Table 1.
Epidemiological studies on mediterranean diet and osteoarthritis.
| Author, Year | Country Population, N (sex) Age | Sample Characteristics | MD Definition. Diets and Other Interventions | Osteoarthritis | Follow-Up | Results |
|---|---|---|---|---|---|---|
| Dyer J et al., 2017 [37]. | UK N = 99 (83% female) Age: 31–90 years. |
Volunteers with a clinician diagnosis of OA. 16-week dietary intervention (N = 50) and control (N = 49). |
Fruit, vegetables, legumes, olive oil, fish and shellfish, poultry, cereals (refined and whole grain), red and processed meat, animal fat, sugary drinks, sweets and pastries. Completed a 7-day food diary (as a food frequency questionnaire). |
Clinician diagnosis of OA. | Food frequency questionnaire and an Arthritis Impact Measurement Scale (AIMS2) questionnaire at baseline, 2 months and 4 months (end). Subset patients (DIET = 33, CON = 28) were asked about joint range of motion (ROM) at start and end of study and to provide blood samples (DIET = 29, CON = 25) for biomarker analysis. |
AIMS2 components and most biomarkers p > 0.05, except IL-1α in the DIET group (~47%, p = 0.010). ↓ Markers of cartilage degradation in the DIET group (~8%, p = 0.014). ↑ Knee flexion and hip rotation ROM in the DIET group (p < 0.05). |
| Veronese N et al., 2016 [38]. | USA N = 4358 (2527 females) Mean age: 61.2 ± 9.1 years. |
Community-dwelling participants from the Osteoarthritis Initiatives were included |
The Mediterranean diet score proposed by Panagiotakos et al. was used to evaluate aMED categorized into quartiles [40]. | Knee OA was diagnosed both clinically and radiologically. The presence of pain, stiffness, and physical functioning due to OA was assessed through the WOMAC. The responses for each subscale (pain, stiffness, disability) are categorized on Likert scale (0–4). |
Block Brief 2000 food frequency questionnaire (FFQ) during the baseline visit. | ↑ aMED ↓ prevalence of knee OA (Q4: 25.2% vs. Q1: 33.8%; p < 0.0001). Highest aMED ↓in presence of knee OA (OR: 0.83; 95% CIs: 0.69–0.99, p < 0.04). Among individual components of MD only higher use of cereals ↓ odds of knee OA (OR: 0.76; 95% CI: 0.60e0.98; p < 0.03). |
| Veronese N et al., 2017 [39]. | USA N = 4470 (2605 females) Mean age: 61.3 ± 9.2 years. |
Community-dwelling participants from the Osteoarthritis. Initiatives were included. |
The Mediterranean diet score proposed by Panagiotakos et al. [40] was used to evaluate aMED categorized into quintiles. | Block Brief 2000 food frequency questionnaire (FFQ) during the baseline visit. Quality of life as primary outcome (SF-12) physical composite scale (PCS) and Mental composite scale (MCS). Secondary outcomes: WOMAC (pain, stiffness, disability caused by OA). Depressive symptoms (CES-D instrument) [41]. |
↑ aMED ↑ SF-12 PCS (Q5 50 ± 8.5 vs. Q1 47.2 ± 9.8 p < 0.0001) and SF-12MCS (Q5 54.5 ± 7.6 vs. Q1 53.2 ± 8.8 p < 0.0001). ↑ aMED ↓ WOMAC (except for stiffness). ↑ aMED ↓ CES-D (β −0.05; 95% CI: −0.09, −0.01; p < 0.05). |
AIMS2: Arthritis Impact Measurement Scale; aMED: Adherence to the Mediterranean diet; CES-D: Center for Epidemiologic Studies Depression Scale instrument; FFQ: food frequency questionnaire; MCS: Mental composite scale of SF-12; MD: Mediterranean Diet; OA: Osteoarthritis; PCS: Physical composite scale of SF-12; ROM: Range of motion; SF-12: 12-Item Short-Form Health Outcome Survey; WOMAC: Western Ontario and McMaster Universities Arthritis Index.