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Nutrition, osteoarthritis and cartilage metabolism

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.

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Authors and Affiliations

  1. Rheumatology IRO Medical Center and Hospital C Argerich, Member of the Board of Governance, International Osteoporosis Foundation (IOF), Buenos Aires, Argentina

    Osvaldo Daniel Messina

  2. Centro de Diagnóstico de Osteoporosis y Enfermedades Reumáticas (CEDOR), Lima, Peru

    Maritza Vidal Wilman & Luis F. Vidal Neira

  3. Member of International Osteoporosis Foundation, Latin America (IOF–LATAM), Lima, Peru

    Luis F. Vidal Neira

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  1. Osvaldo Daniel Messina
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  3. Luis F. Vidal Neira
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Correspondence to Maritza Vidal Wilman.

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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.

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Messina, O.D., Vidal Wilman, M. & Vidal Neira, L.F. Nutrition, osteoarthritis and cartilage metabolism. Aging Clin Exp Res 31, 807–813 (2019). https://doi.org/10.1007/s40520-019-01191-w

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