Joint Problems eg Arthritis

Our joints wear with age, and for some individuals arthritis may cause severe pain and reduction in mobility. To prevent such problems, or to reduce pain and further damage, nutrition can play a significant role.

Dietary factors, such as the balance of omega fatty acids and supply of important vitamins and minerals including magnesium and vitamin D, can help to reduce the inflammation in the joints, and support cartilage and surrounding joint tissues for optimal functioning and pain reduction.

In constant use, our joints are exposed to high pressures, moving in various twisting and turning motions, giving us our ability to move freely. Inevitably, our joints become prone to deterioration over time, leading to pain, discomfort and reduced mobility. The food we eat can have a huge impact on our joint health, supplying nutrients needed to keep joints strong and lubricated, and inflammation under control. The most common joint condition is arthritis, which is thought to affect around 1 in 5 people in the UK.

Symptoms

Joint problems can manifest as inflamed, stiff, achy and painful, with severity of symptoms ranging from feeling stiff in the mornings to not being able to walk because of excruciating pain and/or physical deformity of the joints.

Causes

The causes of joint problems vary, and arthritis presents itself in many different forms. The two most common forms of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis is the most common form and occurs when the cartilage that lies between the bones gradually wears away; this occurs with age. As the function of cartilage is to protect the surface of the bone by providing a spongy layer to absorb energy from impact, its absence allows the bones to rub against each other, resulting in damage and pain. The most frequently affected joints are in the hands, spine, knees and hips. Osteoarthritis, sometimes called degenerative joint disease, tends to be uncommon in people under 40. Risk factors include being overweight and having an injury, operation or repeated joint strain.

Rheumatoid arthritis is less common, but more severe. Unlike osteoarthritis, the body’s immune system actually attacks and destroys the joint, causing inflammation, pain and swelling. This can lead to a reduction of movement, and the breakdown of bone and cartilage. Rheumatoid arthritis usually develops between the age of 30 and 50. Whilst osteoarthritis and rheumatoid arthritis are relatively well known, there are approximately 200 types of arthritis, which are classified into three categories: inflammatory arthritis, non-inflammatory arthritis and connective tissue disease.

Conventional drug treatment

Current medical treatment optionsfor arthritis include the use of non-steroidal anti-inflammatory drugs (NSAIDs), physiotherapy and surgery. NSAIDs prevent the production of inflammatory and pain-producing products called prostaglandins, which are derived from an omega-6 fatty acid called arachidonic acid (AA). Whilst these drugs are very effective in reducing inflammation, they may also have detrimental side effects, including serious gastrointestinal and cardiovascular complications, making long-term use risky. Physiotherapy can help to improve mobility and strengthen the joint connective tissues, so may be beneficial for supporting joint health. Surgery such as joint resurfacing and joint replacement are also effective at reducing pain associated with arthritis (after a recovery period of several months), though this is only recommended in severe cases and ideally for elderly individuals, as joint prosthetic implants have a limited life.

Lifestyle factors

Staying active is a crucial factor in keeping your joints healthy, even if they start to feel stiff. Gentle exercise such as swimming and cycling can be very helpful for those who have joint problems, to prevent joints from seizing up. Impact weight-bearing exercise is also beneficial, for which the intensity may depend on current joint health. Running with good trainers on soft ground (i.e. not concrete) can help to keep cartilage strong and also improves the density of bones, which may help reduce risk of breaks and other joint problems in the future. For those with severe arthritis, regular short walks may be adequate. Exercise can actually reduce pain in mild to moderate arthritis and helps to improve the mobility and function of joints.

Maintaining a healthy body weight is also essential for good joint health, as being even slightly overweight can considerably increase the stresses on your joints. Having a high body weight has been shown to increase risk of joint problems later in life.

Vitamin D is essential for joint health and can be produced from sunlight exposure between spring and autumn in the UK, so try to expose skin to the sun to top up your levels if possible. For the winter months in the UK, the rays from the sun are not strong enough for our skin to make vitamin D, so supplementation may be required to prevent deficiency.

Omega-3 EPA fish oil

Omega-3 EPA is one of nature’s strongest anti-inflammatory nutrients. In stronger doses in purified fish oil, it exerts powerful effects that benefit people with painful conditions such as arthritis.

As inflammation plays a significant role in the progression of arthritis, keeping inflammation regulated to low levels is vital for ensuring joint damage is kept to a minimum. Omega-3 EPA is the key active ingredient found in fish oil which helps to reduce inflammation in the body.

