How To Really Look After Your Joints
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The Other Ways To Look After Your Joints
When it comes to joint health, most people have two quick go-to items:
- Stretching
- Supplements like omega-3 and glucosamine sulfate
Stretching, and specifically, mobility exercises, are important! We’ll have to do a main feature on these sometime soon. But for today, we’ll just say: yes, gentle daily stretches go a long way, as does just generally moving more.
And, those supplements are not without their merits. For example:
- Effect of omega-3 on painful symptoms of patients with osteoarthritis of the synovial joints: systematic review and meta-analysis
- Glucosamine sulfate in the treatment of knee osteoarthritis symptoms: a randomized, double-blind, placebo-controlled study using acetaminophen as a side comparator
Of those, glucosamine sulfate may have an extra benefit in now just alleviating the symptoms, but also slowing the progression of degenerative joint conditions (like arthritis of various kinds). This is something it shares with chondroitin sulfate:
Effect of glucosamine or chondroitin sulfate on the osteoarthritis progression: a meta-analysis
An unlikely extra use for the humble cucumber…
As it turns out, cucumber extract beats glucosamine and chondroitin by 200%, at 1/135th of the dose.
You read that right, and it’s not a typo. See for yourself:
Reduce inflammation, have happier joints
Joint pain and joint degeneration in general is certainly not just about inflammation; there is physical wear-and-tear too. But combatting inflammation is important, and turmeric, which we’ve done a main feature on before, is a potent helper in this regard:
See also: Keep Inflammation At Bay
(a whole list of tips for, well, keeping inflammation at bay)
About that wear-and-tear…
Your bones and joints are made of stuff, and that stuff needs to be replaced. As we get older, the body typically gets worse at replacing it in a timely and efficient fashion. We can help it do its job, by giving it more of the stuff it needs.
And what stuff is that?
Well, minerals like calcium and phosphorus are important, but a lot is also protein! Specifically, collagen. We did a main feature on this before, which is good, as it’d take us a lot of space to cover all the benefits here:
We Are Such Stuff As Fish Are Made Of
Short version? People take collagen for their skin, but really, its biggest benefit is for our bones and joints!
Wrap up warmly and… No wait, skip that.
If you have arthritis, you may indeed “feel it in your bones” when the weather changes. But the remedy for that is not to try to fight it, but rather, to strengthen your body’s ability to respond to it.
The answer? Cryotherapy, with ice baths ranking top:
- Effects of an Exercise Program and Cold-Water Immersion Recovery in Patients with Rheumatoid Arthritis (RA): Feasibility Study
- Effectiveness of home-based conventional exercise and cryotherapy on daily living activities in patients with knee osteoarthritis: A randomized controlled clinical trial
- Local Cryotherapy, Comparison of Cold Air and Ice Massage on Pain and Handgrip Strength in Patients with Rheumatoid Arthritis
Note that this can be just localized, so for example if the problem joints are your wrists, a washing-up bowl with water and ice will do just nicely.
Note also that, per that last study, a single session will only alleviate the pain, not the disease itself. For that (per the other studies) more sessions are required.
We did a main feature about cryotherapy a while back, and it explains how and why it works:
A Cold Shower A Day Keeps The Doctor Away?
Take care!
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Level-Up Your Fiber Intake! (Without Difficulty Or Discomfort)
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Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
First things first… How much fiber should we be eating?
- The World Health Organization recommends we each get at least 25g of fiber per day:
- A more recent meta-review of studies, involving thousands of people and decades of time, suggests 25–29g is ideal:
- The British Nutritional Foundation gives 30g as the figure:
- The US National Academy of Sciences’ Institute of Medicine recommends 21g–38g per day, depending on age and sex:
- A large study last year gave 30–40g as the figure:
*This one is also a great read to understand more about the “why” of fiber
Meanwhile, the average American gets 16g of fiber per day.
So, how to get more fiber, without piling on too many carbs?
Foods that contain fiber generally contain carbs (there’s a limit to how much celery most people want to eat), so there are two key ideas here:
- Getting a good carb:fiber ratio
- Making substitutions that boost fiber without overdoing (or in some case, even changing) carbs
Meat → Lentils
Well-seasoned lentils can be used to replaced ground beef or similar. A cup of boiled lentils contains 18g of fiber, so you’re already outdoing the average American’s daily total.
Meat → Beans
Black beans are a top-tier option here (15g per cup, cooked weight), but many kinds of beans are great.
Chicken/Fish → Chickpeas
Yes, chicken/fish is already meat, but we’re making a case for chickpeas here. Cooked and seasoned appropriately, they do the job, and pack in 12g of fiber per cup. Also… Hummus!
Bonus: Hummus, eaten with celery sticks.
White pasta/bread → Wholewheat pasta/bread
This is one where “moderation is key”, but if you’re going to eat pasta/bread, then wholewheat is the way to go. Fiber amounts vary, so read labels, but it will always have far more than white.
Processed salty snacks → Almonds and other nuts
Nuts in general are great, but almonds are top-tier for fiber, amongst other things. A 40g handful of almonds contains about 10g of fiber.
