Research shows that added sugar not natural sugars in fruits can promote chronic systemic inflammation, which is tied to worsening joint health and conditions like osteoarthritis. A 2024 PLOS ONE study using NHANES (USA national health data) found that adults with the highest amounts of added sugar intake had significantly higher prevalence of osteoarthritis — a major reason many people eventually need knee surgery.

In nutrition science, this pattern of harm from excessive sugar has been discussed historically, including in books like Pure, White and Deadly by John Yudkin, which examines how high sugar consumption contributes to inflammation and metabolic problems (Penguin Books, 2012). While the book itself doesn’t cover knee surgery directly, it provides a foundational view on how sugar can worsen chronic diseases linked to inflammation, an underlying driver in osteoarthritis progression. Study reference: Xiaolong Liao et al., Added sugars and risk of osteoarthritis in adults: A case-control study based on NHANES 2007–2018, PLOS ONE, 2024.

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