Part 1 -- Osteoarthritis Prevention Strategies
The best medical strategy is to prevent disease. In this post and the next I will discuss preventive strategies for osteoarthritis. These are very effective, but obviously cannot protect against arthritis completely. One can only do so much in following this advice. Remember that injuries are never completely preventable, lifestyle is seldom perfect even for the most determined and, to some degree, osteoarthritis development is influenced by genetics. Nevertheless, following this advice will make a very substantial difference in your health in the future.
As we discussed last time, osteoarthritis is a disease for which we are still awaiting disease-modifying treatments. That does not mean there is nothing you can do to help avoid developing it. More and more, people are realizing that despite all our wonderful technology, there is still a lot to be appreciated in the simple basic ideas that have never failed us.
Make Your Weight Healthy
Most important for osteoarthritis is to maintain a healthy weight! The more excess weight you carry, the more likely you are to develop arthritis of the hips and knees and even the ankles and feet. The Framingham Study, which has been in progress since 1948 and covers many different diseases, looked at risk factors for osteoarthritis of the knee. The most important was weight. Women in the highest weight category more than doubled their risk. The good news was that reducing weight by at least ten pounds or more halved the risk of continuing to develop osteoarthritis. Of course, keeping trim is vitally important to the health of your entire body, to how you feel every day and to whether you will develop cancer, heart disease, diabetes and other serious disorders. (In regard to OA, total weight is what counts. For all the other diseases, it is mainly the visceral fat that counts. That is the fat hidden inside your belly, liver and heart and can be in excess even with a normal BMI.)
A guideline to a healthy weight is to keep your BMI around 22-24. The BMI is a crude measure that is calculated from height and weight. Muscle differences are not calculated in the BMI and having more muscle is good for you. Thus very muscled people will have higher BMI's but could still be in a healthy condition if they have no excess fat. Still, for the average person, BMI is a handy guide. You can find a BMI calculator on our Diet & Exercise site.
Get Enough Vitamin D and Calcium
There have been three studies of Vitamin D and osteoarthritis using The Framingham Study. There seems to be an association of low vitamin D and symptoms of OA, but not with loss of cartilage. Evidence for the importance of Vitamin D for bone health is well established and it is becoming apparent that Vitamin D is probably vital for general health and for helping prevent heart disease and cancer. Thus it seems worthwhile to maintain adequate levels of vitamin D.
Information on Vitamin D is available through the National Institutes of Health. Maintaining adequate blood Vitamin D levels is very important. Of course, check with your doctor before changing your intake of Vitamin D and calcium. I am not aware of any clear evidence of the value of other vitamins or supplements.
Adequate calcium intake is also very important. A few cautions: Milk and other dairy products are excellent sources of calcium but whole milk contains unhealthy fats. Milk is 3.5% fat, so even "2% milk" and "1% milk" still have significant milk fats. The healthiest dairy products for your heart are fat-free (such as skim milk or products made from it).
Also, when considering supplements, remember that the weight of calcium in milligrams should be for ‘elemental' calcium. In calcium carbonate, for example, if it says 600 milligrams, less than half will be calcium if it refers to the weight of the whole calcium carbonate molecule.
Lastly, some calcium supplements have been found to contain lead, which of course should not be there, primarily in supplements made from bone or shells and not refined properly. Unfortunately, it can sometimes be hard to tell the elemental calcium amount and which are the contaminated ones, so be careful what and where you buy them.
Exercise Regularly For Joint Support
The second most important strategy is to keep active every day and build strong muscles, especially around the shoulders, hips, knees and back. Muscles support joints and also promote good general health. Ligaments and tendons are tough, strong tissues that connect muscles and joints and help stabilize the joint. They are not elastic! That is why they are common sites of injuries; a sprain is a torn ligament. You want strong muscles to protect the joint and avoid excessive shear on the tendons and ligaments. You don't need to be a professional body builder, just have a reasonably good muscle structure.
Aerobic activity (that's where you are using numerous muscles for a sustained time, enough to increase your heart rate a reasonable amount, like walking, swimming, riding a bicycle) nourishes your bone and muscle and induces a good balance of nutrients and hormones.
In the next post I will complete the list of prevention strategies.
Please feel free to post comments, suggest topics and ask questions, but I cannot respond to them directly. At times I will address a reader's question or comment within a posting. As with all such sites as this, it is not intended to give individual advice, to advise on your treatment or to substitute for your own doctors. It is intended to give you some insight and background that I hope will help you understand the disease better.