Knee osteoarthritis and nutrition: analysis of body composition, diet and bowel habits and sociodemographic characteristics
DOI:
https://doi.org/10.11606/issn.2317-0190.v33e241447Keywords:
Osteoarthritis, Knee, Body Composition, Diet, Healthy, Sociodemographic FactorsAbstract
Objective: To evaluate the nutritional status profile, including body composition, bowel habits, and dietary intake, of patients with knee osteoarthritis. Method: A cross-sectional study was conducted, involving 71 patients with primary knee osteoarthritis (KOA). The following parameters were assessed: nutritional status using body mass index (BMI), dietary intake using the adapted Healthy Eating Index ( IASad), body composition via bioelectrical impedance analysis (BIA), and bowel habits using the Bristol Stool Form Scale (BSFS). Results: Participants had a mean age of 68.30 years, with most having completed high school or higher education (45.07% and 30.80%, respectively), and were predominantly female ($76.1\%$). Nutritional status classification indicated obesity (mean BMI of 32.51kg/m²) with a high percentage of body fat (42.67%) and poor dietary quality (mean score of 70.02). On the Bristol Stool Scale, the majority of patients reported Type 3 or Type 4. When distributed by gender, women had a higher percentage of body fat than men, although their diet quality was superior. Conclusion: The evaluated patients presented with obesity and a high percentage of body fat in both genders, although the majority did not show indications of reduced lean body mass. Despite adequate bowel habits, dietary intake was considered of poor quality.
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References
1. Hunter DJ, Bierma-Zeinstra S. Osteoarthritis. Lancet. 2019;393(10182):1745-1759. Doi: 10.1016/S0140-6736(19)30417-9
2. Anil U, Markus DH, Hurley ET, Manjunath AK, Alaia MJ, Campbell KA, et al. The efficacy of intra-articular injections in the treatment of knee osteoarthritis: A network meta-analysis of randomized controlled trials. Knee. 2021;32:173-182. Doi: 10.1016/j.knee.2021.08.008
3. Campos RMP, Ribeiro MVMB, Barbosa IM, Lessa JMS, Thorp MGB, Camelo LS, et al. Perfil epidemiológico das internações por Osteoartrose no Brasil: análise de 2013 a 2023. Braz J Hea Rev. 2024;7(9):e74865. Doi: 10.34119/bjhrv7n9-185
4. Imamura M, Shinzato GT, Sugawara AT, Uchiyama SST, Matheus D, Simis M, et al. The Institute of Physical Medicine and Rehabilitation, Hospital das Clínicas University of São Paulo School of Medicine comprehensive rehabilitation program for elderly people with knee osteoarthritis. Front Med (Lausanne). 2022;9:1029140. Doi: 10.3389/fmed.2022.1029140
5. Godziuk K, Hawker GA. Obesity and body mass index: Past and future considerations in osteoarthritis research. Osteoarthritis Cartilage. 2024;32(4):452-459. Doi: 10.1016/j.joca.2024.02.003
6. Jarecki J, Potoczniak B, Dziedzic A, Małecka-Masalska T, Skrzypek T, Kazimierczak W, et al. Impact of the Body Composition on Knee Osteoarthritis Assessed Using Bioimpedance Analysis. J Clin Med. 2023;12(22):7037. Doi: 10.3390/jcm12227037
7. Bennell KL, Lawford BJ, Keating C, Brown C, Kasza J, Mackenzie D, et al. Comparing Video-Based, Telehealth-Delivered Exercise and Weight Loss Programs With Online Education on Outcomes of Knee Osteoarthritis : A Randomized Trial. Ann Intern Med. 2022;175(2):198-209. Doi: 10.7326/M21-2388
8. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957;16(4):494-502. Doi: 10.1136/ard.16.4.494
9. Philippi ST. Pirâmide dos alimentos: fundamentos básicos da nutrição. 4ª ed. Barueri: Manole; 2014.
10. Martinez AP, Azevedo GR. The Bristol Stool Form Scale: its translation to Portuguese, cultural adaptation and validation. Rev Lat Am Enfermagem. 2012;20(3):583-9. Doi: 10.1590/s0104-1169201200030002111. Ayres DVM, Uchiyama SST, Prates AO, Lopes RAF, Silva ABS, Tsukimoto DR, et al. The Knee-SCHOOL: a brief patient-centered multidisciplinary educational program for knee osteoarthritis. Front Med (Lausanne). 2025;11:1497774. Doi: 10.3389/fmed.2024.1497774
12. Organização Panamericana de la Salud. Encuesta multicêntrica saúde, bem-estar e envejecimiento (SABE) na América Latina: relatório preliminar. Washington, DC: Organização Panamericana de la Salud (2001).
