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Dietary fatty acid intake affects the risk of developing bone marrow lesions in healthy middle-aged adults without clinical knee osteoarthritis: a prospective cohort study

Yuanyuan Wang1, Miranda L Davies-Tuck1, Anita E Wluka12, Andrew Forbes1, Dallas R English34, Graham G Giles4, Richard O'Sullivan5 and Flavia M Cicuttini1*

Author Affiliations

1 Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Alfred Hospital, Commercial Road, Melbourne, VIC 3004, Australia

2 Baker Heart and Diabetes Research Institute, Commercial Road, Melbourne, VIC 3004, Australia

3 Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, School of Population Health, University of Melbourne, Swanston Street, Carlton, VIC 3053, Australia

4 Cancer Epidemiology Centre, The Cancer Council Victoria, Rathdowne Street, Carlton, VIC 3053, Australia

5 MRI Unit, Symbion Imaging, Epworth Hospital, Bridge Road, Richmond, VIC 3121, Australia

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Arthritis Research & Therapy 2009, 11:R63  doi:10.1186/ar2688

Published: 8 May 2009



Fatty acids have been implicated in osteoarthritis (OA), yet the mechanism by which fatty acids affect knee structure and consequently the risk of knee OA has not been fully elucidated. Higher intakes of fatty acids have been shown to be associated with the risk of bone marrow lesions (BMLs) in a healthy population. The aim of this study was to examine the association between fatty acid consumption and the incidence of BMLs in healthy middle-aged adults without clinical knee OA.


Two hundred ninety-seven middle-aged adults without clinical knee OA underwent magnetic resonance imaging (MRI) of their dominant knee at baseline. BMLs were assessed. Of the 251 participants with no BMLs in their knee at baseline, 230 underwent MRI of the same knee approximately 2 years later. Intakes of fatty acids were estimated from a food frequency questionnaire.


Increased consumption of saturated fatty acids was associated with an increased incidence of BMLs over 2 years after adjusting for energy intake, age, gender, and body mass index (odds ratio of 2.56 for each standard deviation increase in dietary intake, 95% confidence interval 1.03 to 6.37, P = 0.04). Intake of monounsaturated or polyunsaturated fatty acids was not significantly associated with the incidence of BMLs.


Increased fatty acid consumption may increase the risk of developing BMLs. As subchondral bone is important in maintaining joint integrity and the development of OA, this study suggests that dietary modification of fatty acid intake may be one strategy in the prevention of knee OA which warrants further investigation.