July 7, 2022, by bmillar

Effect of Dietary fibre & Exercise on Knee pain

Why we are doing the INSPIRE Study?

Endocannabinoids are molecules made by our bodies which are similar to some of the substances in marijuana. They regulate appetite, mood, sleep, muscle strength, inflammation and they also are involved in how strongly we feel and respond to pain. There have been efforts to generate new drugs that are similar to “endocannabinoids” to treat various diseases but because they are involved in so many functions these compounds end up having unforeseen side effects.

The microbes in our guts have been implicated in the levels of pain and inflammation that people experience. And physical exercises are well known to reduce the levels of pain experienced by people with chronic conditions such as arthritis.

We propose to understand (identify) the molecules that are involved in all of these related processes linked to pain by asking people to take fibre and or do exercise for six weeks, both of which increase endocannabinoid levels.

We will measure levels of pain and pain sensitivity, peoples’ mood, and take bloods to measure endocannabinoids, gut microbes, substances produced by microbes that alter inflammation, inflammatory substances, other pain related substances.

The results of this study will help people with chronic pain in the following ways:

  • Understand the mechanisms by which lifestyle interventions like diet and exercise work and whether they can be added to each other to improve pain.
  • To measure how much of the effects of changes in endocannabinoids on pain reduction is linked to changes in mood or to changes in inflammation or to different levels of substances directly related to pain transmission and which genes in our bodies are involved.
  • Understand if there are molecular factors that result in improved or reduced endocannabinoid changes and their effects on pain.
  • Help develop new drugs to treat pain by understanding which mechanisms are modulated by the various receptors of drugs that target the endocannabinoid system.

We are looking for adults 18 years and older with knee pain caused by Osteoarthritis (OA)  to examine  the effectiveness of dietary fibre and exercise on health.

Short chain fatty acids are chemical compounds, which are produced when the friendly gut bacteria in our guts digest fibre. Previous research has shown that the types of bacteria that reside in your gut as well as the chemicals that they produce have implication on inflammation. Further, previous research has shown that gentle exercise can reduce inflammation and knee pain.


The purpose of the study is to investigate the effect of consuming dietary fibre and exercise on knee pain levels by changing the composition of the bacteria that reside within the gut and the levels of short chain fatty acids that they produce.

What you need to do:

Attend: two separate visits

Asked: for 6 weeks to either

  • Take dietary fibre supplement
  • Or Complete a gentle exercise routine
  • Or Both (Fibre and Exercise)

Study Location:

Both visits will be in the Clinical Sciences Centre

Study Duration:

The study is recruiting from May 2022 until December 2023.

You are eligible if you:

  • Have not have a gastrointestinal condition, such as IBS/IBD, coeliac
  • Are not currently following or anticipated to commence a specialised commercially available weight loss diet and/or program
  • Are not pregnant or breast feeding
  • Have not have a history of current psychiatric illness or neurological condition (e.g. epilepsy)
  • Have not taken part in a research study in the last 3 months involving invasive procedures or an inconvenience allowance

If you are unsure if you meet the requirements, contact a member  of the study team:

Chief Investigator: Professor Ana Valdes

Research Coordinators: Dr Bonnie Millar 

                                            Dr Amrita Vijay

Contact Details: msk-recruitment@nottingham.ac.uk

                                                                                                                                                                                           0115 8231676

Posted in AgeingDietDisabilityExerciseGutJointsMetabolismMusculoskeletalOrthopaedicsOsteoarthritisPainRehabilitationRheumatology