For example, vitamin A beta-carotene has been associated with a reduced risk of certain cancers, but an increase in others — such as lung cancer in smokers if vitamin A is purified from foodstuffs.

A study examining the effects of vitamin E found that it did not offer the same benefits when taken as a supplement. A well-balanced diet, which includes consuming antioxidants from whole foods, is best.

If you need to take a supplement, seek advice from your doctor or dietitian and choose supplements that contain all nutrients at the recommended levels. Research is divided over whether antioxidant supplements offer the same health benefits as antioxidants in foods.

To achieve a healthy and well-balanced diet , it is recommended we eat a wide variety from the main 5 food groups every day:. To meet your nutritional needs, as a minimum try to consume a serve of fruit and vegetables daily.

Although serving sizes vary depending on gender, age and stage of life, this is roughly a medium-sized piece of fruit or a half-cup of cooked vegetables.

The Australian Dietary Guidelines External Link has more information on recommended servings and portions for specific ages, life stage and gender.

It is also thought antioxidants and other protective constituents from vegetables, legumes and fruit need to be consumed regularly from early life to be effective. See your doctor or dietitian for advice.

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Skip to main content. Healthy eating. Home Healthy eating. Actions for this page Listen Print. Summary Read the full fact sheet. On this page. About oxidation Antioxidants and free radicals The effect of free radicals Disease-fighting antioxidants Sources of antioxidants Vitamin supplements and antioxidants Dietary recommendations for antioxidants Where to get help.

About oxidation The process of oxidation in the human body damages cell membranes and other structures, including cellular proteins, lipids and DNA. Antioxidants and free radicals Antioxidants are found in certain foods and may prevent some of the damage caused by free radicals by neutralising them.

Disease-fighting antioxidants A diet high in antioxidants may reduce the risk of many diseases including heart disease and certain cancers. Sources of antioxidants Plant foods are rich sources of antioxidants. Also derived from the plants that animals eat. Vitamin supplements and antioxidants There is increasing evidence that antioxidants are more effective when obtained from whole foods, rather than isolated from a food and presented in tablet form.

Dietary recommendations for antioxidants Research is divided over whether antioxidant supplements offer the same health benefits as antioxidants in foods. Nondifferential misclassification tends to underestimate the strength of any observed associations. The prospective design is also a potential strength of our study since a substantial period of time has elapsed between the ascertainment of exposure to nutritional factors and the development of outcomes cartilage and bone measures.

Another limitation of this study is that no information on dietary supplements was available, and we were therefore unable to adjust the effect of these supplements in the statistical analyses.

Articular cartilage and bone health is dependent upon the regular provision of nutrients, and it has been suggested that diets deficient in nutrients may lead to arthropathy [ 3 ]. The effect of foods and nutrients on knee structure is likely to be complex.

Our study suggests that the direct effect of vitamin C is on bone rather than on cartilage. Although vitamin C and vitamin E are known potent antioxidants, given that different effects of vitamin C and vitamin E were found on the bone area in the present study, the mechanism of action in this situation may not be via an antioxidant effect.

Vitamin C is a cofactor in the hydroxylation of lysine and proline, and therefore is required in the cross-linking of collagen fibrils in bone. Vitamin C stimulates alkaline phosphatase activity, a marker for osteoblast formation. Several studies have reported a beneficial effect of vitamin C intake on the bone mineral density [ 34 , 35 ].

A higher bone mineral density is associated with greater rigidity and strength of the bone. Bone may therefore expand less in relation to factors such as increased loading on the bone. This may provide an explanation of the association of higher vitamin C intake with decreased bone area and the risk of bone marrow lesions.

The emerging evidence of structural change in OA and pre-OA suggests that bony changes occur early and that cartilage defects predate changes in the cartilage volume, which in turn occur before any radiological change is evident. This continuum acknowledges that bone plays an important role in early OA.

