What foods can help manage osteoarthritis (OA) symptoms?

Foods for Managing Osteoarthritis Symptoms

The Mediterranean diet, rich in fiber, and weight loss for overweight individuals are strongly recommended for managing osteoarthritis symptoms and potentially slowing disease progression. 1

Dietary Approaches with Strong Evidence

Mediterranean Diet

• Higher adherence to a Mediterranean diet is associated with significantly lower risk of pain worsening and symptomatic knee OA 1
• The anti-inflammatory properties of the Mediterranean diet may help reduce OA symptoms through its rich content of nutrients that have protective effects 1

Fiber-Rich Foods

• Data from the Framingham cohort and Osteoarthritis Initiative found that dietary fiber intake was inversely associated with risk of symptomatic OA 1
• Fiber-rich diets are the main fermentable sources for short-chain fatty acids (SCFAs) which contribute to the attenuation of systemic inflammation 1
• Prebiotic fiber supplementation has been shown to prevent microbial dysbiosis and metabolic changes associated with OA in animal models 1

Weight Management Through Diet

• Weight loss is strongly recommended for patients with knee and/or hip OA who are overweight or obese 1
• A dose-response relationship exists between weight loss and symptom improvement:
  • Loss of ≥5% body weight can produce clinical improvements 1
  • Benefits continue to increase with weight loss of 5-10%, 10-20%, and >20% of body weight 1
• The efficacy of weight loss for OA symptom management is enhanced when combined with exercise programs 1

Specific Nutrients and Supplements

Omega-3 Fatty Acids

• Omega-3 polyunsaturated fatty acids (PUFAs) have demonstrated an influential role in reducing cartilage destruction and inhibiting pro-inflammatory cytokine cascades 2
• They may decrease the need for non-steroidal anti-inflammatory drugs while producing fewer adverse events 3
• Food sources include fatty fish (salmon, mackerel, sardines), flaxseeds, chia seeds, and walnuts 2, 4

Dietary Supplements

• Glucosamine and chondroitin sulfate have shown some evidence for temporarily relieving minor aches and pains of muscles and joints due to arthritis 5, 6
• However, the American Academy of Orthopaedic Surgeons (AAOS) notes that evidence for dietary supplements is inconsistent, with the primary barrier being expense as these are typically out-of-pocket expenses 1

Foods to Limit or Avoid

• Diets high in processed foods, sweets, and saturated fats are associated with increased inflammation and potentially worse OA symptoms 1
• A high-fat/high-sucrose diet has been linked to knee joint damage in animal models 1

Comprehensive Approach

• Dietary interventions are most effective when combined with:
  • Regular exercise, particularly strengthening exercises 7
  • Self-management programs that include education about joint protection and fitness goals 1
  • Mind-body practices such as tai chi and yoga, which have shown benefits for OA symptoms 1

Important Considerations

• The gut microbiota plays a significant role in inflammation and potentially OA progression 1
• A balanced gut microbiota may help reduce inflammation associated with OA 1
• Dietary changes should be sustainable and part of a long-term approach to OA management 8
• While nutrition can improve symptoms, there is currently no dietary intervention that can completely halt or reverse OA progression 8, 9

By focusing on anti-inflammatory foods like those in the Mediterranean diet, increasing fiber intake, and maintaining a healthy weight, individuals with osteoarthritis may experience significant improvements in pain and function.