Whole Grain Foods Research Articles

The Effect of Increasing Consumption of Pulses and Wholegrains in Obese People: A Randomized Controlled Trial

Background: Wholegrain intake is inversely related to weight gain over time, but little information is available on the role of pulses in weight control.Objective: To compare weight loss, metabolic outcomes, and nutrient intakes in obese people assigned to a diet rich in pulses and wholegrains or a control diet.Methods: Randomized controlled study of 18 months with 113 volunteers (body mass index [BMI] ≥ 28 kg/m2). Diets were based on guidelines published by the National Heart Foundation of New Zealand. The intervention group was advised to consume 2 serves of pulses and 4 serves of wholegrain foods per day as substitutions for more refined carbohydrates.Results: Fiber intakes were higher, intakes of several vitamins and minerals were better maintained, and dietary glycemic index was lower in the intervention compared with the control group. Mean (standard error [SE]) weight loss at 6 months was 6.0 (0.7) kg and 6.3 (0.6) kg in the control and intervention groups, respectively, and was not different between groups (p > 0.05). Blood pressure, triglycerides, and glycemic load were lowered in both groups compared with baseline. Waist circumference was decreased at 18 months in the intervention compared with the control group (−2.8 cm; 95% confidence interval [CI]: −0.4, −5.1).Conclusions: Incorporation of pulses and wholegrain foods into a weight loss program resulted in a greater reduction in waist circumference compared with the group consuming a control diet, although no difference in weight loss was noted between groups. Retention of several nutrients was better with the pulse and wholegrain diet.

A significant dietary change after breast cancer diagnosis: Early results of a United Kingdom prospective multicenter study.

1588 Background: DietCompLyf, a prospective United Kingdom study, is investigating the effects of phytoestrogens and other lifestyle factors on survival in patients with invasive breast cancer. We present here a comparison of pre- and post-diagnostic dietary intake and supplement use reported by 1760 participants. Methods: Twosemi-quantitative food frequency questionnaires were administered to participants at study entry (approximately one year after diagnosis) one representing usual diet before diagnosis and the other, after diagnosis until study recruitment. Consumption of food groups and daily intake of macro- and micro-nutrients derived by nutritional software program analysis was evaluated. Supplement use was also examined. Results: Consumption of fruit and vegetables, lean protein sources, tea, wholegrain foods and nuts was significantly increased post-diagnosis (p < 0.05). Concurrently, intake of red meat, refined grain products, high-fat and high-sugar foods, coffee and some alcoholic drinks was s...

Finnish adolescents' attitudes towards wholegrain bread and healthiness

Wholegrain food may have an important role in the prevention of chronic diseases, and therefore its consumption should be increased. However, wholegrain products have a low consumption because of unfamiliar taste and poor understanding about the health benefits. Generally, adolescents unfamiliar with wholegrain bread dislike it. Food use in childhood correlates positively with practices in adult life, and therefore adolescents are an important target group for research. The aim was to study adolescents' attitudes towards wholegrain bread in a society where wholegrain products are widely used. A qualitative focus group method (n = 61) and a quantitative procedure (n = 104) with 13-15-year-old secondary school students indicated that Finnish adolescents considered wholegrain breads healthier and more acceptable than refined breads. The motives for wholegrain bread consumption were taste, feeling of fillingness and weight control. Girls were more interested in bread healthfulness than boys (P < 0.01), and participants who showed a more positive attitude towards general health interest reported using more rye and wholegrain breads than participants with negative attitudes. Adolescents familiar with the sensory properties and healthfulness of rye and wholegrain breads consumed them regularly and perceived them as pleasant and very acceptable.

The relationship between whole grain consumption and fiber intake in American adults: Results from NHANES 1999‐04

Evidence indicating the role of whole grain (WG) foods in the reduction of risk for various cancers, coronary heart disease and overweight continues to grow. Total dietary fiber (TDF) is one nutrient often associated with whole grain. One‐day food intakes from the NHANES 1999‐04 and the USDA MyPyramid Equivalents Database 2.0 (MPED) were used to examine this relationship for adults 19+ years. Results indicate that adults in the highest tertile of TDF consumption consumed significantly more WG than adults in the lower 2 tertiles. Adults meeting WG recommendations (≥ 3 oz. eq.) also had significantly higher TDF intakes (28.8g versus 13.4g for no WG group). Vegetables and ready‐to‐eat cereals were the largest contributors of TDF among those adults who met WG recommendations (15% and 13%, respectively). Among adults with the lowest WG intake, RTE cereal contributed very little TDF (&lt;2%). TDF consumption from MPED groups was also examined. For the adults meeting WG recommendation, WG foods were a significant source of TDF (~ 25%). Whole grain consumption should continue to be encouraged for all Americans.

