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While the first thought that might come to mind when you think of the Mediterranean may be the fantastic views of the Adriatic or Aegean from the shores of Italy or Greece, certainly a close second thought would be the great food. On the surface, a Mediterranean diet may seem almost indulgent—as people in this part of the world know how to eat—but many researchers swear by its health benefits. Now, a new study confirms a strong link between the Mediterranean diet and arthritis: specifically, a Mediterranean diet lowers knee osteoarthritis (OA) risk.

Knee Osteoarthritis and What Causes It

Osteoarthritis of the knee occurs when there is too much wear and tear on or loss of the cartilage, the cushioning part of the joint. Literally translated, osteoarthritis means “inflammation of the bone and joint,” and while, traditionally, it is the condition of the joint cartilage commonly attributed to this inflammation, we now believe that what happens to the bone is often the forerunner of what happens to the cartilage. The risk of OA is increased in those who are overweight, in those who have had injuries (for example in sports), in women, and with aging.

Those who suffer from OA know the telltale signs, which include stiffness and tenderness in the joint, pain, and maybe even some clicking or grinding. When the pain gets to be too much, many patients resort to the chronic use of dangerous nonsteroidal anti-inflammatory drugs (NSAIDs), which may be causing more damage; high-dose steroid injections; and even knee replacements that are risky and often unnecessary.

Could something as simple as our diet lower our knee OA risk or at least provide some relief?

What Exactly Is a Mediterranean Diet?

The Mediterranean diet is a specific eating plan consisting of plant-based carbohydrates like vegetables and some fruits, whole grains, fish and poultry (very little red meat), nuts, healthy herbs and spices, and wine. The key seems to be the right balance and combinations of foods. Hydrogenated oils, added sugars, margarine, refined grains, butter, processed meats, and high-fat foods should be avoided in the Mediterranean diet. So red meat, processed food and sugar are off the table. Also, gone are pizza, pasta, and that huge hunk of Italian bread!

So while a Mediterranean diet might not strictly fit the low-carb mindset, it’s easy to see how the low- glycemic values of the foods, anti-oxidant and most importantly anti-inflammatory properties from many of the vegetables, fruits, fatty fish and Olive Oil, and the Resveratrol in red wine, could be helpful. Of course, if you have blood sugar issues, eliminating the grains may or may not be necessary.

Now, let’s look at the study.

The Study on the Mediterranean Diet and Arthritis

The study, published in Clinical Nutrition last month, consisted of 4,358 subjects who had been diagnosed with knee arthritis. Researchers used a tool called a Mediterranean diet score (aMED) to determine how well the subjects stuck to the Mediterranean diet. Then they evaluated the results. The study concluded, “Higher adherence to a Mediterranean diet is associated with lower prevalence of knee OA.”

Arthritis is an inflammatory disease of the cartilage, the cushioning part, of a joint. I mentioned above that hydrogenated oils, margarine, added sugars, and processed foods are not part of a Mediterranean diet, all things which, in some form or fashion, cause or contribute to chronic inflammation. So it’s clear to see why perhaps a Mediterranean diet could lower the prevalence of knee arthritis, which is a result of inflammation in the knee joint.

The upshot? As research continues to show us time and time again, our diets, what we consume as fuel for our bodies, can help or hurt us. While this study is not a traditional trial where one group eats diet x and another diet y, the findings are certainly interesting. So if you want to try a diet to help your aching joints, why not give this one a whirl?

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications. View Profile