Link between Mediterranean Diet and Outcomes in Knee Osteoarthritis

April 9, 2019

By Jill Stein

PARIS -- April 8, 2019 -- Increased adherence to a Mediterranean diet is associated with a decreased risk of worsening pain and symptomatic knee osteoarthritis (OA), according to results of an observational longitudinal study presented here on April 5 at the 2019 World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (WCO).

Nicola Veronese, MD, Italian National Research Council, Padova, Italy, and colleagues recruited 4,330 individuals (mean age: 61.1 years; 58.0% female) from 4 clinical sites in the Unites States between February 2004 and May 2006. All individuals had knee OA with knee pain lasting at least 30 days over the past 12 months or were at high risk of knee OA.

During the mean 4-year follow-up period, participants who were more highly adherent to a Mediterranean diet reported lower risk of their pain worsening (relative risk, RR = 0.96; 95% confidence interval [CI]: 0.91 to 0.999; P = .047) than those who were not adherent to a Mediterranean diet.

In 2,994 subjects without symptomatic OA at baseline, higher adherence to a Mediterranean diet was associated with a lower risk of symptomatic OA during follow up by 9% (Q5 versus Q1, with Q5 reflecting highest adherence to a Mediterranean diet; RR = 0.91; 95% CI: 0.82 to 0.998; P = .04).

The researchers obtained their data during baseline screening evaluations and in subsequent evaluations over a total of 4 years. Adherence to a Mediterranean diet was assessed using a validated Mediterranean diet score (aMED) categorised into 5 quintiles (Q1 to Q5, higher values reflecting higher adherence).

There were no significant associations between aMED and incident radiographic OA.

Dr. Veronese said that these study findings are bolstered by the long duration of follow-up, the multiple knee OA outcomes included, and the large sample size.

He cautioned, however, that study participants already were either at high risk of developing OA or already had knee OA, requiring further research in the general population to confirm these findings.

Additionally, these findings are observational, introducing the potential for recall bias, and the record of medications and co-morbidities is self-reported, which may also lead to recall bias.

Knee OA is a key contributor to global disability, with an increasing overall prevalence, particularly in older people.

[Presentation title: Mediterranean Diet and Knee Osteoarthritis Outcomes. Abstract P523]