Elucidation of dietary risk factors in osteoarthritis knee—a case-control study.
OBJECTIVE
Nutritional imbalance, combined with endocrine abnormalities, may be involved in the pathogenesis of osteoarthritis (OA). This study was conducted to determine the association of OA with dietary factors, such as quantity and quality of nutrient intake.


METHODS
This case-control study enrolled 180 knee osteoarthritis (KOA) subjects who met the American College of Rheumatology definition of KOA, with an equal number of matched controls. Outcome measures, such as dietary nutrient intake and its frequency, were recorded using a food frequency questionnaire.


RESULTS
Compared to controls, cases were older individuals with a higher body mass index (BMI). Physical activity scores were lower in female cases compared to male cases and controls. A significantly higher intake of phosphorus and fat was observed in overall cases (fat in females only). A significantly lower intake of vitamin C and vitamin D was observed in overall cases and the significance of vitamin D persisted on gender-wise bifurcation. On multiple logistic regression analysis, the intake of vitamin D (odds ratio [OR] = 0.79) and vitamin C (OR = 0.97) was inversely associated with the presence of KOA in the observation group, especially in females. Generally, the intake of food servings/day, green leafy vegetables (GLVs), and fats/oils was higher, whereas the intake of fruits, milk/milk products, and meat/poultry was lower in cases compared to controls.


CONCLUSIONS
Low intake of vitamin D and vitamin C is a possible risk factor for KOA. Certain food groups, such as fruits, milk/milk products, and meat/poultry are beneficial for KOA. Further studies are needed to elucidate the associations between diet and KOA.
a Department of Orthopaedic Surgery , King George Medical University , Lucknow , INDIA.
Divya
D
Sanghi
Abhishek
A
Mishra
Amar Chandra
AC
Sharma
Saloni
S
Raj
Rachna
R
Mishra
Reema
R
Kumari
S M
SM
Natu
Sanjiv
S
Agarwal
Rajeshwar Nath
RN
Srivastava
D000328:Adult; D001205:Ascorbic Acid / Q000009:adverse effects; D015992:Body Mass Index; D016022:Case-Control Studies; D004032:Diet / Q000009:adverse effects*; D004034:Diet Surveys; D004041:Dietary Fats / Q000009:adverse effects; D005260:Female; D005502:Food / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009043:Motor Activity; D016017:Odds Ratio; D020370:Osteoarthritis, Knee / Q000209:etiology* / Q000473:pathology; D016226:Phosphorus, Dietary / Q000009:adverse effects; D012307:Risk Factors; D012737:Sex Factors; D014807:Vitamin D / Q000009:adverse effects; D014815:Vitamins / Q000009:adverse effects
D004041:Dietary Fats; D016226:Phosphorus, Dietary; D014815:Vitamins; D014807:Vitamin D; D001205:Ascorbic Acid
diet; knee; nutrients; nutritional status; osteoarthritis