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Posted on 11-27-2013

NUTRITION AND EXERCISE "FIRST LINE" IN FIGHTING ARTHRITIS

Good morning!

With cold weather upon us many patients are asking how they can tame their arthritic pain.  This article from the December 2012 issue of Arthritis is comprehensive and has 106 references.

KEY POINTS FROM THIS ARTICLE:

1)  Low-grade inflammation and oxidative stress underlie chronic osteoarthritis.

2)  The best management for osteoarthritis should include:

Weight control

Exercise

Change in lifestyle to address chronic low-grade inflammation

3)  The Western diet and inactivity are pro-inflammatory.

4)  A plant-based diet and activity are anti-inflammatory.

5)  “Healthy living can be exploited to reduce inflammation, oxidative stress, and related pain and disability and improve patients’ overall health.”

6) Over the past 60 years, lifestyle-related conditions are the leading causes of premature death.

7) “Western diets coupled with inactivity have contributed largely to lifestyle- related conditions which are increasingly prevalent in middle- and low-income countries.”

8) Food guidelines in the United States have “legitimized poor nutrition for several decades further contributing to the pandemic of lifestyle-related conditions.”

9) “The Mediterranean diet known to be health protective is largely plant based, favors olive oil over animal fats, and is high in fiber, vegetables, and fruits.”

10) Both high carbohydrate and high fat consumption contribute to inflammatory and oxidative stress even in healthy people.

11) “Inactivity is pro-inflammatory and augments oxidative stress, whereas activity when not excessive is anti-inflammatory.”

12) Inactivity weakens muscles and contributes to joint stress, and reduces stimulation of synovial fluid which cushions the joints and protects the joint spaces.

13) The anti-inflammatory effects of exercise are well established, and for their maximal anti-inflammatory benefit, both resistance and aerobic training are required.

14) Other lifestyle traits common in western culture are also pro-inflammatory, including smoking, chronic sleep deprivation, and stress.

15)  Obesity is an independent risk factor for osteoarthritis.

16)  Physical activity increases the expression of systemic and cellular anti- inflammatory mediators.

17) “Physiologic cyclic loading of cartilage tissue reduces the expression of pro- inflammatory mediators and decreases cytokine-induced extracellular matrix degradation.”

18) Chronic low-grade inflammation and oxidative stress are linked to:

Osteoarthritis
Atherosclerosis
Chronic cancer 

Chronic obstructive lung disease Diabetes

Hypertension
Insulin resistance

Metabolic syndrome Ischemic heart Disease
Obesity

Stroke

19)  About 20% of American adults report having physician-diagnosed arthritis.

20)  “Overweight is now considered a leading condition associated with marked inflammation followed by arthritis, heart disease, and type 2 diabetes mellitus.”

21) The benefits of healthy living are well documented in a 2009 study that followed more than 23,000 people between 35 and 65 years old, for more than 8 years. Those who did not smoke, were not overweight, were physically active for at least 3.5 hours weekly, and ate healthily reduced their risk of:

Type 2 diabetes mellitus by 93%

Myocardial infarction by 81%

Stroke by 50%

Cancer by 36%
[E. S. Ford, M. M. Bergmann, J. Kroger, A. Schienkiewitz, C. Weikert, and H. Boeing, “Healthy living is the best revenge: findings from the European prospective investigation into cancer and nutrition-potsdam study,” Archives of Internal Medicine, vol. 169, no. 15, pp. 1355–1362, 2009]

22) Chronic systemic low-grade inflammation is a common denominator in osteoarthritis.

23) Anti-inflammatory lifestyle behavior changes should be “first-line” intervention in the management of chronic osteoarthritis.

24) Inflammatory foods include:

Alcohol

Omega-6 cooking oils

“A diet of high imbalance of omega-6 to omega-3 ratio promotes

inflammation (e.g., heart disease and cancer)”

Dairy products

Commercially produced meats where animals are fed grains

Processed meats

Refined grains devoid of fiber and vitamin B

Artificial food additives

Aspartame and monosodium glutamate

Sugars

Trans fats

25) Anti-inflammatory foods and habits include:

Avoidance of sweets and sugar

Avoidance of processed foods such as white bread, rice, and pasta

Extra Virgin olive oil

No alcohol

Asparagus, avocado, beets, Brussel sprouts, broccoli, cauliflower, kale, parsnip, spinach, Romaine lettuce, berries, apples, oranges, pears, lemons, cantaloupe, green tea, low-fat turkey/chicken, eggs, salmon.

Key things to remember as we head into the Thanksgiving weekend!  Happy Thanksgiving everyone and God bless!  

 

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