The majority of people with arthritis are inactive, overweight, diabetic or pre-diabetic. The CDC Morbidity and Mortality Weekly Report (November 9, 2018; 67(44);1238–1241) found that 32 percent of adults with arthritis have pre-diabetes or diabetes, 56.5 percent are physically inactive and 50.1 percent are obese.

Osteoarthritis affects more than 30 million North Americans, making it the most common joint disease. Anything that causes inflammation can damage joints (Nature Medicine, published online Nov. 6, 2011), and inflammation is a more common cause of arthritis than wear-and-tear injuries (Bone, 2012;51:249–257). Everything that helps to reduce inflammation also helps to reduce pain and joint damage: lose excess weight, eat an anti-inflammatory diet, exercise, lower high blood sugar levels and so forth (Ther Adv Musculoskelet Dis, 2013 Apr; 5(2): 77–94).

Inflammation Harms Joints
Your immune system attacks and destroys germs that invade your body because it can tell that germs have different surface proteins than you do. However, if your immune system stays on all the time, it will use these same cells and chemicals to attack and destroy your own tissues. This is called inflammation and anything that causes your immune system to stay active all the time can damage the cartilage in your joints. See Osteoarthritis Linked to Inflammation
Osteoarthritis Probably Caused by Inflammation

Diabetes, Pre-Diabetes and Arthritis
A high rise in blood sugar can cause sugar to stick to the outer membranes of cells. Once there, sugar cannot get off and is eventually converted to sorbitol that destroys that cell. Your immune system responds to these damaged cells in exactly the same way it works to attack invading germs, so high blood sugar is a constant source of inflammation that specifically damages joints (Osteoarthritis Cartilage, Jun 2015;23(6):841–850).

Obesity and Arthritis
Obesity turns on your immune system to raise blood levels of cytokines that can damage joints (Clin Chem Lab Med, 2010;48:1141–1145), and high levels of these cytokines predict the onset and progression of osteoarthritis (Clin Immunol, 2012;144:228–236). More than 80 percent of obese people suffer some form of joint disease, most often because having muscles and liver full of fat is associated with inflammation that can damage every cell in your body including the cartilage in joints. Obesity is frequently associated with both osteoarthritis and rheumatoid arthritis, and losing excess weight can reduce joint damage and disability and improve quality of life (PMR, May 1, 2012;4(5 0):S59–S67).

• Obese people are seven times more likely than normal-weight people to suffer osteoarthritis of the knee (Joint Bone Spine, 2011; 78(2):150-5).
• The more overweight you are, the greater your chance of suffering from osteoarthritis of the knee and hip (Joint Bone Spine, 2012; 79(3):291-7).
• Obesity is a potent trigger to develop rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis (RMD Open, June 29, 2015;1(1): e000012).
• In just 16 weeks, weight loss lowered high markers of inflammation in people with osteoarthritis (Osteoarthritis Cartilage, 2014;22(11):1817–25) and losing weight markedly reduced pain and limitation of movement in patients with osteoarthritis (Arthritis Care Res, 2013;65(1):15–22).

Inactivity and Arthritis
You may believe that people with arthritis don’t exercise BECAUSE of the pain, but osteoarthritis always worsens with inactivity. If you have joint pain, keep on moving but be guided by the pain and slow down or stop when your pain worsens. Avoid sports that involve a lot of impact, because the force of your foot hitting the ground can break off cartilage. Good non-impact sports include cycling, swimming and water aerobics.

A study that followed more than 6500 women for 12 years showed that those who exercised regularly had far fewer complaints of joint pain than those who did not exercise or who exercised only a little bit (Arthritis Care & Research, Dec 5, 2017;69(12)). The women who were overweight and did not exercise had the highest incidence of joint pain. See Knee Osteoarthritis: Exercise Therapy More Effective than Surgery

My Recommendations
The treatment for o0teoarthritis should include:
• Avoidance of overweight. I recommend Intermittent Fasting
• A regular exercise program that includes continuous movement and avoidance of exercises that increase pain when you do them
• An anti-inflammatory diet

Checked 8/24/23