When Dr. Irwin Lim posted "
Diet
Diet is important to reduce weight in obese patients as it reduces
weight load on the knees. Diet alone won't be too successful; but we already
talked about the necessity of exercise. I advocate lots of veggies (easy as I'm
vegetarian) and studies are in favour of a diet rich in antioxidants. I always
stress that diet does the trick and not supplements. There's a study by Y. Wang
and colleagues addressing this issue: " Effect of antioxidants on knee cartilage and bone in
healthy, middle-aged subjects: a cross-sectional study." The author's
concluded: "The
present study suggests a beneficial effect of fruit consumption and vitamin C
intake as they are associated with a reduction in bone size and the number of
bone marrow lesions, both of which are important in the pathogenesis of knee osteoarthritis. While our findings need to be confirmed
by longitudinal studies, they highlight the potential of the diet to modify the
risk of osteoarthritis." Link: http://www.ncbi.nlm.nih.gov/pubmed/17617909.
Also reducing arachidonic acid in the diet may be beneficial.
Drugs
How about drugs? I keep a low profile with drugs. I counsel patients to
be very critical about opiates, being a cause for falls. I use paracetamol or
novaminsulfon instead, if not successful NSAIDs.
Patient education
I think it's important to educate patients on therapeutic goals and do
so right away while they 're in the consultation. As there isn't enough time I
recomment both evening talks, which I and my colleagues do on various topics at
the hospital, and information texts I've put on my blog. As our center has once
been the navel around which the evaluation of an educational program on RA was
turning, I know for sure that education will increase the adherance rate of
patients to therapy.
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