Stephanie Karl, Clinical Nutritionist – UPANDRUNNING Sports Medicine Center, Dubai
Once considered a bit of a ‘wear and tear’ inflammatory disease of the joints as you age, evidence suggests otherwise. Multiple underlying causes and contributing factors include age, female gender and high BMI.(1) Joints and particularly knees are affected where the protective cartilage cushion wears down leaving bones exposed to rub together. Medications are often the first form of treatment rather than looking at the root cause.
Research has focused on the high incidence of obesity and poor dietary choices as well as lack of exercise in OA patients. Obesity increases the load and stress on many joints and data reveals that fat tissue is a major source of catabolic and pro-inflammatory mediators (i.e., cytokines, chemokines, and adipokines), which are implicated in the process of OA (Rai 2011). In addition, obese patients tend to experience insulin resistance and increased glucose load, which may also contribute to the chronic inflammation and cartilage deterioration of OA (Sowers 2010).
A greater understanding of the biochemical nature of cartilage and bone and its formation and breakdown has highlighted the role of nutrition and lifestyle, and the significance of a healthy diet to impact metabolic balance, aging and wellbeing. The big question as to what exactly does a “healthy diet” look like if we are too slow down the onset of age related diseases is the key.
Much of the tissue injury and symptoms of pain and stiffness is due to chemicals produced naturally in our bodies and generated by metabolism of the omega-6 fatty acids from dietary intake of processed foods and seed oils (soy, sunflower, safflower, canola, corn, peanut oils). Tissue injury in the joint may also be due to the lack of intake of anti-inflammatory omega-3 oils (fish, flaxseed, walnuts) and micronutrients such as flavonoids which act naturally to manage inflammation and help to protect against oxidative and other damaging effects to cartilage in joints.
Another dietary consideration is the lack of dietary micro nutrients in modern diets which have shown to help the body naturally manage inflammation and oxidation. Flavonoids and polyphenols are found in berries, grapes, nuts and seeds, non-starchy vegetables, spices such as curcumin and soy.
Research identifies a number of dietary recommendations:
- lose weight, if overweight, preferably combined with exercise
- increase intake of flavonoids to reduce oxidative damage. Berries, cabbage, kale, onions, parsley, tea, chocolate, citrus fruits, soybean
- reduce plasma cholesterol by dietary means. Cholesterol is found in animal fats such as fatty cheese, fatty meat.
- increase intake of long-chain n-3 fatty acids preferably by eating oily fish, flaxseed oil and walnuts or taking a supplement
- aim for a safe level of sun exposure, eat rich vitamin-D dietary sources or take vitamin D supplements, 800IU/d or 10,000IU/wk
- increase vitamin K intake by eating green leafy vegetables.
Stephanie Karl, Clinical Sports Nutritionist
References & Research
1. Lee KM, Chung CY and Sung KH et al (2015) Risk Factors for Osteoarthritis and Contributing Factors to Current Arthritic Pain in South Korean Older Adults. Yonsei Med J. 56(1): 124–131.
2. Rayman MP (2015) Diet, nutrition and osteoarthritis. BMC Musculoskelet Disord; 16(1): S7.
3. Thomas S, Browne H, Mobasheri A and Rayman M (2018) What is the evidence for a role for diet and nutrition in osteoarthritis? Rheumatology; 57(4): iv61–iv74. Arterioscler Thromb Vasc Biol. Author manuscript; available in PMC 2012 May 1.
