Poster Presentation 29th Australian and New Zealand Bone and Mineral Society Annual Scientific Meeting 2019

The cross-sectional and longitudinal associations of dietary patterns with knee symptoms and MRI detected structure in patients with knee osteoarthritis (#142)

Shuang Zheng 1 , Feitong Wu 1 , Tania Winzenberg 1 , Flavia Cicuttini 2 , Anita Wluka 2 , Dawn Aitken 1 , Leigh Blizzard 1 , Changhai Ding 1 3
  1. Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
  2. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  3. Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China

Objectives

To examine the cross-sectional and longitudinal associations of dietary patterns with knee symptoms and structures in patients with knee osteoarthritis (OA).

Methods

Participants were from a randomised, placebo-controlled trial of 50,000IU vitamin D3 vs placebo monthly for 24 months in Tasmania (N= 261) and Victoria (N=152), and had symptomatic knee OA and vitamin D deficiency at baseline. Diet was assessed by the Anti-Cancer Council of Victoria food frequency questionnaire. Exploratory factor analysis was used to identify dietary patterns. Each participant received a score for each dietary pattern, with a higher score indicating greater intakes of foods comprising that pattern. At baseline and 24 months, knee symptoms were assessed using WOMAC and knee structures using MRI and radiography.

Results

Three dietary patterns “western pattern”, “vegetable and meat pattern” and “healthy pattern” were identified in Tasmania, and two dietary patterns “meat and high-fat pattern” and “vegetable pattern” were identified in  Victoria. Participants with higher “healthy pattern” or “vegetable and meat pattern” scores associated with lower baseline WOMAC function and total WOMAC scores. Participants with higher intake of a “western pattern” had greater increase in total WOMAC (β:115.3, 95%CI:33.5, 197.0) and function (β:94.1, 95%CI:35.9, 152.3) scores over 24 months. In participants with higher “vegetable pattern”, total WOMAC and all subscale scores significantly decreased over 24 months as did effusion-synovitis volume (β:-0.95, 95%CI: -1.85, -0.05). There were no significant associations between dietary patterns and other knee structural changes. All analyses were adjusted for age, gender, BMI and total calorie intake.

Conclusion

These findings suggest that maintaining a western dietary pattern could worsen knee pain while a healthy and vegetable pattern may reduce knee symptoms, with vegetable pattern also reducing joint synovitis independent of obesity and total calorie intake. These findings are novel and should be confirmed by more longitudinal studies and RCTs.

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