Investigating the role of nutrition and self-monitoring in osteoarthritis management: evidence from a cross-sectional study of UK adults

Background Osteoarthritis (OA) is a prevalent, debilitating condition that significantly impacts global health. In addition to commonly recommended approaches (e.g., nonpharmacological, pharmacological and surgical therapy), the impact of nutrition on OA has become increasingly important, as supported by recent dietary randomized controlled trials on OA patients. However, very few studies have reported the attitudes, awareness and perceived barriers of community-dwelling adults in the UK with respect to nutrition and dietary intervention for OA. In addition, symptom tracking is proposed to stimulate engagement in self-management behaviours, including dietary modifications. Aim This study aims to investigate the prevailing attitudes, awareness, and perceived barriers to nutrition as a viable self-management approach to OA and maintaining joint health among community-dwelling adults in the UK. Methods This cross-sectional study employed an electronic survey. The survey, which was available online for three months, comprised 30 questions exploring attitudes, awareness and perceived barriers to adopting an anti-inflammatory diet for osteoarthritis management. Participants aged 18 years or older, with or without osteoarthritis, were recruited through various channels. Descriptive and inferential analyses were conducted, with a p value <0.05 considered significant. Results Among the 1,104 participants analysed, 53.3% were female, with the 36–45 years being the predominant age group (38.9%). Among those with OA (33.1%), 47.1% presented with tracked symptoms. The OA participants were more aware of treatment modalities and were more likely to seek nutritional information (45.9% vs. 23.8%, p < 0.001). They reported less frequent consumption of processed foods (p < 0.001), refined sugars (p = 0.010), trans fats (p < 0.001) and refined carbohydrates (p = 0.033). Uncertainty about the right diet was the main barrier to using food as medicine (78.5%, p < 0.01), followed by the cost of living (60.2%, p < 0.01). Symptom trackers demonstrated greater familiarity with dietary patterns exacerbating OA (adjusted relative risk ratio (aRRR): 2.43, 95% CI: 1.24--4.74, p = 0.01), were less likely to disagree about differences in their inflammatory diet (aRRR: 0.45, 95% CI: 0.25--0.82, p < 0.01) and were more likely to focus on diet during flare-ups (p < 0.001). Conclusion This study provides significant insights into the awareness, attitudes and dietary behaviours related to OA management among UK adults. While participants with OA showed increased awareness of treatment options and healthier dietary choices, uncertainty about the right diet was the primary barrier to using food as medicine. Symptom tracking was significantly associated with greater dietary knowledge and focus during flare-ups. Future research should develop personalized dietary interventions and evaluate the long-term effects of symptom tracking and dietary changes on OA outcomes.