Improved Joint Mobility Associated with Reduced Inflammation Related to Consumption of Nopal Cactus Fruit Juice: Results from a Placebo-Controlled Trial Using Digital Inclinometry to Objectively Document Mobility of All Major Joints

Figures & data

Table 1 Demographics of the Study Population

	Placebo	NFJ	P-value
Females	12	12
Age, average^a	56.2 ± 7.8	60.8 ± 7.5	0.16
Age range	45.8–74.4	48.8–70.7
BMI, average^a	30 ± 4.3	27.1 ± 3.7	0.09
BMI range	23.2–34.9	22.1–33.3
Males	8	8
Age, average^a	57.1 ± 11.9	54.9 ± 7.9	0.67
Age range	37–69.1	42.7–69.3
BMI, average^a	30.7 ± 3.5	28.9 ± 4.0	0.36
BMI range	25–34.8	23.4–33.5

Note: ^aThe group average ± standard deviation

Abbreviation: BMI, body mass index (kg/m²).

Table 2 Compliance

Product	Average^a	Range	Number of Participants
Placebo	89.3%	68.8–100%	20
Nopal fruit juice	91.8%	64.9–100%	20

Note: ^aThe group average ± standard deviation

Table 3 Joint Range of Motion (ROM)

Motion	Product	Baseline^a	Week 8^a	P-value Within Group^b	P-value Between Groups^c
Cervical Flexion/Extension	Placebo	96.1 ± 3.11	98.9 ± 2.93	NS	NS
	Nopalea	85.3 ± 3.65	92.8 ± 3.89	*
Cervical Lateral Motion	Placebo	59.9 ± 4.28	60.4 ± 4.09	NS	##
	Nopalea	52.4 ± 3.13	62.8 ± 3.37	**
Cervical Rotation	Placebo	143.4 ± 3.41	149.7 ± 4.20	(*)	NS
	Nopalea	124.2 ± 4.63	136.5 ± 4.27	**
Thoracic Rotation	Placebo	36.5 ± 2.54	37.5 ± 2.57	NS	(#)
	Nopalea	34.7 ± 3.01	41.7 ± 3.57	*
Lumbar Rotation	Placebo	27.6 ± 2.98	26.3 ± 2.56	NS	NS
	Nopalea	21.7 ± 2.65	24.9 ± 2.88	NS
Lumbar Flexion/Extension	Placebo	72.3 ± 4.01	70.7 ± 4.57	NS	NS
	Nopalea	62.9 ± 2.90	68.2 ± 3.79	NS
Sacral Hip Flexion/Extension	Placebo	51.7 ± 3.35	55.2 ± 2.76	NS	NS
	Nopalea	50.2 ± 4.88	56.2 ± 5.96	(*)
Left Shoulder Flexion/Extension	Placebo	229.3 ± 6.61	234.2 ± 4.96	NS	NS
	Nopalea	212.6 ± 4.66	219.9 ± 5.77	NS
Right Shoulder Flexion/Extension	Placebo	224.3 ± 6.55	231.2 ± 5.48	NS	NS
	Nopalea	207.4 ± 5.40	221.9 ± 6.04	*
Left Shoulder Abduction/Adduction	Placebo	175.9 ± 3.13	184.3 ± 4.15	*	NS
	Nopalea	169.4 ± 4.92	176.9 ± 5.41	*
Right Shoulder Abduction/Adduction	Placebo	167.4 ± 6.09	185.9 ± 6.23	*	NS
	Nopalea	170.4 ± 4.64	177.9 ± 5.36	(*)
Left Hip Flexion/Extension	Placebo	112.2 ± 3.16	114.3 ± 3.46	NS	NS
	Nopalea	99.6 ± 4.07	104.0 ± 4.40	NS
Right Hip Flexion/Extension	Placebo	114.6 ± 3.37	115.7 ± 3.63	NS	NS
	Nopalea	100.4 ± 3.66	105.2 ± 4.60	NS
Left Knee Flexion/Extension	Placebo	125.2 ± 2.97	128.3 ± 2.74	(*)	NS
	Nopalea	124.0 ± 2.48	123.5 ± 3.47	NS
Right Knee Flexion/Extension	Placebo Nopalea	121.9 ± 3.99 121.4 ± 3.21	126.9 ± 2.64 118.4 ± 5.48	NS NS	(#)

Notes: ^aThe average ± standard deviation of degrees of motion was recorded by dual digital inclinometry at baseline and after 8 weeks. ^bThis column shows within-subject statistical analysis, where NS: Not significant, (*) P<0.1, * P<0.05, and **P<0.01. ^cThis column shows between-group statistical analysis, where NS: Not significant, (#) P<0.1, # P<0.05; ##P<0.01.

