Mediterranean diet and knee osteoarthritis outcomes: A longitudinal cohort study

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 crosssectional 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. 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-4,330 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 2,994 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.

The Association between Dietary Magnesium Intake and Magnetic Resonance Parameters for Knee Osteoarthritis

“…OA progression is significantly related to oxidative stress and ROS [36], suggesting that adequate intake and/or supplementation of Mg can reduce inflammation and oxidative stress, leading to better preservation of knee structures. Third, Mg is particularly present in the Mediterranean diet, rich in vegetables, and, consequently, this can further justify our findings [22,37,38]. Finally, it is widely known that Mg is able to potentiate the effects of vitamin D on the skeletal system, further reinforcing the positive effect of Mg on knee OA [27].…”

Gut–Joint Axis: The Role of Physical Exercise on Gut Microbiota Modulation in Older People with Osteoarthritis

“…Indeed, these two interventions combined with vitamin D and amino acid supplementation and physical exercise could prevent several sequelae of the aging process including sarcopenia, as shown by several studies in the literature [47][48][49][50][51][52][53]. Finally, it has been demonstrated that there is a strong correlation between the adherence to a Mediterranean diet and a lower risk of OA manifestation, mediated by the well-known anti-inflammatory activity of fibers [54]. Taken together, these findings suggest that a rich in fiber nutritional approach like the Mediterranean diet combined with an adequate intake of micronutrients and physical exercise might be a cornerstone to maintain good health status, particularly in older people.…”

The Implication of Reactive Oxygen Species and Antioxidants in Knee Osteoarthritis

“…The Mediterranean diet has been much appreciated for its inclusion of many antioxidant-containing foods. In older adults on a Mediterranean diet, the symptomatic forms of KOA and pain were found to be much lower [ 243 ], while combining a diet that included extra-virgin olive oil with exercise was proved as a beneficial combination for cartilages and joints [ 244 ]. Olive oil is rich in active polyphenols, such as oleuropein, tyrosol, hydroxytyrosol, and oleocanthal, with important antioxidant and anti-inflammatory properties, being an important candidate in the prevention of degenerative changes [ 245 ].…”