Can people with osteoarthritis derive clinical benefit from dietary and lifestyle changes? A pilot study

Osteoarthritis is a leading cause of pain and disability in the western world⁽¹⁾. Patient education is the cornerstone of successful management, and patients should ideally receive written information to support their self-care⁽²⁾. The quality of the written information is of paramount importance, but is often inadequate⁽³⁾. Booklets typically provide very little nutritional information. This pilot study explored, whether an evidence-based, nutritional booklet could encourage dietary and lifestyle changes and improve symptoms in people with osteoarthritis of the hip and/or knee. Evidence-based approaches were identified from the textbook, Nutrition & Arthritis ⁽⁴⁾ and from a search of the published literature. The information was incorporated into a coloured, illustrated 40-page lay booklet entitled Nutrition and Osteoarthritis. Thirty-one men and women with self-reported hip and/or knee osteoarthritis completed a Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire at base-line, and 12 weeks after receiving the booklet. A 20% relative reduction in symptom scores is considered a clinically important change⁽⁵⁾. Analysis of paired data from 21 participants who returned both questionnaires showed mean relative reductions in WOMAC symptom scores of 21.95% for pain (95% CI±1.32; P=0.026), 21.26% for stiffness (95% CI±0.67; P=0.028), 22.47% for physical function (95% CI±4.38; P=0.012) and 22.25% for global score (95% CI±5.92; P=0.10). Effect sizes were moderate to large (Cohen's d between 0.42 and 0.52). This pilot study suggests that an evidence-based booklet that encourages dietary and lifestyle changes can provide clinically meaningful benefit for people with osteoarthritis of the hip and/or knee.