Can bioactive foods affect obesity?

Many dietary factors or substances exert effects on the three components of energy balance, and one strategy for tackling weight gain could be to use the inherent properties of these substances. Here, we will review the evidence regarding nutritional factors with a potential impact on energy balance, such as wholegrain foods, dietary fiber and protein content, calcium, and certain spices. There is ample evidence to suggest that dietary protein, wholegrain, and fiber promote satiety and either reduce energy absorption or stimulate energy expenditure. Dietary calcium reduces fat absorption, and a sufficient intake may also prevent excessive hunger during weight loss diets. Chili and mustard have beneficial effects on energy balance, although the quantitative importance of this may be modest. Manipulation of diet composition with an aim to prevent weight gain and weight regain is a promising avenue of research.

Whole-Grain Intake Correlates among Adolescents and Young Adults: Findings from Project EAT

Background National survey data indicate few adolescents or young adults consume whole grains in the amount recommended to prevent chronic disease and maintain a healthful weight. Interventions are needed to address this gap; however, little is known about what modifiable factors influence whole-grain intake among youth. Objective This study aimed to identify socioenvironmental, personal, and behavioral correlates of whole-grain intake among adolescents and young adults. Design Data for this cross-sectional analysis were drawn from Project EAT (Eating Among Teens)-II, the second wave of a population-based study in Minnesota. Mailed surveys and food frequency questionnaires were completed by male (44.8%) and female (55.2%) participants in 2003-2004, including 792 adolescents (mean age=17.2 years) and 1,686 young adults (mean age=20.5 years). Linear regression models adjusted for demographic characteristics were used to identify factors associated with energy-adjusted daily intake of whole grains. Results Mean daily intake of whole grains was lower than recommended among adolescents (males: 0.59±0.04 servings, females: 0.61±0.04 servings) and young adults (males: 0.68±0.03 servings, females: 0.58±0.03 servings). Home availability of whole-grain bread, self-efficacy to consume ≥3 daily servings of whole grains, and preference for the taste of whole-grain bread were positively associated with whole-grain intake during adolescence and young adulthood across sex. Conversely, fast-food intake was associated with lower intake of whole grains among adolescents and young adults of both sexes. The factors examined in this study explained 28% to 34% of variance in whole-grain intake across sex and the two age groups. Conclusions The findings suggest nutrition interventions should address the availability of whole-grain foods in homes and restaurants. In addition, young people should be provided with opportunities to taste a variety of whole-grain foods to enhance taste preferences and self-efficacy to consume whole-grain products.

Dietary Approaches to Stop Hypertension (DASH) diet: applicability and acceptability to a UK population

The Dietary Approaches to Stop Hypertension (DASH) diet is widely promoted in the USA for the prevention and treatment of high blood pressure. It is high in fruit and vegetables, low-fat dairy and wholegrain foods and low in saturated fat and refined sugar. To our knowledge, the use of this dietary pattern has not been assessed in a free-living UK population. The DASH diet was adapted to fit UK food preferences and portion sizes. Fourteen healthy subjects followed the adapted DASH diet for 30 days in which they self-selected all food and beverages. Dietary intake was assessed by 5-day food diaries completed before and towards the end of the study. Blood pressure was measured at the beginning and end of the study to assess compliance to the DASH style diet. The DASH diet was easily adapted to fit with UK food preferences. Furthermore, it was well tolerated and accepted by subjects. When on the DASH style diet, subjects reported consuming significantly (P < 0.01) more carbohydrate and protein and less total fat (5%, 6% and 9% total energy, respectively). Sodium intakes decreased by 860 mg day(-1) (P < 0.001). Systolic and diastolic blood pressure decreased significantly (P < 0.05) by 4.6 and 3.9 mmHg, respectively when on the DASH style diet. The DASH style diet was well accepted and was associated with a decrease in blood pressure in normotensive individuals and should be considered when giving dietary advice to people with elevated blood pressure in the UK.

