الفهرس 
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Abstract
Conclusions
The aims of the present study are:
1- Knowing the role of eating pomegranate seeds and pomegranate peel powder, which is a natural food source, in patients with osteoarthritis.
2- Evaluating the chemical composition of pomegranate seeds and peel powder.
3- Determination of total phenol and flavonoid content for pomegranate seeds and peel powders.
4- Reducing joint pain in osteoarthritis through healthy nutrition and food awareness.
5- Improving clinical parameters, and anthropometric measurements of osteoarthritis patients.
The study sample included 196 osteoarthritis patients from 25 to 65 years, of both sexes, and free from chronic diseases, in the rheumatoid outpatient clinic at Assuit University Hospitals. They were divided into 4 groups. group (1): taking medical therapy only (control group). group (2): taking medical therapy +(50 mg/kg) per/day of pomegranate seeds. group (3): taking medical treatment +(5 mg/kg) per/day pomegranate peels powder. group (4): taking medical treatment+(5mg/kg) per/day of pomegranate peel powder +(50 mg/kg) per/day of pomegranate seeds for three months.
The Chemical Composition of pomegranate fruit seeds and peel powder is considered a good source of crude Moisture, Protein, Fat, Ash, Fiber and Carbohydrate.
Pomegranate peels powder contains the highest total phenol (27 ± 1.1%) and total flavonoid (38.22± 0.1%), while the lowest in seeds total phenol (1.0 ± 0.25%) and total flavonoid (7.5± 0.22%).They have been thoroughly studied for their numerous effects on health, such as their antioxidant, anti-inflammatory and antiproliferative properties, meaning that they can contribute to the prevention of several diseases.
The experimental anthropometric measurements of OA patients before and after the experiment period.The results showed before nutritional awareness and taking pomegranate products showed that the average weight and body mass index were (80.33 ± 17.36) and (29.5 ± 0.7), respectively, and after nutritional awareness, food habits and taking pomegranate products, mean weight and BMI became (72.25 ± 15.33) and (26.6 ± 0.6), respectively. BMI that appeared in the results BMI >25.5 is over wight.
After the patients’ nutritional awareness and food habitsaffected their health status, the results led to losing weight, focusing on the wilderness of cooking methods, eating fruits and vegetables, eating dairy products, reducing snacks, and also reducing the intake of sugar and ready-made foods, and raising awareness on eating pomegranates seeds and peels, which led to an increase in antioxidants in the patients’ bodies. That there significant (P<0.05)(p<0.01)difference between before and after nutritional awareness and food habits.
Regarding,general health for neck and spine cartilage patients. It was found that there is a clear improvement significantly (p<0.01) different between groups (1,2,3) before and afternutritional awareness and taking the pomegranate products
Concerning, Physical health for neck and spine cartilage patients such as vigorous activities, running, lifting heavy objects, and participating in strenuous sports. The result showed a significant (p<0.01) difference between groups (1,2,3) before and after nutritional awareness and taking the pomegranate products.
Concerning, the statistical analysis model of the social activities of patients with a herniated disc in the neck and spine, where emotional problems interfere with normal social activities with family, friends, and neighbors, in groups(1,2,3) before and afternutritional awareness and taking the pomegranate products.The results between the groups (1,2,3) showed that there was a significant (P < 0.01) difference in relieving pain, and relieving physical pain led to an improvement in relations with the family.
Regarding,energy and emotions in patients with neck and spine cartilage from the sense of vitality, energy, frustration and fatigue. There is no significant change in group 2 compared to group 1,3. There was a significant (P>0.05) difference in groups (1,3) before and afternutritional awareness and taking the pomegranate products.
Represents the total KOOS score used in the different Knee OA patients’ groups (1,2,3) which revealed the presence of highly significant differences (p<0.01) in different problems encountered by these patients in each group), before and after nutritional awareness and food habits and taking the pomegranate products indicating the marked improvement of knee symptoms, pain, function, the activity of daily living and quality of life and accordingly improvement of the Knee disease condition.
group 3 had the highest percentage of patients’ compliance with recovery, which took pomegranate seeds and boiled pomegranate peels powder, followed by group 2, which took boiled pomegranate peels powder only, followed by group 1, which took pomegranate seeds. This is evidence of the presence of antioxidants in the peel greater than in the seeds, and this is consistent with studies.
Conclusions
According to the findings of this clinical trial,pomegranate seeds and peels powder consumption can improve physical function and stiffness, decrease the breakdown of cartilage enzymes and increase antioxidant status in patients withneck, spine and knee OA.