More than 20 million Americans are afflicted with the most common type of arthritis, which is called osteoarthritis (OA). OA results from the deterioration of the cartilage in the joints. OA often starts between ages 40-60 and is common in overweight people. In a study published in the October 2003 Obesity Research Journal, Dr. Fountain observed that only 12% of those who were thin had OA joint pain compared to 60% of those who were overweight.
The aging of the baby boomers, coupled with America’s expanding waistlines, makes it likely that millions more Americans will develop OA in the next decade.
Surgery Doesn’t Help
At the start of the 21st century, physicians were doing 650,000 arthroscopic surgeries each year. The surgeons believed they could reduce knee pain and improve joint motility in patients with OA. Unfortunately, a controlled clinical trial comparing the effectiveness of these arthroscopic procedures to a sham (pretend) operation demonstrated that these surgical procedures worked no better than the “placebo” surgery.1
What Promotes Osteoarthritis?
Trauma to the joint can lead to inflammation and more osteoarthritic damage. However, OA appears to be due in part to a chronic low level of inflammation in the joints, which contributes to the breakdown of cartilage even in the absence of severe joint trauma. Elevated levels of CRP (an inflammatory protein) are seen particularly in those with more serious OA.2 Drugs like aspirin, Advil and other nonsteroidal anti-inflammatory drugs (NSAIDS) often reduce the pain and stiffness of osteoarthritic joints within a few days, but taking these drugs for a long time can often irritate the stomach and occasionally cause life-threatening stomach bleeding. The newer NSAIDS (COX-2 inhibitors) can increase blood pressure in those on certain blood pressure medications.
Weight Loss Helps
It has been known for a long time that people who put a lot of weight around their waist are far more likely to end up with osteoarthritic joints. Increased body fat increases the release of certain substances (leptin, cytokines, CRP) in the blood that may play a role in developing OA. A recent study at the Florida Pritikin Center found a 45% drop in CRP levels in older women in just two weeks with proper diet and exercise.3
Glucosamine May Help Repair Joints
One of the molecules the human body uses to make new cartilage and the fluid that lubricates the joints is called glucosamine. However, as people grow older, the production of this natural component of cartilage may not be adequate. Two long-term clinical trials have shown that 1,500 mg/day of glucosamine sulfate prevented the loss of cartilage in osteoarthritic joints and significantly reduced the pain associated with OA.4, 5 The National Institute of Health is currently funding a large clinical trial involving 1,600 people age 40 and older to determine the effectiveness of supplemental glucosamine in slowing or possibly even reversing some of the damage caused to joints by aging, trauma, and inflammation. Methylsulfonylmethane (MSM) is another supplement that has shown promise in reducing OA pain. A recent study found that the combination of glucosamine plus MSM worked better than glucosamine alone to relieve OA symptoms.
Vitamin C May Promote Osteoarthritis
For many years, people have been led to believe high doses of vitamin C may protect their joints from OA. Guinea pigs, like humans, require vitamin C in their diet and also develop OA in old age. Vitamin C deficiency can impair cartilage formation and higher doses were believed to help protect joints by blocking free radicals that can damage cartilage. However, a recent study of guinea pigs at Duke University published in the June 2004 Arthritis and Rheumatism journal cast serious doubt on the long-term benefit of high-dose vitamin C supplements for staving off OA. The results showed that high doses of vitamin C did slow the loss of cartilage in the joints over time; but it also stimulated the overproduction of bone growth factor and led to the formation of bony spurs in the joints, which significantly increased joint damage and OA.
By James Kenney, PhD, RD, LD, FACN
1. N Engl J Med 2002;34781-8
2. J Rheuamatol. 1995;22:1527-31
3. Metabolism 2004;53:377-81
4. Lancet 2001;357:251-65. Arch Intern Med 2002;163:2113-23
Judy’s passion for cooking began with helping her grandmother make raisin oatmeal for breakfast. From there she earned her first food service job at 15, was accepted to the world-famous Culinary Institute of America at 18 (where she graduated second in her class), and went on to the Fachschule Richemont in Switzerland where she focused on pastry arts and baking. After a decade in food service for Hyatt Hotels, Judy launched Food and Health Communications to focus on flavor and health. She graduated with Summa Cum Laude distinction from Johnson and Wales University with a BS in Culinary Art, holds a master’s degree in Food Business from the Culinary Institute of America, 2 art certificates from UC Berkeley Extension, and runs a food photography studio where her love is creating fun recipes.
Judy received The Culinary Institute of America’s Pro Chef II certification, the American Culinary Federation Bronze Medal, Gold Medal, and ACF Chef of the Year. Her enthusiasm for eating nutritiously and deliciously leads her to constantly innovate and use the latest in nutritional science and Dietary Guidelines to guide her creativity, from putting new twists on fajitas to adapting Italian brownies to include ingredients like toasted nuts and cooked honey. Judy’s publishing company, Food and Health Communications, is dedicated to her vision that everyone can make food that tastes as good as it is for you.