Does intermittent fasting have benefits for our brain?

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Intermittent fasting has become a popular dietary approach to help people lose or manage their weight. It has also been promoted as a way to reset metabolism, control chronic disease, slow ageing and improve overall health.

Meanwhile, some research suggests intermittent fasting may offer a different way for the brain to access energy and provide protection against neurodegenerative diseases like Alzheimer’s disease.

This is not a new idea – the ancient Greeks believed fasting enhanced thinking. But what does the modern-day evidence say?

First, what is intermittent fasting?

Our diets – including calories consumed, macronutrient composition (the ratios of fats, protein and carbohydrates we eat) and when meals are consumed – are factors in our lifestyle we can change. People do this for cultural reasons, desired weight loss or potential health gains.

Intermittent fasting consists of short periods of calorie (energy) restriction where food intake is limited for 12 to 48 hours (usually 12 to 16 hours per day), followed by periods of normal food intake. The intermittent component means a re-occurrence of the pattern rather than a “one off” fast.

Food deprivation beyond 24 hours typically constitutes starvation. This is distinct from fasting due to its specific and potentially harmful biochemical alterations and nutrient deficiencies if continued for long periods.

4 ways fasting works and how it might affect the brain

The brain accounts for about 20% of the body’s energy consumption.

Here are four ways intermittent fasting can act on the body which could help explain its potential effects on the brain.

1. Ketosis

The goal of many intermittent fasting routines is to flip a “metabolic switch” to go from burning predominately carbohydrates to burning fat. This is called ketosis and typically occurs after 12–16 hours of fasting, when liver and glycogen stores are depleted. Ketones – chemicals produced by this metabolic process – become the preferred energy source for the brain.

Due to this being a slower metabolic process to produce energy and potential for lowering blood sugar levels, ketosis can cause symptoms of hunger, fatigue, nausea, low mood, irritability, constipation, headaches, and brain “fog”.

At the same time, as glucose metabolism in the brain declines with ageing, studies have shown ketones could provide an alternative energy source to preserve brain function and prevent age-related neurodegeneration disorders and cognitive decline.

Consistent with this, increasing ketones through supplementation or diet has been shown to improve cognition in adults with mild cognitive decline and those at risk of Alzheimer’s disease respectively.

2. Circadian syncing

Eating at times that don’t match our body’s natural daily rhythms can disrupt how our organs work. Studies in shift workers have suggested this might also make us more prone to chronic disease.

Time-restricted eating is when you eat your meals within a six to ten-hour window during the day when you’re most active. Time-restricted eating causes changes in expression of genes in tissue and helps the body during rest and activity.

A 2021 study of 883 adults in Italy indicated those who restricted their food intake to ten hours a day were less likely to have cognitive impairment compared to those eating without time restrictions.

older man playing chess
Matching your eating to the active parts of your day may have brain benefits.
Shutterstock

3. Mitochondria

Intermittent fasting may provide brain protection through improving mitochondrial function, metabolism and reducing oxidants.

Mitochondria’s main role is to produce energy and they are crucial to brain health. Many age-related diseases are closely related to an energy supply and demand imbalance, likely attributed to mitochondrial dysfunction during ageing.

Rodent studies suggest alternate day fasting or reducing calories by up to 40% might protect or improve brain mitochondrial function. But not all studies support this theory.

4. The gut-brain axis

The gut and the brain communicate with each other via the body’s nervous systems. The brain can influence how the gut feels (think about how you get “butterflies” in your tummy when nervous) and the gut can affect mood, cognition and mental health.

In mice, intermittent fasting has shown promise for improving brain health by increasing survival and formation of neurons (nerve cells) in the hippocampus brain region, which is involved in memory, learning and emotion.

medical clinician shows woman a sheet of brain scans
What we eat can affect our brain, and vice versa.
Shutterstock

There’s no clear evidence on the effects of intermittent fasting on cognition in healthy adults. However one 2022 study interviewed 411 older adults and found lower meal frequency (less than three meals a day) was associated with reduced evidence of Alzheimer’s disease on brain imaging.

