This text was developed by Dr Kasia Pirog in collaboration with the Dunhill Medical Trust Project Working Group
Osteoarthritis (OA) is a multifactorial condition that is impacted by lifestyle, age, past injury and genetics. Diet can have an impact on OA progression, and it has been shown that obesity can dramatically increase the risk of joint degeneration. Food is also an important source of vitamins and elements necessary to maintain healthy tissues, as explained in the Versus Arthritis “Eating Well with Arthritis” booklet attached below. Several active compounds that are present in our everyday foods can be extracted and used in arthritis management. In 2012, Arthritis Research UK (now Versus Arthritis) produced a booklet in which they collated the up-to-date results of different complementary dietary components on management of arthritis (appended below). In the report they found that capsaicin, an active compound found in Acxsain®, Zacin®, and pepper gel, and extracted from chillies, is really effective in reducing pain and tenderness in the affected joints when used topically through its ability to reduce Substance P, a pain transmitter found in the human nerves. However, recent studies are showing that more subtle changes to one’s diet may also have an impact on susceptibility to OA, although the reports of these are often insufficient or conflicting. For example, several studies have shown that ingesting cartilage components such as chondroitin sulphate or glucosamine sulphate may reduce OA related pain and improve joint health. There is also limited evidence that anti-inflammatory substances such as curcumin found in turmeric or resveratrol found in grapes can have an effect in modulating inflammatory illness, although the levels of these in every day foods are often not high enough to have a significant effect. This is partially because various clinical trials test the delivery of the same drug by different methods (oral vs cream for example), in slightly different age and gender groups, or test different outputs (some test pain management whereas others test mobility) which makes collating data and obtaining conclusive results difficult.
Ingestion of natural medicines with known anti-inflammatory properties such as Devil’s Claw (Harpagophytum procumbens) and ginger has been shown to have a positive effect on OA joints, however, Devil’s Claw has been known to trigger some side effects and should be treated with caution. Interestingly, green lipped mussels (Perna canaliculus) and natural medicine compounds/lipids extracted from them such as Seaton®, GLM, and Lyprinol® have been shown to be beneficial in OA management, potentially through the anti-inflammatory effect of the omega-3 fatty acids. Indian frankincense, an Ayurvedic medicine, has also been shown to have anti-inflammatory properties that can ease the pain and mobility issues in knee OA, and is available over the counter as Sallaki®, S-compound®, and 5-LOXIN®. Pine bark extract, available in the UK under the trade name Pycnogenol®, is rich in bioflavonoids that have anti-inflammatory and antioxidant properties and have the potential to slow down the breakdown of cartilage. Rosehips (Rosa canina) and rosehip extracts have long been known to have anti-inflammatory properties. Rosehips also contain large amounts of vitamin C (ascorbic acid) which and antioxidant and an essential factor for the production of collagen, one of the main building blocks of cartilage. Several studies have shown that rosehip extracts have improved OA patient pain scores and mobility.
To conclude, for many natural compounds, the concentration of active substances contained within them may not be enough to have an effect, or the effect would not be as pronounced as when they are tested in their pure form in the laboratory. However, there is some evidence that they could be helpful even at lower concentrations. Moreover, having a healthy well-balanced diet that is rich is fruit, vegetables and fish, and maintaining a healthy body weight whilst remaining active, will help promote healthy ageing.
Useful resources
https://www.versusarthritis.org/media/23186/eating-well-with-arthritis-information-booklet.pdf
https://www.versusarthritis.org/media/23149/diet-and-arthritis-information-booklet.pdf