Is diet related to osteoarthritis? A univariable and multivariable Mendelian randomization study that investigates 45 dietary habits and osteoarthritis

BACKGROUND: Diet is a safe intervention for many chronic diseases as a modifiable lifestyle. However, the potential causal effect of many dietary intake habits on the risk of osteoarthritis has not been fully understood. The purpose of this study was to reveal the potential causal relationship of 45 genetically predicted dietary intakes with osteoarthritis and its subtypes. METHODS: Data on 45 dietary intakes were obtained from the UK Biobank study of approximately 500,000 participants, and data on six osteoarthritis-related phenotypes were obtained from the Genetics of Osteoarthritis Consortium study of 826,690 participants. We performed univariable Mendelian randomization (MR), multivariable MR and linkage disequilibrium score regression (LDSC) analyses. RESULTS: In univariate analyses, 59 potential associations between diet and osteoarthritis were found. After false discovery rate (FDR) correction and sensitivity analyses, 23 reliable causal evidence were identified. In multivariate analyses, controlling separately for the effects of body mass index, total body bone mineral density, and smoking status, eight robust causal relationships remained: Muesli intake was negatively associated with knee osteoarthritis, spine osteoarthritis and total knee replacement. Dried fruit intake had a negative association with osteoarthritis of knee and total knee replacement. Eating cheese may reduce the risk of osteoarthritis in the knee and spine. And alcohol usually taken with meals was associated with a reduced risk of total knee replacement. LDSC analyses showed significant genetic correlations between all exposures and their corresponding outcomes, respectively, in these eight causal relationships. CONCLUSION: Evidence of dietary effects on osteoarthritis is provided in our study, which has important implications for the prevention, management, and intervention of osteoarthritis in common sites through rational dietary modification.