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June 23, 2005

Living longer & better: Fighting those aches & pains before they start

For the 70 million Americans who suffer bone or joint disease, there is no cure.

So prevention and treatment are of the essence, according to Leslie Bonci, director of the nutrition program at the UPMC Center for Sports Medicine.

“Many treatments are reactive,” she said, “but people can handle this problem pro-actively by being fit and looking at what they’re eating.” And there’s much maintenance to consider since the human body has more than 230 joints.

Keeping those joints supple and well lubricated begins with healthy bone cartilage, Bonci noted. Cartilage is the smooth surface protecting the ends of bones, serving as shock absorbers for the body. When cartilage wears away, people have problems with bone-on-bone movement and painful physical problems such as arthritis begin.

One in seven Americans suffers from arthritis. The most common form is osteoarthritis, which is characterized by the gradual wearing away of the joint cartilage. Major risk factors include heredity, gender (women are twice as susceptible as men), age (risk increases in later years), weight (obesity increases risk) and injury. (See related story on osteoarthritis.)

One of the most effective ways to stave off arthritis is to stay fit, Bonci emphasized. “We need to be healthy, and not just for our heart, but for our whole body.” She prescribes moderate exercise with the credo: “If you don’t move it, you lose it.”

Hand-in-hand with exercise is nutrition focused on joint health. According to Bonci, food choices are important for the delivery of nutrients that play a role in collagen, bone and cartilage formation. She advises a diet rich in calcium, protein, vitamins D and C, phosphorus and zinc, whether found in food or vitamin supplements.

Bonci offered some tips on nutrition not necessarily found on the back of a vitamin bottle: Multiple doses of calcium are essential. For people age 50 and older, she recommends 1,500 milligrams per day, the equivalent of one quart of milk. And don’t expect to meet the daily calcium requirement in one dose. The human body can only absorb about 500 milligrams at a time. She suggests taking 500 milligrams after each meal. But be wary of calcium-fortified beverages such as orange juice. Calcium settles to the bottom of beverage containers, so shake well.

Don’t forget the vitamin D, Bonci urged. The major source of vitamin D is sunshine. In fact, 10 minutes of sun exposure without a sunscreen provides a daily dose. But given Pittsburgh weather and the damaging effects of UV rays, a sufficient dose is not always possible. According to Bonci, the vitamin D dose in an average multi-vitamin will suffice.

Some nutritional supplements on the market may help preserve and augment bone joints and cartilage, but they don’t offer a quick fix, she said. Expect at least a month lag time between beginning a new supplement regimen and results. Buyer beware: Organizations such as the National Institutes of Health are still studying the effects of the following popular nutritional supplements:

• Glucosamine: This supplement offers the same basic building blocks of chemicals that are elements of joint cartilage. The recommended dose of 1,500 milligrams a day may reduce inflammation. Benefits are noticed typically in eight weeks. Consult your physician first if you have diabetes or are allergic to shellfish, according to Bonci.

• Chondroitin sulfate: The contents of this supplement may attract fluid into cartilage for greater cushioning between bones. The usual dose is 1,200 milligrams a day. Benefits are realized usually in 40 days.

Bonci recommended the use of collagen hydrolysate, which may stimulate and support the regeneration of joint cartilage, thus reducing discomfort and improving physical function. Results can be noticed within two months of taking daily doses of 10 grams. And so far, there are no side effects.

Touting the new supplement, Bonci said, “More collagen means healthier, stronger cartilage for less pain and a more active lifestyle.”

For those looking to treat bone and joint pain, Bonci recommends consulting a physician to weigh the benefits and risks of non-steroidal, anti-inflammatory drugs and analgesic pain relievers. These drugs can suppress pain and reduce inflammation, but side effects can include gastro-intestinal reactions, she cautioned. Cox-2 inhibitors offer similar relief but side effects may include cardiovascular risks.

—Mary Ann Thomas

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