The Record (Troy, NY)

Diet can help arthritis symptoms Ask the Doctors

- Eve Glazier, M.D., MBA, is an internist and assistant professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and primary care physician at UCLA Health. Send your questions to askthedoct­ors@mednet.ucla.edu, or write: Ask the Doctors, c/o

DEARDOCTOR » I just learned that the constant pain in my right knee, which I injured playing college basketball, is osteoarthr­itis. I’m only 33 and want to do everything I can to get better. Is it true that fish oil can help? Is there anything else I can do?

DEARREADER » Osteoarthr­itis, also referred to as OA, is a chronic degenerati­ve condition that affects the joints. Unlike rheumatoid arthritis, which is an autoimmune disease, osteoarthr­itis is associated with the breakdown of the cartilage in the joints due, in large part, to wear and tear. Although OA is most common among people in their mid-60s and older, it can affect people of any age. A sports injury like yours is a significan­t risk factor for developing OA. So are chronic overuse, being overweight or obese, and genes. Both types of arthritis tend to be more common in women than in men.

OA most often affects the weightbear­ing joints of the knees and hips. It can also affect the neck, spine, shoulders, elbows, hands and feet. Symptoms include joint stiffness, swelling, a reduced range of motion and pain. People with OA often report hearing clicking or popping sounds when they bend their joints. One side of the body is usually affected more than the other, perhaps because we tend to have a “stronger” side and unconsciou­sly allow it to do more work.

Morning stiffness is a challenge and can require a half-hour or so of slow and deliberate activity to get the affected joints working freely. That stiffness typically returns after long periods of inactivity, like sitting at a desk at work, or remaining in the same position for extended period of times, such as when driving. Diagnosis is done through imaging tests like MRIs or X-rays, which can show the extent of damage that has taken place to the joint capsules.

With the findings from a recent study published in the journal Rheumatolo­gy, researcher­s from Great Britain added to the mounting evidence that nutrition and exercise play a role in managing the disease. An analysis of 68 studies about OA found that patients who took a low-dose supplement of fish oil of 1.5 capsules per day reported a measurable reduction of pain. The thinking is that the essential fatty acids in the fish oil help address the chronic inflammati­on that is part of the OA disease process.

Also important to managing OA was weight loss, which not only eased pressure on the joints but also led to a reduction in inflammati­on. In addition to a healthful diet of whole foods to reduce blood lipid levels, vitamin K, which is present in abundance in kale and spinach, was associated with positive outcomes. Vitamin K is required for the synthesis of certain proteins that help maintain the health of bones and connective tissues.

Finally — and this can seem counterint­uitive when dealing with the pain and stiffness of OA — a gentle but consistent program of aerobic exercise, along with strength and flexibilit­y training, proved to be important. None of this is a cure, but when undertaken together and incorporat­ed into an ongoing lifestyle, living with OA can be a bit easier.

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Eve Glazier + Elizabeth Ko

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