Dietary Quality Independent of Body Mass Index in Knee Osteoarthritis

Authors

• Lori Mormino, University of LynchburgFollow

Specialty

Orthopedic Surgery

Advisor

Lawrence Herman, DMSc, MPA, PA-C, DFAAPA

Abstract

Knee osteoarthritis (OA) is a chronic, progressive degenerative joint disease characterized by cartilage loss, pain, stiffness, and functional limitation, affecting hundreds of millions of individuals worldwide. Although aging and obesity contribute to the rising prevalence, mechanical loading alone does not fully account for symptom severity. Emerging evidence suggests that dietary composition influences inflammatory and metabolic pathways involved in OA pathophysiology, independent of body mass index (BMI). A targeted PubMed search identified randomized controlled trials, cohort studies, and systematic reviews, with seventeen studies meeting inclusion criteria. Across these studies, higher adherence to Mediterranean-style and other anti-inflammatory dietary patterns was associated with improvements in pain, function, and quality of life, with several studies reporting reduced symptom progression after adjustment for BMI. Observational evidence generally links higher diet quality with more favorable OA outcomes. In contrast, diets with higher inflammatory potential, particularly those rich in refined carbohydrates and saturated fats, are associated with worse symptoms and functional limitation. These findings support a shift in clinical perspective, in which diet is considered not only in the context of weight management but also as a modifier of disease expression. Integrating dietary quality into OA management aligns with a lifestyle medicine framework, positioning nutrition alongside physical activity, sleep, stress management, and social connection. Clinically, this supports structured, evidence-informed dietary counseling as a practical and low-risk strategy to complement conventional therapies and improve long-term symptom outcomes.

Recommended Citation

Mormino L. Dietary Quality Independent of Body Mass Index in Knee Osteoarthritis. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2026; 8(1).