Nutraceuticals: do they represent a new era in the management of osteoarthritis? - a narrative review from the lessons taken with five products.

OBJECTIVES: The aim of this first global systematic review on selected nutraceuticals was to synthesize and evaluate scientific relevant data available in the literature. Evidences that can support health, physiological or functional benefit on osteoarthritis (OA) were gathered and the level of evidence relative to each of these ingredients was highlighted. METHODOLOGY: Relevant scientific data (positive or not) regarding OA were searched for five groups of compounds (avocado/soybean unsaponifiables (ASU), n-3 polyunsaturated fatty acids, collagen hydrosylates (CHs), vitamin D, polyphenols) within preclinical (in vitro and in vivo), epidemiological, and clinical studies. The following criteria were evaluated to assess the methodology quality of each study: (1) study question; (2) study population; (3) primary endpoint; (4) study design (randomization, control, blinding, duration of follow up); (5) data analysis and interpretation. A scientific consensus was determined for all studied nutraceuticals to evaluate their efficacy in OA. RESULTS: The studied compounds demonstrated different potencies in preclinical studies. Most of them have demonstrated anti-catabolic and anti-inflammatory effects by various inhibitory activities on different mediators. Vitamin D showed a pro-catabolic effect in vitro and the polyphenol, Genistein, had only anti-inflammatory potency. The evaluation of the clinical data showed that ASU was the only one of the studied ingredients to present a good evidence of efficacy, but the efficient formulation was considered as a drug in some countries. Pycnogenol showed moderate evidence of efficacy, and vitamin D and collagen hydrolysate demonstrated a suggestive evidence of efficacy, whereas curcumin, epigallocatechin-3-gallate (EGCG) and resveratrol had only preclinical evidence of efficacy due to the lack of clinical data. The literature gathered for n-3 PUFA, nobiletin and genistein was insufficient to conclude for their efficacy in OA. CONCLUSION: Additional data are needed for most of the studied nutraceuticals. Studies of good quality are needed to draw solid conclusions regarding their efficacy but nutraceuticals could represent good alternates for OA management. Their use should be driven by any recommendations.

Effect of sucrose on the thermomechanical behavior of concentrated wheat and waxy corn starch-water preparations.

The rheological behavior of concentrated starch preparations from two different origins (wheat and waxy corn) was studied in the presence of sucrose by dynamic mechanical thermal analysis (DMTA). Moisture contents ranged from 30 to 60% (w/w wsb), and samples contained 0, 10, or 20 g of sucrose for 100 g of the starch-water mixture. The storage modulus (G') changes during heating depended strongly on water content (in the moisture range studied), and the importance of these variations was dependent upon the starch type. Sucrose addition resulted in a shift to higher temperatures of the increase in G' during heating. Differential scanning calorimetry (DSC) and electron-spin resonance (ESR) analyses were performed in parallel in order to relate the viscoelastic changes to water migrations and to structural disorganization of starch. Sucrose was found to increase the gelatinization temperature and enthalpy of both starches, implying a stabilization of the granular structure during heating. The sugar-water interactions do not appear to be the only way by which sucrose delays starch gelatinization. The obtained results suggest that sugar-starch interactions in the amorphous and/or the crystalline regions of the starch granules should be envisaged.