Some research has suggested calorie restriction may have a protective effect against Alzheimer’s disease by reducing oxidative stress and inflammation and promoting vascular health.

When we look at the effects of overall energy restriction (rather than intermittent fasting specifically) the evidence is mixed. Among people with mild cognitive impairment, one study showed cognitive improvement when participants followed a calorie restricted diet for 12 months.

Another study found a 25% calorie restriction was associated with slightly improved working memory in healthy adults. But a recent study, which looked at the impact of calorie restriction on spatial working memory, found no significant effect.

Bottom line

Studies in mice support a role for intermittent fasting in improving brain health and ageing, but few studies in humans exist, and the evidence we have is mixed.

Rapid weight loss associated with calorie restriction and intermittent fasting can lead to nutrient deficiencies, muscle loss, and decreased immune function, particularly in older adults whose nutritional needs may be higher.

Further, prolonged fasting or severe calorie restriction may pose risks such as fatigue, dizziness, and electrolyte imbalances, which could exacerbate existing health conditions.

If you’re considering intermittent fasting, it’s best to seek advice from a health professional such as a dietitian who can provide guidance on structuring fasting periods, meal timing, and nutrient intake. This ensures intermittent fasting is approached in a safe, sustainable way, tailored to individual needs and goals.The Conversation

Hayley O’Neill, Assistant Professor, Faculty of Health Sciences and Medicine, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Latest Alzheimer’s Prevention Research Updates

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    Questions and Answers at 10almonds

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    I am now in the “aging” population. A great concern for me is Alzheimers. My father had it and I am so worried. What is the latest research on prevention?

    One good thing to note is that while Alzheimer’s has a genetic component, it doesn’t appear to be hereditary per se. Still, good to be on top of these things, and it’s never too early to start with preventive measures!

    You might like a main feature we did on this recently:

    See: How To Reduce Your Alzheimer’s Risk

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  • Falling vaccination rates put children at risk of preventable diseases. Governments need a new strategy to boost uptake

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    Child vaccination is one of the most cost-effective health interventions. It accounts for 40% of the global reduction in infant deaths since 1974 and has led to big health gains in Australia over the past two decades.

    Australia has been a vaccination success story. Ten years after we begun mass vaccination against polio in 1956, it was virtually eliminated. Our child vaccination rates have been among the best in the world.

    But after peaking in 2020, child vaccination in Australia is falling. Governments need to implement a comprehensive strategy to boost vaccine uptake, or risk exposing more children to potentially preventable infectious diseases.

    Yuri A/Shutterstock

    Child vaccination has been a triumph

    Thirty years ago, Australia’s childhood vaccination rates were dismal. Then, in 1997, governments introduced the National Immunisation Program to vaccinate children against diseases such as diphtheria, tetanus, and measles.

    Measures to increase coverage included financial incentives for parents and doctors, a public awareness campaign, and collecting and sharing local data to encourage the least-vaccinated regions to catch up with the rest of the country.

    What followed was a public health triumph. In 1995, only 52% of one-year-olds were fully immunised. By 2020, Australia had reached 95% coverage for one-year-olds and five-year-olds. At this level, it’s difficult even for highly infectious diseases, such as measles, to spread in the community, protecting both the vaccinated and unvaccinated.

    Nurse talks to mother and toddler
    By 2020, 95% of children were vaccinated. Drazen Zigic/Shutterstock

    Gaps between regions and communities closed too. In 1999, the Northern Territory’s vaccination rate for one-year-olds was the lowest in the country, lagging the national average by six percentage points. By 2020, that gap had virtually disappeared.

    The difference between vaccination rates for First Nations children and other children also narrowed considerably.

    It made children healthier. The years of healthy life lost due to vaccine-preventable diseases for children aged four and younger fell by nearly 40% in the decade to 2015.

