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“But it’s not simply about the load on the joints,” says Blum.


Fat cells release compounds called inflammatory cytokines, which can boost inflammation and pain. And new research from the University of Rochester, in New York, suggests that obesity may also impair the gut microbiome (beneficial bacteria lining the gastrointestinal tract), further exacerbating arthritis.


“There is no doubt that the gut bacte- ria are involved in the onset and perpetua- tion of inflammation and pain in arthritis,” says Blum.


When researchers fed mice the equivalent of a “cheeseburger and milk- shake” diet for 12 weeks, doubling their body fat, they found more pro-inflamma- tory bacteria in their colon, more cartilage deterioration than in lean mice and more inflammation in their knees.


Healing the Gut Heals Joints Blum explains that dysbiosis, an overgrowth of harmful bacteria in the intestinal tract, can damage its fragile lining, allowing bits of bacteria to enter the bloodstream and ignite an autoimmune response. Dysbiosis can be kick-started by antibiotics, drugs like proton pump inhibitors, bad diet or stress, says Blum, who battled autoimmune arthritis after her son had a traumatic accident. For curbing arthritis through the gut mi- crobiome, the science is young. A few small human studies conducted in China and Fin- land suggest that ingesting specific strains of Lactobacillus (including casei, acidophilus, reuteri and rhamnosus) and Bifidobacterium (bifidum and infantis) may decrease inflam- mation and pain associated with arthritis. In the University of Rochester study, overweight mice fed prebiotics (indigest- ible fibers that good bacteria feed on) had less arthritis progression.


Blum recommends taking antimicro- bial herbs like oregano oil to heal a gut overgrown with bad bacteria and a high- quality probiotic supplement to replenish good bacteria. She also suggests ditching processed food and products with refined sugar, along with known allergens like gluten, soy and dairy, which can spawn inflammation. Avoid nightshade vegetables like tomatoes, potatoes and peppers,


which anecdotally have been suggested to aggravate joint pain. Overall, strive for a plant-based diet high in fiber, colorful, antioxidant-rich vegetables and “good” fats. One recent Michigan State Univer- sity study found that when osteoarthritis patients switched to a plant-based diet for six weeks, they experienced less pain than those in the meat-eating control group.


Exercise Smart


When joint pain begins to flare up, a care- fully chosen workout may be exactly what’s needed for relief. A.J. Gregg, a chiroprac- tor in Flagstaff, Arizona, says, “There is an element of ‘use-it-or-lose it’.” The proper


exercise depends partly on which joints are affected. He notes that properly executed strength training exercises like lifting weights can stabilize muscles around joints, easing strain and preventing arthritis from accelerating. Low-impact aerobic exercises like cycling or swimming can fuel the production and flushing of fluids through the joints without overloading them. Tai chi can improve range of motion. Even run- ning, long falsely maligned as a precursor to arthritis, can help prompt cartilage cells to divide and replenish faster, research suggests. A study of 75,000 runners by re- searchers at Lawrence Berkeley National Laboratory, in California, found that they


Supplementing Suppleness by Lisa Marshall


Curcumin: Derived from turmeric (Curcuma longa), this bright yellow culinary spice has been used as an anti-inflammato- ry agent in Asia for centuries. Today, it’s used as an alternative to non-steroidal anti-inflammatory drugs (NSAID), which can wreak havoc on the stomach and kidneys if taken long term, according to Naturopath Casey Seenauth. One industry-sponsored review concluded that 1,000 milligrams (mg) per day of curcumin can


rival a NSAID like Advil for relief of pain and inflammation.


Collagen or gelatin: Integrative medicine practitioners have long prescribed gelatin powder made from animal connective tissue to provide the nutrients required for joint regeneration. Supplement makers have developed arthritis-specific collagen supplements in which the gelatin is broken down for better absorption. A Chinese study of 500 rheumatoid arthritis patients found that collagen de- rived from chicken cartilage improved symptoms of pain, stiffness


and swelling in joints. Plant-based options are available.


Glucosamine: This classic tissue-building block has been shown in multiple studies to slow cartilage loss associated with osteoarthritis. Taken long enough, it can also ease pain, says Seenauth. “People often take it, don’t feel anything right away and quit. Give


it time.” He recommends 2,000 mg per day for at least six to eight weeks.


Fish oil: Omega-3 fatty acids like eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are established anti-inflammatories. A Korean University review of 10 trials involving nearly 400 rheumatoid arthritis patients found that those taking more than three grams per day of omega-3 fatty acid supplements reduced their reliance on


NSAIDs and had less pain.


Probiotics: While their impact on pain reduction isn’t clearly known, many studies show that certain strains of Lactobacillus and Bifidobacterium can boost immune function, repair damaged gut lining and reduce system-aggravating inflammation, says Dr. Susan Blum. She recommends products containing a mixed blend of 20 billion to 30 billion colony-forming units (CFU) per capsule.


September 2018 19


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