KOA: mostly vegetarian diet linked to reduced disease progression

  • Xu C & al.
  • Am J Clin Nutr
  • 7 ene. 2020

  • de Miriam Davis, PhD
  • Clinical Essentials
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Takeaway

  • A diet rich in vegetables, whole grains, and fish (a "prudent" pattern) is associated with slower progression of knee osteoarthritis (KOA).
  • A diet rich in processed meats and refined grains (a "Western" pattern) is associated with more rapid disease progression.

Why this matters

  • This study is among the first to evaluate dietary patterns and KOA progression.

Study design

  • Prospective cohort (the Osteoarthritis Initiative; n=2757).
  • Radiographic progression defined by 1 full Kellgren-Lawrence (KL) grade increase and loss in joint space width (JSW); symptomatic progression defined by an increase in or remaining in 1 of the 2 highest categories of the Western Ontario and McMaster Universities Arthritis Index (WOMAC).
  • Funding: NIH; Novartis, MSD; GlaxoSmithKline; Pfizer.

Key results

  • Median follow-up, 48 months.
  • Increasing Western pattern score (quartile 4 vs 1) was associated with:
    • Increased KL-worsening: HR, 1.30 (95% CI, 1.05-1.61);
    • Increased progression to higher WOMAC score: OR, 1.39 (95% CI, 1.18-1.63); but
    • No change in JSW.
  • Increasing prudent pattern score (quartile 4 vs 1) was associated with:
    • Decreased KL-worsening: HR, 0.79 (95% CI, 0.64-0.98);
    • Decreased progression to higher WOMAC score: OR, 0.73 (95% CI, 0.62-0.86); and
    • Decreased JSW loss: 0.38 vs 0.46 mm (Ptrend<.01>

Limitations

  • Observational design.