National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy; National Institute of Gastroenterology-Research Hospital, Castellana Grotte, Bari, Italy.
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.
Clin Nutr. 2019 Dec;38(6):2735-2739. doi: 10.1016/j.clnu.2018.11.032. Epub 2018 Dec 4.
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.
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%.
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.
Higher adherence to Mediterranean diet is associated with a lower risk of pain worsening and symptomatic forms of knee OA.
地中海饮食对健康有多种有益影响，但关于地中海饮食与膝骨关节炎（OA）之间关联的数据主要限于横断面研究。我们调查了在北美高风险或患有膝骨关节炎的人群中，较高的地中海饮食依从性是否与较低的放射学 OA（ROA）、放射学症状性膝 OA（SxOA）和疼痛加重风险相关。
采用经过验证的地中海饮食评分（aMED）评估地中海饮食的依从性，分为五个等级（Q1 至 Q5，分数越高表示对地中海饮食的依从性越高）。膝骨关节炎的结局包括：（1）新发 ROA；（2）新发 SxOA，即疼痛性膝关节和 ROA 的新发病例；（3）膝关节疼痛加重，即 Western Ontario 和 McMaster 大学骨关节炎指数在基线和每次年度检查之间的差值≥14%。
共纳入 4330 名受试者（平均年龄：61.1 岁；58.0%为女性）。基于多变量泊松回归分析，在平均 4 年的随访期间，与 Q1 相比，地中海饮食依从性较高（Q5）的参与者报告疼痛加重的风险较低（相对风险，RR=0.96；95%置信区间：0.91-0.999）。在 2994 名基线时无 SxOA 的人群中，较高的地中海饮食依从性与随访期间 SxOA 的风险降低 9%相关（Q5 与 Q1 相比；RR=0.91；95%置信区间：0.82-0.998）。aMED 与新发 ROA 之间无显著相关性。
较高的地中海饮食依从性与疼痛加重和膝关节症状性 OA 的风险降低相关。
