Effects of a Mediterranean Diet Compared with the Low-Fat Diet on Patients with Knee Osteoarthritis: A Randomized Feeding Trial

Abstract

Objectives. Knee osteoarthritis is a common global problem, especially in overweight and obese people. It is not clear that weight loss is a factor for pain reduction in these patients or dietary components are important. Herein, we compared the effects of Mediterranean (MD) and low-fat diet on pain, stiffness, and physical function in patients with knee osteoarthritis. Subjects/Methods. In this randomized feeding trial, 129 patients with knee osteoarthritis were enrolled. Participants were randomly allocated to the MD (n = 43), low-fat diet (n = 43), and control group (regular diet) (n = 43) for 12 weeks by the blocked randomization method. Total Western Ontario and McMaster Universities Arthritis Index (WOMAC) score and its subscales and anthropometric indices were compared among the groups at the baseline and end of the study. Results. Weight and waist circumference reduction was significantly higher in the MD and low-fat diet groups compared with the regular group (p < 0.001 and p < 0.001, respectively), but there was no significant difference between the MD and low-fat diet groups (p = 0.2). Pain was significantly decreased in the Mediterranean-style compared with the low-fat (p = 0.04) and regular (p = 0.002) diet groups. Physical function was significantly improved in the MD compared with the regular diet group (p = 0.01), but had no significant difference with the low-fat one. Stiffness had no significant difference among the dietary groups. Conclusions. Pain severity was reduced in the MD group, but no significant change was reported in patients on low-fat and regular diets. It seems that dietary components in the MD, regardless of weight loss effect, are effective on pain reduction in patients with KOA. The present study was registered in the IRCT under the code of IRCT20200929048876N1.

Fatty Acid Intake and Polyunsaturated Fatty Acid Biomarkers and Risk of Total Knee or Hip Arthroplasty Among Older Women in the Women's Health Initiative

“…Diets high in EPA and DHA, such as the Mediterranean diet, also have been associated with improvements of pain in patients with OA. 43 However, other OSs found no significant associations of FAs with incidence of OA. 44,45 The difference in findings between intervention and OSs may suggest that the dose of n-3 PUFAs needed to benefit individuals with OA exceeds the usual intake of n-3 PUFAs consumed without supplementation, especially in participants living in areas who have low intakes of marine foods.…”

“…It is possible that women with more symptomatic OA (ie, more pain) at baseline may have increased consumption of n‐3 PUFA–rich foods in response to symptoms. Diets high in EPA and DHA, such as the Mediterranean diet, also have been associated with improvements of pain in patients with OA 43 . However, other OSs found no significant associations of FAs with incidence of OA 44,45 .…”

Health-Related Quality of Life and Injuries in Physical Education Students: A Multi-Group Model According to the Degree of Adherence to the Mediterranean Diet

“…This analysis indicates that the young people with a low adherence show higher emotional role and bodily pain. It has been shown that in populations with osteoarthritis, the Mediterranean diet helps to reduce bodily pain [28]. Furthermore, a reduction in chronic pain has been observed with a high adherence to the Mediterranean diet [29].…”

Omega-3 Supplementation and Its Effects on Osteoarthritis

“…High-fat diets, consisting of greater concentrations of trans and saturated fats, have demonstrated increased risk factors and pain in individuals with OA [ 101 ]. Conversely, the Mediterranean diet emphasizes fruit and vegetables, whole grains, and healthy fats (omega-3 sources of olive oil, nuts, fatty fish, and low-fat dairy) and has been shown to reduce the prevalence of OA in some individuals [ 102 ].…”