Maintaining healthy joints starts with adequate nutrition. Athletes should get adequate levels of protein to maintain and repair muscles, tendons, ligaments, and joints. Fruits and vegetables provide antioxidants that can help reduce inflammation and improve recovery from and adaptation to exercise. Essential fats, especially omega-3 fatty acids, are beneficial for promoting prostaglandins that control inflammation and pain pathways. Some essential fatty acids, such as omega-6 fatty acids, are easy to obtain from dietary sources because they are readily available in plant oils. A 1:1 or 2:1 ratio of omega-6 to omega-3 fats in the daily diet has been suggested. The amount of omega-3 fatty acids can be achieved by eating fish two to three times per week and using flax oil regularly.
In animal studies, high levels of vitamin C (150 mg/d) in the diet resulted in less severe joint damage in guinea pigs with surgically induced osteoarthritis compared with guinea pigs receiving low levels (2.4 mg/d) [38,39]. In the Framingham Osteoarthritis Cohort Study, a moderate intake of vitamin C (120-200 mg/d) resulted in a threefold lower risk of osteoarthritis progression, but did not have an impact on the incidence of the disease . A multicenter, double-blind, randomized, placebo-controlled, crossover trial was conducted on 133 patients with radiographically verified symptomatic osteoarthritis of the hip or knee joints. The patients received 1 g of calcium ascorbate (containing 898 mg of vitamin C) or placebo daily for 14 ± 3 days, separated by 7 ± 3 days washout. Calcium ascorbate was reported to reduce pain significantly compared with placebo, although the demonstrated effect was less than half that commonly reported with nonsteroidal anti-inflammatory drugs (NSAIDs) .
Clinical studies have reported benefits from vitamin E administered for the treatment of symptomatic osteoarthritis over a short-term period [42-44]. Two large studies, performed over a longer period, found no evidence of benefits in terms of reduced pain or stiffness or improved physical function [45,46].
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