title: Effects of diet type and supplementation of glucosamine, chondroitin, and MSM on body composition, functional status, and markers of health in women with knee osteoarthritis initiating a resistance-based exercise and weight loss program.
abstract: BACKGROUND
  The purpose of this study was to determine whether sedentary obese women with knee OA initiating an exercise and weight loss program may experience more beneficial changes in body composition, functional capacity, and/or markers of health following a higher protein diet compared to a higher carbohydrate diet with or without GCM supplementation.
  
  
  METHODS
  Thirty sedentary women (54 ± 9 yrs, 163 ± 6 cm, 88.6 ± 13 kg, 46.1 ± 3% fat, 33.3 ± 5 kg/m2) with clinically diagnosed knee OA participated in a 14-week exercise and weight loss program. Participants followed an isoenergenic low fat higher carbohydrate (HC) or higher protein (HP) diet while participating in a supervised 30-minute circuit resistance-training program three times per week for 14-weeks. In a randomized and double blind manner, participants ingested supplements containing 1,500 mg/d of glucosamine (as d-glucosamine HCL), 1,200 mg/d of chondroitin sulfate (from chondroitin sulfate sodium), and 900 mg/d of methylsulfonylmethane or a placebo. At 0, 10, and 14-weeks, participants completed a battery of assessments. Data were analyzed by MANOVA with repeated measures.
  
  
  RESULTS
  Participants in both groups experienced significant reductions in body mass (-2.4 ± 3%), fat mass (-6.0 ± 6%), and body fat (-3.5 ± 4%) with no significant changes in fat free mass or resting energy expenditure. Perception of knee pain (-49 ± 39%) and knee stiffness (-42 ± 37%) was decreased while maximal strength (12%), muscular endurance (20%), balance indices (7% to 20%), lipid levels (-8% to -12%), homeostasis model assessment for estimating insulin resistance (-17%), leptin (-30%), and measures of physical functioning (59%), vitality (120%), and social function (66%) were improved in both groups with no differences among groups. Functional aerobic capacity was increased to a greater degree for those in the HP and GCM groups while there were some trends suggesting that supplementation affected perceptions of knee pain (p < 0.08).
  
  
  CONCLUSIONS
  Circuit style resistance-training and weight loss improved functional capacity in women with knee OA. The type of diet and dietary supplementation of GCM provided marginal additive benefits.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT01271218.
authors.affiliation: Department of Health, Human Performance and Recreation, Baylor University, One Bear Place, Box 97313, Waco, TX 76798-7313, USA.
authors.forename: Teresa
authors.initials: T
authors.lastname: Magrans-Courtney
authors.affiliation: Human Performance Lab, Exercise & Sport Science Department, University of Mary-Hardin Baylor, Belton, Texas 76513, USA.
authors.forename: Colin
authors.initials: C
authors.lastname: Wilborn
authors.affiliation: Exercise & Sport Nutrition Lab, Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843-4243, USA.
authors.forename: Christopher
authors.initials: C
authors.lastname: Rasmussen
authors.affiliation: Higuchi Biosciences Center, University of Kansas, Lawrence, KS 66047, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Ferreira
authors.affiliation: Exercise & Sport Nutrition Lab, Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843-4243, USA.
authors.forename: Lori
authors.initials: L
authors.lastname: Greenwood
authors.affiliation: School of Physical Education & Exercise Science, University of South Florida, Tampa, FL 33620, USA.
authors.forename: Bill
authors.initials: B
authors.lastname: Campbell
authors.affiliation: Department of Health and Exercise Science, University of Oklahoma, Norman OK 73019, USA.
authors.forename: Chad M
authors.initials: CM
authors.lastname: Kerksick
authors.affiliation: Quality Improvement Programs, BlueCross and BlueShield of Texas, Dallas, TX 75266, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Nassar
authors.affiliation: Bouve College of Health, Northeastern University, Boston, MA 02115, USA.
authors.forename: Rui
authors.initials: R
authors.lastname: Li
authors.affiliation: Department of Health, Exercise Science, and Secondary Education, Lee University, Cleveland, TN 37320 m USA.
authors.forename: Mike
authors.initials: M
authors.lastname: Iosia
authors.affiliation: Schools of Biomedical & Health Sciences, Victoria University, Victoria University, Melbourne Victoria 8001, Australia.
authors.forename: Matt
authors.initials: M
authors.lastname: Cooke
authors.affiliation: Human Performance Lab, Exercise & Sport Science Department, University of Mary-Hardin Baylor, Belton, Texas 76513, USA.
authors.forename: Kristin
authors.initials: K
authors.lastname: Dugan
authors.affiliation: Department of Health, Human Performance and Recreation, Baylor University, One Bear Place, Box 97313, Waco, TX 76798-7313, USA.
authors.forename: Darryn
authors.initials: D
authors.lastname: Willoughby
authors.affiliation: Department of Family & Consumer Sciences, Baylor University, One Bear Place, Box 97346, Waco, TX 76798-73346, USA.
authors.forename: LuAnn
authors.initials: L
authors.lastname: Soliah
authors.affiliation: Exercise & Sport Nutrition Lab, Department of Health & Kinesiology, Texas A&M University, College Station, TX 77843-4243, USA.
authors.forename: Richard B
authors.initials: RB
authors.lastname: Kreider