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Saturday, December 4

Arthritis and diet

by Eduardo Gonzales, MD

Arthritis simply means inflammation of a joint, which often manifests in the form of pain, swelling, redness, and limitation of movement. It is a very common condition, but greatly misunderstood and shrouded by food myths. For example, there is a widespread belief among Filipinos—including your friends, obviously—that a high protein diet can lead to arthritis because it increases the level of uric acid in blood. This belief is largely incorrect.There are more than 100 types of arthritis and the only type that is associated with uric acid is gout, a relatively rare form of arthritis that accounts for only about 5% of all forms of arthritis. It is a disease that has a genetic predisposition and that mainly affects adult men in their third to sixth decades of life.

In gout, uric acid crystals are deposited in the tissues lining and surrounding a joint causing arhritis. Uric acid is the end-product of purine, not protein, metabolism in the body. Purines are nitrogen-containing compounds that are derived from the breakdown of nucleic acids, which are abundant in innards such as liver, kidneys, and brain, as well as in sardines, anchovies, clams, shrimps, mackerel, mushrooms, dried legumes like beans and peas, and some vegetables like cauliflower.

In normal people, the uric acid that is formed by the body as a by-product of nucleic acid metabolism, regardless of amount, does not pose a health risk because it is promptly excreted by the kidneys. It is only in people with gout that uric acid accumulates in the blood and deposit in joints. Thus, the only people who need to watch their diet to prevent arthritis are those with gout because in these people, intake of foods that are rich in purine can trigger or aggravate an arthritic attack.

Incidentally, the most common type of arthritis, and which you probably are starting to develop, is osteoarthritis. How common is osteoarthritis? At age 40, 90% of all individuals will have x-ray findings in their joints that are consistent with the disease although many of them will still be asymptomatic (i.e., without symptoms). By age 55, however, at least 80% of all people will experience a symptom or two of the disease.

Osteoarthritis, like all the other forms of arthritis except gout, is not caused by dietary indiscretion. It is generally attributed to the wear and tear that occurs in a joint because of use. It is associated with aging and is almost exclusively a disease of late middle and old age except in occasional instances when it appears in young people in association with an injury, infection or congenital abnormality of a joint. It is a disorder that spares no one regardless of sex or race.

The exact mechanisms that cause the joint changes associated with osteoarthritis are not yet known and this partly explains why there is no cure for the disease yet. All we know is that the development and progression of the disease is influenced by numerous factors including age, trauma, joint instability, obesity, and hormonal and genetic factors.

Source: Manila Bulletin



1 comment:

  1. Rub Out the Ache!

    Beth E. Shubin Stein, MD
    Women's Sports Medicine Center


    If you suffer from chronic arthritis pain or have aching muscle strains or spasms after exercising, chances are you regularly take aspirin or another nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen (Advil) or naproxen (Aleve).

    There is another option. Over-the-counter (OTC) topical pain relievers can be very effective without causing the stomach upset or gastrointestinal bleeding that may accompany oral pain medication.
    Latest development: A topical form of the oral prescription NSAID diclofenac (Voltaren) is expected to undergo FDA review. It is already available in Europe and Canada.
    Meanwhile, a variety of OTC topical pain relievers are available now. The products below relieve arthritis, backache and muscle strain. Most are used three to four times daily. Follow label instructions.
    Helpful: If one type of topical pain reliever doesn't work for you, try one from another class until you find a product that provides relief. Caution: Keep these products away from your eyes, nose and other mucous membranes.
    SALICYLATES
    These aspirin-based products dull pain and curb the inflammation that often accompanies and worsens pain.
    How they work: Topical salicylates inhibit the production of prostaglandins, substances in the body that cause pain and swelling when they are released in response to strains, sprains and other injuries. Salicylates include...
    BenGay Ultra Strength Pain Relieving Cream.
    Aspercreme Analgesic Creme Rub with Aloe.
    Sportscreme Deep Penetrating Pain Relieving Rub.
    Flexall Maximum Strength Pain Relieving Gel.
    Warning: Do not use salicylates if you are sensitive or allergic to aspirin or take blood-thinning medication that might interact with them. Consult a doctor before applying a salicylate to a large area several times a day.
    COUNTERIRRITANTS
    These pain relievers give the sensation of warmth or coolness to mask pain.
    How they work: Creating a secondary stimulus to diminish the feeling of pain reduces physical discomfort. It's what you do instinctively when you stub your toe, then grab it to apply pressure. Both competing sensations travel to your brain at the same time -- but because only a limited number of messages can be processed at one time, the initial feeling of pain is diminished. Counterirritants include...
    Icy Hot Pain Relieving Balm, Extra Strength.
    Tiger Balm Extra Strength Pain Relieving Ointment.
    Therapeutic Mineral Ice.
    In most cases, coolness is beneficial for acute injuries, such as sprains, while warmth eases stiffness.
    Caution: People sensitive to heat or cold should avoid counter-irritants.
    CAPSAICINS
    These products, which are a type of counterirritant, contain capsaicin, an extract of hot peppers that causes a burning sensation.
    How they work: Unlike most other counterirritants, capsaicin inhibits the production of substance P, a chemical that sends pain messages to the brain via the nervous system. Capsaicins include...
    Zostrix Arthritis Pain Relief Cream.
    Capzasin HP Arthritis Pain Relief Creme.
    LIDOCAINE
    Lidoderm is a prescription-only patch that contains lidocaine, a topical anesthetic similar to the novocaine that dentists often use to numb the gums.
    How it works: Lidocaine blocks signals at the skin's nerve endings. The Lidoderm patch (lidocaine 5%) is worn for 12 hours a day over a period of days. It slowly releases medication, so it has longer-lasting effects than other pain relievers and helps with pain that emanates from nerves near the surface of your skin, such as that caused by shingles or diabetic neuropathy.
    Caution: Side effects include dizziness, headache and nausea. Allergic reactions are rare but may occur.

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