    Some diseases have even been eliminated in Australia.

    Our success is slipping away

    But that success is at risk. Since 2020, the share of children who are fully vaccinated has fallen every year. For every child vaccine on the National Immunisation Schedule, protection was lower in 2024 than in 2020.

    Gaps between parts of Australia are opening back up. Vaccination rates in the highest-coverage parts of Australia are largely stable, but they are falling quickly in areas with lower vaccination.

    In 2018, there were only ten communities where more than 10% of one-year-old children were not fully vaccinated. Last year, that number ballooned to 50 communities. That leaves more areas vulnerable to disease and outbreaks.

    While Noosa, the Gold Coast Hinterland and Richmond Valley (near Byron Bay) have persistently had some of the country’s lowest vaccination rates, areas such as Manjimup in Western Australia and Tasmania’s South East Coast have recorded big declines since 2018.

    Missing out on vaccination isn’t just a problem for children.

    One preprint study (which is yet to be peer-reviewed) suggests vaccination during pregnancy may also be declining.

    Far too many older Australians are missing out on recommended vaccinations for flu, COVID, pneumococcal and shingles. Vaccination rates in aged care homes for flu and COVID are worryingly low.

    What’s going wrong?

    Australia isn’t alone. Since the pandemic, child vaccination rates have fallen in many high-income countries, including New Zealand, the United Kingdom and the United States.

    Globally, in 2023, measles cases rose by 20%, and just this year, a measles outbreak in rural Texas has put at least 13 children in hospital.

    Alarmingly, some regions in Australia have lower measles vaccination than that Texas county.

    The timing of trends here and overseas suggests things shifted, or at least accelerated, during the pandemic. Vaccine hesitancy, fuelled by misinformation about COVID vaccines, is a growing threat.

    This year, vaccine sceptic Robert F. Kennedy Jr was appointed to run the US health system, and Louisiana’s top health official has reportedly cancelled the promotion of mass vaccination.

    In Australia, a recent survey found 6% of parents didn’t think vaccines were safe, and 5% believed they don’t work.

    Those concerns are far more common among parents with children who are partially vaccinated or unvaccinated. Among the 2% of parents whose children are unvaccinated, almost half believe vaccines are not safe for their child, and four in ten believe vaccines didn’t work.

    Other consequences of the pandemic were a spike in the cost of living, and a health system struggling to meet demand. More than one in ten parents said cost and difficulty getting an appointment were barriers to vaccinating their children.

    There’s no single cause of sliding vaccination rates, so there’s no one solution. The best way to reverse these worrying trends is to work on all the key barriers at once – from a lack of awareness, to inconvenience, to lack of trust.

    What governments should do

    Governments should step up public health campaigns that counter misinformation, boost awareness of immunisation and its benefits, and communicate effectively to low-vaccination groups. The new Australian Centre for Disease Control should lead the charge.

    Primary health networks, the regional bodies responsible for improving primary care, should share data on vaccination rates with GPs and pharmacies. These networks should also help make services more accessible to communities who are missing out, such as migrant groups and disadvantaged families.

    State and local governments should do the same, sharing data and providing support to make maternal child health services and school-based vaccination programs accessible for all families.

    A girl and clinician smile at each other
    Governments can communicate better about the benefits of vaccination. Yuri A/Shutterstock

    Governments should also be more ambitious about tackling the growing vaccine divides between different parts of the country. The relevant performance measure in the national vaccination agreement is weak. States must only increase five-year-old vaccination rates in four of the ten areas where it is lowest. That only covers a small fraction of low-vaccination areas, and only the final stage of child vaccination.

    Australia needs to set tougher goals, and back them with funding.

    Governments should fund tailored interventions in areas with the lowest rates of vaccination. Proven initiatives include training trusted community members as “community champions” to promote vaccinations, and pop-up clinics or home visits for free vaccinations.

