Longevity: Live Long Without Arthritis

I've been meaning to incorporate some of my reading into the blog for awhile, so here's my first attempt. This is from a book called "Secrets of Longevity" by Dr. Mao Shin Ni.

More than 40 million Americans, one out of six, have some form of arthritis- but you don't have to be one of them. Recent studies show that osteoarthritis is not an inevitable part of the aging process. Here's your program: maintain an ideal wight; get regular low-impact exercise; eat a diet rick in antioxidants such as viatamins C, A, and E; get some sun for vitamin D; eat lots of enzyme-rick foods containing bromelain, like papaya and pineapples; take supplements such as glucosamine and chrondroitin that support joing and cartilage health. and use the herbs ginger, turmeric, and cinnamon, all of wihich can help reduce inflammation and increase circulation. Additionally, some people may find it helful to avoid foods from the night shade family , which contain a plant alkaloid called solanine. These include tomatoes, potatoes, eggplants, and bell peppers.

I don't necessarily endorse all of these suggestions (I was planning on making "escalivada" for dinner with roasted potatoes...) I haven't been convinced by the studies on glucosamine and chontroitin. I was at a conference where a rheumatologist quipped, "Eating glucosamine and chondroitin for your joints is like eating brains to get smart." But studies don't always tell the full story.
I would also add that Meir Schneider, a movement specialist in San Francisco says that where there is flexibility, there is no arthritis, submitted for your consideration.
Info on my practice here.

Comparison of celebrex, glucosamine, glucosamine chondroitin and placebo

The University of Utah School of Medicine has published a review looking at the popular supplement, glucosamine, and its efficacy in comparison to celebrex, placebo, and the combination of glucosamine-condroitin.
http://www.ncbi.nlm.nih.gov/pubmed/20525840
Ann Rheum Dis. 2010 Aug;69(8):1459-64.
"Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT."

Osteoarthritis is a significant cause of disability, and knee osteoarthritis is one of the more prevalent subsets of debilitating osteoarthritis. The methods of the study are as follows.
"METHODS: A 24-month, double-blind, placebo-controlled study, conducted at nine sites in the US ancillary to the Glucosamine/chondroitin Arthritis Intervention Trial, enrolled 662 patients with knee OA who satisfied radiographic criteria (Kellgren/Lawrence grade 2 or 3 changes and baseline joint space width of at least 2 mm). This subset continued to receive their randomised treatment: glucosamine 500 mg three times daily, CS 400 mg three times daily, the combination of glucosamine and CS, celecoxib 200 mg daily, or placebo over 24 months. The primary outcome was a 20% reduction in Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain over 24 months. Secondary outcomes included an Outcome Measures in Rheumatology/Osteoarthritis Research Society International response and change from baseline in WOMAC pain and function."

Their conclusions were as follows.
"CONCLUSIONS: Over 2 years, no treatment achieved a clinically important difference in WOMAC pain or function as compared with placebo. However, glucosamine and celecoxib showed beneficial but not significant trends. Adverse reactions were similar among treatment groups and serious adverse events were rare for all treatments."

From this study, though glucosamine and celecoxib achieved some benefit, it was not significant. In my practice I have had patients' have GI problems with celecoxib, which is anecdotal, of course. As with all supplements, or medications, each person reacts differently, so it is important to keep an open mind and try the safest solutions first. From this study, if patients wanted to try a supplement, I could recommend glucosamine with the same enthusiasm as celebrex, but might urge them to try the avocado and soybean unsaponifiables (ASU) from yesterday's post. Of course, there are many more targeted herbal therapies, but don't have the benefit of clinical studies behind them.