The relationship between the dietary inflammatory index and prevalence of radiographic symptomatic osteoarthritis: Data from the Osteoarthritis Initiative

Nicola Veronese, Nitin Shivappa, Brendon Stubbs, Toby Smith, James Hébert, Cyrus Cooper, Giuseppe Guglielmi, Jean-Yves Reginster, Renè Rizzoli, Stefania Maggi

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Purpose: To investigate whether higher dietary inflammatory index (DII ® ) scores were associated with higher prevalence of radiographic symptomatic knee osteoarthritis in a large cohort of North American people from the Osteoarthritis Initiative database. Methods: A total of 4358 community-dwelling participants (2527 females; mean age 61.2 years) from the Osteoarthritis Initiative were identified. DII ® scores were calculated using the validated Block Brief 2000 Food-Frequency Questionnaire and scores were categorized into quartiles. Knee radiographic symptomatic osteoarthritis was diagnosed clinically and radiologically. The strength of association between divided into quartiles (DII ® ) and knee osteoarthritis was investigated through a logistic regression analysis, which adjusted for potential confounders, and results were reported as odds ratios (ORs) with 95% confidence intervals (CIs). Results: Participants with a higher DII ® score, indicating a more pro-inflammatory diet, had a significantly higher prevalence of radiographic symptomatic knee osteoarthritis compared to those with lower DII ® score (quartile 4: 35.4% vs. quartile 1: 24.0%; p < 0.0001). Using a logistic regression analysis, adjusting for 11 potential confounders, participants with the highest DII ® score (quartile 4) had a significantly higher probability of experiencing radiographic symptomatic knee osteoarthritis (OR 1.40; 95% CI 1.14–1.72; p = 0.002) compared to participants with the lowest DII ® score (quartile 1). Conclusions: Higher DII ® values are associated with higher prevalence of radiographic symptomatic knee osteoarthritis.

Original languageEnglish
Pages (from-to)253–260
Number of pages8
JournalEuropean Journal of Nutrition
Issue number1
Early online date5 Dec 2017
Publication statusPublished - Feb 2019


  • knee osteoarthritis
  • dietary inflammatory index
  • inflammation

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