Omega-3 supplementation showed potential in reducing inflammation and improving symptoms in individuals with osteoarthritis, though further research was needed to confirm its efficacy.
Osteoarthritis (OA) was a degenerative joint disease characterized by the destruction of articular cartilage and a resulting pro-inflammatory response. The progression of OA was multifactorial, influenced by factors such as trauma, metabolism, biology, comorbidities, and biomechanics. The chronic inflammatory environment in OA negatively impacted surrounding tissues like the synovium, ligaments, and subchondral bone, further limiting their functional abilities and enhancing symptoms of OA.
Traditional treatments for OA remained inconsistent due to the inability to determine the underlying mechanism of disease onset, severity of symptoms, and complicating comorbidities. Recently, diet and nutritional supplements, particularly omega-3 polyunsaturated fatty acids (PUFAs), gained interest for their potential to slow the disease process, prevent OA, and alleviate symptoms due to their anti-inflammatory properties. Omega-3 PUFAs showed promise in reducing cartilage destruction, inhibiting pro-inflammatory cytokine cascades, and promoting anti-inflammatory pathways through the production of oxylipins.
This review, published in the journal Nutrients, assessed the evidence explaining the inflammatory processes of osteoarthritis and the influence of omega-3 supplementation on the progression of the disease.
Prevalence and Risk Factors
Osteoarthritis was the leading cause of disability globally, with a significant increase in incidence rates from 1990 to 2017. Factors influencing OA progression included occupation, joint injury, alignment, obesity, physical activity, age, gender, and genetics. Aging was the most significant risk factor, with higher incidence rates in older adults, especially women. Genetic studies identified risk variants associated with OA, indicating that knee, hip, and hand OA had substantial genetic components.
Inflammatory Process
Inflammation in OA was driven by an imbalance of cytokines that promoted a pro-inflammatory response. Key pro-inflammatory cytokines involved included IL-1β, TNF-α, and IL-6, which stimulated chemokines and activated catabolic enzymes like matrix metalloproteinases and aggrecanases, leading to cartilage degradation.
Role of Omega-3 PUFAs
Omega-3 PUFAs, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), demonstrated anti-inflammatory effects. They reduced pro-inflammatory cytokine production and promoted anti-inflammatory pathways. Specialized pro-resolving mediators derived from omega-3 PUFAs, such as resolvins, protectins, and maresins, enhanced macrophage phagocytosis, reduced neutrophil infiltration, and promoted tissue repair.
Supplementation and Dietary Sources
Omega-3 PUFAs were primarily found in fatty fish, seafood, and dietary supplements. The National Institute of Health recommended adequate intakes of omega-3 PUFAs, with supplements typically providing about 1000 mg of fish oil containing EPA and DHA. Studies explored the effects of omega-3 supplementation on OA symptoms, with varying results. Some research indicated improvements in pain, joint stiffness, and physical function, while others showed limited effects on cartilage volume and long-term outcomes.
Conclusion
Omega-3 PUFAs showed potential in modulating OA symptoms through their anti-inflammatory properties. Despite promising findings, the effects of omega-3 supplementation on OA progression and symptoms remained inconclusive. Further clinical trials were needed to establish standardized supplementation guidelines for omega-3 PUFAs in managing osteoarthritis.
This research received no external funding and the authors declared no conflicts of interest.
