Nutrition, osteoarthritis and cartilage metabolism
Osteoarthritis (OA) is a degenerative joint disease and a leading cause of adult disability. There is no cure for OA and there is no effective treatment to stop its progression. Current pharmacologic treatments such as analgesics and non-steroidal anti-inflammatory drugs may improve the pain and offer some relief but they do not affect the progression of the disease. The chronic intake of these drugs may result in severe adverse events. The aim of this review is to revise the effects of nutrition on cartilage metabolism and OA progression.
A systematic literature search was performed including those related to macro- and micro-nutrients’ actions on cartilage and OA outcome. We selected peer-reviewed articles reporting the results of human clinical trials.
Glucosamine and chondroitin sulfate have shown to delay OA knee progression in several clinical trials. The effectiveness of some products considered nutraceuticals has been widely reviewed in the literature. This article presents a general description of the effectiveness and mechanism of action of nutrients, vitamins, antioxidants and other natural components considered as part of the normal diet. Many in vitro studies indicate the efficacy of specific nutrients in cartilage metabolism and its involvement in OA. However, rigorous clinical studies needed to evaluate the efficacy of these compounds in humans are still missing. The influence of nutrients and diet on the metabolism of cartilage and OA could represent a long-term coadjuvant alternative in the management of patients with OA. Effects of diet modifications on lipid and cholesterol profiles, adequate vitamin levels and weight reduction in obese patients could influence the course of the disease.
This review demonstrates that nutrition can improve the symptoms of OA. Glucosamine and chondroitin sulfate have shown robustly to delay the progression of knee OA in several well-designed studies, however more controlled clinical trials are needed to conclude that nutritional changes slow down the progression of the disease.
KeywordsOsteoarthritis Cartilage Nutrition Cartilage metabolism
Compliance with ethical standards
Conflict of interest
Author Osvaldo Daniel Messina has received honoraria for speaking from Pfizer, Eli Lilly and American Health Foundation. Author Maritza Vidal Wilman has received financial support for attending symposia from PeruLab. Author Luis F Vidal Neira has received honoraria for speaking from Expanscience, Menarini, MSD, PeruLab, Sanofi, Eli Lilly and American Health Foundation.
This article does not contain any studies with human participants or animals performed by any of the authors.
- 5.Bruyère O, Cooper C, Al-Daghri NM et al (2018) Inappropriate claims from non-equivalent medications in osteoarthritis: a position paper endorsed by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Aging Clin Exp Res 30:111–117CrossRefPubMedGoogle Scholar
- 16.Hodge JA, McKibbin B (1969) The nutrition of mature and immature cartilage in rabbits: an autoradiographic study. J Bone Jt Surg Br 51:140–147Google Scholar
- 36.Veronese N, Shivappa N, Stubb B, Smith T, Hébert JR, Cooper C et al (2017) The relationship between the dietary inflammatory index and prevalence of radiographic symptomatic osteoarthritis: data from the osteoarthritis initiative. Eur J Nutrition. https://doi.org/10.1007/s00394-017-1589-6 CrossRefGoogle Scholar
- 49.Neogi T, Booth SL, Zhang YQ et al (2006) Low vitamin K status is associated with osteoarthritis in the hand and knee. Arthritis Rheum 54:125561Google Scholar
- 67.Weglicki WB, Phillips TM (1992) Pathobiology of magnesium deficiency: a cytokine/neurogenic inflammation hypothesis. Am J Physiol 263:R734–R737Google Scholar