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REVIEW article

Front. Nutr.

Sec. Clinical Nutrition

Volume 12 - 2025 | doi: 10.3389/fnut.2025.1661136

Nutritional Interventions for Osteoarthritis: Targeting the Metabolism-Inflammation-Oxidative Stress Axis—Clinical Evidence and Translational Practice

Provisionally accepted
Yushan  WangYushan Wang1Zhiyan  CaoZhiyan Cao1郜  英杰郜 英杰1Pengfei  ShaoPengfei Shao1Shuai  GaoShuai Gao1Mingjie  DongMingjie Dong1Zui  TianZui Tian1Yi  FengYi Feng1Jiake  XuJiake Xu2,3Chuan  XiangChuan Xiang1*
  • 1Second Hospital of Shanxi Medical University, Taiyuan, China
  • 2Chinese Academy of Sciences Shenzhen Institute of Advanced Technology, Shenzhen, China
  • 3The University of Western Australia, Perth, Australia

The final, formatted version of the article will be published soon.

Abstract Osteoarthritis (OA) is the most common chronic joint disease worldwide. Increasing studies have confirmed that obesity, metabolic status and gut microbiota imbalance can promote the occurrence of OA through the "metabolism-inflammation-oxidative stress" network, which is closely related to daily nutrition or dietary intake.. The key nutrients with therapeutic effects mainly exert anti-inflammatory, anti-oxidative and chondro-protective effects. Among them, ω-3 polyunsaturated fatty acids and polyphenols are important components of anti-inflammatory diets, while collagen peptides, vitamin D, calcium, probiotics, glucosamine, chondroitin and hyaluronic acid are commonly used in clinical practice as important nutritional support treatments or preventive measures for OA to promote cartilage repair. In terms of dietary patterns, the Mediterranean diet (MD) rich in various nutrients can be used as the basic pattern for OA patients due to its anti-inflammatory and anti-oxidative properties and good clinical effects. Based on MD and evidence from clinical studies, this review constructs a four-level progressive nutritional plan for OA patients with the goals of relieving pain, delaying cartilage degeneration, improving function, and reducing the need for drugs and surgical intervention. We have also proposed customized nutritional management strategies for several special OA populations to reduce the occurrence of nutrition-related adverse events. Collectively, systematic nutritional intervention is expected to become the third major treatment alongside physical and drug therapy, enabling more OA patients to avoid adverse effects caused by repeated drug use and potential risks associated with surgery and prosthesis replacement.

Keywords: nutritional interventions, Osteoarthritis, Metabolism, Inflammation, Oxidative Stress, Gut- joint axis

Received: 07 Jul 2025; Accepted: 10 Oct 2025.

Copyright: © 2025 Wang, Cao, 英杰, Shao, Gao, Dong, Tian, Feng, Xu and Xiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Chuan Xiang, chuangxiang@sxmu.edu.cn

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.