Study on the Association Between Dietary Intake, KOOS Scores, Stress Scores and Sleep Quality in Individuals Diagnosed with Knee Osteoarthritis Aged 40-65 Years

Background: Knee osteoarthritis (KOA) is a chronic, degenerative joint disorder that leads to reduced mobility and quality of life among adults, particularly with advancing age. While aging and obesity are recognized risk factors, recent evidence highlights the contribution of lifestyle and psychosocial factors such as dietary intake, stress, and sleep quality. The present study aimed to assess the association between nutritional status, dietary intake, perceived stress, sleep quality, and KOOS scores in adults aged 40–65 years diagnosed with KOA. Methods: A cross-sectional study was conducted among 100 individuals with KOA recruited through purposive sampling from physiotherapy and orthopaedic clinics. Data collection involved anthropometric assessments (self-reported Weight, Height, Waist Circumference, BMI), a 24-hour dietary recall, a food frequency questionnaire (FFQ), and a validated tools such as the Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI), and Knee Injury and Osteoarthritis Outcome Score (KOOS) were administered along with dietary assessment tools. Statistical analysis included descriptive and correlational methods using SPSS Version 21. Results: The majority of participants were females (62%) and were overweight or obese (mean BMI: 27.4 ± 3.8 kg/m²). Protein intake was below RDA in 72% of participants, with 68% and 74% showing inadequate calcium and vitamin D intake, respectively. While no significant associations were found between macronutrient intake and KOOS scores (p > 0.05), stress and sleep quality showed significant relationships (p < 0.05). Participants with high perceived stress had lower KOOS Pain (47.6 ± 10.4) and QoL scores (42.1 ± 9.8) than those with low stress (Pain: 62.1 ± 9.5; QoL: 51.3 ± 8.7). Poor sleep quality (reported by 63%) was significantly associated with lower KOOS ADL scores (44.8 ± 11.7 vs. 58.9 ± 10.1, p = 0.002). Conclusion: The study shows that stress and poor sleep quality are strongly linked to lower KOOS scores in pain, ADL, and QoL domains. While dietary gaps were common, they had no direct impact. These findings underscore the importance of addressing psychosocial factors alongside nutritional care in KOA management through a holistic, lifestyle-based approach Key words: Knee Osteoarthritis, Dietary Intake, KOOS Scores, Stress Levels, Sleep Quality, Knee Pain, Symptoms, Quality of Life