Osteo Arthritis Knee, Protein Synthesis
Conditions
Brief summary
Rationale: Protein from plant-based foods may be unable to stimulate protein synthesis due to a suboptimal essential amino acid content and a lower digestibility. However, a more optimal amino acid profile may be achieved by increasing portions sizes and blending multiple plant-based sources. Studies investigating the anabolic properties of vegan diets (total elimination of animal-based foods) rather than single plant-based foods in older adults are scarce. It remains unknown if a vegan diet can also affect protein synthesis rates in other musculoskeletal tissues than muscle. Primary objective: To assess the effects of a 2-week preoperative vegan diet in comparison to an omnivorous diet on protein synthesis rates in Hoffa's fat pad, synovium, tendon, bone, ligaments, menisci, and cartilage in older adults with knee osteoarthritis undergoing total knee arthroplasty. Secondary objective: To assess the effects of a 2-week preoperative vegan diet in comparison to an omnivorous diet on blood pressure and plasma amino acids in older adults with knee osteoarthritis undergoing total knee arthroplasty. Study design: Multi-center, randomized, controlled trial with an intervention and a control group. Study population: 40 older adults (60 - 80 years) with osteoarthritis of the knee undergoing total knee replacement. Intervention: Controlled vegan diet versus controlled omnivorous diet, for a duration of 14 days. Main study parameters/endpoints: Primary study parameters are protein synthesis rates of Hoffa's fat pad, synovium, tendon, bone, ligament, menisci, and cartilage. Secondary parameters include blood pressure and plasma amino acids.
Interventions
DIETARY_SUPPLEMENTVegan diet
Vegan diet for 2 weeks before surgery
DIETARY_SUPPLEMENTOmnivorous diet
Omnivorous diet for 2 weeks before surgery
Sponsors
Gelderse Vallei Hospital
Rijnstate Hospital
Wageningen University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
60 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* Written informed consent; * Patients scheduled for total knee arthroplasty; * BMI between 20-32 kg/m2; * Aged 60 - 80 years; * Mentally competent, as judged by the treating physician;
Exclusion criteria
* Following a vegetarian or vegan diet or a diet that affects protein intake during the six months prior to the study; * Participating in a structured progressive exercise training program in the past three months; * Lost more than 4 kg body weight during three months prior to the study; * Chronic use of medications that affect protein metabolism (i.e. systemic corticosteroids, or prescription strength acne medications); * Being diagnosed with one of the following: diabetes mellitus, rheumatoid arthritis, peripheral artery disease Fontaine III or IV, COPD GOLD III or IV, neoadjuvant chemotherapy or radiotherapy, phenylketonuria, collagen disorders (e.g. Marfan and Ehler-Danlos); * Alcohol abuse; * Surgical intervention to the knee in the past four weeks; * Total parenteral nutrition at day of surgery; * Glomerular filtration rate (GFR) \<20 mL/min/1.73 m2; * Allergic or intolerant to any product included in the diets; * Osteoarthritis of the knee secondary to septic arthritis, osteonecrosis, fracture, osteochondritis dissecans, or malignant processes; * Any other medical condition that may interfere with the safety of the participants or the outcome parameters, in the investigators judgement; * Not willing to stop nutritional supplements, with the exception of vitamin D and supplements on medical advice. * Investigator's uncertainty about the willingness or ability of the participant to comply with the protocol instructions; * Participation in other studies that may have an impact on the outcomes during the three months before the start of the current study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in tissue-specific protein synthesis rates | During the 2-week preoperative period | Tissue-specific protein synthesis rates in the knee using D2O dosing methodology |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in blood pressure | Measured at baseline and 1 day before surgery | Blood pressure measurement using an CE-certified ambulatory blood pressure monitor |
| Change in plasma amino acids | During the 2-week preoperative period | Difference in circulating concentrations between the two diets. In addition, it will be investigated if plasma amino acids can be used as a marker for dietary intake. |
Countries
Netherlands
Contacts
Primary ContactInge Groenendijk, PhD
Backup ContactLisette de Groot, PhD
Outcome results
None listed