Starchy vegetables → Non-starchy vegetables
Potatoes, parsnips, and their friends have their place. But they cannot compete with broccoli, peas, cabbage, and other non-starchy vegetables for fiber content.
Bonus: if you’re going to have starchy vegetables though, leave the skins on!
Fruit juice → Fruit
Fruit juice has had most, if not all, of its fiber removed. Eat an actual juicy fruit, instead. Apples and bananas are great options; berries such as blackberries and raspberries are even better (at around 8g per cup, compared to the 5g or so depending on the size of an apple/banana)
Processed cereals → Oats
5g fiber per cup. Enough said.
Summary
Far from being a Herculean task, getting >30g of fiber per day can be easily accomplished by a lentil ragù with wholewheat pasta.
If your breakfast is overnight oats with fruit and some chopped almonds, you can make it to >20g already by the time you’ve finished your first meal of the day.
Enjoy!
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Walking… Better.
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Walking… Better.
We recently reviewed “52 Ways To Walk” by Annabel Streets. You asked us to share some more of our learnings from that book, and… Obviously we can’t do all 52, nor go into such detail, but here are three top tips inspired by that book…
Walk in the cold!
While cold weather is often seen as a reason to not walk, in fact, it has numerous health benefits, the most exciting of which might be:
Walking in the cold causes us to convert white and yellow fat into the healthier brown fat. If you didn’t know about this, neither did scientists until about 15 years ago.
In fact, scientists didn’t even know that adult humans could even have brown adipose tissue! It was really quite groundbreaking.
In case you missed it: The Changed Metabolic World with Human Brown Adipose Tissue: Therapeutic Visions
Work while you walk!
Obviously this is only appropriate for some kinds of work… but if in your life you have any kind of work that is chiefly thinking, a bunch of it can be done while walking.
Open your phone’s note-taking app, lock the screen and pocket your phone, and think on some problem that you need to solve. Whenever you have an “aha” moment, take out your phone and make a quick note on the go.
For that matter, if you have the money and space (or are fortunate to have an employer disposed towards facilitating such), you could even set up a treadmill desk… At worst, it wouldn’t harm your work (and it’ll be a LOT better than sitting for so long).
Walk within an hour of waking!
No, this doesn’t mean that if you don’t get out of the house within 60 minutes you say “Oh no, missed the window, guess it’s a day in today”
But it does mean: in the evening, make preparations to head out first thing in the morning. Set out your clothes and appropriate footwear, find your flask to fill with the beverage of your choice in the morning and set that with them.
Then, when morning arrives… do your morning necessaries (e.g. some manner of morning ablutions and perhaps a light breakfast), make that drink for your flask, and hit the road.
Why? We’ll tell you a secret:
You ever wondered why some people seem to be more able to keep a daylight-regulated circadian rhythm than others? It’s not just about smartphones and coffees…
This study found that getting sunlight (not electric light, not artificial sunlight, but actual sunlight, from the sun, even if filtered through partial cloud) between 08:30—09:00 resulted in higher levels of a protein called PER2. PER2 is critical for setting circadian rhythms, improving metabolism, and fortifying blood vessels.
Besides, on a more simplistic level, it’s also a wonderful and energizing start to a healthy and productive day!
Read: Beneficial effects of daytime light exposure on daily rhythms, metabolic state and affect
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New News From The Centenarian Blue Zones
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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 the US, which is 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:
- 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.
- 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.
- 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.
- 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).
And showing that yes, even parks in cities make a significant difference:
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!
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Complex PTSD – by Pete Walker
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We’ve written before about Complex PTSD, but there’s a lot more to be said than we can fit into an article or two.
Pete Walker, a licensed marriage and family therapist, does an excellent job and pulls no punches, starting from the book’s dedication and carrying the hard-hitting seriousness all the way through to the Appendices.
To this end, it absolutely may not be an easy book to read at times (emotionally speaking), especially if you have C-PTSD. On the other hand, you may also find it a very validating 300-odd pages of “Yes, he is telling my life story in words, now this makes sense!”
That said, it’s mostly not an anecdotes-based book and nor is it just a feelsy ride; it’s also a textbook and a how-to manual. It’s a textbook of how and why things come about the way they do, and a manual of how to effectively manage C-PTSD, and find peace. There’s no silver bullet here, but there is a very comprehensive guide, and chapters full of tools to use (and no, not the same CBT things you’ve probably read a hundred times, this is C-PTSD-specific stuff).
Bottom line: this is the C-PTSD book; if you buy only one book on the topic, make it this one.
Click here to check out Complex PTSD: From Surviving To Thriving, and indeed thrive!
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A new government inquiry will examine women’s pain and treatment. How and why is it different?
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The Victorian government has announced an inquiry into women’s pain. Given women are disproportionately affected by pain, such a thorough investigation is long overdue.
The inquiry, the first of its kind in Australia and the first we’re aware of internationally, is expected to take a year. It aims to improve care and services for Victorian girls and women experiencing pain in the future.
The gender pain gap
Globally, more women report chronic pain than men do. A survey of over 1,750 Victorian women found 40% are living with chronic pain.
