Ask the Doctors February 2018 Issue

Ask The Doctors: February 2018

Dr. Steven Maschke

Arthritis Advisor Editor-in-Chief Steven Maschke, MD, Department of Orthopaedic Surgery, Cleveland Clinic Orthopaedic & Rheumatologic Institute.

Q: Is there anything I can do to prevent osteoarthritis?

A: Osteoarthritis may seem like something we have to put up with as we age. It may not be possible to completely stop the underlying cause of osteoarthritis, but that does not mean there’s nothing you can do. Osteoarthritis develops when cartilage, a cushioning tissue that covers the ends of bones at joints, starts to deteriorate. This can cause pain, stiffness and swelling to varying degrees.

One risk factor for painful osteoarthritis is being overweight (BMI 25 to 29.9) or obese (BMI of 30 or more). (You can find BMI calculators on the internet.) Your joints are meant to withstand a certain amount of force. But every pound of excess weight adds two to four pounds of pressure on your knees. By losing 20 pounds, you’re taking 40 to 80 pounds of force off of them. Losing weight can help to at least slow down the progression of osteoarthritis.

You can also protect joints by staying physically fit, in particular by strengthening the muscles that surround vulnerable joints. Strong muscles mean less stress on the joint itself. Regular exercise of all kinds, including aerobic activity, helps keep joints healthy. That’s because the most mobile joints in the body contain a liquid called synovial fluid. When a joint is compressed, this fluid washes over the joint, providing lubrication and nourishment.

Other tips for keeping joints healthy include not smoking, staying well hydrated (water is a major component of cartilage) and eating a healthy diet. One study, published in Annals of the Rheumatic Diseases (August 2017), found that people who ate the highest amounts of fiber were less likely to have symptoms of knee osteoarthritis.

Q: How can I know if I’m getting enough calcium? Are there symptoms of calcium deficiency?

A: Both calcium and vitamin D are essential for bone health. The body needs calcium for other functions as well, including those involving muscles, nerves, blood vessels, and the release of hormones and enzymes. You need to get enough calcium, which comes from food and is stored in the bones and teeth.

While it’s possible to get a blood test to determine your vitamin D level to see if you might be deficient, there’s no such test for calcium. That’s because when lacking enough calcium for basic functions, the body takes it from bone, which keeps calcium blood levels normal. There generally are no obvious symptoms, at least in the short term, from not consuming enough calcium. Over time, low calcium intake can have detrimental effects on different body systems, including contributing to low bone mass and risk for osteoporosis. A severe calcium deficiency can produce symptoms, such as numbness and tingling in the fingers, convulsions and abnormal heart rhythm.

To know you are getting enough calcium, consume the recommended amount. Dairy products (milk, yogurt, cheese) are plentiful sources. Other sources include canned salmon and sardines with bones, kale, collards, broccoli, bok choy, almonds and sesame seeds. Some foods are fortified with calcium.

All adults age 19 to 50 and men up to age 70 should get 1,000 mg of calcium a day. Women age 51 and older and men age 71 and older need 1,200 mg a day. If you’re not getting this much from food, you can take a supplement. There is no need to exceed the recommended daily allowance for calcium since your body will eliminate the excess calcium.

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