    At this time of year, childcare centres and schools are back in full swing. But every year, each new intake has less protection than the previous cohort. Governments are developing a new national vaccination strategy and must seize the opportunity to turn that trend around. If it commits to a bold national plan, Australia can get back to setting records for child vaccination.

    Peter Breadon, Program Director, Health and Aged Care, Grattan Institute and Wendy Hu, Associate, Health Program, Grattan Institute

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Hashimoto’s Food Pharmacology – by Dr. Izabella Wentz

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    The author is a doctor of pharmacology, and we’ve featured her before as an expert on Hashimoto’s, which she has. She has recommendations about specific blood tests and medications, but in this book she’s mainly focussing on what she calls the “three Rs” of managing hypothyroidism:

    1. Remove the causes and triggers of your hypothyroidism, so far as possible
    2. Repair the damage caused to your body, especially your gut
    3. Replace the thyroid hormones and related things in which your body has become deficient

    To this end, she provides recipes that avoid processed meats and unfermented dairy, and include plenty of nutrient-dense whole foods specifically tailored to meet the nutritional needs of someone with hypothyroidism.

    A nice bonus of the presentation of recipes (of which there are 125, if we include things like “mint tea” and “tomato sauce” and “hot lemon water” as recipes) is explaining the thyroid-supporting elements of each recipe.

    A downside for some will be that if you are vegetarian/vegan, this book is very much not, and since many recipes are paleo-style meat dishes, substitutions will change the nutritional profile completely.

    Bottom line: if you have hypothyroidism (especially if: Hashimoto’s) and like meat, this will be a great recipe book for you.

    Click here to check out Hashimoto’s Food Pharmacology, and get cooking!

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  • Having an x-ray to diagnose knee arthritis might make you more likely to consider potentially unnecessary surgery

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Osteoarthritis is a leading cause of chronic pain and disability, affecting more than two million Australians.

    Routine x-rays aren’t recommended to diagnose the condition. Instead, GPs can make a diagnosis based on symptoms and medical history.

    Yet nearly half of new patients with knee osteoarthritis who visit a GP in Australia are referred for imaging. Osteoarthritis imaging costs the health system A$104.7 million each year.

    Our new study shows using x-rays to diagnose knee osteoarthritis can affect how a person thinks about their knee pain – and can prompt them to consider potentially unnecessary knee replacement surgery.

    pikselstock/Shutterstock

    What happens when you get osteoarthritis?

    Osteoarthritis arises from joint changes and the joint working extra hard to repair itself. It affects the entire joint, including the bones, cartilage, ligaments and muscles.

    It is most common in older adults, people with a high body weight and those with a history of knee injury.

    Many people with knee osteoarthritis experience persistent pain and have difficulties with everyday activities such as walking and climbing stairs.

    How is it treated?

    In 2021–22, more than 53,000 Australians had knee replacement surgery for osteoarthritis.

    Hospital services for osteoarthritis, primarily driven by joint replacement surgery, cost $3.7 billion in 2020–21.

    While joint replacement surgery is often viewed as inevitable for osteoarthritis, it should only be considered for those with severe symptoms who have already tried appropriate non-surgical treatments. Surgery carries the risk of serious adverse events, such as blood clot or infection, and not everyone makes a full recovery.

    Most people with knee osteoarthritis can manage it effectively with:

    • education and self-management
    • exercise and physical activity
    • weight management (if necessary)
    • medicines for pain relief (such as paracetamol and non-steroidal anti-inflammatory drugs).

    Debunking a common misconception

    A common misconception is that osteoarthritis is caused by “wear and tear”.

    However, research shows the extent of structural changes seen in a joint on an x-ray does not reflect the level of pain or disability a person experiences, nor does it predict how symptoms will change.

    Some people with minimal joint changes have very bad symptoms, while others with more joint changes have only mild symptoms. This is why routine x-rays aren’t recommended for diagnosing knee osteoarthritis or guiding treatment decisions.