Recent work has suggested that the well described risk factors for OA, including obesity and the knee adduction moment, may act through an effect on tibial bone before any effect on cartilage occurs [ 25 , 26 ].

The enlargement of the tibial plateau bone may attenuate the tibial cartilage, and this attenuation may play a role in the pathogenesis of OA [ 15 ].

The present study suggests a beneficial effect of vitamin C intake on the reduction in bone size and the number of bone marrow lesions, both of which are important in the pathogenesis of knee OA.

Our study also suggests benefits for bone health from fruit consumption, consistent with fruit being an important source of vitamin C.

These observations support the dietary recommendation for eating more fruit. While our findings need to be confirmed by larger longitudinal studies, they do highlight the potential of diet to modify the risk of OA.

Lawrence R, Helmick C, Arnett F, Deyo R, Felson D, Giannini E, Heyse S, Hirsch R, Hochberg M, Hunder G, et al: Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States.

Arthritis Rheum. Article CAS PubMed Google Scholar. Wang Y, Prentice LF, Vitetta L, Wluka AE, Cicuttini FM: The effect of nutritional supplements on osteoarthritis.

Altern Med Rev. PubMed Google Scholar. Okma-Keulen P, Hopman-Rock M: The onset of generalized osteoarthritis in older women: a qualitative approach. Henrotin Y, Deby-Dupont G, Deby C, Franchimont P, Emerit I: Active oxygen species, articular inflammation and cartilage damage.

CAS PubMed Google Scholar. Machlin LJ, Bendich A: Free radical tissue damage: protective role of antioxidant nutrients.

FASEB J. Michaud DS, Giovannucci EL, Ascherio A, Rimm EB, Forman MR, Sampson L, Willett WC: Associations of plasma carotenoid concentrations and dietary intake of specific carotenoids in samples of two prospective cohort studies using a new carotenoid database. Cancer Epidemiol Biomarkers Prev.

McAlindon TE, Jacques P, Zhang Y, Hannan MT, Aliabadi P, Weissman B, Rush D, Levy D, Felson DT: Do antioxidant micronutrients protect against the development and progression of knee osteoarthritis?.

Wluka AE, Stuckey S, Brand C, Cicuttini FM: Supplementary vitamin E does not affect the loss of cartilage volume in knee osteoarthritis: a 2 year double blind randomized placebo controlled study.

J Rheumatol. Wang Y, Cicuttini FM, Vitetta L, Wluka AE: What effect do dietary antioxidants have on the symptoms and structural progression of knee osteoarthritis over two years?.

Clin Exp Rheumatol. Peterfy CG: MR imaging. Baillieres Clin Rheumatol. Wluka AE, Stuckey S, Snaddon J, Cicuttini FM: The determinants of change in tibial cartilage volume in osteoarthritic knees.

Article PubMed Google Scholar. Jones G, Glisson M, Hynes K, Cicuttini F: Sex and site differences in cartilage development: a possible explanation for variations in knee osteoarthritis in later life. Cicuttini F, Ding C, Wluka A, Davis S, Ebeling PR, Jones G: Association of cartilage defects with loss of knee cartilage in healthy, middle-age adults: a prospective study.

Ding C, Garnero P, Cicuttini F, Scott F, Cooley H, Jones G: Knee cartilage defects: association with early radiographic osteoarthritis, decreased cartilage volume, increased joint surface area and type II collagen breakdown.

Osteoarthritis Cartilage. Wang Y, Wluka AE, Cicuttini FM: The determinants of change in tibial plateau bone area in osteoarthritic knees: a cohort study. Arthritis Res Ther. Article PubMed Central PubMed Google Scholar.

Felson DT, Chaisson CE, Hill CL, Totterman SM, Gale ME, Skinner KM, Kazis L, Gale DR: The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med. Felson DT, McLaughlin S, Goggins J, LaValley MP, Gale ME, Totterman S, Li W, Hill C, Gale D: Bone marrow edema and its relation to progression of knee osteoarthritis.

