Blueberries Improve Pain, Gait Performance, and Inflammation in Individuals with Symptomatic Knee Osteoarthritis

Abstract

Osteoarthritis (OA) is the most common joint disorder in the world and is the most frequent cause of walking related disability among older adults in the US, which brings a significant economic burden and reduces quality of life. The initiation and development of OA typically involves degeneration or progressive loss of the structure and function of articular cartilage. Inflammation is one of the major drives of the progression of OA. Dietary polyphenols have been studied for their anti-inflammatory properties and potential anabolic effects on the cartilage cells. Blueberries are widely consumed and are high in dietary polyphenols, therefore regular consumption of blueberries may help improve OA. The purpose of the present study was to examine the effect of freeze dried whole blueberries on pain, gait performance, and inflammation in individuals with symptomatic knee OA. In a randomized, double-blind trial, adults age 45 to 79 with symptomatic knee OA, were randomized to either consume 40 g freeze-dried blueberry powder (n = 33) or placebo powder (n = 30) daily for four months. Blood draws and assessment of pain and gait were conducted at baseline, two months, and four months. Western Ontario McMaster Osteoarthritis Index (WOMAC) questionnaires were used to assess pain and GAITRite® electronic walkway was used to evaluate gait spatiotemporal parameters. WOMAC total score and sub-groups, including pain, stiffness, and difficulty to perform daily activities decreased significantly in the blueberry treatment group (p < 0.05), but improvement of WOMAC total score and difficulty to perform daily activities were not observed in the placebo group. Normal walking pace single support percentage for both limbs increased (p = or < 0.007), while double support percentage for both limbs decreased in the blueberry treatment group (p = or < 0.003). No significant changes were observed in plasma concentrations of tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-10, IL-13, matrix metalloproteinases (MMP)-3, MMP-13, and monocyte chemoattractant protein-1 (MCP-1) in both treatment groups. However, an increasing trend for IL-13 concentration and a decreasing trend in MCP-1 concentration were noted in the blueberry group. The findings of this study suggest that daily incorporation of whole blueberries may reduce pain, stiffness, and difficulty to perform daily activities, while improving gait performance, and would therefore improve quality of life in individuals with symptomatic knee OA.

Health effects of a low-inflammatory diet in adults with arthritis: a systematic review and meta-analysis

“…Of the 453 citations retrieved from multiple sources, seven articles (19,21,22,33,(42)(43)(44) met the eligibility criteria ( Fig. 1).…”

Effects of Nutritional Interventions in the Control of Musculoskeletal Pain: An Integrative Review

“…Four studies evaluated the nutritional interventions with fruits, specifically the effects observed when blueberry [ 8 ], lyophilized strawberry powder [ 46 ], pomegranate juice [ 47 ], and passion fruit peel extract were consumed [ 48 ]. The studies had a total of 151 participants, and three were randomized and double-blind [ 8 , 46 , 48 ]. All studies compared the intervention group with the control or placebo group.…”

“…All studies compared the intervention group with the control or placebo group. Studies evaluating blueberry, strawberry, and passion fruit peel extract revealed that a significant reduction in musculoskeletal pain was observed after the consumption of blueberry, strawberry, and passion fruit peel extract [ 8 , 46 , 48 ].…”

“…Of the four studies, three evaluated the levels of some inflammatory markers [ 8 , 46 , 47 ], and according to the results of these studies, nutritional intervention with the consumption of strawberry demonstrated a significant reduction in the levels of IL-6 and IL-1B [ 46 ] ( Table 2 ). The follow-up period in these studies ranged from 6 to 26 weeks.…”

Chondroprotective Properties of Human-Enriched Serum Following Polyphenol Extract Absorption: Results from an Exploratory Clinical Trial

“…To date, a reconstituted freeze-dried strawberry beverage (50 g/day) given to obese adults with radiographic evidence of knee OA significantly lowered serum biomarkers of inflammation including (IL)-6, IL-1 β, and cartilage degradation mediators including matrix metalloproteinase (MMP)-3 [37]. Forty g of freeze-dried blueberry powder given daily for four months to adults with symptomatic knee OA significantly decreased (WOMAC, Western Ontario and McMaster Universities Osteoarthritis Index) total score and subgroups, including pain, stiffness, and difficulty to perform daily activities [38]. Pomegranate juice decreases serum levels of matrix metalloproteinase (MMP)-13 and improves antioxidant status (glutathione peroxidase) in patients with knee OA [39].…”