Following on from Part 2 we explore the impact of supplements on osteoarthritis.
GLUCOSAMINE CHONDROITIN
Glucosamine is prominent in cartilage and a precursor in the synthesis of lipids and proteins.
Chondroitin is a mucopolysaccharide component of connective tissue that helps retain water. (And is
therefore, contraindicated with the use of anticoagulants) The evidence for the use of both is
contradictory. A recent systemic review in 2012 (Train et al) reviewed 28 systemic reviews on
glucosamine (used alone) Chondroitin (used alone) and both used together and concluded only low
quality studies are providing support. The NICE guidelines for OA management do not recommend
glucosamine chondroitin supplementation.
COLLAGEN
Due to its prominence in cartilage, collagen supplementation is recommended however evidence is
conflicting and limited. A recent meta-analysis of randomised placebo-controlled trials found
collagen supplementation for OA can be effective in improving overall scores of pain, stiffness and
function. A systematic review of collagen supplementation as a complimentary therapy for
treatment and prevention of OA found that collagen supplementation has a protective effect on
articular cartilage and in symptom relief for pain associated with OA. A systematic review in 2006
(Bello and Oesser) found that many studies that investigated collagen supplementation for the
treatment of OA did not show statistically significant findings, however they found collagen to be
safe and provide improvement in some measures of pain and function in individuals with OA. There
is a growing body of evidence suggesting that collagen supplementation has a potential therapeutic
effect as a nutritional supplement for the management of OA and joint health, however further
research is needed to support this.
OMEGA 3 FATTY ACIDS
Evidence of supplementation with omega-3 poly unsaturated fatty acids (PUFAs) for OA is limited as
fatty acid intake is less well controlled in human studies compared to animal studies. Omega-3
PUFAs may be associated with less structural damage and improvement in pain in OA and have been
found to be associated with reductions in inflammatory and degradation markers. A 2012 literature
review on the effectiveness and potential mechanisms of omega 3 PUFAs on OA concluded that
supplementation with Omega 3 from fish oil may significantly modulate inflammatory markers and
lead to decreased joint pain and improved joint function and can be beneficial in OA treatment and
prevention.
References available on request
This concludes our series on O.A X Nutrition. Please reach out to our PHYSIOTHERAPISTS or DIETITIANS with any questions via [email protected]
