Friday, August 18, 2017

"Knee osteoarthritis has doubled in prevalence since the mid-20th century"

There has been an article on the prevalence of osteoarthritis recently by I.J. Wallace and colleagues [1]: "Knee osteoarthritis has doubled in prevalence since the mid-20th century". Among the authors is also David T. Felson, whom I've heard several times during the past decade on osteoarthritis at various meetings. As rheumatologists we are often contacted by patients and mostly our advice is to reduce weight, exercise moderately, and see, that the diet is rich in beta-carotene, vitamin C and E. So research on the prevalence of osteoarthritis and knowing more about factors are very much warranted.

The authors analyzed long-term trends in knee OA prevalence “using cadaver-derived skeletons of people aged 50 y whose BMI at death was documented and who lived during the early industrial era (1800s to early 1900s; n = 1,581) and the modern postindustrial era (late 1900s to early 2000s; n = 819).” They also looked at “archeologically derived skeletons of prehistoric hunter-gatherers and early farmers (6000300 B.P.; n = 176).”

The authors concluded: “Overall, knee OA prevalence was found to be 16% among the postindustrial sample but only 6% and 8% among the early industrial and prehistoric samples, respectively. After controlling for age, BMI, and other variables, knee OA prevalence was 2.1-fold higher (95% confidence interval, 1.5–3.1) in the postindustrial sample than in the early industrial sample.” The authors think “that increases in longevity and BMI are insufficient to explain the approximate doubling of knee OA prevalence”.

Of course, more research on additional independent risk factors is necessary. But let me try an educated guess. Changes in diet and physical activity are obvious. Preventive measures might be:
·         Changing from sedentary to a more active lifestyle
·         Reducing supernutrition
·         Reducing processed foods
·         Increasing veggies and herbs
·         Reducing dairy and meats
One would have to wait for results in research about how effective these measures could be. But as you wouldn’t harm yourself with these measures, you could start right away.



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