Food sources of dietary fibre and risk of total knee replacement related to severe osteoarthritis, the Singapore Chinese Health Study

Leung YY, Jin A, Tan KB, Ang LW, Yuan JM, Koh WP · RMD Open

The largest and hardest-endpoint fibre study, and it is null on the headline exposure: total fibre intake was **not** associated with total knee replacement for severe OA after adjustment, across 2,816 incident operations. Among food sources only legumes showed a dose-dependent association (highest vs lowest quartile HR 0.86, 95% CI 0.76-0.96, p trend 0.004), consistent after adding BMI and homogeneous across BMI categories. Grain products, nuts and seeds, soy food, fruits and vegetables: nothing.

Population

63,257 Singapore Chinese Health Study participants aged 45-74 at recruitment (1993-1998), linked to the national hospital discharge database through 2017

Intervention

Higher dietary fibre intake, and fibre by food source

Comparator

Lowest quartile

Limitations

Total knee replacement captures severe disease that reaches surgery, which is a different endpoint from symptomatic OA and is shaped by healthcare access. A single baseline questionnaire in 1993-1998 against operations through 2017. The legume finding is one food source among six examined.