Title:

The Association Between Whole Grain Intake and Osteoarthritis Odds in Women Over the Age of 65 Using Data from NHANES 2017 to Pandemic 2020

Objective Osteoarthritis (OA) is the most common form of arthritis in the US, predominantly impacting older women. While dietary approaches to reduce inflammation have been investigated, limited research exists on whole grain intake. Their anti-inflammatory components such as fiber, vitamins, and phytochemicals, may be beneficial in preventing the chronic inflammation associated with osteoarthritis. The goal of this study is to examine the association between whole grain consumption and osteoarthritis in women over the age of 65. Methods Cross-sectional NHANES 2017 to March 2020 pre-pandemic data were used to evaluate OA prevalence and whole grain intake in women ≥65 years. Participants were excluded if they were male, <65 years, had rheumatoid or psoriatic arthritis, or were missing dietary data. The final dataset included 640 participants. Whole grain intake (oz/eq) was measured as a continuous variable collected from the NHANES 24-hour recalls. OA was measured as a binary categorical variable via the participants response to the osteoarthritis question in NHANES. The variables were analyzed using Logistic Regression. Results were reported using odds ratios (ORs) with 95% confidence intervals (CIs). Statistical significance was recognized as p < 0.05. Results In the unadjusted model, higher whole grain intake was not significantly associated with OA (OR = 0.838, 95% CI: [0.562, 1.252], p = 0.388). When adjusting for demographic factors and lifestyle factors, the association remained nonsignificant, but showed a reversed direction with an OR > 1 (OR = 1.708, 95% CI: [0.540, 5.395], p = 0.362). In the model that adjusted for dietary covariates, the results were nonsignificant (OR = 0.887, 95% CI: [0.586, 1.341], p = 0.569). In the fully adjusted model, whole grain intake was positively associated with OA risk (OR = 4.428, 95% CI: [1.003, 19.552], p = 0.050), suggesting a potentially significant association. Nevertheless, the wide confidence interval indicates a high degree of variability, and the borderline significance suggests that this result should be interpreted with caution. Conclusions Overall, the findings from this study do not provide strong evidence that whole grain intake is significantly associated with OA risk in women over the age of 65. A limitation of this study is its cross-sectional design, so a causal relationship cannot be established. Further research is needed to explore potential confounding factors, and underlying mechanisms at play that may influence the association between whole grain intake and osteoarthritis.

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