Giles GG, English DR: The Melbourne Collaborative Cohort Study. IARC Sci Publ. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M, et al: Development of criteria for the classification and reporting of osteoarthritis.

Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Ireland P, Jolley D, Giles G: Development of the Melbourne FFQ: a food frequency questionnaire for use in an Australian prospective study involving and ethnically diverse cohort.

Asia Pac J Clin Nutr. Lewis J, Milligan G, Hunt A: NUTTAB95 Nutrient Data Table for Use in Australia. Google Scholar. USDA-NCC Carotenoid Database for U. pdf ] Groff JL, Gropper SS, Hunt SM: Advanced Nutrition and Human Metabolism. Kraus VB, Huebner JL, Stabler T, Flahiff CM, Setton LA, Fink C, Vilim V, Clark AG: Ascorbic acid increases the severity of spontaneous knee osteoarthritis in a guinea pig model.

Jackson BD, Teichtahl AJ, Morris ME, Wluka AE, Davis SR, Cicuttini FM: The effect of the knee adduction moment on tibial cartilage volume and bone size in healthy women.

Rheumatology Oxford. Article CAS Google Scholar. Ding C, Cicuttini F, Scott F, Cooley H, Jones G: Knee structural alteration and BMI: a cross-sectional study. Obes Res. Wluka AE, Wang Y, Davis SR, Cicuttini FM: Tibial plateau size is related to grade of joint space narrowing and osteophytes in healthy women and in women with osteoarthritis.

Ann Rheum Dis. Article PubMed Central CAS PubMed Google Scholar. De Roos AJ, Arab L, Renner JB, Craft N, Luta G, Helmick CG, Hochberg MC, Jordan JM: Serum carotenoids and radiographic knee osteoarthritis: the Johnston County Osteoarthritis Project.

Public Health Nutr. McCarty CA, De Paola C, Livingston PM, Taylor H: Reliability of a food frequency questionnaire to assess dietary antioxidant intake.

Ophthalmic Epidemiol. Goldbohm RA, van 't Veer P, van den Brandt PA, van 't Hof MA, Brants HA, Sturmans F, Hermus RJ: Reproducibility of a food frequency questionnaire and stability of dietary habits determined from five annually repeated measurements.

Eur J Clin Nutr. Fernyhough LK, Horwath CC, Campbell AJ, Robertson MC, Busby WJ: Changes in dietary intake during a 6-year follow-up of an older population. Osler M, Heitmann BL, Schroll M: Ten year trends in the dietary habits of Danish men and women.

Cohort and cross-sectional data. Zhang H, Hsu-Hage BH, Wahlqvist ML: Longitudinal changes in nutrient intakes in the Melbourne Chinese Cohort Study. Hall SL, Greendale GA: The relation of dietary vitamin C intake to bone mineral density: results from the PEPI study.

Calcif Tissue Int. Morton DJ, Barrett-Connor EL, Schneider DL: Vitamin C supplement use and bone mineral density in postmenopausal women. J Bone Miner Res. Download references. The MCCS recruitment was funded by VicHealth and The Cancer Council of Victoria.

This study was funded by a program grant from the National Health and Medical Research Council NHMRC grant and was further supported by infrastructure provided by The Cancer Council of Victoria. The authors would like to acknowledge the NHMRC project grant , the Colonial Foundation and the Shepherd Foundation for support.

YW is the recipient of an NHMRC PhD Scholarship. AEW is the recipient of an NHMRC Public Health Australia Fellowship NHMRC and a co-recipient of the Cottrell Fellowship, Royal Australasian College of Physicians.

The authors would especially like to thank the study participants who made this study possible. Department of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Melbourne, VIC , Australia.

Cancer Epidemiology Centre, The Cancer Council of Victoria, Carlton, VIC , Australia. Baker Heart Research Institute, Commercial Road, Melbourne, VIC , Australia. School of Population Health, The University of Melbourne, Australia.

