Green tea and exercise interventions as nondrug remedies in geriatric patients with rheumatoid arthritis

Abstract

This study aimed to evaluate the effects of green tea and supervised exercise training interventions on improvement of disease activity and bone metabolism markers in rheumatoid arthritis patients. [Subjects and Methods] One-hundred and twenty subjects who had a mean age of (60.7 ± 2.53 years) and had been diagnosed with rheumatoid arthritis at least ten years previously were randomly included in this study. Patients were treated with infliximab, green tea, or a supervised exercise program for six months. Disease activity markers as well as antioxidant activity of green tea extracts were estimated before supplementation using in vitro assays. [Results] Rheumatoid arthritis patients treated with green tea for 6 months alone or in combination with infliximab or an exercise program showed significant improvement in disease activity parameters, including C-reactive protein, and erythrocyte sedimentation rate, swollen and tender joints counts, and modified Stanford Health Assessment Questionnaire score, along with an increase in serum levels of bone resorption markers, i.e., deoxypyridinoline, amino-terminal telopeptide of type 1 collagen, and bone alkaline phosphatase, at 6 months of after initial treatment. The European League Against Rheumatism and American College of Rheumatology scores revealed more clinical improvement in the disease activity of rheumatoid arthritis patients treated with green tea along with exercise compared with rheumatoid arthritis patients treated with infliximab or exercise combinations. This may have been due to the higher potential antioxidant activity of green tea (89.6% to 96.5%). [Conclusion] Both exercise and green tea interventions appeared to be beneficial as nondrug modulates for rheumatoid arthritis disorders.

The effect of green tea on inflammatory mediators: A systematic review and meta‐analysis of randomized clinical trials

“…Titles and abstracts of 813 articles were read, and 774 articles were excluded. By considering criteria for inclusion and exclusion, 22 articles were excluded due to following reasons: not having a control group ( N = 3; Alghadir, Gabr, & Al‐Eisa, ; Lee et al, ; Sung et al, ), intervention less than 1 day ( N = 3; Alexopoulos et al, ; Hsu et al, ; Koutelidakis et al, ), and using other nutrients beside green tea in the intervention group ( N = 16; Bakker et al, ; Braga et al, ; Cialdella‐Kam et al, ; de Jesus Romero‐Prado et al, ; Dominiak, McKinney, Heilbrun, & Sarkar, ; Kim et al, ; Madaric et al, ; Nieman et al, ; Nieman et al, ; Ormsbee et al, ; Peluso et al, ; Rondanelli et al, ; Rubio‐Perez, Albaladejo, Zafrilla, Vidal‐Guevara, & Morillas‐Ruiz, ; Scolaro et al, ; Soriano‐Maldonado, Hidalgo, Arteaga, de Pascual‐Teresa, & Nova, ; Thomas, Williams, Sharma, Chaudry, & Bellamy, ; Figure ). Therefore, 17 articles were included in our systematic review (Basu et al, ; Bogdanski et al, ; de Maat et al, ; Dower et al, ; Fukino et al, ; Fukino, Shimbo, Aoki, Okubo, & Iso, ; Gutierrez‐Salmean et al, ; Hu et al, ; Hussain, Habib Ur, & Akhtar, ; Mielgo‐Ayuso et al, ; Mombaini & Jafarirad, ; Nogueira, Nogueira Neto, Klein, & Sanjuliani, ; Oyama et al, ; Oyama, Maeda, Sasaki, et al, ; Ryu et al, ; Shin et al, ; Sone et al, ); because the article by Ryu et al () did not report baseline values, we did not include it in our meta‐analysis (Table ).…”

“…not having a control group (N = 3;Alghadir, Gabr, & Al-Eisa, 2016;Lee et al, 2005;Sung et al, 2005), intervention less than 1 day (N = 3;Alexopoulos et al, 2008;Hsu et al, 2007;Koutelidakis et al, 2014), and using other nutrients beside green tea in the intervention group (N = 16;Bakker et al, 2010;Braga et al, 2012;Cialdella-Kam et al, 2016;de Jesus Romero-Prado et al, 2015;Dominiak, McKinney, Heilbrun, & Sarkar, 2010;Kim et al, 2016;Madaric et al, 2013;Nieman et al, 2013;Nieman et al, 2017;Ormsbee et al, 2014;Peluso et al, 2014;Rondanelli et al, 2013;Rubio-Perez, Albaladejo, Zafrilla, Vidal-Guevara, & Morillas-Ruiz, 2016; Scolaro et al, 2018; Soriano-Maldonado, Hidalgo, Arteaga, de Pascual-Teresa, & Nova, 2014; Thomas, Williams, Sharma, Chaudry, & Bellamy, 2014; Figure 1).Therefore, 17 articles were included in our systematic review(Basu et al, 2011;Bogdanski et al, 2012;de Maat et al, 2000;Dower et al, 2015;Fukino et al, 2008;Fukino, Shimbo, Aoki, Okubo, & Iso, 2005;Gutierrez-Salmean et al, 2016;Hu et al, 2016;Hussain, Habib Ur, & Akhtar, 2017;Mielgo-Ayuso et al, 2014;Mombaini & Jafarirad, 2017;Nogueira, Nogueira Neto, Klein, & Sanjuliani, 2017;Oyama, Maeda, Sasaki, et al, 2010;Ryu et al, 2006;Shin et al, 2018;Sone et al, 2011)…”

Tea Consumption Is Associated with Decreased Disease Activity of Rheumatoid Arthritis in a Real-World, Large-Scale Study

“…The types of tea were recorded as jasmine tea, black tea, green tea, and both green and black tea. The assessment of tea consumption ranged from 1 to 3 (1 = no, 2 = low-intake: ≤3 cups/day, 3 = highintake: > 3 cups/day [250 mL/cup]) [10,15]. Demographic data such as age, gender, nationality, body mass index (BMI), alcohol consumption, smoking habits and rheumatic disease family history were collected from all patients.…”

“…More recently, it has been shown that green tea might have preventive effects on the development of RA (OR 0.65, CI 0.45-0.93) [9]. Another small-scale clinical trial showed that RA patients treated with green tea for 6 months alone or in combination with infliximab had significant improvement in disease activity [10]. Tea contains polyphenolic components such as epicatechin, epigallocatechin, epicatechin-3-O-gallat, and epigallocatechin-3-O-gallate (EGCG), which have been shown to be protective against cardiovascular disease, cancer and inflammation [11].…”

Rheumatoid Cachexia, a Metabolic Rheumatoid Arthritis Disorder: Pathophysiological Mechanisms, Diagnostic Tools and Current Therapeutic Strategy

“…The perceptions of people with RA may provide reasoning for the lower physical activity levels of RA patients when compared to the general population [58]. Thus, understanding the perceptions of RA patients regarding exercise is salient to the role of the health professional.…”