Comparing alkylresorcinols and mammalian lignans as biomarkers of wholegrain wheat or wholegrain rye intake in a dose-response intervention trial: the Grain Mark Study

Observational studies indicate that wholegrain foods are beneficial for health. However, these findings are restricted by difficulties in accurate assessment of wholegrain food intake in populations due to poor definitions of wholegrain foods, limited information on portion/ serving sizes and lack of detail on the wholegrain content of individual foods. Thus, there is a need to identify biomarker(s) for wholegrain foods, which can be used to accurately assess intake for better correlation with health outcomes and to give strength to observational and intervention studies. Sixty-eight non-smoking healthy volunteers (48% male), mean age 54.5 years, participated in the study. After a wash-out period of 4 weeks during which volunteers avoided all wholegrain foods, they were randomly allocated into two groups; a wholegrain wheat group and a wholegrain rye group. The volunteers were asked to consume 3 servings (48 g) of either whole grain per day for 4 weeks (Dose 1) from a selection of foods provided. After this period, they were asked to double their intake of the same foods (Dose 2) for further 4 weeks. At the end of each period, volunteers provided fasting blood and 24 h urine samples for the measurement of plasma alkylresorcinols and plasma/24 h urine mammalian lignans; enterolactone (ENL) and enterodiol (END).

Plasma levels of alkylresorcinols and incidence of endometrial cancer

A high intake of whole-grain foods may protect against endometrial cancer, but the existing literature is both limited and inconsistent. A significant reason for the inconsistent evidence could be methodological problems regarding accurate assessment of whole-grain intake. Alkylresorcinol (AR) has been suggested as a reliable biomarker of whole-grain wheat and rye intake. Our aim was to overcome the methodological problems in previous questionnaire-based studies, by using AR as exposure measurement when studying the incidence of endometrial cancer. ARs were measured by gas chromatography-mass spectrometry in stored plasma samples from 177 endometrial cancer cases and a subcohort of 152 women, all originating from the same prospective cohort study. Incidence of endometrial cancer according to plasma levels of AR was estimated in a Cox regression model. No associations between plasma levels of AR and endometrial cancer were observed. Body mass index or use of hormone replacement therapy of the participants did not modify the association. This is the first study to associate the whole-grain wheat and rye biomarker AR to a cancer endpoint. No association was found, but more studies are warranted to further explore AR as a marker of whole-grain exposure in relation to cancer and other disease endpoints.

Longitudinal and secular trends in adolescent whole-grain consumption, 1999–2004

The replacement of refined grains in the diet with whole grains may help prevent chronic disease and excess weight gain, but intakes in adolescents are often lower than recommended. This study aimed to examine demographic disparities and 5-y longitudinal and secular trends (1999-2004) in whole-grain intake among 2 cohorts of Minnesota adolescents. Whole-grain intake was examined among 996 adolescent males and 1222 adolescent females who were Project EAT (Eating Among Teens) participants in 1999 and 2004. Multinomial logistic regression models were used to examine demographic differences in whole-grain intake. Mixed linear regression models were used to estimate 1) longitudinal trends among 2 cohorts of adolescents during developmental transitions and 2) age-matched secular trends between the cohorts at middle adolescence. In 1999, 11% of adolescent males and 13% of adolescent females reported that they consumed more than one daily serving of whole grains. Whole-grain intake was lowest among youth of the Native American and white races and among youth of high socioeconomic status. During the transition from middle to late adolescence, whole-grain intake increased by a mean of 0.14 daily servings among adolescent males and 0.09 daily servings among adolescent females. No significant changes in whole-grain intake were shown among either sex during the transition from early to middle adolescence. Yeast breads, popcorn, and ready-to-eat breakfast cereals were major sources of whole grains in 1999 and 2004. Findings suggest the need to advance efforts that target improvements in the amount of whole-grain foods selected by adolescents.

Role of hydroxycinnamic acids in food flavor: a brief overview

The influence of hydroxycinnamic acids (HCAs) on food flavor is reviewed. In coffee, whole-grain foods and related model systems, the HCAs have been reported to contribute to the flavor profile by multiple mechanisms, such as to impart taste attributes, to generate aroma and taste-active compounds by phenolic degradation, as well as to alter the mechanisms of the Maillard reaction and related flavor development. Consequently the role of HCAs on the flavor properties of food products is complex, multifaceted and can be related to the chemistry and fate of HCAs during thermal processing.

