The association of dietary patterns with knee symptoms and MRI detected structure in patients with knee osteoarthritis
S. Zheng Osteoarthritis and Cartilage VOLUME 27, SUPPLEMENT 1, S251-S252, APRIL 01, 2019
Purpose: Dietary pattern is a comprehensive approach to identify common underlying patterns of food consumption. This current study aims to examine the cross-sectional and longitudinal associations of dietary patterns with knee symptoms and structures in knee OA patients.
Methods: Participants were selected from a randomised, placebo-controlled trial in Tasmania (N= 261) and Victoria (N=152), who had symptomatic knee OA and vitamin D deficiency at baseline and received 50,000IU vitamin D3 or placebo monthly for 24 months. Dietary was assessed by the Anti-Cancer Council of Victoria food frequency questionnaire. Exploratory factor analysis was used to identify dietary patterns. Each participant received a score for each dietary pattern, with a higher score indicating a great intake of food composing that pattern. At baseline and 24 months, knee symptoms were assessed using WOMAC and knee structures using MRI. Associations between dietary pattern scores and knee OA outcomes were examined using multivariable linear regressions with adjustment for potential covariates.
Results: Three dietary patterns in Tasmania were identified: “western pattern”, characterised by high intakes of processed food (processed meat, refined grain, margarine), meat (red meat, poultry and fish) and high-fat food (hamburger, pizza, meat pies, chips and wine); “vegetable and meat pattern”, characterised by high intakes of potatoes, vegetables, chips, red meat, pizza and beers; and “healthy pattern”, characterised by high intakes of vegetables, garlic, legumes, nuts, fish, wine, grain and fewer intakes of margarine and hamburger (Figure 1).
Two dietary patterns in Victoria were identified: “meat and high-fat pattern”, characterised by high intakes of meat, nut, condiments and high-fat food and “healthy pattern”, characterised by high intakes of vegetables and fruit, and fewer intakes of high-fat food (Figure 2).Participants with higher “healthy pattern” or “vegetable and meat pattern” scores had lower baseline dysfunction scores (β: -47.0, 95% CI: -88.4, -5.6; β: -45.01, 95% CI: -80.4, -9. and lower baseline total WOMAC scores (β:-59.2, 95% CI: -106.5, -11.9; β: -61.0, 95% CI: -116.5, -5.5). Participants who adhered to “western pattern” had significantly increased total WOMAC and dysfunction scores overtimes (β: 115.3, 95% CI: 33.5, 197.0; β: 94.1, 95% CI: 35.9, 152.3). Additionally, participants who adhered to “vegetable pattern” had significantly decreased knee symptoms impairment: pain (β: -25.4, 95% CI: -48.4, -2.5), dysfunction (β: -82.4, 95% CI: -151.7, -113.7), stiffness (β: -12.5, 95% CI: -23.5, -1.5); and effusion-synovitis volume (β: -0.95, 95% CI: -1.85, -0.05) over 24 months.
Conclusions: Our findings suggest that maintaining a healthy dietary pattern is associated with less knee function disability, whereas maintaining a western dietary pattern may contribute to increased functional disability over time. High intake of vegetables may be beneficial for joint symptom and effusion-synovitis. Our findings provide evidence for developing potential dietary strategies, such as keeping a healthy dietary may improve joint symptoms and effusion-synovitis in OA patients.