Weight and Arthritis

It probably comes as no surprise that being overweight aggravates arthritis. Certainly weight bearing joints such as the low back, hips, and knees are aggravated by excess weight.  However, all joints including upper body joints are also impacted by fat. Fat stimulates omega 6 ( contained in beef and fatty foods).  Omega 6 is an inflammatory mediator and since inflammation is at the core of arthritis and cardiovascular diseases,..,..well, you can figure out the rest.  For those reasons among others, we advocate diets high in omega 3s such as fruits, vegetables, fish, and tree nuts like walnuts and almonds.  This diet is the mainstay of the Mediterranean diet which has been critically tested and reported this year in the New England Journal of Medicine.

For years, low fat diets had been popular.  In addition to the Mediterranean type diets, we  try to get our patients to avoid sugar as much as possible. Refined sugar stimulates insulin which alters metabolism by storing fat and making us hungry.  Low fat diets usually translate into high carb diets and in patients who are insulin resistant, weight gain is even more of a problem.  Simple things like avoiding sugary beverages (i.e. Coke and Pepsi) need to be done.  Currently, we are trying to get the hospital cafeteria to get rid of these drinks.  We’ll let you know if we succeed.

The value of exercise seems fairly obvious, but there are complications in our understanding.  Average exercise burns about 400 calories an hour- that is about the same as a single patty hamburger.  Unless you are exercising several hours a day, it becomes clear that you still need to control intake and avoid a lot of processed foods. Unfortunately, food manufacturers employ food chemists who are constantly searching for foods with the right amount of sugar, fat and salt to stimulate the sugar receptors in your brain to addict you. They work on the right “mouth feel” and smell.  It takes a lot of discipline to walk past a Cinnabun store at the airport.  Nevertheless, exercise is still important for you.  Both weight lifting activities as well as aerobic exercise-enough to make you perspire can help burn some of that midriff.  We can point you in the right direction for that.

One of the latest advances in our understanding of what makes some people fat relates to our gut bacteria.  Our bodies mostly live in harmony with billions of bacteria in our gut that help digest food.  There are at least 2 populations of bacteria.  One set of bacteria can cause fattening and the other is associated with leanness.  So does that mean we should have skinny bacteria transplanted into our guts?  Maybe, but there is one significant catch.  The skinny bacteria work only with the right diet.  According to Jeffrey Gordon, director of the Center for Genome Sciences and Systems Biology at Washington University in St. Louis,  the microbes associated with leanness only succeed with a diet high in fruits, vegetables and low in saturated fats.  So you still have to eat right.

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