How does nutrition influence the prevention and management of osteoarthritis?

In a recent editorial published in the journal Nutrients, researchers describe the influence of nutrition on osteoarthritis (OA).

Learn: The role of nutrition in the development of osteoarthritis. Image credit: Lizelle Lotter /


Arthritis, a type of degenerative joint disorder, has increased significantly globally since 1990. With individual age and obesity rates increasing, cases of arthritis are expected to increase. increased further.

Arthritis patients suffer from chronic pain and stiffness. Arthritis is a significant economic burden on patients and society. The United States Food and Drug Administration (US FDA) has considered it a serious disease.

To research new intervention strategies, improving scientific knowledge about the protective mechanisms of nutritional supplementation against arthritis is important. This will shed light on the relationship of nutrition to arthritis pathogenesis and potentially lead to new diet-based therapies.

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In this editorial, researchers present the dietary prescription of arthritis.

Targeting obesity and the gut for arthritis management

Arthritis is a complex condition influenced by obesity, age, inflammation, mechanical load, joint damage and genetics. However, the exact mechanism behind its development is not fully understood, and there are currently no treatments that can slow the progression of arthritis or restore cartilage.

Current pharmacological management focuses on pain control, while nonpharmacological measures rely on physical activity and weight loss. In advanced cases, surgical intervention may be considered. Recently, scientific interest has increased in dietary modification of osteoarthritis risk and pathology.

Obesity is a significant risk factor for osteoarthritis because it alters joint biomechanics and releases inflammatory factors. Studies have reported a correlation between arthritis and elevated n-6/n-3 fatty acid ratio. Increased n-6 ​​fatty acid intake is associated with synovitis and cartilage degradation in obese individuals.

In contrast, diets rich in omega-3 fatty acids reduce pain and inflammation and improve joint function in arthritis patients. Therefore, dietary modification by increasing consumption of omega-3 fatty acids may represent a new treatment and prevention approach for arthritis.

Obesity-related osteoarthritis can be controlled by restoring the gut microbial balance of beneficial and pathogenic microorganisms. Oligofructose, a prebiotic supplement, can manipulate specific gut bacteria to treat obesity-related dysbiosis, reduce general inflammation, and prevent cartilage loss in obese mice.

Manipulating gut bacteria may also treat arthritis associated with medial articular cartilage instability. The combined use of probiotics after fecal bacteria transplantation may prevent cartilage damage due to medial meniscus instability and positively impact the subchondral bone structure, especially the condylar region of the bone. femoral. This suggests a new approach to treating obesity-related arthritis.

The role of vitamins and antioxidants in arthritis management

Vitamin D is important for strong muscles, teeth and bones, and increases the absorption of phosphorus and calcium in the intestines. Hydroxylation in the kidney and liver forms activated vitamin D, 1,25-dihydroxy vitamin D [1,25(OH)2D].

Vitamin D binds to vitamin D receptors (VDR), activating gene transcription, affecting the transport of phosphorus and calcium. Studies have shown that VDR knockout mouse animals do not have an osteoarthritis phenotype although osteomalacia and rickets appear after the first month of life.

Vitamin D receptors have been detected in the joint cartilage of people with osteoarthritis but not in healthy people.

Although there is no evidence that activated vitamin D can improve radiation-induced osteoarthritis or prevent cartilage volume loss in people with adequate vitamin D, randomized controlled trials indicate that Supplementation may reduce pain and may improve radiation-induced osteoarthritis in people with vitamin D deficiency.

Vitamin K, a fat-soluble molecule found in green leafy vegetables, fermented foods, and animal sources, serves as a cofactor for the enzyme gamma-glutamyl carboxylase that forms the component gamma-carboxyglutamate ( Gla) of proteins that affect blood and bone clotting. calcification.

Matrix Gla protein (MGP) is expressed on chondrocytes and is involved in the calcification process. MGP polymorphisms are associated with radiographic hand osteoarthritis, and vitamin K deficiency may hinder chondrocyte differentiation and prevent endochondral bone formation.

Vitamin K has demonstrated potential for arthritis prevention in cross-sectional, cohort, and case-control studies. Vitamin K supplementation has prevented joint space narrowing in people with vitamin K deficiency. However, more research is needed to explore the effects of Vitamin K on osteoarthritis symptoms.

Studies have reported that antioxidants such as vitamins E, C and curcumin can improve osteoarthritis symptoms by fighting oxidative stress. Although dietary supplements and intra-articular injections of Vitamin C may reduce osteoarthritis symptoms, studies have reported that excessive vitamin C intake may cause adverse effects.

The anti-inflammatory and antioxidant properties of Vitamin E have the potential to improve arthritis management. However, data on the association between joint health and vitamin E remains controversial.

Recent studies have shown that curcumin effectively improves knee osteoarthritis symptoms, with improved tolerability and comparable efficacy to nonsteroidal anti-inflammatory drugs (NSAIDs).

Trace elements such as copper, selenium and boron can prevent osteoarthritis due to their antioxidant and anti-inflammatory properties, while iron and cadmium can worsen the development and progression of osteoarthritis.

Overall, the editorial findings highlight the nutritional management of arthritis. The data can inform treatment strategies to reduce disease burden and improve the standard of care for arthritis patients.

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