Movement for Osteoarthritis and More

April 13, 2011

I’m taking an Orthopaedic Biomechanics class right now, so expect some fun stuff on bones and joints over the next few months.

This morning the professor read us a few excerpts from yesterday’s WSJ article on osteoarthritis treatment, and I’d like to do the same here. I’m not going to get scientifically in-depth today, I’ll just give a few thoughts.

The main premise of the article is that an increasing number of health care providers are recommending movement as a treatment for osteoarthritis. Read on for quotes and discussion.

Osteoarthritis, which can affect knees, hips, feet, hands and other parts of the body, occurs when the cartilage that cushions the spaces between the joints wears away. The disease affects some 27 million Americans and leads to 632,000 surgical joint replacements a year.

First some quick and easy math courtesy of my prof: 632,000 surgeries * $30k per surgery = $18.96 billion annually.

Let’s think about a human knee. Every day, the cartilage in the knee is wearing away and being rebuilt in the human body. However, cartilage doesn’t get a direct blood supply like the majority of the body – it gets the nutrients required for reconstruction from surrounding synovial fluid. This means that it heals more slowly, but the point remains: When you have osteoarthritis, you have less cartilage than you should. This can result from two distinct issues: your cartilage is wearing too quickly, or it is healing too slowly. This sounds simple, but as far as I can tell from conversations with my professor, this is not common sense in the field.

Osteoarthritis, a degenerative joint disease once considered a problem of old age, has begun showing up in more middle-aged and young adults as a result of obesity and sports injuries.

Emphasis mine. The classical explanation of the correlation between obesity and osteoporosis (as I know it to be from a few hours of class) is that being obese wears your joints out faster because they are supporting more weight. I like the simplicity of this explanation, but I feel that ignoring what seems an obvious link is a mistake.

The same Standard American Diet (SAD) that causes obesity also results in a lack of nutrition for rebuilding the worn cartilage.

I’m not going to get pubmed-thorough here, I just have a few off-the-cuff remarks. The inflammatory nature of the SAD does not create a conducive environment for healing in the body. The leaky-gut digestive problems so awfully common with the grain-heavy SAD impair the ability to obtain the nutrients required for cartilage repair from dietary intake. The insulinogenic nature of the high-carbohydrate SAD reduces the likelihood of any nutrients in the blood stream making it all the way to synovial fluid and then into the cartilage.

I feel guilty throwing these hypothetical connections into the ether like a nutritional loose-cannon (it’s definitely not my style), but none of this seems far-fetched to me.

Since each pound of extra body weight adds the equivalent of four pounds to the knees, even a small loss of weight can cut in half the risk of knee osteoarthritis for women, who are at higher risk than men, studies show.

The 1lb/4lb thing is a result of human geometry. I’m more interested in the sex differences here. The classical understanding in the field of the increased risk for women is that they menstruate, each month disposing of valuable nutrients for cartilage reconstruction. This lends credence to the suggestion that the SAD can cause osteoarthritis; instead of nutrients, well, um, flowing out, they get locked up in fat cells or are never consumed in the first place. In fact, I find it utterly absurd that the community could embrace nutrient deficiencies at the cartilage as a cause for the sexual dimorphism, but not the entire condition.

The Bottom Line:

Well we all already knew that the SAD was bad. Osteoarthritis is just another thing to throw on the pile that may have a dietary component. Keep on eating paleo/primal and enjoying your resistance exercises. (I guess reading this was a waste of time 🙂 ).

Again, I apologize I didn’t go to the study archives for this post. I’m just not feeling it tonight. Next time look for a more thoroughly researched post about bone geometry changes.

Entry filed under: Food Choices, Ortho. Tags: .

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