In The News: July 2018
Lower Risk for Hip Fracture with a Healthy Diet
Eating a healthy diet has many advantages, including for your bones, according to a study published in the Journal of the Academy of Nutrition and Dietetics (February 2018). Researchers analyzed dietary and health data on 74,446 postmenopausal women who participated in the Nurses’ Health Study and 36,602 men age 50 and older who participated in the Health Professionals Follow-Up Study. They answered questionnaires twice a year from 1980 to 2012 for the women and 1986 to 2012 for the men. Their eating patterns were scored based on how closely they followed a Mediterranean diet, the Dietary Approaches to Stop Hypertension (DASH) diet, or another healthy eating pattern. Hip fractures occurred in 2,143 women and 603 men. Women who had the highest healthy eating scores were 13 percent less likely to experience a hip fracture than those who scored the lowest. The association was not seen in men.
Nonopioid Pain Medications Underused after Surgery
Following joint replacement or spine surgery, many patients are sent home from the hospital with a prescription for an opioid pain medication. They generally are advised to also use nonopioid medications, such as acetaminophen (Tylenol®) or a nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen (Advil®, Motrin®) or naproxen (Aleve®). A study published in the journal Anesthesia &Analgesia (April 2018) examined use of these medications in 140 people. The researchers found that two days after surgery an NSAID was used by only 18 percent and Tylenol by 56 percent of participants. One month after surgery, 73 percent of patients reported having unused opioids; 46 percent of them had 20 or more unused pills. Over 90 percent of study participants reported unsafe storage of opioids and failure to dispose of them. Better education is needed about nonopioid alternatives for postsurgical pain relief.
Age a Factor in Knee Pain Relief Following Weight-Loss Surgery
People who are obese and also have knee osteoarthritis may get some pain relief from a type of weight-loss surgery called laparoscopic gastric band (LAGB) surgery. A study published in Seminars in Arthritis & Rheumatism (February 2018) found the greatest improvements were among younger people and those who lost the most weight. The researchers contacted 120 people who had undergone LAGB surgery, in which a band is placed around the stomach to restrict food intake, and asked them about knee pain before and after surgery. Men and women in their 40s had pain reduction of about 50 to 60 percent one year after surgery, while pain reduction was 30 to 40 percent for those in their 50s. This dropped to 20 to 30 percent among those in their 60s. Those with the greatest reduction in body mass index reported the most pain reduction.
Poor Adherence to Medication for Gout
People with gout are generally prescribed a medication to lower levels of uric acid, which is a substance that, at high levels, can leave the bloodstream and settle in joints. Once in joints, uric acid can form crystals, and these cause the swollen, painful joint of a gout attack. Taking medication over the long term can prevent future attacks. To find out whether people with gout were routinely taking uric-acid-lowering medication, such as allopurinol (Zyloprim®), a group of researchers combined results from 16 studies that looked at medication adherence. They published their finding in Seminars in Arthritis & Rheumatism (April 2018). They found that only 46 percent of patients took at least 80 percent of prescribed medication. Factors associated with poor adherence included older age, a greater number of additional health problems, and having diabetes or high blood pressure.