EPA is a long-chain omega-3 fatty acid which works in several ways. Firstly, it is converted to hormone-like substances called prostaglandins that, unlike those derived from the omega-6 AA, are anti-inflammatory and provide pain relief. Secondly, if EPA levels in the diet are increased, it can lower the amount of AA in the body, as they take up space in the cell membranes and physically displace AA. Thirdly, EPA works in a very similar way to NSAIDs by preventing the formation of inflammatory products – although without the associated side effects. It also appears that if another fatty acid called GLA (gamma linolenic acid – an anti-inflammatory omega-6) is present with EPA, then all these factors are intensified – in other words, there is a synergistic effect between these two substances such that, when taken in combination, they work even better in the fight against inflammation.

Many independent studies have shown that adding concentrated omega-3 fish oils to the diet can result in a significant reduction of chronic joint pain in arthritis sufferers. Fish oil supplements vary considerably, therefore, to achieve optimal results, it is best to take a concentrated EPA that provides a high dose.

Glucosamine

Glucosamine is made naturally in the body and is involved in the production of compounds called proteoglycans and glycosaminoglycans (GAGs). It is these compounds which make up the cartilage that covers and protects the ends of the bones in the joints. These amino sugars absorb water and provide lubrication (synovial fluid) and shock absorption for the cartilage, as well as inhibiting the production of enzymes that degrade cartilage. Cartilage and other related structures such as discs, tendons and ligaments are continuously being remodelled – worn away during activity and then reformed again afterwards. As we get older, we are unable to produce enough glucosamine to meet the body’s needs. Also, if demands are increased by significant activity (such as in very active individuals or athletes) and glucosamine needs not met, then damage may occur.

Supplementing with glucosamine not only helps rebuild cartilage and decrease joint deterioration without side effects, but also provides pain relief, equivalent in effect to some NSAIDs. Review studies have shown that supplementing with glucosamine has beneficial effects, including improved mobility and reduced pain, in individuals with osteoarthritis and preserves joint structure. Research also suggests that combining EPA with glucosamine may offer superior benefits to those who suffer with arthritis than supplementing with glucosamine alone.

    

 

 

 

Vitamin C

Vitamin C is a powerful antioxidant which mops up free radicals that can otherwise cause direct damage to joints. Damaging free radical levels are high in our modern lifestyles as a result of pollution and refined chemical-ridden foods, so we need to maintain high levels of free radical-fighting antioxidants such as vitamin C. Vitamin C is also required for proper collagen production, which helps to make up the structure of connective tissues holding joints in place.

Zinc

Zinc is required for repair and growth of tissues in the joints, but our diets are often deficient in this essential mineral. Zinc is also required by enzymes to produce the bone matrix.

NUTRITION

grilled salmon with spring vegetables on white plate, soft focusOmega-3 rich sources include wild fish such as salmon and mackerel. We recommend up to two portions weekly.

Fatty acids

The number one dietary tip for joint health is to eat a healthy balance of fatty acids. Oily fish such as salmon, mackerel, herring and anchovies are a rich source of omega-3 EPA, which helps to reduce inflammation. Wild fish have higher levels of EPA and lower levels of AA compared to farmed fish, so are more beneficial.

Omega-6 AA increases inflammation in the body and is found in grain-fed meats, therefore choose grass fed meats where possible as these are a richer source of EPA. Plant fats such as vegetable oils can also be converted to pro-inflammatory omega-6 AA in the body, so try to limit processed foods containing oils such as refined sunflower or corn oil.

Important vitamins and minerals

Consuming plenty of foods rich in antioxidants such as vitamins C and E will help to reduce oxidative stress and inflammation present in joint problems. High amounts of antioxidants are found in brightly coloured fruits and vegetables such as kale, peppers, beetroot, nuts and seeds.

It is well known that calcium-rich foods such as dairy and green leafy vegetables are good for joint and bone health, but as dietary calcium needs are fairly easy to meet, concentrate on obtaining the required amounts of magnesium and vitamin D, which work alongside calcium in the body to support joints. Magnesium is found in green leafy vegetables, nuts, seeds, beans and lentils, whilst vitamin D is found in small amounts in fish, but is predominantly made by the skin when exposed to sunlight.

Zinc is another mineral that supports joint integrity and is found in foods such as seafood, meat, wheat germ, nuts and seeds.

Hydration

Drinking adequate amounts of water can help to keep joints more flexible by plumping up the cartilage with water. Keeping hydrated also supports the transport of nutrients into cells, which is needed for supplying the joints with the nutrients required for optimal functioning.

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