Figure 1 Change in joint mobility.

Notes: Data reflects the physical degrees of motion and is shown as the group averages ± standard error of mean for the Nopal fruit juice group (solid lines) and the placebo group (dashed lines), for the sum of the range of motion for the three cervical motions flexion/extension, lateral motion and rotation (A) and the sum of the range of motions for thoracic and lumbar rotation and lumbar flexion/extension (B). The average improvement in the Nopal fruit juice group was statistically significant when compared to the placebo group, as indicated by * (P<0.05).

Figure 2 Change in pain interfering with physical functioning.

Notes: Data is shown as the group averages ± standard error of mean for the Nopal fruit juice group (solid lines) and the placebo group (dashed lines), for the questions “pain when walking on flat surface” (A) and “pain when sitting or lying” (B). The average change in the Nopal fruit juice group was larger at 2 weeks than the placebo group, and was further reduced at 8 weeks for “pain when walking on flat surface”. The differences between the two groups did not reach statistical significance.

Figure 3 Daily activities.

Notes: Data is shown as the group averages ± standard error of mean for the Nopal fruit juice group (solid lines) and the placebo group (dashed lines), for the questions “pain affecting daily activities” (A), “rely on medications to complete daily activities” (B), and “breathing problems limiting daily activities” (C). Regarding pain (A), the average change in the NFJ group was larger at 2 weeks than the placebo group and was further reduced at 8 weeks; the difference between the two groups did not reach statistical significance. Regarding use of medication (B), the average change at 2 weeks reached a statistical trend (P<0.06, indicated by (*)), and the average change for breathing problems also reached a statistical trend at 2 weeks (P<0.1, indicated by (*)).

Table 4 Serum Cytokine Levels (Pg/mL)

	Placebo			Nopal Fruit Juice			P-value^a
	N	Baseline	8 Weeks	N	Baseline	8 Weeks
MIP-1β	20	4.37 ± 0.35	5.27 ± 0.37	20	4.89 ± 0.38	6.15 ± 0.37	NS
RANTES	20	2210 ± 98	4021 ± 316	20	2079 ± 166	3640 ± 346	NS
MCP-1	20	3.16 ± 0.48	2.45 ± 0.46	20	3.23 ± 0.45	2.38 ± 0.31	NS
IP-10	20	126.2 ± 28.6	103.0 ± 14.2	20	87.67 ± 10.29	87.48 ± 14.37	NS
Eotaxin	19^b	16.01 ± 1.94	16.77 ± 1.81	20	16.04 ± 1.49	15.46 ± 1.47	0.047

Notes: ^aP-value between the groups, using 2-tailed unpaired t-test. NS: Not significant, P>0.05. ^bOne study participant was removed from this analysis due to lack of compliance during the 8-week study with respect to medication that may have influenced this biomarker.

Figure 4 Serum Eotaxin levels.

Notes: Data is shown as the group averages ± standard error of mean for the Nopal fruit juice group (solid line) and the placebo group (dashed line), for the serum level of Eotaxin, provided in picogram/milliliter (pg/mL). A decrease in serum Eotaxin levels was seen for the Nopal fruit juice group over the 8 weeks of study participation, in contrast to a mild increase in serum Eotaxin levels seen for the placebo group. The difference in the change in Eotaxin levels between the two groups reached statistical significance (P<0.047, indicated by * on the graph).

Table 5 Serum C-Reactive Protein Levels (Mg/L)

	Placebo			Nopal Fruit Juice			P-value^a
	N	Baseline	8 Weeks	N	Baseline	8 Weeks
All study participants	20	2.84 ± 0.92	2.72 ± 0.72	20	2.41 ± 0.64	2.09 ± 0.55	0.494
CRP <3.0 mg/L at baseline	16	1.18 ± 0.18	1.57 ± 0.23	14	0.93 ± 0.18	1.04 ± 0.15	0.831
CRP >1.0 mg/L at baseline	13	4.08 ± 1.29	3.72 ± 1.00	11	3.96 ± 0.93	3.11 ± 0.90	0.060
1.0 mg/L < CRP at baseline <10.0 mg/L	12	2.95 ± 0.68	3.86 ± 1.08	10	3.26 ± 0.68	2.29 ± 0.39	0.013

Note: ^aP-value between the groups, using 2-tailed unpaired t-test.