Variations in compliance with starchy food recommendations and consumption of types of starchy foods according to sociodemographic and socioeconomic characteristics

Nutritional recommendations call for balanced, diversified consumption of starchy foods and increased whole-grain food intake. Their efficiency may depend on sociodemographic and socioeconomic factors, for which little information is available. The aim of the present study was to investigate the relationship between sociodemographic and socioeconomic characteristics and starchy food consumption in a large general population of French adults. Dietary intake was assessed using at least six 24-h dietary records collected, during a 2-year period, from 4574 men and women aged 45-60 years who participated in the Supplémentation en VItamines Minéraux et AntioXydants cohort study in 1995-7. Compliance with the recommendation ( > or = 3 and < 6 servings/d), non-consumption of whole-grain products, variety and daily cost were compared across sociodemographic and socioeconomic categories using logistic regression and covariance analyses. About 55 % of subjects complied with the starchy food recommendation, with little variation across sociodemographic characteristics. Consumption of whole-grain products was less likely in men (P = 0.001), in subjects with a lower education level (P-trend = 0.01) and in those belonging to intermediate occupational categories (P = 0.02). The variety of starchy food intake increased with education level (P-trend = 0.0002) and was lowest for manual workers (P = 0.03). The proportion of daily food cost spent on starchy foods decreased with occupational category (P < 0.0001), and was higher in rural areas (P = 0.0004). The starchy food budget spent on potatoes decreased with the educational level (P-trend = 0.007), whereas it increased for rice and unsweetened breakfast cereals (P-trend = 0.001 for both). Public recommendations concerning starchy food variety and whole-grain intake should specifically target subjects with a lower education level and/or occupational category.

Whole-grain Continuing Education for School Foodservice Personnel: Keeping Kids from Falling Short

Objective The purpose of this project was to develop and test whole-grain continuing education for school foodservice personnel. Methods A continuing education program was developed to address planning, purchasing, preparing, and serving whole-grain food in schools. Participants completed a pre-post questionnaire to assess changes in knowledge, attitudes and intention. Results Participants (n = 211) were mostly non-Hispanic white women. Pre-post test scores indicated improvements in whole-grain knowledge and intention to find whole-grain recipes for school menus ( P < 0.05); however, attitudes about storage and cost issues became less positive. After 3–6 months, participants indicated more whole-grain food items were offered in schools. Conclusions and Implications Whole-grain education for school foodservice personnel may increase awareness and menu placement and increase opportunities for whole-grain consumption by children.

Wholegrain vs. refined wheat bread and pasta. Effect on postprandial glycemia, appetite, and subsequent ad libitum energy intake in young healthy adults

Wholegrain foods have received much attention in recent years, and have been proposed to play a role in energy regulation through lowering of postprandial glycemia and appetite. This randomized crossover single meal study in 16 young adults was conducted to test the effect of iso-caloric meals based on wholemeal wheat breads and pasta in comparison to similar refined wheat products on postprandial glycemia, appetite and ad libitum energy intake (EI). Test meals (50 g carbohydrates; 2MJ) consisted of refined wheat bread (RWB), wholegrain wheat bread (WWB), refined wheat pasta (RWP) and wholegrain wheat pasta (WWP) and were served after an overnight fast. Appetite ratings and blood glucose were assessed for 180 min after which an ad libitum lunch meal was served and EI measured. The 180 min glucose responses were similar for wholemeal and refined products, but pasta meals gave significantly lower glucose responses. Only RWP had a lower glycemic index compared to RWB. WWB, but not WWP, resulted in increased satiety and reduced hunger compared to RWB. Ad libitum EI did not differ. In conclusion, the results show that wholemeal breads increased satiety measures compared to their refined counterparts; however no significant effect on subsequent EI was observed.

Dietary Glycemic Index: Health Implications

Weight loss can be achieved by any means of energy restriction, but the challenge is to achieve sustainable weight loss and prevent weight “creep” without increasing the risk of chronic disease. The modest success of low fat diets has prompted research on alternative dietary strategies, including high protein diets and low glycemic index (GI) diets. Conventional high carbohydrate diets, even when based on wholegrain foods, increase postprandial glycemia and insulinemia and may compromise weight control via mechanisms related to appetite stimulation, fuel partitioning, and metabolic rate. This paper makes the case for the benefits of low glycemic index diets over higher protein diets. Both strategies are associated with lower postprandial glycemia, and both are commonly labeled as “low glycemic load,” but the long-term health effects are likely to be different. A large body of evidence, which now comprises observational prospective cohort studies, randomized controlled trials, and mechanistic experiments in animal models, provides robust support for low GI carbohydrate diets in the prevention of obesity, diabetes, and cardiovascular disease. Although lower carbohydrate, higher protein diets increase the rate of weight loss, cohort studies and meta-analyses of clinical trials suggest the potential for increased mortality.

