Diet May Affect Pain in Knee OA

A proinflammatory diet, indicated by a higher score on the Dietary Inflammatory Index (DII), may be associated with greater pain among patients with osteoarthritis (OA) of the knee, but may not have an impact on structural damage, according to a recent study published in Arthritis Care & Research.

The investigators used data from a prospective cohort study in which participants completed assessments at baseline (n = 1099), 2.6 years (n = 875); 5.1 years (n = 768), and 10.7 years, (n = 566). At baseline and 10.7 years, T1-weighted and T2-weighted magnetic resonance imaging was performed to measure cartilage volume (CV) and bone marrow lesions (BMLs). In addition, the Western Ontario and McMaster Universities Osteoarthritis Index pain questionnaire was used to measure knee pain at each visit and baseline energy-adjusted DII (E-DII^T) scores were calculated.

“The mean E-DII score at baseline was -0.48±1.39,” the authors stated. “In multivariable analyses, higher E-DII scores were not associated with tibial CV loss or BML size increase except for medial tibial BML size increase. Higher E-DII scores were associated with greater pain score (β=0.21, 95% CI 0.004-0.43) and an increased risk of belonging to ‘Moderate pain’ compared to ‘Minimal Pain’ trajectory group [relative risk ratio (RRR): 1.19, 95%CI 1.02-1.39].”

The authors concluded, “A proinflammatory diet, as indicated by higher DII score, may be associated with greater pain score and higher risk of more severe pain trajectory over 10 years. However, inconsistent findings related to structural changes suggest a discordance between the potential impact of diet on structural damage and pain in knee OA.”

Ma C, Searle D, Tian J, et al. Dietary inflammatory index and MRI-detected knee structural change and pain: a 10.7-year follow-up study. Arthritis Care Res. Published online January 29, 2024.