What are the key risk factors for developing knee osteoarthritis? We reviewed theĀ evidence
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Osteoarthritis is the most common joint disease, affecting more than 3 million Australians and over 500 million people worldwide.
The knee is the most commonly affected joint, but osteoarthritis can also affect other joints including the hips and hands. The condition causes painful and stiff joints.
For someone with knee osteoarthritis, simple activities that many people take for granted such as walking, going up and down stairs or squatting can be very challenging.
Thereās currently no cure for osteoarthritis. Most available treatments, such as exercise, walking aids and medicines (including paracetamol and non-steroidal anti-inflammatory drugs), focus on managing symptoms. But itās important to consider how we can prevent knee osteoarthritis in the first place.
With this in mind, we undertook a systematic review to summarise the risk factors for developing knee osteoarthritis. Our findings, published today in the journal Osteoarthritis and Cartilage, can help us better understand how to lower the risk of this condition.
What we found
We gathered data from studies which followed people over time, to see which risk factors were associated with developing knee osteoarthritis. We included a total of 131 studies, involving more than 5 million people.
We identified more than 150 factors that influenced the risk of developing knee osteoarthritis.
Some key factors which increased the risk of developing knee osteoarthritis included being overweight or obese, past knee injury and occupational physical activity such as lifting heavy objects and shift work.
We also found several other possible risk factors, including:
- eating large amounts of ultra-processed foods (which include ājunk foodsā, sugary drinks and processed meats)
- poor sleep quality (for example, sleeping less than six hours a day or having 1ā2 restless nights per week)
- feeling depressed.
Being overweight or obese and past knee injury together accounted for 14% of the overall risk of developing knee osteoarthritis.
In other words, if we were able to completely remove these two risk factors, we could potentially reduce the incidence of knee osteoarthritis in the population by 14%.
Females had almost double the risk of developing knee osteoarthritis, and older age was slightly related to developing knee osteoarthritis.
Protective factors
On the other hand, we found some factors may lower the risk of developing knee osteoarthritis. These included following a Mediterranean diet (which includes plenty of vegetables, olive oil, nuts, fruit and healthy fats found in fish), and following a diet higher in fibre.
Avoiding the things which increase the risk of developing knee osteoarthritis such as a diet high in ultra-processed foods, knee injury, weight gain and heavy lifting can also help a person reduce their risk of developing the condition.
Exercise is an effective treatment for knee osteoarthritis. It can reduce pain and improve function.
There was not enough information in our study to determine what types of physical activity (for example, walking, running, swimming) and how much time spent doing these activities could lower the risk of developing knee osteoarthritis, so this is an important area for future research.
How can we explain these links?
The studies we included did not generally explore the possible mechanisms linking key risk factors with the development of knee osteoarthritis.
However other research may provide some helpful insights. Knee injury can lead to instability of the knee joint and additional wear on the knee which can lead to knee osteoarthritis. Similarly, occupational physical activity such as kneeling, squatting, climbing or heavy lifting can increase the risk of wear and tear on the knee.
Poor sleep has been linked to weight gain and depression.
The duration and quality of sleep has been found to affect how much we eat and the hormones responsible for regulating metabolism. Depression has been linked to reduced physical activity which can lead to weight gain. Carrying extra weight can increase the load on the knee and contribute to knee osteoarthritis.
Shift work can lead to bad food choices and lack of sleep, which in turn can increase the risk of knee osteoarthritis.
So it seems that while the risk factors we found may be contributing individually to the development of knee osteoarthritis, they may also be interacting together to increase the risk.
Itās not clear why women are at greater risk of developing knee osteoarthritis. However this is likely to be due to a combination of factors, including lifestyle, biological and hormonal factors.
A Mediterranean diet is high in polyphenols, which can reduce inflammation in the body and destruction of cartilage. It may lower the risk of developing knee osteoarthritis in this way.
Most risk factors are modifiable
There were some limitations with the available evidence. Most studies were based on populations from the United States, or did not report on ethnicity. We know little about the risk of developing knee osteoarthritis in certain groups such as people from Hispanic, African and Southeast Asian backgrounds. We need more studies exploring risk factors in other countries and populations.
Nonetheless, a review like this allows us to better understand what can be done to lower the risk of developing knee osteoarthritis.
We found most risk factors associated with developing knee osteoarthritis are modifiable, which means they can be changed or better managed with healthy diet and lifestyle choices. Eating healthy, maintaining a healthy weight and taking proactive steps to prevent injuries in the workplace and sporting communities can potentially lower a personās risk of developing the condition.
Public health strategies aimed at encouraging healthy eating and weight loss (for example, subsidised nutrition programs and education programs starting from a young age to promote optimal diet and physical activity) could reduce the burden of knee osteoarthritis and have broader health benefits as well.
