Should Patients With Osteoarthritis Avoid Dairy?

January 11, 2019

Is dairy linked to inflammation? Here’s what the literature says.

Dairy is widely reported as a potential contributor to inflammation, but scientific data support a positive role. Scroll through the slides for a look at the evidence.

Cow’s milk in particular has been an accepted part of the Western diet, known to deliver prebiotics and probiotics that modulate the gut microflora central to immune and inflammatory processes. The substantial rise in chronic inflammatory conditions has led to consideration of the potential contributions of high dairy consumption to this growing problem. Dairy products are often characterized in the lay press as inflammatory foods, because of potential histamine reactions to lactose, fermentation processes, and the vast quantities of antibiotics given to milk cows.

At the same time, scientific studies have often reported the benefits of dairy consumption. A 2017 review of 52 clinical trials found a significant overall trend toward anti-inflammatory activity associated with the consumption of dairy products.¹

The Maastricht Study assessed the impact of consumption of more than 50 dairy products on the risk of osteoarthritis (OA) of the knee. This study of 3010 participants from the Netherlands demonstrated that higher intake of full-fat dairy and Dutch cheese, but not milk was associated with a lower risk of osteoarthritis of the knee.²

The Melbourne Collaborative Cohort Study (2001-2013) showed that men with osteoarthritis (OA) who consumed high quantities of dairy products were at greater risk for total hip arthroplasty than men who consumed lower quantities.³ The study included a total of 38,924 participants; 1505 total hip arthroplasties were reported (524 in men, 981 in women).

While high dairy consumption was associated with a greater risk in men, there seemed to be little or no impact on the risk of hip arthroplasty in women with OA.

Some studies have indicated differences in inflammatory responses to milk compared with other types of dairy products.

Studies across different countries are limited by variations in the types of dairy consumed in each nation.^1-4

References

1. Bordoni A, Danesi F, Dardevet D. Dairy products and inflammation: a review of the clinical evidence. Crit Rev Food Sci Nutr. 2017;57:2497-2525.

2. Deissen KFM, Boonen A, Neilen TH, et al. Consumption of dairy products in relation to the presence of clinical knee osteoarthritis: The Maastricht Study. Eur J Nutr. 2018 Sep 21. doi: 10.1007/s00394-018-1818-7. [Epub ahead of print]

3. Hussain SM, Cicuttini FM, Giles GG, et al. Association between dairy product consumption and incidence of total hip arthroplasty for osteoarthritis. J Rheumatol. 2017;44:1066-1070.

4. Kacar C, Gilgil E, Tuncer T, et al. The association of milk consumption with the occurrence of symptomatic knee osteoarthritis. Clin Exp Rheumatol. 2004;22:473-476.

5. Lu B, Driban JB, Duryea J, et al. Milk consumption and progression of medial tibiofemoral knee osteoarthritis: data from the Osteoarthritis Initiative. Arthritis Care Res. 2014;66:802-809.