Ultra-processed Foods and Muscle Fat Infiltration at Thigh MRI: Data from the Osteoarthritis Initiative

Akkaya Z, Joseph GB, Ziegeler K, Sims WM, Lynch JA, Kreutzinger V, McCulloch CE, Lane NE, Nevitt MC, Link TM · Radiology

Offers a route that is not cartilage. Greater ultra-processed intake was associated with more fatty infiltration of thigh muscle on T1 MRI, graded by Goutallier score: all thigh muscles β = 0.108 (95% CI 0.029-0.186, p = 0.007), flexors β = 0.111 (p = 0.008), adductors β = 0.122 (p = 0.004) after BMI adjustment — and the associations were stronger when abdominal circumference replaced BMI (all muscles β = 0.134, p = 0.001). No sex interaction. Muscle quality is the thing that unloads a knee, which makes this a plausible mechanism for the symptom findings.

Population

615 Osteoarthritis Initiative participants at risk for knee OA but with Kellgren-Lawrence grade ≤ 1 and no knee or hip pain; mean age 59.5, mean BMI 27

Intervention

Higher proportion of NOVA-4 ultra-processed food in the diet (mean 41.4% of intake)

Comparator

Lower proportion

Limitations

Cross-sectional, 615 people, all free of radiographic OA and pain, so this is a risk-factor association rather than a disease one. Goutallier grading is ordinal and reader-dependent. That the association strengthens with abdominal circumference in place of BMI suggests body-fat distribution is doing part of the work.