Osteoarthritis is Preventable

I have a family history of osteoarthritis.  I spent many years thinking that eventually my joints would ‘wear out,’ resulting in debilitating pain and requiring replacement just as I witnessed my mom and her knee, my aunt and her shoulder, and my grandmother and her hip.  I was certain I was destined to have swollen knuckles and pain.   I now know I have some control over the health of my joints as I age.

Let me suggest that osteoarthritis is the combination of aging or injury plus systemic inflammation.  The emphasis is on the word plus. Systemic inflammation is a recurrent concept. I like to refer to systemic inflammation as ‘the common denominator’ because it is the physiologic imbalance that drives much chronic disease and illness.  Let me explain how this works in joints.

An imbalance between the production of reactive oxygen species (a.k.a. free radicals) and antioxidants creates oxidative stress.  Oxidative stress results in tissue damage.  In the joint, oxidative stress causes thickening of the synovial membrane.  The synovial membrane surrounds the joint.  When the membrane thickens, there is decreased lubrication in the joint, resulting in cartilage and bone destruction.  Inflammation may end up in the joint, but that is not where it starts.   

The triggers of oxidative stress include excess body fat around the waistline (a.k.a visceral adipose tissue or VAT), elevated blood pressure, elevated blood sugar, abnormal cholesterol or triglyceride levels; and imbalance in the gut microbiome.  By reducing carbohydrate intake, making sure to get regular aerobic activity, eating unprocessed and diverse food, managing stress in healthy ways, and restoring gut health, we can reduce oxidative stress in our bodies.

Consuming foods rich in antioxidants will reduce the free radicals in our body.  There is a principle of dietary guidance called ‘eating the rainbow,’ by which people attempt to eat foods of all the colors of the rainbow every day.  The more colorful the food, the richer it is in antioxidants.  Think blueberries, raspberries, and green tea.   Genes also play a role in our ability to both synthesize and utilize antioxidants.

Osteoarthritis is not inevitable.  If it is something you are experiencing, I encourage you to get to the root cause of whatever is driving your systemic inflammation, with the goal of reducing pain, restoring joint function, or at least prolonging any deterioration.


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