Higher Dietary Fiber Intake Associated With Lower Osteoarthritis Risk

Increasing dietary fiber consumption may reduce the risk of osteoarthritis, offering potential strategies for prevention and management, according to a study published in the Journal of Orthopaedic Surgery and Research.1

Past studies have shown that long-term consumption of ultra-processed food can predispose individuals to various chronic diseases. Conversely, dietary fiber intake may help mitigate inflammation, a key factor in chronic conditions, like osteoarthritis.2

Several studies have explored the relationship between diet and arthritis.1 One study, for example, found that high dietary fiber intake may help with knee protection in individuals with a high prevalence of osteoarthritis.3

Previous studies have had limited sample sizes and difficulty accurately measuring dietary fiber intake, leaving the association between dietary fiber consumption and osteoarthritis risk unclear.1 To address this gap, the researchers investigated the relationship between dietary fiber intake and the prevalence of osteoarthritis in US adults.

A dietary fiber intake between 14.4 and 26.7 g reduced the risk of osteoarthritis, but an intake above this dose was not significantly protective. | Image Credit: photka - stock.abode.com

Consequently, they used data spanning 1999 to 2018 from the National Health and Nutrition Examination Survey (NHANES). NHANES collects data on the health, nutritional status, and behaviors of the non-institutionalized US population through personal interviews, physical examinations, and laboratory assessments on demographics and dietary habits.

Using data on eligible patients from the NHANES database, the researchers evaluated the relationship between dietary fiber intake and osteoarthritis risk with univariate and multivariate weighted regression models, along with restricted cubic spline (RCS) curves.

The final analysis included 32,484 eligible participants, aged between 20 and 85. Of these participants, 1864 self-reported having osteoarthritis, while 30,620 reported normal joint function. Therefore, the prevalence of osteoarthritis was 5.74% among this population.

Both univariate and multivariate weighted logistic regression models indicated a negative association between dietary fiber and lower osteoarthritis risk. To refine their analysis, the researchers categorized dietary fiber intake into quartiles. After adjusting for all possible covariates, patients in the highest quartile of dietary fiber (Q4) had a 27% lower risk of developing osteoarthritis than those in the lowest quartile (Q1) (OR, 0.73; 95% CI, 0.58-0.92; P = .007).

The researchers also examined the association between dietary fiber intake and osteoarthritis risk by gender. After multivariable adjustment, they found that higher dietary fiber intake among females was significantly associated with a lower risk of osteoarthritis (OR, 0.60; 95% CI, 0.41-0.88; P = .009).

Additionally, dose-response curve analyses using RCS demonstrated a nonlinear relationship between dietary fiber intake and osteoarthritis risk. The risk decreased with increasing dietary fiber intake within a certain range (P = .013). More specifically, a daily dietary fiber intake between 14.4 and 26.7 g reduced the risk of osteoarthritis, while an intake above this range did not provide significant protection.

Lastly, the researchers acknowledged their study’s limitations, including its retrospective design, which prevented the establishment of a causal relationship between dietary fiber intake and osteoarthritis risk. Also, since the analysis was limited to the US population, the findings may not be generalizable to other groups. Despite these limitations, the researchers expressed confidence in their study.

“This provides ideas for clinicians in the treatment of OA [osteoarthritis], as well as prevention for patients with joint pain and OA,” the authors wrote. “More studies between dietary fiber and OA should be added in the future, which will also reduce the NHS burden of OA.”

References

1. Lv X, Deng X, Lai R, et al. The association between dietary fiber intake and osteoarthritis: a cross-sectional study from the 1999-2018 U.S. National Health and Nutrition Examination Survey. J Orthop Surg Res. 2025;20(1):209. doi:10.1186/s13018-025-05625-2
2. Sánchez-Rosales AI, Guadarrama-López AL, Gaona-Valle LS, Martínez-Carrillo BE, Valdés-Ramos R. The effect of dietary patterns on inflammatory biomarkers in adults with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials. Nutrients. 2022;14(21):4577. doi:10.3390/nu14214577
3. Dai Z, Lu N, Niu J, Felson DT, Zhang Y. Dietary fiber intake in relation to knee pain trajectory. Arthritis Care Res (Hoboken). 2017;69(9):1331-1339. doi:10.1002/acr.23158