    Instead, guidelines recommend a “clinical diagnosis” based on a person’s age (being 45 years or over) and symptoms: experiencing joint pain with activity and, in the morning, having no joint-stiffness or stiffness that lasts less than 30 minutes.

    Despite this, many health professionals in Australia continue to use x-rays to diagnose knee osteoarthritis. And many people with osteoarthritis still expect or want them.

    What did our study investigate?

    Our study aimed to find out if using x-rays to diagnose knee osteoarthritis affects a person’s beliefs about osteoarthritis management, compared to a getting a clinical diagnosis without x-rays.

    We recruited 617 people from across Australia and randomly assigned them to watch one of three videos. Each video showed a hypothetical consultation with a general practitioner about knee pain.

    Woman descends steps
    People with knee osteoarthritis can have difficulties getting down stairs. beeboys/Shutterstock

    One group received a clinical diagnosis of knee osteoarthritis based on age and symptoms, without being sent for an x-ray.

    The other two groups had x-rays to determine their diagnosis (the doctor showed one group their x-ray images and not the other).

    After watching their assigned video, participants completed a survey about their beliefs about osteoarthritis management.

    What did we find?

    People who received an x-ray-based diagnosis and were shown their x-ray images had a 36% higher perceived need for knee replacement surgery than those who received a clinical diagnosis (without x-ray).

    They also believed exercise and physical activity could be more harmful to their joint, were more worried about their condition worsening, and were more fearful of movement.

    Interestingly, people were slightly more satisfied with an x-ray-based diagnosis than a clinical diagnosis.

    This may reflect the common misconception that osteoarthritis is caused by “wear and tear” and an assumption that the “damage” inside the joint needs to be seen to guide treatment.

    What does this mean for people with osteoarthritis?

    Our findings show why it’s important to avoid unnecessary x-rays when diagnosing knee osteoarthritis.

    While changing clinical practice can be challenging, reducing unnecessary x-rays could help ease patient anxiety, prevent unnecessary concern about joint damage, and reduce demand for costly and potentially unnecessary joint replacement surgery.

    It could also help reduce exposure to medical radiation and lower health-care costs.

    Previous research in osteoarthritis, as well as back and shoulder pain, similarly shows that when health professionals focus on joint “wear and tear” it can make patients more anxious about their condition and concerned about damaging their joints.

    If you have knee osteoarthritis, know that routine x-rays aren’t needed for diagnosis or to determine the best treatment for you. Getting an x-ray can make you more concerned and more open to surgery. But there are a range of non-surgical options that could reduce pain, improve mobility and are less invasive.

    Belinda Lawford, Senior Research Fellow in Physiotherapy, The University of Melbourne; Kim Bennell, Professor of Physiotherapy, The University of Melbourne; Rana Hinman, Professor in Physiotherapy, The University of Melbourne, and Travis Haber, Postdoctoral Research Fellow in Physiotherapy, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • The Exercise That Protects Your Brain

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    The Neuroscientist In The Gym

    This is Dr. Wendy Suzuki. She’s a neuroscientist, and an expert in the neurobiology of memory, as well as neuroplasticity, and the role of exercise in neuroprotection.

    We’ve sneakily semi-featured her before when we shared her Big Think talk:

    Brain Benefits In Three Months… Through Walking?

    Today we’re going to expand on that a little!

    A Quick Recap

    To share the absolute key points of that already fairly streamlined rundown:

    • Exercise boosts levels of neurotransmitters such as dopamine and serotonin (and, which wasn’t mentioned there, noradrenaline)
      • These are responsible for motivation, happiness, and focus (amongst other things)
    • Persistent exercise boosts certain regions of the brain in particular, most notably the pre-frontal cortex and the hippocampi*
      • These are responsible for planning and memory (amongst other things)

    Dr. Suzuki advocates for stepping up your exercise routine if you can, with more exercise generally being better than less (unless you have some special medical reason why that’s not the case for you).

    *often referred to in the singular as the hippocampus, but you have one on each side of your brain (unless a serious accident/incident destroyed one, but you’ll know if that applies to you, unless you lost both, in which case you will not remember about it).

