Association of dietary approaches to stop hypertension, genetic predisposition, and the risk of musculoskeletal disorders: a prospective cohort study.

OBJECTIVE

To investigate the associations of the Dietary Approaches to Stop Hypertension (DASH) diet with the incidence of overall and specific musculoskeletal (MSK) disorders, taking genetic predispositions into account.

METHODS

Study populations included 115,692 participants. DASH diet scores were calculated using the Oxford WebQ dietary questionnaire, and poly-genetic risk scores (PRS) were calculated summing weighted risk alleles. Cox regressions were performed to evaluate the associations between DASH diet, PRS, and incidence of MSK disorders. The primary outcome was overall disease defined as any of MSK disorders. The secondary outcomes were five major specific conditions, including osteoarthritis, rheumatoid arthritis, gout, low back pain, and neck pain.

RESULTS

During a median follow-up period of 11.64 years, 33,230 incident cases of overall MSK disorders were observed. Each 5-point increment in the DASH diet score was associated with a modest 2-4% reduced risk of overall MSK disorders, consistent across three models (Model 1: HR = 0.96, 95%CIs = 0.95-0.97; Model 2: HR = 0.98, 95%CIs = 0.97-0.99; Model 3: HR = 0.98, 95%CIs = 0.97-0.99) as well as different genetic risk groups (low: HR = 0.95, 95%CIs = 0.87-1.03; moderate: HR = 0.98, 95%CIs = 0.94-1.03; high: HR = 0.95, 95%CIs = 0.87-1.03). No gene-diet interaction was identified. When extending to the five specific MSK disorders, a similar pattern of results was observed, except for RA and gout.

CONCLUSIONS

Adherence to DASH diet is associated with a modestly reduced risk of overall MSK disorders in European populations. In disease-specific analyses, protective associations were observed for OA, low back pain, and neck pain, whereas associations with RA and gout were less consistent. The protective association is broadly consistent across most genetic risk strata, although a potential interaction was noted for RA.