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Inflammation and Arthritis

Does what and when you eat matter in osteoarthritis? We think it does.

Metabolic syndrome (MetS) has been described in medical literature as a combination of hypertension, dyslipidaemia, insulin resistance and abdominal obesity. MetS has been associated with a state of chronic low-grade inflammation. It has been associated with several increased serious health risks.

MetS has been associated with a higher risk of developing severe symptomatic knee arthritis. The number of components present in a patient of the MetS has also been associated with poorer outcomes one year after knee replacement surgery. In other words, even if you replace the joint, it still appears more likely to be painful.

Equally, obesity is regarded as a chronic inflammatory state and is associated with a high risk of symptomatic knee arthritis and hand OA. The association with hand arthritis says to us this is not simply the effect of additional weight on a weight bearing joint.

Some take home messages:

The pain from osteoarthritis is not simply from ‘joint surfaces wearing out’, but rather involves a multitude of tissues and structures.

Recently, there has been a larger focus on inflammation as a contributor to pain and the progression of osteoarthritis.

Replacing the joint surfaces does not always fix the pain, particularly if you do not address co existing risk factors.

It’s in your interest to improve your metabolic health if you have arthritis. You should look at what, when, and how much you eat, and how you exercise to improve your metabolic health. Simply doing one straightening exercise for your knee arthritis is not enough.

                Felson DT Anderson JJ Naimark Aet al.  Obesity and knee osteoarthritis. The Framingham Study. Ann Intern Med 1988;109:18–24 Google ScholarCrossrefPubMed

Yoshimura N Muraki S Oka Het al.  Accumulation of metabolic risk factors such as overweight, hypertension, dyslipidaemia, and impaired glucose tolerance raises the risk of occurrence and progression of knee osteoarthritis: a 3-year follow-up of the ROAD study. Osteoarthritis Cartilage 2012;20:1217–26.

Inflammation in osteoarthritis: is it time to dampen the alarm(in) in this debilitating disease? Clin Exp Immunol. 2019 Feb;195(2):153-166. doi: 10.1111/cei.13237. Epub 2018 Nov 28.

               

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