Nicola Veronese1, Ai Koyanagi2, Brendon Stubbs3, Cyrus Cooper4, Giuseppe Guglielmi5, Renè Rizzoli6, Leonardo Punzi7, Domenico Rogoli8, Maria Gabriella Caruso9, Ornella Rotolo9, Maria Notarnicola9, Nasser Al-Daghri10, Lee Smith11, Jean-Yves Reginster12, Stefania Maggi8. 1. National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy. Electronic address: ilmannato@gmail.com. 2. Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain; Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain. 3. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London SE5 8AZ, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience King's College London, De Crespigny Park, London SE5 8AF, UK; Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford CM1 1SQ, UK. 4. Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK; MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK; National Institute for Health Research Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK. 5. Department of Radiology, University of Foggia, Foggia, Italy; Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy. 6. Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland. 7. Rheumatology Unit, Department of Medicine (DIMED), University of Padova, Padova, Italy. 8. National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy. 9. National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy. 10. Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia. 11. The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK. 12. Prince Mutaib Chair for Biomarkers of Osteoporosis, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia; Department of Public Health, Epidemiology and Health Economics, University of Liege, CHU Sart Tilman B23, 4000, Liège, Belgium.
Abstract
OBJECTIVES: Mediterranean diet has several beneficial effects on health, but data regarding the association between Mediterranean diet and knee osteoarthritis (OA) are limited mainly to cross-sectional studies. We investigated whether higher Mediterranean diet adherence is prospectively associated with lower risk of radiographic OA (ROA), radiographic symptomatic knee OA (SxOA) and pain worsening in North American people at high risk or having knee OA. METHODS: Adherence to the Mediterranean diet was evaluated using a validated Mediterranean diet score (aMED), categorized in five categories (Q1 to Q5, higher values reflecting higher adherence to Mediterranean diet). Knee OA outcomes included incident (1) ROA, (2) SxOA, as the new onset of a combination of a painful knee and ROA, (3) knee pain worsening, i.e. a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual exam of ≥14%. RESULTS: 4330 subjects (mean age: 61.1 years; 58.0% females) were included. Based on a multivariable Poisson regression analysis, during a mean follow-up period of 4 years, participants who were more highly adherent to a Mediterranean diet (Q5) reported lower risk of pain worsening (relative risk, RR = 0.96; 95% CI: 0.91-0.999) compared to those in Q1. In 2994 people free from SxOA at baseline, higher adherence to a Mediterranean diet was associated with a lower risk for SxOA during follow-up by 9% (Q5 vs. Q1; RR = 0.91; 95% CI: 0.82-0.998). No significant associations emerged between aMED and incident ROA. CONCLUSION: Higher adherence to Mediterranean diet is associated with a lower risk of pain worsening and symptomatic forms of knee OA.
OBJECTIVES: Mediterranean diet has several beneficial effects on health, but data regarding the association between Mediterranean diet and knee osteoarthritis (OA) are limited mainly to cross-sectional studies. We investigated whether higher Mediterranean diet adherence is prospectively associated with lower risk of radiographic OA (ROA), radiographic symptomatic knee OA (SxOA) and pain worsening in North American people at high risk or having knee OA. METHODS: Adherence to the Mediterranean diet was evaluated using a validated Mediterranean diet score (aMED), categorized in five categories (Q1 to Q5, higher values reflecting higher adherence to Mediterranean diet). Knee OA outcomes included incident (1) ROA, (2) SxOA, as the new onset of a combination of a painful knee and ROA, (3) knee pain worsening, i.e. a Western Ontario and McMaster Universities Osteoarthritis Index difference between baseline and each annual exam of ≥14%. RESULTS: 4330 subjects (mean age: 61.1 years; 58.0% females) were included. Based on a multivariable Poisson regression analysis, during a mean follow-up period of 4 years, participants who were more highly adherent to a Mediterranean diet (Q5) reported lower risk of pain worsening (relative risk, RR = 0.96; 95% CI: 0.91-0.999) compared to those in Q1. In 2994 people free from SxOA at baseline, higher adherence to a Mediterranean diet was associated with a lower risk for SxOA during follow-up by 9% (Q5 vs. Q1; RR = 0.91; 95% CI: 0.82-0.998). No significant associations emerged between aMED and incident ROA. CONCLUSION: Higher adherence to Mediterranean diet is associated with a lower risk of pain worsening and symptomatic forms of knee OA.
Authors: E Kelaiditi; A Jennings; C J Steves; J Skinner; A Cassidy; A J MacGregor; A A Welch Journal: Osteoporos Int Date: 2016-07-14 Impact factor: 4.507
Authors: Chang Xu; Nathalie E Marchand; Jeffrey B Driban; Timothy McAlindon; Charles B Eaton; Bing Lu Journal: Am J Clin Nutr Date: 2020-03-01 Impact factor: 7.045