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Clin Nutr. 2017 Dec;36(6):1609-1614. doi: 10.1016/j.clnu.2016.09.035. Epub 2016 Oct 8.

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

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Department of Medicine (DIMED), Geriatrics Division, University of Padova, Italy; Institute for Clinical Research and Education in Medicine, Padua, Italy. Electronic address:
Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, UK; Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK; Faculty of Health, Social Care and Education, Anglia Ruskin University, Bishop Hall Lane, Chelmsford, CM1 1SQ, UK.
National Research Council, Neuroscience Institute, Aging Branch, Padova, Italy.
Institute for Clinical Research and Education in Medicine, Padua, Italy; Department of Neurosciences, University of Padova, Padova, Italy; National Health Care System, Padova Local Unit ULSS 17, Italy.
Department of Pathology and Diagnostics, University and Hospital Trust of Verona, Verona, Italy; Surgical Pathology Unit, Santa Chiara Hospital, Trento, Italy.
Faculty of Medicine and Health Sciences, University of East Anglia, Norwich Research Park, Norwich, NR4 7TJ, UK.
Oxford NIHR Musculoskeletal Biomedical Research Unit, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK; MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, SO16 6YD, UK; National Institute for Health Research, Nutrition Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, SO16 6YD, UK.
Department of Radiology, University of Foggia, Foggia, Italy; Department of Radiology, Scientific Institute "Casa Sollievo della Sofferenza" Hospital, San Giovanni Rotondo, Foggia, Italy.
Department of Public Health, Epidemiology and Health Economics, University of Liege, CHU Sart Tilman B23, 4000, Liège, Belgium.
Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.



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.


4358 community-dwelling participants (2527 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 (ORs) with 95% confidence intervals (CIs), adjusted for potential confounders.


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).


Higher adherence to a Mediterranean diet is associated with lower prevalence of knee OA. This remained when adjusting for potential confounders.


Aged; Healthy ageing; Lifestyle; Mediterranean diet; Osteoarthritis

[Available on 2018-12-01]
[Indexed for MEDLINE]

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