Validation of a FFQ for estimating whole-grain cereal food intake

Estimation of whole-grain (WG) food intake in epidemiological and nutritional studies is normally based on general diet FFQ, which are not designed to specifically capture WG intake. To estimate WG cereal intake, we developed a forty-three-item FFQ focused on cereal product intake over the past month. We validated this questionnaire against a 3-d-weighed food record (3DWFR) in thirty-one subjects living in the French-speaking part of Switzerland (nineteen female and twelve male). Subjects completed the FFQ on day 1 (FFQ1), the 3DWFR between days 2 and 13 and the FFQ again on day 14 (FFQ2). The subjects provided a fasting blood sample within 1 week of FFQ2. Total cereal intake, total WG intake, intake of individual cereals, intake of different groups of cereal products and alkylresorcinol (AR) intake were calculated from both FFQ and the 3DWFR. Plasma AR, possible biomarkers for WG wheat and rye intake were also analysed. The total WG intake for the 3DWFR, FFQ1, FFQ2 was 26 (sd 22), 28 (sd 25) and 21 (sd 16) g/d, respectively. Mean plasma AR concentration was 55.8 (sd 26.8) nmol/l. FFQ1, FFQ2 and plasma AR were correlated with the 3DWFR (r 0.72, 0.81 and 0.57, respectively). Adjustment for age, sex, BMI and total energy intake did not affect the results. This FFQ appears to give a rapid and adequate estimate of WG cereal intake in free-living subjects.

EMPIRICAL MODELING OF DRYING PROCESS FOR APPLE (CV.GRANNY SMITH) SLICES AT DIFFERENT AIR TEMPERATURES

ABSTRACT This study investigated and modeled the drying kinetics of Granny Smith variety apples at five different temperatures from 40 to 80C, with an air flow of 2.0 ± 0.1 m/s and load density of 4.4 kg/m2. Prior to mathematical modeling of the drying process, desorption isotherm was determined using the Guggenheim, Anderson and de Boer equation. Empirical equations used for modeling the drying kinetics were Newton, Henderson-Pabis, Page and Modified Page models. The fit quality obtained with each model was evaluated using statistical tests (determination coefficient, sum squared error, root mean square errors and chi-square). The kinetic parameters values were between 0.0046–0.0115/min for k1; 0.0050–0.0129/min for k2; 0.0006–0.0039/min for k3; and 0.0041–0.0090/min for k4. When comparing experimentally obtained values with those calculated from the models, it was shown that the best fit on the data was obtained employing the Modified Page model based on the statistical tests used for evaluation. PRACTICAL APPLICATION The main value of this study is the application of the proposed mathematical models using Newton, Henderson-Pabis, Page and Modified Page equations in food dehydration, which can be considered as a basis for an estimation of drying time in this kind of industry. The study of drying kinetics of apple cv. Granny Smith arouses technological and commercial interest, since this product is worldwide and extensively used in prepared foods including snack preparations, whole-grain breakfast foods and functional food among others. In addition, dried apples and other dried fruit exports (raisins and prunes) from Chile have become very important for the economy of the country, thanks to Free Trade Treaties. The major markets for these products include the U.S.A., the European community and Japan.

Total phenolic compounds and antioxidant capacity of wheat graded flours by polishing method

The graded flour fractions, which were milled from whole wheat grain from outer to inner parts without removal of germ and bran, are rich in dietary fibers and minerals, the sources of nutrition for human beings. In this study, the whole waxy wheat was milled into five fractions using the gradual milling method and the phenolic contents and antioxidant capacity of these flours were investigated. The total phenolic and flavonoid contents of free and bound phenolic extracts gradually increased in the order from the inner to the outer fractions. The flours milled from the outer parts of grain contained significantly higher amount of phenolics and exhibited significantly higher antioxidant capacity than did the whole grain. Likewise, the inner flour fractions milled from mostly endosperm part had significantly higher amount of phenolics and exhibited significantly higher antioxidant capacity than did the white flour, which was milled by a conventional milling method. Thus, the graded flours from whole waxy wheat should be encouraged to be used for processing whole-grain foods to improve both qualities of end-use products and health benefits.

