Dietary Fiber Intake in Relation to Knee Pain Trajectory

Zhaoli Dai, Na Lu, Jingbo Niu, David T. Felson, Yuqing Zhang

Research output: Contribution to journalArticlepeer-review

40 Citations (Scopus)


Objective: Dietary fiber may reduce knee pain, in part by lowering body weight and reducing inflammation. In this study, we assessed whether fiber intake was associated with patterns of knee pain development. Methods: In a prospective, multicenter cohort of 4,796 men and women ages 45–79 years with or at risk of knee osteoarthritis, participants underwent annual followups for 8 years. Dietary fiber intake was estimated using a validated food frequency questionnaire at baseline. Group-based trajectory modeling was used to identify Western Ontario and McMaster Universities Osteoarthritis Index pain trajectories, which were assessed for associations with dietary fiber intake using polytomous regression models. Results: Of the eligible participants (4,470 persons and 8,940 knees, mean ± SD age 61.3 ± 9.1 years, 58% women), 4.9% underwent knee replacement and were censored at the time of surgery. Four distinct knee pain patterns were identified: no pain (34.5%), mild pain (38.1%), moderate pain (21.2%), and severe pain (6.2%). Dietary total fiber was inversely related to membership in the moderate or severe pain groups (P ≤ 0.006 for trend for both). Subjects in the highest versus those in the lowest quartile of total fiber intake had a lower risk of belonging to the moderate pain pattern group (odds ratio [OR] 0.76 [95% confidence interval (95% CI) 0.61–0.93]) and severe pain pattern group (OR 0.56 [95% CI 0.41–0.78]). Similar results were found with grain fiber and these 2 pain pattern groups. Conclusion: Our findings suggest that a high intake of dietary total or grain fiber, particularly the recommended daily fiber average intake of 25 gm per day, is associated with a lower risk of developing moderate or severe knee pain over time.

Original languageEnglish
Pages (from-to)1331-1339
Number of pages9
JournalArthritis Care and Research
Issue number9
Publication statusPublished - Sept 2017
Externally publishedYes


  • Knee pain
  • Weight loss
  • Dietary fiber
  • Osteoarthritis


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