high-density lipoproteins, and triglycerides did not differ significantly between the groups.ConclusionThe “Plants for Joints” lifestyle program reduced stiffness, relieved pain, and improved physical function in people with hip or knee MSOA compared to usual care.",

keywords = "Diet, Metabolic syndrome, Osteoarthritis, Physical activity, Stress management",

author = "Wendy Walrabenstein and Wagenaar, {Carlijn A.} and {van de Put}, Marieke and {van der Leeden}, Marike and Martijn Gerritsen and Twisk, {Jos W.R.} and {van der Esch}, Martin and {van Middendorp}, Henri{\"e}t and Weijs, {Peter J.M.} and Roorda, {Leo D.} and {van Schaardenburg}, Dirkjan",

note = "With supplementary files. ",

year = "2023",

month = nov,

doi = "10.1016/j.joca.2023.05.014",

language = "English",

volume = "31",

pages = "1491--1500",

journal = "Osteoarthritis and Cartilage",

issn = "1063-4584",

publisher = "W.B. Saunders Ltd",

number = "11",

}

Walrabenstein, W, Wagenaar, CA, van de Put, M, van der Leeden, M, Gerritsen, M, Twisk, JWR, van der Esch, M, van Middendorp, H, Weijs, PJM, Roorda, LD & van Schaardenburg, D 2023, 'A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the “Plants for Joints” randomized controlled trial', Osteoarthritis and Cartilage, vol. 31, no. 11, pp. 1491-1500. https://doi.org/10.1016/j.joca.2023.05.014

A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the “Plants for Joints” randomized controlled trial. / Walrabenstein, Wendy; Wagenaar, Carlijn A.; van de Put, Marieke et al.
In: Osteoarthritis and Cartilage, Vol. 31, No. 11, 11.2023, p. 1491-1500.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis

T2 - the “Plants for Joints” randomized controlled trial

AU - Walrabenstein, Wendy

AU - Wagenaar, Carlijn A.

AU - van de Put, Marieke

AU - van der Leeden, Marike

AU - Gerritsen, Martijn

AU - Twisk, Jos W.R.

AU - van der Esch, Martin

AU - van Middendorp, Henriët

AU - Weijs, Peter J.M.

AU - Roorda, Leo D.

AU - van Schaardenburg, Dirkjan

N1 - With supplementary files.

PY - 2023/11

Y1 - 2023/11

N2 - ObjectiveTo determine the effectiveness of the “Plants for Joints” multidisciplinary lifestyle program in patients with metabolic syndrome-associated osteoarthritis (MSOA).DesignPatients with hip or knee MSOA were randomized to the intervention or control group. The intervention group followed a 16-week program in addition to usual care based on a whole food plant-based diet, physical activity, and stress management. The control group received usual care. The patient-reported Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) total score (range 0–96) was the primary outcome. Secondary outcomes included other patient-reported, anthropometric, and metabolic measures. An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyze between-group differences.ResultsOf the 66 people randomized, 64 completed the study. Participants (84% female) had a mean (SD) age of 63 (6) years and body mass index of 33 (5) kg/m2. After 16 weeks, the intervention group (n = 32) had a mean 11-point larger improvement in WOMAC-score (95% CI 6–16; p = 0.0001) compared to the control group. The intervention group also lost more weight (–5 kg), fat mass (–4 kg), and waist circumference (–6 cm) compared to the control group. Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue, pain interference, C-reactive protein, hemoglobin A1c, fasting glucose, and low-density lipoproteins improved in the intervention versus the control group, while other PROMIS measures, blood pressure, high-density lipoproteins, and triglycerides did not differ significantly between the groups.ConclusionThe “Plants for Joints” lifestyle program reduced stiffness, relieved pain, and improved physical function in people with hip or knee MSOA compared to usual care.

AB - ObjectiveTo determine the effectiveness of the “Plants for Joints” multidisciplinary lifestyle program in patients with metabolic syndrome-associated osteoarthritis (MSOA).DesignPatients with hip or knee MSOA were randomized to the intervention or control group. The intervention group followed a 16-week program in addition to usual care based on a whole food plant-based diet, physical activity, and stress management. The control group received usual care. The patient-reported Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) total score (range 0–96) was the primary outcome. Secondary outcomes included other patient-reported, anthropometric, and metabolic measures. An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyze between-group differences.ResultsOf the 66 people randomized, 64 completed the study. Participants (84% female) had a mean (SD) age of 63 (6) years and body mass index of 33 (5) kg/m2. After 16 weeks, the intervention group (n = 32) had a mean 11-point larger improvement in WOMAC-score (95% CI 6–16; p = 0.0001) compared to the control group. The intervention group also lost more weight (–5 kg), fat mass (–4 kg), and waist circumference (–6 cm) compared to the control group. Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue, pain interference, C-reactive protein, hemoglobin A1c, fasting glucose, and low-density lipoproteins improved in the intervention versus the control group, while other PROMIS measures, blood pressure, high-density lipoproteins, and triglycerides did not differ significantly between the groups.ConclusionThe “Plants for Joints” lifestyle program reduced stiffness, relieved pain, and improved physical function in people with hip or knee MSOA compared to usual care.

KW - Diet

KW - Metabolic syndrome

KW - Osteoarthritis

KW - Physical activity

KW - Stress management

U2 - 10.1016/j.joca.2023.05.014

DO - 10.1016/j.joca.2023.05.014

M3 - Article

C2 - 37328047

AN - SCOPUS:85164339598

SN - 1063-4584

VL - 31

SP - 1491

EP - 1500

JO - Osteoarthritis and Cartilage

JF - Osteoarthritis and Cartilage

IS - 11

ER -

A multidisciplinary lifestyle program for metabolic syndrome-associated osteoarthritis: the “Plants for Joints” randomized controlled trial

Abstract

Funding

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