    What kind(s) of workout?

    While a varied workout is best for overall health, for these brain benefits specifically, what’s most important is that it raises your heart rate.

    This is why in her Big Think talk we shared before, she talks about the benefits of taking a brisk walk daily. See also:

    Walking, Better

    If that’s not your thing, though (and/or is for whatever reason an inaccessible form of exercise for you), there is almost certainly some kind of High Intensity Interval Training that is a possibility for you. That might sound intimidating, but if you have a bit of floor and can exercise for one minute at a time, then HIIT is an option for you:

    How To Do HIIT (Without Wrecking Your Body)

    Dr. Suzuki herself is an ardent fan of “intenSati” which blends cardio workouts with yoga for holistic mind-and-body fitness. In fact, she loves it so much that she became a certified exercise instructor:

    Wendy Suzuki | IntenSati

    How much is enough?

    It’s natural to want to know the minimum we can do to get results, but Dr. Suzuki would like us to bear in mind that when it comes to our time spent exercising, it’s not so much an expense of time as an investment in time:

    ❝Exercise is something that when you spend time on it, it will buy you time when you start to work❞

    ~ Dr. Wendy Suzuki

    Read more: A Neuroscientist Experimented on Her Students and Found a Powerful Way to Improve Brain Function

    Ok, but we really want to know how much!

    Dr. Suzuki recommends at least three to four 30-minute exercise sessions per week.

    Note: this adds up to less than the recommended 150 minutes of moderate exercise per week, but high-intensity exercise counts for twice the minutes for these purposes, e.g. 1 minute of high-intensity exercise is worth 2 minutes of moderate exercise.

    How soon will we see benefits?

    Benefits start immediately, but stack up cumulatively with continued long-term exercise:

    ❝My lab showed that a single workout can improve your ability to shift and focus attention, and that focus improvement will last for at least two hours. ❞

    ~ Dr. Wendy Suzuki

    …which is a great start, but what’s more exciting is…

    ❝The more you’re working out, the bigger and stronger your hippocampus and prefrontal cortex gets. Why is that important?

    Because the prefrontal cortex and the hippocampus are the two areas that are most susceptible to neurodegenerative diseases and normal cognitive decline in aging. ❞

    ~ Dr. Wendy Suzuki

    In other words, while improving your heart rate through regular exercise will help prevent neurodegeneration by the usual mechanism of reducing neuroinflammation… It’ll also build the parts of your brain most susceptible to decline, meaning that when/if decline sets in, it’ll take a lot longer to get to a critical level of degradation, because it had more to start with.

    Read more:

    Inspir Modern Senior Living | Dr. Wendy Suzuki Boosts Brain Health with Exercise

    Want more from Dr. Suzuki?

    You might enjoy her TED talk:

    Click Here If The Embedded Video Doesn’t Load Automatically

    Prefer text? TED.com has a transcript for you

    Prefer lots of text? You might like her book, which we haven’t reviewed yet but will soon:

    Healthy Brain, Happy Life: A Personal Program to Activate Your Brain and Do Everything Better – by Dr. Wendy Suzuki

    Enjoy!

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  • Do you have knee pain from osteoarthritis? You might not need surgery. Here’s what to try instead

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    Most people with knee osteoarthritis can control their pain and improve their mobility without surgery, according to updated treatment guidelines from the Australian Commission on Safety and Quality in Health Care.

    So what is knee osteoarthritis and what are the best ways to manage it?

    Pexels/Kindelmedia

    More than 2 million Australians have osteoarthritis

    Osteoarthritis is the most common joint disease, affecting 2.1 million Australians. It costs the economy A$4.3 billion each year.

    Osteoarthritis commonly affects the knees, but can also affect the hips, spine, hands and feet. It impacts the whole joint including bone, cartilage, ligaments and muscles.

    Most people with osteoarthritis have persistent pain and find it difficult to perform simple daily tasks, such as walking and climbing stairs.

