Dietary Fibre Reduces Risk of Knee Osteoarthritis

This month a fascinating report was published in Annals of the Rheumatic Diseases. It was a collaborative study between Tufts University (Boston) and the University of Manchester. Dai et al looked into the link between dietary fibre and knee osteoarthritis (OA). They used data from the Osteoarthritis Initiative (4796 participants) and the Framingham Offspring Osteoarthritis Study (1268 participants). The first group was followed for 4 years and the second group was reassessed after 9 years. The findings consistently showed that higher total fibre intake was related to a lower risk of symptoms of knee osteoarthritis (pain, stiffness, and swelling). It was unclear whether fibre had an effect on the result of knee x-rays.

The authors note that “there is increasing evidence suggesting that OA shares similar metabolic characteristics including obesity, dyslipidaemia and inflammation with cardiovascular diseases and diabetes”. Clinical trials have already shown the beneficial effect of dietary fibre on reducing body weight, blood pressure, blood sugar and in reducing circulating C reactive protein (a marker of inflammation). Increasing our intake of fibre can help improve musculoskeletal problems in addition to bettering our overall health. Fibre can be found in cereal grains, fruits, vegetables, nuts and legumes.

Shared Reading Improves Mood and Decreases Pain

google-site-verification: googleec220f26f2a6a6de.html

Earlier this year Billington et al. from the University of Liverpool published the results of their study looking at the effects of shared reading (SR) on people with chronic pain. The shared reading model they used was the one employed by the charity “The Reader“. “The Reader is an award-winning charitable social enterprise working to connect people with great literature through shared reading. We’re here to bring books to life, creating welcoming environments in which personal feeling is recognised and valued, forming vital connections between people and literature through which everyone can feel more alive.”

The researchers concluded “Qualitative evidence indicates SR’s potential as an alternative or long-term follow-up or adjunct to CBT in bringing into conscious awareness areas of emotional pain otherwise passively suffered by patients with chronic pain. In addition, quantitative analysis, albeit of limited pilot data, indicated possible improvements in mood/pain for up to 2?days following SR. Both findings lay the basis for future research involving a larger sample size.”

The preliminary findings are encouraging. There may be other factors such as distraction, social bonding and the benefits of having regular scheduled activities that may also play a part in improving the well-being of the participants.

Resistance Training Improves Mental Function

Mild cognitive impairment (MCI) is a condition where a person has minor problems with things like memory, thinking, attention, language or visual depth perception. The problems are usually not severe enough to affect activities of daily living. But some people with MCI go on to develop dementia – Alzheimer’s in particular. A new study published in the Journal of the American Geriatrics Society by Mavros et al from the University of Sydney has looked into the effects of strength training on cognitive function. The researchers selected 100 people with MCI aged 55 or over. Part of the subjects were put through progressive resistance training (PRT) 2x/week for 6 months. Unsurprisingly, the resistance training led to increases in strength but interestingly the strength increases were linked to improvements in mental ability. The researchers conclude that the link between strength gains and cognitive function merits further study.

Testosterone May Strengthen ACL

New research by Romani et al. from The John Hopkins University in Baltimore has been published in The Knee and has shown that testosterone levels can have an impact on the strength of the anterior cruciate ligament (ACL). Romani’s previous research has shown that estrogen could reduce ACL strength.

The most recent study was performed on male rats. The ACLs of normal rats were compared to those of castrated rats. The testosterone levels in the castrated rats was close to zero. The researchers concluded that “rats with normal circulating testosterone had higher ACL load-to-failure and ultimate stress, indicating that testosterone may influence ACL strength and the injury rate of the ligament“. The results suggest that testosterone may help to strengthen the ACL. If coupled with the findings that estrogen could weaken the ACL, we can start to understand some of the reasons behind the differences in prevalence of ACL injuries between the sexes. Obviously, this only holds if these findings are the same in humans as well. It would also be interesting to know if these findings apply to other ligaments.

Smoking Causes Inflammation

It’s been known for a while that smoking decreases blood flow and hence reduces the transport of oxygen and other nutrients to tissues. But recent research by Ava Hosseinzadeh et al from the University of Umea in Sweden has looked into its effects on inflammation. Their findings were published in the Journal of Leucocyte Biology. They found that nicotine induces neutrophils to release neutrophil extracellular traps (NETs). NETs surround and destroy microbial pathogens but they can also lead to excessive inflammation and tissue damage. Obviously, it’s the excessive inflammation and tissue damage that’s of concern and it provides yet another reason to stop smoking.

