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Public Health Nutr. 2011 Apr;14(4):709-15. doi: 10.1017/S1368980010001783. Epub 2010 Aug 16.

The effects of vitamin C supplementation on incident and progressive knee osteoarthritis: a longitudinal study.

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Department of Epidemiology, College of Public Health, University of South Florida, Clearwater, FL 33755, USA.



To evaluate the association between vitamin C supplementation and the incidence and progression of radiographic knee osteoarthritis (OA).


Prospective cohort study.


Clearwater Osteoarthritis Study (COS): (1988 to the present) a longitudinal study.


Male and female COS participants aged 40 years and above (n 1023). The study exposure was the participants' self-reported history of vitamin C supplementation. The participants underwent biennial, sequential knee radiographs, which were assessed using the Kellgren-Lawrence ordinal scale to determine evidence of the study 2 outcomes: incident radiographic knee OA (RKOA) and progression of RKOA.


Individuals without baseline knee OA who self-reported vitamin C supplement usage were 11% less likely to develop knee OA than were those individuals who self-reported no vitamin C supplement usage (risk ratio (RR)=0.89, 95% CI 0.85, 0.93). Among those participants with RKOA at baseline, vitamin C supplement usage did not demonstrate an association with RKOA progression (RR=0.94, 95% CI 0.79, 1.22).


In the present prospective cohort study, we found no evidence to support a protective role of vitamin C in the progression of knee OA. However, after controlling for confounding variables, these data suggest that vitamin C supplementation may indeed be beneficial in preventing incident knee OA. Given the massive public health burden of OA, the use of a simple, widely available and inexpensive supplement to potentially reduce the impact of this disease merits further consideration.

[Indexed for MEDLINE]

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