    Is it caused by ‘wear and tear’?

    Knee osteoarthritis is most likely to affect older people, those who are overweight or obese, and those with previous knee injuries. But contrary to popular belief, knee osteoarthritis is not caused by “wear and tear”.

    Research shows the degree of structural wear and tear visible in the knee joint on an X-ray does not correlate with the level of pain or disability a person experiences. Some people have a low degree of structural wear and tear and very bad symptoms, while others have a high degree of structural wear and tear and minimal symptoms. So X-rays are not required to diagnose knee osteoarthritis or guide treatment decisions.

    Telling people they have wear and tear can make them worried about their condition and afraid of damaging their joint. It can also encourage them to try invasive and potentially unnecessary treatments such as surgery. We have shown this in people with osteoarthritis, and other common pain conditions such as back and shoulder pain.

    This has led to a global call for a change in the way we think and communicate about osteoarthritis.

    What’s the best way to manage osteoarthritis?

    Non-surgical treatments work well for most people with osteoarthritis, regardless of their age or the severity of their symptoms. These include education and self-management, exercise and physical activity, weight management and nutrition, and certain pain medicines.

    Education is important to dispel misconceptions about knee osteoarthritis. This includes information about what osteoarthritis is, how it is diagnosed, its prognosis, and the most effective ways to self-manage symptoms.

    Health professionals who use positive and reassuring language can improve people’s knowledge and beliefs about osteoarthritis and its management.

    Many people believe that exercise and physical activity will cause further damage to their joint. But it’s safe and can reduce pain and disability. Exercise has fewer side effects than commonly used pain medicines such as paracetamol and anti-inflammatories and can prevent or delay the need for joint replacement surgery in the future.

    Many types of exercise are effective for knee osteoarthritis, such as strength training, aerobic exercises like walking or cycling, Yoga and Tai chi. So you can do whatever type of exercise best suits you.

    Increasing general physical activity is also important, such as taking more steps throughout the day and reducing sedentary time.

    Weight management is important for those who are overweight or obese. Weight loss can reduce knee pain and disability, particularly when combined with exercise. Losing as little as 5–10% of your body weight can be beneficial.

    Pain medicines should not replace treatments such as exercise and weight management but can be used alongside these treatments to help manage pain. Recommended medicines include paracetamol and non-steroidal anti-inflammatory drugs.

    Opioids are not recommended. The risk of harm outweighs any potential benefits.

    What about surgery?

    People with knee osteoarthritis commonly undergo two types of surgery: knee arthroscopy and knee replacement.

    Knee arthroscopy is a type of keyhole surgery used to remove or repair damaged pieces of bone or cartilage that are thought to cause pain.

    However, high-quality research has shown arthroscopy is not effective. Arthroscopy should therefore not be used in the management of knee osteoarthritis.

    Joint replacement involves replacing the joint surfaces with artificial parts. In 2021–22, 53,500 Australians had a knee replacement for their osteoarthritis.

    Joint replacement is often seen as being inevitable and “necessary”. But most people can effectively manage their symptoms through exercise, physical activity and weight management.

    The new guidelines (known as “care standard”) recommend joint replacement surgery only be considered for those with severe symptoms who have already tried non-surgical treatments.

    I have knee osteoarthritis. What should I do?

    The care standard links to free evidence-based resources to support people with osteoarthritis. These include:

    If you have osteoarthritis, you can use the care standard to inform discussions with your health-care provider, and to make informed decisions about your care.

    Belinda Lawford, Postdoctoral research fellow in physiotherapy, The University of Melbourne; Giovanni E. Ferreira, NHMRC Emerging Leader Research Fellow, Institute of Musculoskeletal Health, University of Sydney; Joshua Zadro, NHMRC Emerging Leader Research Fellow, Sydney Musculoskeletal Health, University of Sydney, and Rana Hinman, Professor in Physiotherapy, The University of Melbourne

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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