Background/Purpose:  Animal studies have shown that high-fat diet may increase the risk of osteoarthritis (OA), while other evidence suggests that dietary polyunsaturated fatty acids may be protective.

Methods:  We investigated the associations between high-fat diet and radiographic OA in a well-established knee OA incidence and progression cohort (Osteoarthritis Initiative) N = 4796. Fixed flexion radiographs of bilateral knees were evaluated for Kellgren and Lawrence score (KL) and joint space narrowing (JSN) at baseline, 12, 24, 36, 48, 72, and 96 months of follow up (mean follow-up 8 years); incident radiographic OA was defined as a new KL score ≥2 in either knee, and JNS progression was defined as progression from a previous radiograph by a partial grade or more. Diet was assessed at baseline by food frequency questionnaire. Dietary fat consumption was expressed as per cent of total calorie intake and categorized in quartiles (Q1:<29.05% (referent group), Q2: 29.06-34.29%, Q3: 34.30-39.42%, Q4: >39.43%). Logistic regression was used for analyses.

Results:  After adjustment for age, race, and gender, higher dietary fat consumption was associated with increased odds of incident radiographic knee OA (aOR Q2 1.14 (0.89-1.45), Q3 1.37 (1.07-1.75), and Q4 1.52 (1.20-1.94), p = 0.003) and progression of knee JSN (aOR Q2 1.15 (0.96-1.38), Q3 1.40 (1.17-1.67), and Q4 1.28 (1.07-1.54), p = 0.002). Similarly, higher consumption of poly- and monounsaturated fats as well as saturated fats was associated with incident radiographic knee OA and JSN progression. Further adjustment for BMI attenuated the associations of higher dietary fat consumption with these outcomes; for example, the aORs for incident radiographic knee OA were Q2 1.05 (0.81-1.35), Q3 1.25 (0.97-1.61), and Q4 1.28 (0.99-1.65), p = 0.15).

Conclusion:  In a cohort of high risk adults, high-fat diet was associated with an increased incidence of radiographic knee OA and progression of knee JSN due in large part to greater body weight among those with higher fat consumption. Biological mechanisms underlying the relationship between high dietary fat consumption, obesity and OA should be explored in further studies.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/high-fat-diet-is-associated-with-a-higher-incidence-of-radiographic-knee-oa-and-progression-of-knee-joint-space-narrowing-data-from-the-osteoarthritis-initiative/