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.
Highlights
Osteoarthritis (OA) is the most predominant form of arthritis, affecting about 230 million people in the world [1]
Knee OA (KOA) is the main cause of disability in aged men and women [2]. ere is no treatment for KOA and therapies focused on pain severity reduction with opioids, acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), which have side effects [3,4,5]
We showed that weight and WC significantly decreased in the MD and low-fat diet groups compared with the regular diet. e pain and physical function alteration were significantly higher in the MD group compared with the regular one, but there was no significant difference between the low-fat and regular diet in these parameters
Summary
Osteoarthritis (OA) is the most predominant form of arthritis, affecting about 230 million people in the world [1]. Knee OA (KOA) is the main cause of disability in aged men and women [2]. Ere is no treatment for KOA and therapies focused on pain severity reduction with opioids, acetaminophen, and nonsteroidal anti-inflammatory drugs (NSAIDs), which have side effects [3,4,5]. Side effects and patient’s discomforts from drug intake make us to find new therapies for pain relief. The risk of OA is higher in overweight and obese people, and the prevalence is increasing because of aging in the communities [6]. Obesity plays an important role in the disease severity through several mechanisms. In addition to the mechanical pressure on joints, inflammatory markers secreted from white adipose tissue cause inflammatory status, which increase disease progression and pain severity
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