Physical Activity and Health

A group of researchers led by Per Ladenvall (University of Gothenburg in Sweden) have looked into the relationship between physical capacity and health. They studied 800 middle-aged men over a period of 45 years. Physical fitness was measured by VO2 max. The results showed that low physical fitness is a greater risk of death than high blood pressure or cholesterol. It was second only to smoking as a risk of death.

Several studies have linked prolonged sitting with increased risk of mortality. A meta-analysis of data from over a million people was recently conducted by Ekeland et al. They wanted to find out if physical activity could attenuate, or even eliminate, the detrimental association of sitting time with mortality. They found that “high levels of moderate intensity physical activity (about 60–75 min/day) seem to eliminate the increased risk of death associated with high sitting time. However, this high activity level attenuates, but does not eliminate the increased risk associated with high TV-viewing time”.

Once again, the benefits of physical activity and physical fitness are clear. It’s up to us to make it a priority to move more, whether it’s through structured exercise or simply through the activities of daily living.

Sleep Deprivation Can Negatively Affect Cholesterol Levels And Inflammation

Vilma Aho et al from the University of Helsinki conducted 2 studies looking into the effects of sleep deprivation. The first study was experimental and consisted of partial sleep restriction to a small group of subjects. The second was an epidemiological study with over 2700 individuals. Blood samples were analysed in both cases.

The analyses revealed decreased circulating High Density Lipoproteins (HDL cholesterol), otherwise known as ‘good cholesterol’, and elevated inflammatory markers. Sleep loss decreased the expression of genes encoding cholesterol transporters and increased expression in pathways involved in inflammatory responses. The findings help to explain why sleep deprivation is a risk factor for cardiometabolic disease.

Why Is Calcific Tendinitis So Painful?

There are a couple of shoulder conditions that can be extremely painful. One is adhesive capsulitis, better known as frozen shoulder, and the other is calcific tendinitis. Calcific tendinitis is characterised by the formation of calcium deposits in the rotator cuff tendons of the shoulder. A few months ago Hackett et al from the University of New South Wales published the results of a study that could explain why calcific tendinitis is so painful. Their findings are published in The Journal of Bone & Joint Surgery.

They concluded that there was “a significant increase in neovascularization and neoinnervation in calcific tendinitis lesions of the shoulder along with an eightfold increase in mast cells and macrophages. The findings are consistent with the hypothesis that, in calcific tendinitis, the calcific material is inducing a vigorous inflammatory response within the tendon with formation of new blood vessels and nerves”.

Persistent Pain Associated With DNA Changes In Brain And Immune Systems

Renaud Massart et al from McGill University have recently published an article in Scientific Reports on the effects of chronic pain on the body. “Chronic pain” is pain that has lasted for 6 months or more. The study was performed on rats with induced nerve injuries.

The results showed epigenetic changes in the DNA of the prefrontal cortex and in the DNA of T cells. Their findings support the notion that persistent pain affects multiple biological systems. It’s possible that future research will show changes to other systems as well.

Bright Light Effective for Depression

The use of bright light therapy to treat seasonal affective disorder (SAD) is well documented and evidence based but I had never heard of using light therapy to treat nonseasonal major depressive disorder (MDD). Raymond Lam et al, from the Department of Psychiatry at the University of British Columbia, designed an elegant study comparing the effects of light therapy, drug treatment (Fluoxetine), combination therapy (light plus drug) and sham-placebo in adults with nonseasonal depression. Their study was published this month in JAMA Psychiatry.

Treatments were given daily for 8 weeks (the light therapy consisted of a 30 min early morning exposure to a 10,000-lux fluorescent white light box) and depression ratings were taken at baseline and at the 8-week end point. Interestingly, the drug antidepressant did not perform any better than the placebo. Both the light therapy and combination therapy showed significant clinical benefit. The combination therapy had the most consistent effects.

The news that light therapy is effective for both SAD and nonseasonal depression means that there is now a new way of treating depression that has few if any side effects. For more stubborn cases a combination of light and drugs can be used or maybe even a combination of light and cognitive behavioural therapy (CBT).