Urinary 3-(3,5-Dihydroxyphenyl)-1-Propanoic Acid, an Alkylresorcinol Metabolite, Is a Potential Biomarker of Whole-Grain Intake in a U.S. Population

5-n-Alkylresorcinols (AR) are a major group of phenolic compounds in whole-grain wheat, rye, and barley. As such, they may serve as potential biomarkers of whole-grain intake, because they are quantifiable intact in plasma and as metabolites in urine. We examined relationships between 12-h urinary excretion of AR metabolite 3-(3,5-dihydroxyphenyl)-1-propanoic acid (DHPPA) and self-reported habitual intake of whole-grain foods measured by 3-d food record (3DFR) and FFQ. Urine samples from 100 men and women were analyzed for DHPPA using HPLC with coularray detection. DHPPA excretion ranged from 1.3 to 99.4 (mean ± SE, 14.0 ± 1.5) μmol/12 h. Whole-grain food intake, as determined by 3DFR and FFQ and adjusted for BMI and energy and fiber intake, was significantly associated with 12-h urinary DHPPA excretion. Based on 3DFR, whole-grain wheat + rye consumers had a 44% higher DHPPA excretion than nonconsumers [ratio of excretion (95% CI) = 1.44 (1.04, 1.97); P = 0.029]. Using whole-grain intake estimated by FFQ, a serving increase in whole-grain wheat + rye intake increased DHPPA excretion by 94% [ratio of excretion (95% CI) = 1.94 (1.35, 2.78); P = 0.001] and a serving increase in whole grains as defined more broadly in epidemiologic studies of whole-grain intake and disease risk (whole-grain wheat, rye, oats, and corn) increased DHPPA by 67% [ratio of excretion (95% CI) = 1.67 (1.28, 2.17); P < 0.0001]. This study supports the potential utility of urinary DHPPA as a biomarker of whole-grain intake in a U.S. population.

Improved arthritic knee health in a pilot RCT of phytotherapy

Although practitioner-prescribed 'western' herbal medicine (phytotherapy) is a popular complementary therapy in the UK, no clinical studies have been reported on patient-orientated outcomes. The objective of this pilot study was to investigate the effects of phytotherapy on symptoms of osteoarthritis of the knee. A previous study of Chinese herbal medicine for the treatment of irritable bowel syndrome, published in the Journal of the American Medical Association, acted as a model in the development of the protocol of this investigation. Twenty adults, previously diagnosed with osteoarthritis of the knee, were recruited from two Inner London GP practices into this randomized, double-blind, placebo-controlled, pilot study carried out in a primary-care setting. All subjects were seen in consultation three times by a herbal practitioner who was blinded to the randomization coding. Each subject was prescribed treatment and given lifestyle advice according to usual practice: continuation of conventional medication where applicable, healthy-eating advice and nutrient supplementation. Individualized herbal medicine was prescribed for each patient, but only dispensed for those randomized to active treatment-- the remainder were supplied with a placebo. At baseline and outcome (after ten weeks of treatment), subjects completed a food frequency questionnaire and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee health and Measure Yourself Outcome Profile (MYMOP) wellbeing questionnaires. Subjects completing the study per protocol (n = 14) reported an increased intake of wholegrain foods (p = 0.045) and oily fish (p = 0.039) compared to baseline, but no increase in fruit and vegetables and dairy products intakes. There was no difference in the primary outcome measure of knee health assessed as the difference in the mean response (baseline-week 10) in WOMAC score between the two treatment groups. However, there was, compared with baseline, improvement in the active group (n = 9) for the mean WOMAC stiffness sub-score at week 5 (p = 0.035) and week 10 (p = 0.060) but not in the placebo group (n = 5). Furthermore, for the active, but not the placebo group, the mean WOMAC total and sub-scores all showed clinically significant improvement (> or = 20%) in knee symptoms at weeks 5 and 10 compared with baseline. Moreover, the mean MYMOP symptom 2 sub-score, mostly relating to osteoarthritis (OA), showed significant improvement at week 5 (p = 0.02) and week 10 (p = 0.008) compared with baseline for the active, but not for the placebo group. This pilot study showed that herbal medicine prescribed for the individual by a herbal practitioner resulted in improvement of symptoms of OA of the knee.