Programs like these, as well as reducing heavy lifting in the workplace where possible, should be the focus of government strategies to address the burden of this painful condition globally.
Christina Abdel Shaheed, Associate Professor, School of Public Health, University of Sydney; David Hunter, Professor of Medicine, University of Sydney; Lyn March, Liggins Professor of Rheumatology and Musculosketal Epidemiology Medicine, Northern Clinical School, University of Sydney, and Vicky Duong, Research Fellow, Kolling Institute of Medical Research, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Anti-Inflammatory Pineapple Fried Rice
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Fried rice is not most people’s go-to when one thinks of health food, but this one is. It’s packed with plenty of nutrients, many of which are anti-inflammatory, but the real star is the pineapple (with its high bromelain content and thus particularly potent benefits).
You will need
- 2Ā½ cups cooked wholegrain basmati rice (you can use our Tasty Versatile Rice recipe if you don’t already have leftovers to use)
- 1 cup pineapple chunks
- Ā½ red onion, diced
- 1 red bell pepper, diced
- Ā½ cup sweetcorn
- Ā½ peas
- 3 green onions, chopped
- 2 serrano peppers, chopped (omit if you don’t care for heat)
- 2 tbsp coconut oil
- 1 tbsp grated fresh ginger
- 1 tbsp black pepper, coarse ground
Method
(we suggest you read everything at least once before doing anything)
1) Fry the red onion, serrano peppers, and ginger in the coconut oil over a medium heat, stirring frequently, for about 3 minutes.
2) Add the pineapple, bell pepper, sweetcorn, peas, and black pepper, stirring frequently, for about another 3 minutes.
3) Add the rice, stirring gently but thoroughly, until fully reheated and mixed in.
4) Serve, garnishing with the green onions.
Enjoy!
Want to learn more?
For those interested in some of the science of what we have going on today:
- Eat To Beat Inflammation
- Ginger Does A Lot More Than You Think
- Black Pepperās Impressive Anti-Cancer Arsenal (And More)
- Bromelain vs Inflammation & Much More
Take care!
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Brussels Sprouts vs Broccoli ā Which is Healthier?
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.
Our Verdict
When comparing sprouts to broccoli, we picked the sprouts.
Why?
First let’s note that we have an interesting comparison today, because these two plants are the exact same species (and indeed, also the exact same species as cabbage, cauliflower. and kale)ājust a different cultivar. All of these plants and more are simply cultivars of Brassica oleracea.
Them being the same species notwithstanding, there are nutritional differences:
In terms of macros, sprouts have slightly more protein, carbohydrates, and fiber, whereas broccoli has slightly more water weight. An easy win for sprouts here.
In the category of vitamins, sprouts have more of vitamins A, B1, B3, B6, C, E, and K, while broccoli has more of vitamins B2 and B5. Another easy win for sprouts.
When it comes to minerals, sprouts again lead with more copper, iron, magnesium, manganese, phosphorus, and potassium, while broccoli has more calcium and selenium.
A note on oxalates: while oxalates are not a problem for most people, it is important to be mindful of them if one has kidney problems. You may know that spinach (a fellow green vegetable high in vitamins and minerals, as well as being a fellow oleracea, albeit of a different genus, so not the same species for once) is high in oxalates, but these two Brassica oleracea we compared today are amongst the lowest in oxalates (source 1 | source 2), making them an ideal way to get vitamins, minerals, and fiber on an oxalate-controlled diet.
Since both are also high in polyphenols, especially kaempferol and quercetin, we’ll mention that sprouts have more lignans while broccoli has more flavonoids. In short: they’re both very good, just different.
As ever, enjoy both! But if you’re going to pick one for total best nutritional density, it’s sprouts.
Want to learn more?
You might like to read:
Sprout Your Seeds, Grains, Beans, Etc ā sprout your Brassica oleracea, too!
Take care!
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How To Keep Your Mind From Wandering
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Whether your mind keeps wandering more as you get older, or youāre a young student whose super-active brain is more suited to TikTok than your assigned reading, sustained singular focus can be a challenge for everyoneāand yet (alas!) it remains a required skill for so much in life.
Todayās edition of 10Almonds presents a nifty trick to get yourself through those tasks! Weāll also be taking some time to reply to your questions and comments, in our weekly interactive Q&A.
First of all though, weāve a promise to make good on, soā¦
How To Stay On The Ball (Or The Tomato?) The Easy Way
For most of us, we face three main problems when it comes to tackling our to-dos:
- Where to start?
- The task seems intimidating in its size
- We get distracted and/or run out of energy
If youāre really not sure where to start, we recommended a powerful tool in last Fridayās newsletter!