Approximately half of chronic pain conditions have a higher prevalence in women compared to men, including low back pain and osteoarthritis. And female-specific pain conditions, such as endometriosis, are much more common than male-specific pain conditions such as chronic prostatitis/chronic pelvic pain syndrome.
These statistics are seen across the lifespan, with higher rates of chronic pain being reported in females as young as two years old. This discrepancy increases with age, with 28% of Australian women aged over 85 experiencing chronic pain compared to 18% of men.
It feels worse
Women also experience pain differently to men. There is some evidence to suggest that when diagnosed with the same condition, women are more likely to report higher pain scores than men.
Similarly, there is some evidence to suggest women are also more likely to report higher pain scores during experimental trials where the same painful pressure stimulus is applied to both women and men.
Pain is also more burdensome for women. Depression is twice as prevalent in women with chronic pain than men with chronic pain. Women are also more likely to report more health care use and be hospitalised due to their pain than men.
Women seem to feel pain more acutely and often feel ignored by doctors.
ShutterstockMedical misogyny
Women in pain are viewed and treated differently to men. Women are more likely to be told their pain is psychological and dismissed as not being real or “all in their head”.
Hollywood actor Selma Blair recently shared her experience of having her symptoms repeatedly dismissed by doctors and put down to “menstrual issues”, before being diagnosed with multiple sclerosis in 2018.
It’s an experience familiar to many women in Australia, where medical misogyny still runs deep. Our research has repeatedly shown Australian women with pelvic pain are similarly dismissed, leading to lengthy diagnostic delays and serious impacts on their quality of life.
Misogyny exists in research too
Historically, misogyny has also run deep in medical research, including pain research. Women have been viewed as smaller bodied men with different reproductive functions. As a result, most pre-clinical pain research has used male rodents as the default research subject. Some researchers say the menstrual cycle in female rodents adds additional variability and therefore uncertainty to experiments. And while variability due to the menstrual cycle may be true, it may be no greater than male-specific sources of variability (such as within-cage aggression and dominance) that can also influence research findings.
The exclusion of female subjects in pre-clinical studies has hindered our understanding of sex differences in pain and of response to treatment. Only recently have we begun to understand various genetic, neurochemical, and neuroimmune factors contribute to sex differences in pain prevalence and sensitivity. And sex differences exist in pain processing itself. For instance, in the spinal cord, male and female rodents process potentially painful stimuli through entirely different immune cells.
These differences have relevance for how pain should be treated in women, yet many of the existing pharmacological treatments for pain, including opioids, are largely or solely based upon research completed on male rodents.
When women seek care, their pain is also treated differently. Studies show women receive less pain medication after surgery compared to men. In fact, one study found while men were prescribed opioids after joint surgery, women were more likely to be prescribed antidepressants. In another study, women were more likely to receive sedatives for pain relief following surgery, while men were more likely to receive pain medication.
So, women are disproportionately affected by pain in terms of how common it is and sensitivity, but also in how their pain is viewed, treated, and even researched. Women continue to be excluded, dismissed, and receive sub-optimal care, and the recently announced inquiry aims to improve this.
What will the inquiry involve?
Consumers, health-care professionals and health-care organisations will be invited to share their experiences of treatment services for women’s pain in Victoria as part of the year-long inquiry. These experiences will be used to describe the current service delivery system available to Victorian women with pain, and to plan more appropriate services to be delivered in the future.
Inquiry submissions are now open until March 12 2024. If you are a Victorian woman living with pain, or provide care to Victorian women with pain, we encourage you to submit.
The state has an excellent track record of improving women’s health in many areas, including heart, sexual, and reproductive health, but clearly, we have a way to go with women’s pain. We wait with bated breath to see the results of this much-needed investigation, and encourage other states and territories to take note of the findings.
Jane Chalmers, Senior Lecturer in Pain Sciences, University of South Australia and Amelia Mardon, PhD Candidate, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Chia vs Sesame – Which is Healthier?
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Our Verdict
When comparing chia to sesame, we picked the chia.
Why?
This might not be a shocking decision; after all, chia has an awesome reputation, and it’s well deserved. But sesame seeds are great too, and definitely have their strengths!
In terms of macros, chia seeds have more than 3x the fiber (which is lots) for a little over 1.5x the carbs (giving it the lower glycemic index), and about equal protein. The matter of fats is also interesting: sesame seeds have nearly 2x the fat, but chia seeds have the better fats profile, with less saturated fat and more omega-3s. All in all, a sound win for chia in this category!
In the category of vitamins, chia seeds have more of vitamins B3, C, E, and choline, while sesame seeds have more of vitamins B1, B2, and B9. A more marginal win for chia here.
When it comes to minerals, chia seeds have more phosphorus, manganese, and selenium, while sesame seeds have more calcium, copper, iron, and zinc, making it a marginal win for sesame seeds this time!
Adding up the sections make for an overall win for chia (especially if we were to consider the macros category for its full weight, given the importance of those components, but it’s still a 2:1 win for chia even if we pay no attention to that), but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like:
The Tiniest Seeds With The Most Value: If You’re Not Taking Chia, You’re Missing Out
Enjoy!
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