Adherence to a Mediterranean diet is associated with lower prevalence of osteoarthritis: Data from the osteoarthritis initiative

Nicola Veronese, Brendon Stubbs, Marianna Noale, Marco Solmi, Claudio Luchini, Toby O. Smith, Cyrus Cooper, Giuseppe Guglielmi, Jean-Yves Reginster, Rene Rizzoli, Stefania Maggi

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Background & Aims: The Mediterranean diet appears to be beneficial for several medical conditions, but data regarding osteoarthritis (OA) are not available. The aim of this study was to investigate if adherence to the Mediterranean diet is associated with a lower prevalence of OA of the knee in a large cohort from North America. 
Methods: 4,358 community-dwelling participants (2,527 females; mean age: 61.2 years) from the Osteoarthritis Initiative were included. Adherence to the Mediterranean diet was evaluated through a validated Mediterranean diet score (aMED) categorized into quartiles (Q). Knee OA was diagnosed both clinically and radiologically. The strength of the association between aMED (divided in quartiles) and knee OA was investigated through a logistic regression analysis and reported as odds ratios (OR) with 95% confidence intervals (CIs), adjusted for potential confounders. 
Results: Participants with a higher adherence to Mediterranean diet had a significantly lower prevalence of knee OA compared to those with lower adherence (Q4: 25.2% vs. Q1: 33.8%; p<0.0001). Using a logistic regression analysis, adjusting for 10 potential confounders with those in the lowest quartile of aMED as reference, participants with the highest aMED had a significant reduction in presence of knee OA (OR,0.83; 95% CIs: 0.69-0.99, p=0.04). Among the individual components of Mediterranean diet, only higher use of cereals was associated with lower odds of having knee OA (OR: 0.76; 95% CI: 0.60-0.98; p=0.03). 
Conclusions: Higher adherence to a Mediterranean diet is associated with lower prevalence of knee OA. This remained when adjusting for potential confounders.
Original languageEnglish
Pages (from-to)1609-1614
Number of pages6
JournalClinical Nutrition
Issue number6
Early online date8 Oct 2016
Publication statusPublished - Dec 2017


  • osteoarthritis
  • Mediterranean diet
  • aged
  • healthy ageing
  • lifestyle

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