Osteoarthritis and Mobility

Comments 0

Yesterday, I came across a recent article on osteoarthirits by Simon Juang from the University of British Columbia, published in the latest issue of Parkhurst Exchange. Given that osteoarthritis (OA) is probably the most common cause of pain and disability in patients with obesity, as a non-expert, I found the article most informative and relevant. The following are some of the key pieces of information I gleaned from this overview: First of all, I was surprised to learn that OA is not always painful, but on the other hand, that not all joint pain, simply because there may be radiological signs of OA, is actually due to OA. In fact, quite often the pain may result from the structures around the joint, i.e. the muslces, ligaments, tendons, bursae, osteophytes, injury, etc. As the course of treatment may well be different, proper diagnosis of the actual source of pain is essential. The 4 pillars of OA management include: – patient education – non-pharmacological interventions – drug therapy – appropriate referral The 4 goals of treatment are: – reducing pain – maintaining range and strength – preserving function – dercreasing the rate of progression As expected, the basic joint health program starts with “optimal weight”, whereby however, Huang automatically assumes that this can be fixed by “proper diet”, best achieved by referral to a dietitian (readers of these pages will likely appreciate that if obesity management was indeed that simple, we would probably not have a crisis). Other aspects of the joint program involve physiotherapists (exercises, heating pads, nerve stimulation, etc.), occupational therapists (activities of daily living), but also orthoticists, or podiatrists. The article also lists a number of useful resources for patients, which I list here: – The Athritis Society – Arthritis Resource Guide for BC – OASIS (OsteoArthritis Service Integrated System, Vancouver Coastal Health) – Joint Health, Arthritis Consumer Experts – Alberta Bone and Joint Institute – Canadian Orthopedic Foundation Remember, while managing pain and increasing mobility will not automatically result in weight loss, impaired mobility is certainly a major barrier to any weight management program. AMS Edmonton, Alberta

Full Post

An Eater’s Manifesto’s Guide to Obesity

Comments 1

This weekend, on a long flight to Amsterdam, I finally got around to reading Michael Pollan’s “In Defense of Food“, which he describes as “An Eater’s Manifesto”. Many of you may recall that when this book first came out earlier this year, it created a rather significant media stir – having now actually read the book, all I can say is that the attention was well deserved. While I strongly recommend this book to anyone interested in food (and not simply nutrition), I must warn that this book has the potential to precipitate an identity crisis in anyone who has studied or does research in nutrition. Most dietitians will probably find the content rather sobering. The book is also not exactly what industry or policy makers want to hear. Nevertheless, all should read it. Although the book is not specifically about obesity or weight management, I believe that the principles are sound and may in the end also help reduce your risk of weight gain – even if you don’t lose weight, it is likely that you will still be healthier (remember, health is not weighed on a scale). Here are Pollan’s principles: (Warning SPOILER!) Eat food. Not too much. Mostly plants. – Don’t eat anything your grandmother would not recognize as food. – Avoid food products containing ingredients that are a) unfamiliar, b) unpronounceable, c) more than five in number, or that d) include corn syrup* – Shop the periphery of the super market and avoid the middle – Get out of the supermarket whenever possible – Eat plants, especially leaves* – You are what what your food eats too – If you have the space buy a freezer – Eat well-grown foods from healthy soils – Eat wild foods when you can – Be the kind of person who takes supplements (even if you don’t) – Regard nontraditional foods with skepticism – Don’t look for the magic bullet in the traditional diet – Pay more, eat less* – Eat meals* – Do all your eating at a table* – Don’t get your fuel from the same place your car does* – Try not to eat alone* – Consult your gut* – Eat slowly* – Cook, and if you can, plant a garden If you want to know what all these “rules” actually mean, sorry, you’ll have to read the book. I have marked the rules that I believe… Read More »

Full Post