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1. Higher added sugar intake was associated with a greater risk of osteoarthritis, particularly in females, those with low body mass index, never smoked, never consumed alcohol, had no history of hypertension, or had no history of diabetes.

Evidence Rating Level: 3 (Average)

There is emerging evidence that diet contributes to the development of osteoarthritis (OA). Although excessive consumption of added sugars has been linked to increased susceptibility to various chronic illnesses, its relationship with OA remains unclear. This study thus examined the association between consumption of added sugars and OA. This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. The primary outcome was self-reported OA. The primary exposure was added sugars, which included brown sugar, cane syrup, corn syrup, corn syrup solids, dextrose, fructose, fruit syrup, honey, maple syrup, molasses, pancake syrup, raw sugar, sorghum syrup, and white sugar. Added sugar intake was estimated using 24-hour dietary recall. Participants were separated into quartile groups based on their added sugar intake (kcal): Q1 [0.000, 7.444], Q2 [7.444, 13.942], Q3 [13.942, 24.016], and Q4 [24.016, 263.793]. In total, 2,746 participants were included in the study, with 2,152 in the OA group and 594 in the non-OA group, and were weighted to represent 11,854,966 participants (mean age [SD] = 43.77 [0.27] years, mean BMI [SD] = 28.15 [0.09] kg/m2, 47.67% female, 11.08% with OA). Added sugar intake was associated with increased OA risk (OR = 1.01; 95% CI 1.00 to 1.01) even after adjusting for covariates. Additionally, the group with the highest added sugar intake (Q4) had the greatest OA risk compared to those with low added sugar intake (OR = 1.40; 95% CI 1.09 to 1.81). In the subgroup analyses, greater OA risk was observed for participants who never consumed alcohol (OR = 1.02; 95% CI 1.01 to 1.04) and those with no history of diabetes (OR = 1.02; 95% CI 1.01 to 1.04). In the group with the highest added sugar intake (Q4), participants had a greater risk of OA compared to those with low added sugar intake if they were female (OR = 1.44; 95% CI 1.02 to 2.02), had low BMI (OR = 1.88; 95% CI 1.06 to 3.33), never smoked (OR = 1.55; 95% CI 1.05 to 2.30), never consumed alcohol (OR = 3.31; 95% CI 1.42 to 7.74), had no history of hypertension (OR = 1.51; 95% CI 1.00 to 2.27), or had no history of diabetes (OR = 1.44; 95% CI 1.11 to 1.87). Overall, this study found that added sugar intake was associated with an increased risk of OA. Future longitudinal studies are warranted to examine temporal associations. 

Click to read the study in PLOSONE

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