13. Boileau RA. Advances in body composition assessment. Cad Saúde Pública. 1993;9:S116–7. Doi: 10.1590/S0102-311X1993000500016
14. Gould H, Brennan SL, Kotowicz MA, Nicholson GC, Pasco JA. Total and appendicular lean mass reference ranges for Australian men and women: the Geelong osteoporosis study. Calcif Tissue Int. 2014;94(4):363-72. Doi: 10.1007/s00223-013-9830-7
15. Mota JF, Rinaldi AEM, Pereira AF, Maestá N, Scarpin MM, Burini RC. Adaptação do índice de alimentação saudável ao guia alimentar da população brasileira. Rev Nutr. 2008;21(5):545–52. Doi: 10.1590/S1415-52732008000500007
16. Hong JW, Noh JH, Kim DJ. The prevalence of and demographic factors associated with radiographic knee osteoarthritis in Korean adults aged ≥ 50 years: The 2010-2013 Korea National Health and Nutrition Examination Survey. PLoS One. 2020;15(3):e0230613. Doi: 10.1371/journal.pone.0230613
17. van Bussel LM, van Rossum CT, Temme EH, Boon PE, Ocké MC. Educational differences in healthy, environmentally sustainable and safe food consumption among adults in the Netherlands. Public Health Nutr. 2020;23(12):2057-2067. Doi: 10.1017/S1368980019005214
18. Lacerda GJM, Fregni F, Battistella LR, Imamura M. High Body Mass Index Disrupts the Homeostatic Relationship Between Pain Inhibitory Control and the Symptomatology in Patients with Knee Osteoarthritis-A Cross-Sectional Analysis from the DEFINE Study. NeuroSci. 2025;6(1):14. Doi: 10.3390/neurosci6010014
19. Dolatkhah N, Toopchizadeh V, Barmaki S, Salekzamani Y, Najjari A, Farshbaf-Khalili A, et al. The effect of an anti-in- flammatory in comparison with a low caloric diet on physi- cal and mental health in overweight and obese women with knee osteoarthritis: a randomized clinical trial. Eur J Nutr. 2023;62(2):659-672. Doi: 10.1007/s00394-022-03017-4
20. Tong B, Chen H, Wang M, Liu P, Wang C, Zeng W, et al. Association of body composition and physical activity with pain and function in knee osteoarthritis patients: a cross-sectional study. BMJ Open. 2024;14(1):e076043. Doi: 10.1136/bmjopen-2023-076043
21. Samma L, Rasjad C, Prihantono, Seweng A, Haryasena, Latief J, et al. Correlation between Body Mass Index (BMI), Visual Analogue Scale (VAS) score and knee osteoarthritis grading. Med Clin Pract. 2021;4:100228. Doi: 10.1016/j.mcpsp.2021.100228
22. Misra D, Fielding RA, Felson DT, Niu J, Brown C, Nevitt M, et al. Risk of Knee Osteoarthritis With Obesity, Sarcopenic Obesity, and Sarcopenia. Arthritis Rheumatol. 2019;71(2):232-237. Doi: 10.1002/art.40692
23. Liu B, Du Y, Wu Y, Snetselaar LG, Wallace RB, Bao W. Trends in obesity and adiposity measures by race or ethnicity among adults in the United States 2011-18: population based study. BMJ. 2021;372:n365. Doi: 10.1136/bmj.n365
24. Rat AC, Sellam J, Mazières B, Ngueyon Sime W, Fardellone P, Guillemin F. Body composition is associated with changes in health-related quality of life in patients with knee and/or hip osteoarthritis. RMD Open. 2025;11(1):e004733. Doi: 10.1136/rmdopen-2024-004733
25. Basat S, Sivritepe R, Ortaboz D, Sevim E, Atay S, Baygul A. The relationship between osteoarthritis and sarcopenia in geriatric diabetic patients. Sisli Etfal Hastan Tip Bul. 2021;55(4):516-523. Doi: 10.14744/SEMB.2021.42890
26. Lima RJ, Maia SN, Alves Junior TA, Cruz FNI, Pereira ES. Estudo comparativo entre dois protocolos de avaliação da composição corporal: quantidade relativa de massa adiposa e muscular. RBNE. 2024;17(107):693-8.
27. Lawford BJ, Hinman RS, McManus F, Lamb KE, Egerton T, Keating C, et al. How does exercise, with and without diet, improve pain and function in knee osteoarthritis? a secondary analysis of a randomized controlled trial exploring potential mediators of effects. Arthritis Care Res (Hoboken). 2023;75(11):2316-2327. Doi: 10.1002/acr.25140
28. Sadeghi A, Zarrinjooiee G, Mousavi SN, Abdollahi Sabet S, Jalili N. Effects of a Mediterranean Diet Compared with the Low-Fat Diet on Patients with Knee Osteoarthritis: A Randomized Feeding Trial. Int J Clin Pract. 2022;2022:7275192. Doi: 10.1155/2022/7275192
29. Xu C, Marchand NE, Driban JB, McAlindon T, Eaton CB, Lu B. Dietary Patterns and Progression of Knee Osteoarthritis: Data from the Osteoarthritis Initiative. Am J Clin Nutr. 2020;111(3):667-676. Doi: 10.1093/ajcn/nqz333
30. Asnicar F, Berry SE, Valdes AM, Nguyen LH, Piccinno G, Drew DA, et al. Microbiome connections with host metabolism and habitual diet from 1,098 deeply phenotyped individuals. Nat Med. 2021;27(2):321-332. Doi: 10.1038/s41591-020-01183-8
31. Ogasawara N, Kasugai K, Funaki Y, Ebi M, Izawa S, Tamura Y, et al. Relationships between body mass index and constipation, gastroesophageal reflux disease, stool forms based on the Bristol Stool Form Scale, and education level: results from an internet survey in Japan. J Clin Biochem Nutr. 2023;73(1):84-90. Doi: 10.3164/jcbn.22-143
32. Brasil. Ministério da Saúde. Diretriz brasileira para o tratamento não cirúrgico da osteoartrite de joelho. Brasília (DF): Ministério da Saúde; 2018.
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