Sun Nianyi, Zhao Yinuo, Wang Junyu, Zhang Anren, He Yu
Department of Rehabilitation, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
School of Medicine, Tongji University, Shanghai, China.
Front Nutr. 2025 Jul 21;12:1604872. doi: 10.3389/fnut.2025.1604872. eCollection 2025.
Osteoarthritis (OA) is a prevalent whole-joint disease characterized by cartilage degradation, subchondral bone remodeling, synovial inflammation, and systemic metabolic dysregulation, imposing significant health and socioeconomic burdens globally. Conventional treatments primarily offer symptomatic relief without addressing the underlying disease mechanisms. Recently, intermittent fasting (IF), defined by cyclic caloric restriction and metabolic switching, has emerged as a promising lifestyle intervention with therapeutic potential for OA. Preclinical and preliminary clinical studies suggest that IF beneficially impacts OA pathogenesis by improving metabolic profiles, reducing systemic and local joint inflammation, activating cellular protective autophagy pathways, and positively modulating the gut microbiota. This review systematically synthesizes current mechanistic insights, preclinical findings, and emerging clinical evidence regarding IF's role in OA prevention and treatment. We also address practical considerations for implementing IF in clinical practice and outline future research priorities necessary to validate and optimize IF protocols tailored for OA management.
骨关节炎（OA）是一种常见的全关节疾病，其特征为软骨降解、软骨下骨重塑、滑膜炎症和全身代谢失调，在全球范围内造成了重大的健康和社会经济负担。传统治疗主要提供症状缓解，而未解决潜在的疾病机制。最近，间歇性禁食（IF），即周期性热量限制和代谢转换，已成为一种有前景的生活方式干预措施，对OA具有治疗潜力。临床前和初步临床研究表明，IF通过改善代谢状况、减轻全身和局部关节炎症、激活细胞保护性自噬途径以及积极调节肠道微生物群，对OA发病机制产生有益影响。本综述系统地综合了关于IF在OA预防和治疗中作用的当前机制见解、临床前研究结果和新出现的临床证据。我们还讨论了在临床实践中实施IF的实际考虑因素，并概述了验证和优化针对OA管理的IF方案所需的未来研究重点。
