The Potential for Dietary Factors to Prevent or Treat OA

Purpose: Osteoarthritis (OA) is a degenerative joint disease for which there are no disease-modifying drugs. It is a leading cause of disability. Increasing age and obesity are both major risk factors for OA and the health and economic burden of this disease will increase in the future. Focusing on compounds from the habitual diet that may prevent the onset or slow the progression of OA is a strategy that has been under-investigated to date. An approach that relies on dietary modification is clearly attractive in terms of risk/benefit and more likely to be implementable at the population level. However, detailed molecular studies ahead of a full clinical trial are required in order to establish modes of action (which are different from traditional single target pharmaceuticals) at dietary achievable levels and to optimise the design of trials to gain an evidence-base of efficacy. Methods: There are currently limited data on the interrelationship between diet and OA. Data come from a variety of studies: in vitro cell and tissue explant models, animal models, population-based studies using habitual intakes and risk factors/disease incidence and intervention trials. There is a large variability between studies, e.g. in animal models, a dietary intake approach would be optimal in order to relate to human exposure, but some studies use intra-articular injection and/or concentrations not achievable through the diet. The small and short-term intervention trials conducted to date have many different designs, number of patients, time length and outcome measures. Results and Conclusions: There are however, a number of pertinent studies in the literature and this presentation will review these. It will also comment on our own experience developing sulforaphane, a compound derived from the consumption of cruciferous vegetables, particularly broccoli, in OA from laboratory models into proof of principle patient trials, as well as the identification of other bioactive diet-derived compounds.