For the rest, we love the Pomodoro Technique:
- Set a timer for 25 minutes, and begin your task.
- Keep going until the timer is done! No other tasks, just focus.
- Take a 5-minute break.
- Repeat
This approach has three clear benefits:
- No matter the size of the task, you are only committing to 25 minutesāeverything is much less overwhelming when thereās an end in sight!
- Being only 25 minutes means we are much more likely to stay on track; itās easier to defer other activities if we know that there will be a 5-minute break for that soon.
- Even without other tasks to distract us, it can be difficult to sustain attention for long periods; making it only 25 minutes at a time allows us to approach it with a (relatively!) fresh mind.
Have you heard that a human brain can sustain attention for only about 40 minutes before focus starts to decline rapidly?
While thatās been a popular rationale for school classroom lesson durations (and perhaps coincidentally ties in with Zoomās 40-minute limit for free meetings), the truth is that focus starts dropping immediately, to the point that one-minute attention tests are considered sufficient to measure the ability to focus.
So a 25-minute Pomodoro is a more than fair compromise!
Whyās it called the āPomodoroā technique?
And why is the 25-minute timed work period called a Pomodoro?
Itās because back in the 80s, university student Francesco Cirillo was struggling to focus and made a deal with himself to focus just for a short burst at a timeāand he used a (now āretroā style) kitchen timer in the shape of a tomato, or āpomodoroā, in Italian.
If you donāt have a penchant for kitsch kitchenware, you can use this free, simple Online Pomodoro Timer!
(no registration/login/download necessary; itās all right there on the web page)
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Gooseberries vs Starfruit ā Which is Healthier?
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Our Verdict
When comparing gooseberries to starfruit, we picked the gooseberries.
Why?
In terms of macros, gooseberries have nearly 2x the fiber for slightly more carbs and the same (minimal) protein, adding up to a first-round victory for gooseberries.
In the category of vitamins, gooseberries have a lot more of vitamins A, B1, B2, B6, and E, while starfruit has slightly more of vitamins B3, B5, B9, and C, giving a modest-but-clear win to gooseberries here.
Looking at minerals, gooseberries have more calcium, iron, manganese, phosphorus, and potassium, while starfruit has more copper, yielding a 5:1 win for gooseberries in this round.
In other considerations, gooseberries also have more polyphenols, so that’s another round in their favor.
Adding up the sections makes for a clear overall win for gooseberries, but by all means do enjoy either or both, as diversity is best!
Want to learn more?
You might like:
Whatās Your Plant Diversity Score? ā when did you last eat gooseberries? Or a starfruit?
Enjoy!
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Grapefruit vs Orange ā Which is Healthier?
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Our Verdict
When comparing grapefruit to orange, we picked the orange.
Why?
It’s easy, when guessing which is the healthier out of two things, to guess that the more expensive or perhaps less universally available one is the healthier. But it’s not always so, and today is one of those cases!
In terms of macros, they are very similar fruits, with almost identical levels of carbohydrates, proteins, and fats, as well as water. Looking more carefully, we find that grapefruit’s sugars contain a slightly high proportion of fructose; not enough to make it unhealthy by any means (indeed, no whole unprocessed fruit is unhealthy unless it’s literally poisonous), but it is a thing to note if we’re micro-analysing the macronutrients. Also, oranges have slightly more fiber, which is always a plus. So, a very slight win for oranges in this round.
When it comes to vitamins, oranges stand out with more of vitamins B1, B2, B3, B6, B9, C, and E, while grapefruit boasts more vitamin A (hence its color). Still, we’re calling this category another win for oranges.
In the category of minerals, oranges again sweep with more calcium, copper, iron, magnesium, manganese, potassium, and selenium, while grapefruit has just a little more phosphorus. So, another easy win for oranges.
One final consideration that’s not shown in the nutritional values, is something we’ve written about before. Namely, that grapefruit contains furanocoumarin, which can inhibit cytochrome P-450 3A4 isoenzyme and P-glycoptrotein transporters in the intestine and liverāslowing down their drug metabolism capabilities, thus effectively increasing the bioavailability of many drugs manifold. It can also be found in lower quantities in Seville (sour) oranges, and it’s not present (or at least, if it is, it’s in truly tiny quantities) in most oranges.
This may sound superficially like a good thing (improving bioavailability of things we want), but in practice it means that in the case of many drugs, if you take them with (or near in time to) grapefruit or grapefruit juice, then congratulations, you just took an overdose. This happens with a lot of meds for blood pressure, cholesterol (including statins), calcium channel-blockers, anti-depressants, benzo-family drugs, beta-blockers, and more. Oh, and Viagra, too. Which latter might sound funny, but remember, Viagra’s mechanism of action is blood pressure modulation, and that is not something you want to mess around with unduly. So, do check with your pharmacist to know if you’re on any meds that would be affected by grapefruit or grapefruit juice!
