Avoiding/Managing Osteoarthritis

Arthritis is the umbrella term for a cluster of joint diseases involving inflammation of the joints, hence “arthr-” (joint) “-itis” (suffix used to denote inflammation).

Inflammatory vs Non-Inflammatory Arthritis

Arthritis is broadly divided into inflammatory arthritis and non-inflammatory arthritis.

Some forms, such as rheumatoid arthritis, are of the inflammatory kind. We wrote about that previously:

See: Avoiding/Managing Rheumatoid Arthritis

You may be wondering: how does one get non-inflammatory inflammation of the joints?

The answer is, in “non-inflammatory” arthritis, such as osteoarthritis, the damage comes first (by general wear-and-tear) and inflammation generally follows as part of the symptoms, rather than the cause.

So the name can be a little confusing. In the case of osteo- and other “non-inflammatory” forms of arthritis, you definitely still want to keep your inflammation at bay as best you can; it’s just not the prime focus.

So, what should we focus on?

First and foremost: avoiding wear-and-tear if possible. Naturally, we all must live our lives, and sometimes that means taking a few knocks, and definitely it means using our joints. An unused joint would suffer just as much as an abused one. But, we can take care of our joints!

We wrote on that previously, too:

See: How To Really Look After Your Joints

New osteoarthritis medication (hot off the press!)

At 10almonds, we try to keep on top of new developments, and here’s a shiny new one from this month:

• Methotrexate to treat hand osteoarthritis with synovitis (12th Oct, clinical trial)
• New research has found an existing drug could help many people with painful hand osteoarthritis (24th Oct, pop-science article about the above, but still written by one of the study authors!)

Note also that Dr. Flavia Cicuttini there talks about what we talked about above—that calling it non-inflammatory arthritis is a little misleading, as the inflammation still occurs.

And finally…

You might consider other lifestyle adjustments to manage your symptoms. These include:

• Exercise—gently, though!
• Rest—while keeping mobility going.
• Mobility aids—if it helps, it helps.
• Go easy on the use of braces, splints, etc—these can offer short-term relief, but at a long term cost of loss of mobility.
  • Only you can decide where to draw the line when it comes to that trade-off.

You can also check out our previous article:

See: Managing Chronic Pain (Realistically!)

Take good care of yourself!

From Blue To Green…

We sometimes write about supercentenarians, which word is usually used in academia to refer to people who are not merely over 100 years of age, but over 110 years. These people can be found in many countries, but places where they have been found to be most populous (as a percentage of the local population) have earned the moniker “Blue Zones”—of which Okinawa and Sardinia are probably the most famous, but there are others too.

This is in contrast to, for example “Red Zones”, a term often used for areas where a particular disease is endemic, or areas where a disease is “merely” epidemic, but particularly rife at present.

In any case, back to the Blue Zones, where people live the longest and healthiest—because the latter part is important too! See also:

• Lifespan: how long we live
• Healthspan: how long we stay healthy (portmanteau of “healthy lifespan”)

Most of our readers don’t live in a Blue Zone (in fact, many live in a COVID Red Zone, a diabetes Red Zone, and a heart disease Red Zone), but that doesn’t mean we can’t all take tips from the Blue Zones and apply them, for example:

• The basics: The Blue Zones’ Five Pillars Of Longevity
• Going beyond: The Five Key Traits Of Healthy Aging

You may be wondering… How much good will this do me? And, we do have an answer for that:

When All’s Said And Done, How Likely Are You To Live To 100?

Now that we’re all caught-up…

The news from the Blues

A team of researchers did a big review of observational studies of centenarians and near-centenarians (aged 95+). Why include the near-centenarians, you ask? Well, most of the studies are also longitudinal, and if we’re doing an observational study of the impact of lifestyle factors on a 100-year-old, it’s helpful to know what they’ve been doing recently. Hence nudging the younger-end cutoff a little lower, so as to not begin each study with fresh-faced 100-year-olds whom we know nothing about.

Looking at thousands of centenarians (and near-centenarians, but also including some supercentenarians, up the age of 118), the researchers got a lot of very valuable data, far more than we have room to go into here (do check out the paper at the bottom of this article, if you have time; it’s a treasure trove of data), but one of the key summary findings was a short list of four factors they found contributed the most to extreme longevity:

1. A diverse diet with low salt intake: in particular, a wide variety of plant diversity, including protein-rich legumes, though fish featured prominently also. On average they got 57% and 65% of their energy intake from carbohydrates, 12% to 32% from protein, and 27% to 31% from fat. As for salt, they averaged 1.6g of sodium per day, which is well within the WHO’s recommendation of averaging under 2g of sodium per day. As a matter of interest, centenarians in Okinawa itself averaged 1.1g of sodium per day.
2. Low medication use: obviously there may be a degree of non-causal association here, i.e. the same people who just happened to be healthier and therefore lived longer, correspondingly took fewer medications—they took fewer medications because they were healthier; they weren’t necessarily healthier because they took fewer medications. That said, overmedication can be a big problem, especially in places with a profit motive like the US, and can increase the risk of harmful drug interactions, and side effects that then need more medications to treat the side effects, as well as direct iatrogenic damage (i.e. this drug treats your condition, but as the cost of harming you in some other way). Naturally, sometimes we really do need meds, but it’s a good reminder to do a meds review with one’s doctor once in a while, and see if everything’s still of benefit.
3. Getting good sleep: not shocking, and this one’s not exactly news. But what may be shocking is that 68% of centenarians reported consistently getting enough good-quality sleep. To put that into perspective, only 35% of 10almonds readers reported regularly getting sleep in the 7–9 hours range.
4. Rural living environment: more than 75% of the centenarians and near-centenarians lived in rural areas. This is not usually something touted as a Blue Zones thing on lists of Blue zones things, but this review strongly highlighted it as very relevant. In the category of things that are more obvious once it’s pointed out, though, this isn’t necessarily such a difference between “country folk” and “city folk”, so much as the ability to regularly be in green spaces has well-established health benefits physically, mentally, and both combined (such as: neurologically).

See: The health benefits of the great outdoors: A systematic review and meta-analysis of greenspace exposure and health outcomes

And showing that yes, even parks in cities make a significant difference:

The association of green space, tree canopy and parks with life expectancy in neighborhoods of Los Angeles

Want to know more?

You can read the study in full here:

A systematic review of diet and medication use among centenarians and near-centenarians worldwide

Take care!