MRI Unit, Mayne Health Diagnostic Imaging Group, Epworth Hospital, Richmond, VIC , Australia. You can also search for this author in PubMed Google Scholar. Correspondence to Flavia M Cicuttini.

FMC and YW participated in the design of the study. DRE, GGG, and RO participated in the acquisition of data. YW carried out the measurement of knee cartilage and bone structure, performed the statistical analysis and interpretation of data, and drafted the manuscript. AF provided statistical support.

AMH, AEW, FMC, DRE, and GGG participated in the analysis and interpretation of data, and reviewed the manuscript. All authors read and approved the final manuscript. Reprints and permissions. Wang, Y. et al. Effect of antioxidants on knee cartilage and bone in healthy, middle-aged subjects: a cross-sectional study.

Arthritis Res Ther 9 , R66 Download citation. Received : 20 February Revised : 14 May Accepted : 06 July Published : 06 July Anyone you share the following link with will be able to read this content:. Sorry, a shareable link is not currently available for this article. Provided by the Springer Nature SharedIt content-sharing initiative.

Skip to main content. Search all BMC articles Search. Download PDF. Abstract The aim of the present study is to examine the effect of dietary antioxidants on knee structure in a cohort of healthy, middle-aged subjects with no clinical knee osteoarthritis.

Introduction Osteoarthritis OA is a disease affecting the whole joint, including the articular cartilage, bone and soft tissues. Patients and methods Participants The study was conducted within the MCCS, which is a prospective cohort study of 41, residents of Melbourne, Australia aged between 27 and 75 years Anthropometric and dietary data Extensive information was collected at MCCS baseline — using questionnaires and physical measurements.

MRI and measurement of cartilage volume, bone area, cartilage defects, and bone marrow lesions During —, each subject had an MRI scan performed on the dominant knee defined as the lower limb the subject used to step off when walking. Results Two hundred and ninety-seven participants entered the study.

Table 1 Characteristics of study participants Full size table. Table 2 Relationship between vitamin C and vitamin E intake and knee structures Full size table.

Table 3 Relationship between carotenoid intake and knee structures Full size table. Table 4 Relationship between fruit and vegetable intake and knee structures Full size table.

Discussion In this population of healthy, middle-aged people with no clinical knee OA, vitamin C intake was inversely associated with the tibial plateau bone area and with the presence of bone marrow lesions, both of which are important in the pathogenesis of knee OA.

Conclusion The present study suggests a beneficial effect of vitamin C intake on the reduction in bone size and the number of bone marrow lesions, both of which are important in the pathogenesis of knee OA.

References Lawrence R, Helmick C, Arnett F, Deyo R, Felson D, Giannini E, Heyse S, Hirsch R, Hochberg M, Hunder G, et al: Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States. Article CAS PubMed Google Scholar Wang Y, Prentice LF, Vitetta L, Wluka AE, Cicuttini FM: The effect of nutritional supplements on osteoarthritis.

PubMed Google Scholar Okma-Keulen P, Hopman-Rock M: The onset of generalized osteoarthritis in older women: a qualitative approach. Article CAS PubMed Google Scholar Henrotin Y, Deby-Dupont G, Deby C, Franchimont P, Emerit I: Active oxygen species, articular inflammation and cartilage damage.

CAS PubMed Google Scholar Machlin LJ, Bendich A: Free radical tissue damage: protective role of antioxidant nutrients. CAS PubMed Google Scholar Michaud DS, Giovannucci EL, Ascherio A, Rimm EB, Forman MR, Sampson L, Willett WC: Associations of plasma carotenoid concentrations and dietary intake of specific carotenoids in samples of two prospective cohort studies using a new carotenoid database.

CAS PubMed Google Scholar McAlindon TE, Jacques P, Zhang Y, Hannan MT, Aliabadi P, Weissman B, Rush D, Levy D, Felson DT: Do antioxidant micronutrients protect against the development and progression of knee osteoarthritis?.