## 4 Discussion
Indeed, several experimental, clinical, and cross-sectional studies have illustrated the ability of \(\omega\)-3 PUFAs to suppress the severity of RA and prevent cartilage and bone destruction mainly via their potent anti-inflammatory effects that suppress the synthesis of inflammatory cytokines by nuclear factor kappa B (NF-\(\kappa\)B); inhibit matrix metalloproteinases (MMPs), LTs, and PGE2; and reduce macrophage infiltration and osteoclasts activation [74; 75]. Osteoclasts are terminally differentiated cells of the monocyte/macrophage lineage that resorb bone matrix. The abnormal activation of osteoclasts is mostly responsible for bone destruction in RA [76]. The inhibition of osteoclast formation and function was noticed in serum acquired four hours following the almond meal consumption. Gene expression data in cultured human osteoclast precursors provide evidence for a positive effect of almonds on bone health [77]. [PERSON] et al. [78] showed that the walnut extract has a high anti-atherogenic potential and impressive osteoblastic activity for cardio protection and bone health. Walnuts are an excellent source of dietary fibers and magnesium that suppress inflammation. ALA is the major precursor of both EPA and DHA and is the major \(\omega\)-3 PUFA; it is abundant in walnut oil [75]. The precise molecular mechanism behind the anti-inflammatory potential of \(\omega\)-3 PUFAs, including ALA, EPA, and DHA, is attributed to the suppression of iNOS (nitric oxide), COX-2 (PGE2), NF- \(\kappa\)B, and inflammatory cytokines (IL-1\(\beta\), IL-6, and TNF-\(\alpha\)[75; 79; 80]). In addition, the decrease in the severity of RA and the concomitant reduction in the circulatory levels of IL-6, TNF-\(\alpha\), and IL-1\(\beta\) in AIA + walnut oil is mediated by the direct inflammatory effect of the ALA and its metabolites, EPA and DHA, on the expression of NF-\(\kappa\)B. In addition to their high content of \(\omega\)-3 PUFAs, walnuts can protect against numerous inflammatory conditions via their high content of several antioxidants and bioactive anti-inflammatory components, including gamma-tocopherol (vitamin E), folate, selenium, and flavonoids such as ellagic acid [75; 81]. Of the 1113 different food items tested for their antioxidant potentials, walnuts ranked second place [82]. Peanuts are one of the most common nuts in the world with good nutritional value and low cost. Peanuts have the highest lipid (oil) and protein contents (50% and 25%, respectively) [83]. A higher peanut intake was connected with lower serum levels of IL-6 and CRP among healthy individuals, thus suggesting a potent inflammatory effect [26]. The protective effect of oleic acid was attributed to decreased lymphocyte activities; inhibited macrophage infiltration; suppressed production of LB4, IL-1, and TNF-\(\alpha\); and decreased expression of several adhesive molecules and MMP activity. Cashew nuts are also an excellent source of lipids (47.8 g/100)--most are MUFAs in the form of oleic acid (84%) [84]. Cashew nuts are very rich in flavonoids such as tannin and anacardic acids as well as anthocyanins, fibers, folate, and tocopheroids, which are known for their hypolipidemic, antioxidant, and anti-inflammatory effects [84; 85]. Cashew nuts suppressed the levels of TNF-\(\alpha\), IL-6, ICAM-1, and P-selectin; they also inhibited NF-\(\kappa\)B [85]. Our data showed that cashew nuts could suppress the AIA in rats by suppressing the synthesis and release of inflammatory markers. Therefore, we suggest that the anti-arthritic and anti-inflammatory effect of cashew nuts observed here is due to their high content of oleic acid and other ingredients such as flavonoids, anthocyanins, tannins, fiber, folate, and tocopheroids [23]. Hazelnuts are very rich in FAs (>60% of dry weights) and are an excellent source of MUFAs and oleic acid (80%); they are comparable to olive oil. Other fatty acids found in hazelnuts include linoleic, palmitic, and stearic acid.