This booklet presents sixteen 'practice briefs' which are popular publications based on 12 Master and one Bachelor theses of Van Hall Larenstein University of Applied Sciences (VHL). All theses were commissioned through the research project entitled 'Inclusive and climate smart business models in Ethiopian and Kenyan dairy value chains (CSDEK)'. The objective of this research is to identify scalable, climate smart dairy business models in the context of the ongoing transformation from informal to formal dairy chains in Kenya and Ethiopia.
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ObjectiveTo determine the effectiveness of the “Plants for Joints” multidisciplinary lifestyle program in patients with metabolic syndrome-associated osteoarthritis (MSOA).DesignPatients with hip or knee MSOA were randomized to the intervention or control group. The intervention group followed a 16-week program in addition to usual care based on a whole food plant-based diet, physical activity, and stress management. The control group received usual care. The patient-reported Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) total score (range 0–96) was the primary outcome. Secondary outcomes included other patient-reported, anthropometric, and metabolic measures. An intention-to-treat analysis with a linear-mixed model adjusted for baseline values was used to analyze between-group differences.ResultsOf the 66 people randomized, 64 completed the study. Participants (84% female) had a mean (SD) age of 63 (6) years and body mass index of 33 (5) kg/m2. After 16 weeks, the intervention group (n = 32) had a mean 11-point larger improvement in WOMAC-score (95% CI 6–16; p = 0.0001) compared to the control group. The intervention group also lost more weight (–5 kg), fat mass (–4 kg), and waist circumference (–6 cm) compared to the control group. Patient-Reported Outcomes Measurement Information System (PROMIS) fatigue, pain interference, C-reactive protein, hemoglobin A1c, fasting glucose, and low-density lipoproteins improved in the intervention versus the control group, while other PROMIS measures, blood pressure, high-density lipoproteins, and triglycerides did not differ significantly between the groups.ConclusionThe “Plants for Joints” lifestyle program reduced stiffness, relieved pain, and improved physical function in people with hip or knee MSOA compared to usual care.
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