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Healthbeat Reducing the inflammation of osteoarthritis

Portsmouth Herald - 9/10/2017

According to the Centers for Disease Control, about one-third of people 65 years of age and older have osteoarthritis. There are several forms of arthritis, but of these, the most common is osteoarthritis. It may also be called "degenerative joint disease." With regard to quality of life, it is one of the leading causes of disability. Although the damage it causes is irreversible, there are lifestyle factors that can slow its progression and reduce symptoms.

Symptoms of osteoarthritis can include joint pain, swelling, stiffness, and reduced range of motion. Sufferers of osteoarthritis can notice these symptoms in any joint, but the most common are those of the knees, hips, fingers, base of the thumb, neck, and lower back. The arthritis occurs when the cartilage of these joints breaks down. This then results in an inflammatory response by the body, which can then lead to further tissue damage.

Besides contributing to the progression of tissue breakdown, inflammation can also be related to its development. This means that ongoing inflammation throughout the body can lead to and worsen the symptoms and damage of osteoarthritis.

Inflammation in the body can be caused by a number of factors. Obesity is one of the major triggers and sustainers of whole body inflammation. In addition, a higher body weight puts more pressure on the joints, which may already be compromised.

Obesity also increases the risk of type 2 diabetes and insulin resistance. It appears that these conditions can promote inflammation and therefore initiate and perpetuate the risk of osteoarthritis. Statistically, osteoarthritis is more common in persons with metabolic syndrome (elevated blood glucose, high blood pressure, low good cholesterol and greater abdominal fat).

Some dietary factors may also increase the risk of osteoarthritis. A diet higher in refined starches, added sugars, saturated and/or trans fats can promote an inflammatory state in the body.

On the other hand, studies suggest that some substances found in food can help to counter inflammation. These include the omega three fatty acids, antioxidants (from foods not supplements), phytonutrients (beneficial substances found in plant-based foods), dietary fiber, isoflavones, and others. More specifically, this includes the omega three fatty acids found in fish oils and other foods like walnuts and flaxseed, fruits, vegetables, whole grains, nuts, seeds, soy foods, and olive oil.

The good news is that the foods that help your joints are also beneficial for your heart, brain, eyes, and lungs. A few popular diets recommend guidelines that can assist in the health of all these body tissues. These are also supported by research, as well as by the major medical organizations related to health promotion.

One of the dietary patterns endorsed by the Arthritis Foundation is the Mediterranean Diet. Research tells us that this diet can improve the markers of inflammation (such as C reactive protein), slow the progression of osteoarthritis and reduce symptoms. This pattern of eating promotes a high intake of fruits and vegetables, the use of high fiber whole grains, moderation in the intake of animal proteins, fish a few times a week, frequent use of beans, nuts, and seeds, as well as the inclusion of olive oil. It also suggests limited intake of highly processed foods, added sugars (from foods and beverages), and saturated fats.

A dietary pattern very similar to the Mediterranean Diet is the DASH Diet (Dietary Approaches to Stop Hypertension), which was originally studied for its benefits in improving blood pressure. In addition to the foods recommended in the Mediterranean Diet, the DASH Diet suggests adequate intake of calcium from low fat or fat-free dairy products.

The Portfolio Diet has been shown to lower inflammation as well. This diet focuses on nuts, soy products containing isoflavones, viscous fibers (as in oats, psyllium, barley, okra), and plant sterols.

Fiber seems to be a recurring theme in the guidelines for osteoarthritis. A diet that is high in fiber not only suggests a higher intake of anti-inflammatory substances (as compared to low fiber processed foods), but it can also be useful for weight loss. High fiber foods are more filling so fewer calories may be eaten at a meal or snack. Fiber can also help the fuel from foods last longer so the individual may be inclined to eat less often. A diet higher in fiber can boost the populations of beneficial gut microbes as well, which can in turn help to reduce systemic inflammation.

Although people with osteoarthritis symptoms are inclined to reduce physical activity, some forms of activity are important for slowing the progression of symptoms and for reducing pain. Range of motion exercises are especially helpful in sustaining joint mobility.

Cardiovascular exercises, with consideration of joint issues, can assist with desired weight loss. Swimming, which does not involve impact to the joints, is a good option. Some balance and strength exercises can help to reduce the risk of falling and fracture. Stronger muscles can also help to support and protect the joints. In addition, daily exercise can boost mood and lower stress, which can lead to less muscle/joint tightness and a reduction in pain.

So, although osteoarthritis may not be preventable, there are certainly some lifestyle habits that can slow the progression and decrease the symptoms. These include consuming a healthy diet, achieving and sustaining a healthy body weight, and establishing a habit of daily physical activity.

- Pam Stuppy, MS, RD, CSSD, LD, is a registered, licensed dietitian with nutrition counseling offices in York, Maine, and Portsmouth. She is also the nutritionist for Phillips Exeter Academy, presents workshops nationally, and is board certified as a specialist in sports dietetics. Visit www.pamstuppynutrition.com for nutrition information, some healthy cooking tips and recipe ideas.