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The Importance of Diet, Nutrition and Exercise for Bone Health

22nd February 2021

Ben Steele-Turner is a Musculoskeletal Physiotherapist, he qualified with First-class honours in BSc (Hons) Physiotherapy from Bournemouth University and is now a full member of the Chartered Society of Physiotherapy. Ben is also an Associate Registered Nutritionist having gained a Master’s degree with Distinction in Human Nutrition from the University of Surrey.

Ben has filmed three separate videos exploring topics around the importance of nutrition, diet, and exercise for bone health. Firstly, Ben’s gives a brief overview of Osteoarthritis (OA), he then delves deeper into how elements of your diet, such as sugar or different types of fats can have an impact your OA symptoms.

What is OA?

Osteoarthritis is inflammation of the bone and joint. You can have severe OA from a scan but not feel pain, show symptoms or have a high pain score. One explanation of this is ‘systemic inflammation’ or low-grade inflammation. Inflammation is your bodies reaction to harm or injury. If you have systemic inflammation this could activate your innate immune system at a low level a lot of the time. This could go on to circulate around the body and worsen symptoms of OA.

Will losing weight help reduce my OA Symptoms?

Yes! Losing weight will definitely help with symptoms of OA, especially in weight-bearing joints in the lower body; knee, foot and ankle. Joints have to work harder if the body has extra body fat. Body fat isn’t innate, it is a living tissue that can give off cytokines or inflammatory chemicals into the blood which can feed into systemic inflammation. There is a correlation between people with high levels of body fat, specifically visceral fat and intraabdominal fat with systemic inflammation. This is more metabolically active. There are links between higher levels of intraabdominal fat with OA in the hand joint, which is not a load-bearing joint, showing a non-mechanical link. Aiming to lose weight is one of the core principles of the treatment of OA.

What is body composition and what does it mean?

Body composition is the ratio of what your body is made of. Fat mass and lean mass, specifically muscle. We want to make our body composition as optimal as possible for health and OA symptoms. We want to reduce body fat and increase muscle mass, this is especially important around the affected joint that has signs of OA. For the knee we want to strengthen our quads to improve control and hips for bio-mechanical improvement, and the whole leg in general which will be hugely helpful.

Dietary Fats can be confusing, can you clarify this?

There are two types of fat, saturated and unsaturated. We want to try and avoid saturated fats, such as animal fats, butter, creams, cheese etc. Saturated fats have a higher chance of aggravating OA and OA symptoms, if they are consumed more regularly.

Unsaturated fats, omega 3, 6, 7 and 9s are different types of unsaturated fats. 3 and 6s are Polyunsaturated, and 7 and 9s are monounsaturated.

The most important we need when dealing with OA is Omega 3. If systemic inflammation is affecting the body and worsening OA, then Omega 3 is something we need to focus on. Good examples of Omega 3 sources are fish, olives, olive oil, chia seeds and flax seeds. We need to look at getting as much omega 3 as possible. You can check with a local dietician if you need more personalised information.

There are two types of fat, saturated and unsaturated. There are two types of fat, saturated and unsaturated.

Does sugar affect symptoms of OA, and how?

Yes. When we eat something with a high sugar content it causes our blood sugar glucose to rise and be transported around the body and into the blood. When the sugar reacts with protein in the blood it can cause AGEs which are linked to high levels of systemic inflammation and worsen OA symptoms. This is individual to each person; some people may be more affected by sugar. You may not have tried reducing sugar for OA symptoms therefore it could be good to give it a go.

Should I be taking Vitamin D supplements?

It is worth considering taking Vitamin D supplements for general health but also for OA. In the UK we have limited amounts of vitamin D during the winter months. We should consider a supplement of 10mg a day for adults.

Are there any other supplements I should be taking for OA?

Omega 3, we can get enough through our diet but taking a cod-liver or other fish oil supplement is worth considering, I recommend getting individual advice if you are unsure. Then there are other supplements such as, glucosamine and chondroitin which are known to promote joint health but have no evidence for OA. Turmeric and curcumin, supplements are available, these are usually in your diet already, however there is not enough evidence to prove it for OA. Collagen has become common more recently, it has potential but there is not yet enough evidence for OA. The main one I recommend focussing on is Omega 3, and even more so if you have a low fish diet.

Supplements for Osteoarthritis Supplements for Osteoarthritis

How can I get individual advice on this?

You can speak to a specialist in your area for further information.

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