Osteoarthritis (OA) is a progressive, degenerative condition which results in the breakdown of the protective and cushioning ends of bones called cartilage. Traditionally understood risk factors for developing OA include genetic predisposition, history of trauma, older age, and obesity. More recently, we have discovered that metabolic, immune, and lifestyle factors play a huge role in determining whether you will suffer from OA. Whole body inflammation is a well-known cause and contributor to chronic diseases such as heart disease, diabetes, and cancer. Lifestyle medicine which includes emphasis on “clean living”: anti-inflammatory diets with avoidance of processed foods and sugars, supplements like turmeric and fish oil and routine exercise all are aimed towards the goal of reducing inflammation.
A recent review article, “Metabolic Triggered Inflammation in Osteoarthritis” supports the contention that the same inflammation which causes chronic disease can also affect your joints. Metabolic disease creates a pro inflammatory environment in your body. Inflammation is mediated by cytokines. There are pro-inflammatory cytokines and anti-inflammatory cytokines. Cytokines are molecules in the body that help regulate inflammation. The pro-inflammatory cytokine environment in the body can wreak havoc in your joints causing a chronic state of irritation. This environment, in time, leads to the destruction of cartilage, subsequent instability, and further pain.
The good news: Lifestyle changes can improve your joint pain. It has been proven that weight loss for people with OA has increased function, decreased pain, and decreased inflammation. This effect is above and beyond the decreased load that a lighter body exerts on your joints. The weight loss improves the inflammation load too!
Diet matters. Our joints don’t just wear out from too much running or overuse activities, they wear out from too much eating, or better yet, what we eat. Have you ever thought about the effects the foods you eat have on your body, specifically your joints? A recent study, “Inflammatory cytokines mediate the effects of diet and exercise on pain and function in knee osteoarthritis independent of BMI,” showed that there was a significant improvement in pain and function after a diet and exercise intervention was introduced in individuals that are overweight and obese and have knee osteoarthritis. Both calorie restriction and exercise increase the anti-inflammatory cytokines. This finding was independent of changes in weight.
Despite commonly held beliefs, exercise is good for joints! Exercise has also been shown to improve pain and function of an arthritic joint. Osteoarthritis is more prevalent in the sedentary population. Active people have less OA. Exercise won’t make OA worse. We do a disservice to patients if we tell them otherwise.
Unfortunately, there is no “cure” for OA, but there are ways to control the symptoms. By focusing on controlling the joint environment, (increase anti-inflammatory chemicals and growth factors) many people can thrive with radiographic evidence of OA. Staying active, keeping weight under control, monitoring what you eat, and starting an anti-inflammatory diet are just a few things to incorporate into your lifestyle to help manage your arthritic symptoms.
Some examples of foods or food groups that you should start incorporating into your diet include fruits, and vegetables, seeds, nuts, fish, and healthy oils. These foods have been shown to help decrease inflammation. Foods that should be avoided or enjoyed in moderation include dairy products, certain meats, processed/sugary foods and inflammation inducing vegetable oils. Consuming high amounts of the foods that should be avoided can also lead to other conditions such as diabetes and heart disease. This can begin a cascade effect that can promote obesity, cancer, diabetes, and OA. As always, for good health, prevention is the best medicine.
Osteoarthritis Cartilage. 2019 Aug;27(8):1118-1123. doi: 10.1016/j.joca.2019.04.009. Epub 2019 Apr 20.
Metabolic triggered inflammation in osteoarthritis
Wang, X. et al.
Osteoarthritis and Cartilage, Volume 23, Issue 1, 22 - 30