Adding up the sections makes for a very clear overall win for oranges, but by all means do enjoy either or both, unless you’re on any meds that contraindicate grapefruit!
Want to learn more?
You might like:
Watch Out For Furanocoumarins!
Take care!
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Knitting helps Tom Daley switch off. Its mental health benefits are not just forĀ Olympians
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Olympian Tom Daley is the most decorated diver in Britainās history. He is also an avid knitter. At the Paris 2024 Olympics Daley added a fifth medal to his collection ā and caught the worldās attention knitting a bright blue āParis 24ā jumper while travelling to the games and in the stands.
At the Tokyo Olympics, where Daley was first spotted knitting, he explained its positive impact on his mental health.
It just turned into my mindfulness, my meditation, my calm and my way to escape the stresses of everyday life and, in particular, going to an Olympics.
The mental health benefits of knitting are well established. So why is someone famous like Daley knitting in public still so surprising?
Africa Voice/Shutterstock Knitting is gendered
Knitting is usually associated with women ā especially older women ā as a hobby done at home. In a large international survey of knitting, 99% of respondents identified as female.
But the history of yarn crafts and gender is more tangled. In Europe in the middle ages, knitting guilds were exclusive and reserved for men. They were part of a respected Europe-wide trade addressing a demand for knitted products that could not be satisfied by domestic workers alone.
The industrial revolution made the production of clothed goods cheaper and faster than hand-knitting. Knitting and other needle crafts became a leisure activity for women, done in the private sphere of the home.
World Wars I and II turned the spotlight back on knitting as a āpatriotic dutyā, but it was still largely taken up by women.
During COVID lockdowns, knitting saw another resurgence. But knitting still most often makes headlines when men ā especially famous men like Daley or actor Ryan Gosling ā do it.
Men who knit are often seen as subverting the stereotype itās an activity for older women.
Knitting the stress away
Knitting can produce a sense of pride and accomplishment. But for an elite sportsperson like Daley ā whose accomplishments already include four gold medals and one silver ā its benefits lie elsewhere.
Olympics-level sport relies on perfect scores and world records. When it comes to knitting, many of the mental health benefits are associated with the process, rather than the end result.
Daley says knitting is the āone thingā that allows him to switch off completely, describing it as āmy therapyā. https://www.youtube.com/embed/6wwXGOki–c?wmode=transparent&start=0
The Olympian says he could
knit for hours on end, honestly. Thereās something thatās so satisfying to me about just having that rhythm and that little āclick-clackā of the knitting needles. There is not a day that goes by where I donāt knit.
Knitting can create a āflowā state through rhythmic, repetitive movements of the yarn and needle. Flow offers us a balance between challenge, accessibility and a sense of control.
Itās been shown to have benefits relieving stress in high-pressure jobs beyond elite sport. Among surgeons, knitting has been found to improve wellbeing as well as manual dexterity, crucial to their role.
For other health professionals ā including oncology nurses and mental health workers ā knitting has helped to reduce ācompassion fatigueā and burnout. Participants described the soothing noise of their knitting needles. They developed and strengthened team bonds through collective knitting practices. https://www.youtube.com/embed/dTTJjD_q2Ik?wmode=transparent&start=0 A Swiss psychiatrist says for those with trauma, knitting yarn can be like āknitting the two halvesā of the brain āback togetherā.
Another study showed knitting in primary school may boost childrenās executive function. That includes the ability to pay attention, remember relevant details and block out distractions.
As a regular creative practice, it has also been used in the treatment of grief, depression and subduing intrusive thoughts, as well countering chronic pain and cognitive decline.
Knitting is a community
The evidence for the benefits of knitting is often based on self-reporting. These studies tend to produce consistent results and involve large population samples.
This may point to another benefit of knitting: its social aspect.
Knitting and other yarn crafts can be done alone, and usually require simple materials. But they also provide a chance to socialise by bringing people together around a common interest, which can help reduce loneliness.
The free needle craft database and social network Ravelry contains more than one million patterns, contributed by users. āYarn bombingā projects aim to engage the community and beautify public places by covering objects such as benches and stop signs with wool.
The interest in Daleyās knitting online videos have formed a community of their own.
In them he shows the process of making the jumper, not just the finished product. That includes where he āwent wrongā and had to unwind his work.
His pride in the finished product ā a little bit wonky, but āmade with loveā ā can be a refreshing antidote to the flawless achievements often on display at the Olympics.
Michelle O’Shea, Senior Lecturer, School of Business, Western Sydney University and Gabrielle Weidemann, Associate Professor in Psychological Science, Western Sydney University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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