Dietary glycemic index/glycemic load and knee osteoarthritis: associations with inflammation and oxidative stress

Abstract

Aims: Although dietary glycemic index (GI) and glycemic load (GL) are known to affect inflammation and oxidative balance, their roles in OA are unclear. This study aims to investigate the relationship between dietary GI and GL with inflammation, oxidative stress, and clinical symptoms in patients with knee osteoarthritis (KOA). Patients and methods: In a cross-sectional study, 160 patients diagnosed with KOA were included. Dietary intake was assessed using a validated food frequency questionnaire, and daily GI and GL values were calculated. Clinical symptoms were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: Higher dietary GI and GL were significantly associated with increased serum levels of malondialdehyde (MDA), total oxidant status (TOS), tumor necrosis factor-alpha (TNF-α), and high-sensitivity C-reactive protein (hs-CRP), as well as with decreased total antioxidant capacity (TAC). Dietary GI and GL were positively correlated with the total WOMAC score, as well as with the WOMAC physical activity and stiffness. Conclusion: High dietary GI and GL may be associated with oxidative stress and inflammatory responses, and may worsen clinical symptoms in KOA patients. Nutritional strategies emphasizing low-GI/GL diets may contribute to better symptom control and disease management in KOA.