1. Introduction
Osteoarthritis, OA, osteoarthritis, pain, disability
OSTEOARTHRITIS, OSTEOARTHRITIS, DISEASE, INFLAMMATION, KNEE DISCOMFORT, CHRONIC PAIN
A single-center, randomized, double-blind, controlled clinical trial with four arms was conducted in healthy subjects with persistent knee discomfort (pain intensity on 1–10 cm visual analog scale (VAS) > 3) aged 40 years and older treated with a dietary supplement for 8 weeks. The study groups were The ongoing demographic change and concomitant population aging as well as unhealthy lifestyles cause a rise in the prevalence of people experiencing joint discomfort [Key prevention strategies include the reduction of the overuse of joints (e.g., related to workload or excessive sporting activities) and the promotion of healthy habits (e.g., regular physical exercise, adequate nutrition, maintaining a normal body weight).Supportive preventative measures such as nutritional supplements are on the rise, but proper scientific evidence for specific ingredients is often rare.If acute symptoms are not counteracted in time, in the worst case chronic conditions such as osteoarthritis can develop. Osteoarthritis (OA) is one of the main causes of functional disability and chronic pain. OA is a very prevalent condition, with a global increase of 113.25% from 1990 to 2019 [Knee OA is the most common subtype of OA. In 2020, it was estimated that there were around 654.1 million subjects (40 years or older) with knee OA worldwide, with a pooled global incidence of 203 per 10,000 person-years in persons of 20 years of age or more [Patients with OA generally seek medical care because of pain, which is the cardinal symptom of the disease. The use of joints increases pain, whereas pain is relieved by resting. Stiffness and pain are typically intermittent at the beginning of OA, becoming more severe and frequent along the progression of the disease. However, the severity of the disease is based on changes shown on plain X-rays and the intensity of pain is poorly correlated [Based on the limitations of efficacy and long-term safety of available pharmacological treatments, there has been an increasing interest in the identification of natural products with anti-oxidative and anti-inflammatory properties that may safely promote joint health and prevent OA. Omega-3 polyunsaturated fatty acids (PUFAs) especially eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) commonly consumed in fatty fish and seafood, cereal products, seeds, nuts, and vegetables are recognized for their anti-inflammatory and pleiotropic properties associated with the formation of eicosanoids, resolvins, key proteins, cytokines, and mediators of inflammation, which play a role in reducing the low-grade inflammatory environment and cartilage degradation associated with OA [On the other hand, pentacyclic triterpenic acids are the active ingredients in Therefore, it was considered of interest to design a clinical trial to assess the efficacy of a dietary supplement of an omega-3-based product given alone or combined with a 