The effectiveness of dietary intervention in osteoarthritis management: a systematic review and meta-analysis of randomized clinical trials

Sara Asadi; Sara Grafenauer; Claire V Burley; Caroline Fitzgerald; Peter Humburg; Belinda J Parmenter

doi:10.1038/s41430-025-01622-0

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The effectiveness of dietary intervention in osteoarthritis management: a systematic review and meta-analysis of randomized clinical trials

Journal article

Open access

Peer reviewed

The effectiveness of dietary intervention in osteoarthritis management: a systematic review and meta-analysis of randomized clinical trials

Sara Asadi, Sara Grafenauer, Claire V Burley, Caroline Fitzgerald, Peter Humburg and Belinda J Parmenter

European Journal of Clinical Nutrition, Vol.79, pp.959-971

2025

DOI: https://doi.org/10.1038/s41430-025-01622-0

PMCID: PMC12537491

PMID: 40295866

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Abstract

osteoarthritis (OA)

dietary interventions

systematic review

diets

meta-analysis

This study aimed to evaluate the impact of various dietary interventions on managing osteoarthritis (OA), a condition significantly affecting global health due to joint alterations driven by inflammatory mediators. A systematic review and meta-analysis, adhering to PRISMA guidelines, examined Randomized Controlled Trials (RCTs) investigating dietary interventions in OA. Two reviewers independently conducted study selection, data extraction, and quality assessment. Random effects models calculated standardized mean differences (SMD) and mean differences (MD). Risk of bias was evaluated with the Cochrane Risk of Bias tool (RoB2), and heterogeneity was assessed using I² values. Nine RCTs (898 participants) were identified, assessing various diets: reduced energy (n = 4), Mediterranean (n = 2), low-fat (n = 2), anti-inflammatory (n = 1), low-carbohydrate (n = 1), and plant-based (n = 1). Dietary interventions significantly improved pain (SMD: -0.67; 95% CI: [-1.01, -0.34]; p < 0.0001), and physical function (SMD: -0.62; 95% CI: [-0.94, -0.30]; p = 0.0001) and body weight (MD: -3.18; 95% CI: [-3.52, -2.83], p < 0.0001). Subgroup analyses revealed reduced energy diets improved pain (SMD: -0.85; 95% CI: [-1.15, -0.55], p < 0.0001), physical function (SMD: -0.95; 95% CI: [-1.33, -0.58], p < 0.0001) and body weight (MD: -3.13; 95% CI: [-3.77, -2.49], p < 0.0001). The Mediterranean diet did not significantly impact pain (SMD: -0.27; 95% CI: [-1.14, 0.60], P = 0.54), or physical function (SMD = -0.28; 95% CI: [-0.79, 0.24], p = 0.29). This study emphasizes the significant impact of dietary interventions on pain, physical function, and weight management in people with OA, with reduced energy diets showing the most effectiveness. Specific dietary patterns show promise but require further investigation.

Details

Title: The effectiveness of dietary intervention in osteoarthritis management: a systematic review and meta-analysis of randomized clinical trials
Authors: Sara Asadi - UNSW Sydney
Sara Grafenauer - UNSW Sydney
Claire V Burley - UNSW Sydney
Caroline Fitzgerald - UNSW Sydney
Peter Humburg - UNSW Sydney
Belinda J Parmenter (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Health - Sports & Exercise Science
Publication details: European Journal of Clinical Nutrition, Vol.79, pp.959-971
Publisher: Nature Publishing Group
Date published: 2025
DOI: 10.1038/s41430-025-01622-0
ISSN: 1476-5640
PMID: 40295866; PMC12537491
Copyright note: © The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http:// creativecommons.org/licenses/by/4.0/.
Data Availability: The data from this study are available upon request to the corresponding author.
Grant note: This study was funded by the Estate of the Late Faye Williams.
Organisation Unit: School of Health - Sports & Exercise Science
Language: English
Record Identifier: 991127004702621
Output Type: Journal article

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