The impact of nutrition on tendon health and tendinopathy: a systematic review

ABSTRACT

Background

Tendinopathy is a painful condition that is prevalent in athletes as well as the general human population, and whose management is challenging.

Objective

This systematic review aimed to evaluate the impact of nutrition on the prevention and treatment of tendinopathy.

Methods

Searches were conducted in PubMed, EMBASE, Web of Science, and SPORTDiscus without restriction to year of publication. Studies examining the impact of exposure to nutrient intake in an adult human population on 1) prevalence/incidence of tendinopathy, 2) clinical outcomes of tendinopathy, 3) structural changes in the tendon by imaging modalities. Experimental and observational study designs written in English, Dutch, or German were eligible.

Results

Nineteen studies met the inclusion criteria. The effects of the habitual diet were investigated in one study. Four studies examined the effects of exposure to alcohol. Alcohol consumption can be a potential risk factor associated with Achilles tendinopathy and rotator cuff tears, although findings were inconsistent. The use of dietary supplements was examined in fourteen studies. Among these, collagen-derived peptides were most often part of the supplements evaluated. Combining training and dietary supplements seems to induce better clinical and functional outcomes in tendinopathy.

Conclusion

This review demonstrates the paucity of high-quality studies and a wide variety among studies regarding nutrients, tendon location, study population, and reported outcome measures. Individual studies showed promising clinical implications for the use of dietary supplements, particularly those containing collagen-derived peptides. However, giving any definitive dietary recommendations on the prevention and treatment of tendinopathy remains elusive.

KEYWORDS:

• Tendon
• tendinopathy
• diet
• supplements
• collagen

Availability of data and materials

The datasets generated during the current study are available from the corresponding author on reasonable request.

Authors’ contributions

Conception and planning of the work that led to the manuscript and analysis and interpretation of the data was performed by all authors. CR performed the database searches. The study selection was performed by AH and JZ and was approved by all authors. AH and CR judged the risk of bias of studies. A first draft of the manuscript was written by AH. CR, MM, and JZ edited and revised the manuscript. All authors approved the final version before submission.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/15502783.2022.2104130

Additional information

Funding

This study was financially supported by the EAT2MOVE project (Province of Gelderland, proposal PS2014-49.