The Impact of Diet on Arthritis

Unfortunately arthritis does not yet have a cure, but there are some habits that you can practice to help alleviate the pain of arthritis symptoms. One question that patients frequently ask is, “Are there foods that can help? What foods should I avoid?” So far, there is no conclusive evidence that eating more or less of a particular food will affect symptoms or joint function. Throughout the ages, there have been many claims made on the influence of dietary habits on arthritis. Many of these claims are mostly anecdotal, though there are some reasonable theories.

Diet impacts many aspects of health, so it is possible that it can affect arthritis. Researchers are currently interested in the role of the microbiome in health and disease. The microbiome refers to the large population of microorganisms living within our bodies. We know that diet impacts the microorganisms in the intestinal tract and that these organisms may affect immune function. Because rheumatoid arthritis is an autoimmune condition, there is a possibility that changes in the microbiome can affect the activity and severity of rheumatoid arthritis.

Previously on this blog, I covered foods that can help arthritis pain, and this month I’m following up with some more healthy nutritional ideas for you to consider. One idea that is supported by medical evidence is weight control. Being overweight is a major risk factor for osteoarthritis, and weight loss can reduce the stress on joints. One study found that losing a pound of body weight reduces the load on your knees by four pounds. The best way to reach that healthy weight is to keep a healthy diet rich in vegetables and low in fat and to engage in regular  physical activity.

This blog was originally published on MichaAbelesMD.net

Not Enough Pediatric Rheumatologists

A child who does not receive adequate treatment for a rheumatic condition may suffer dire lifelong consequences. Over 300,000 children have been diagnosed with rheumatic diseases, yet fewer than 400 pediatric rheumatologists practice in America. Rheumatologists who treat adults are doing their best to meet this care deficit, but they generally lack the expertise of pediatric specialists. The shortage persists amidst efforts to promote awareness of the need.

 

The structure of medical education may be a primary cause of the subspecialist shortage. The fellowships for pediatric rheumatology requires additional schooling. Because rheumatology is mainly an outpatient field, pediatrics residents do not normally have opportunities to see this field and develop an interest in it. Those residents who do observe pediatric rheumatology patients typically only see the sickest ones; they rarely study the spectrum of patients and how innovative therapies are reshaping the landscape of care for rheumatological diseases.

 

The American College of Rheumatology is striving to change this unfortunate scenario. In 2001, it initiated a residency program that pairs residents with mentors. The program has encouraged 73 percent of its students to pursue pediatric rheumatology training. Duke has set up a similar program that is turning more residents on to this subspecialty. Professors note that enabling the residents to survey the scope of inpatient and outpatient care has a significant impact.

 

These gains have not yet been enough to alleviate the shortage, which is expected to worsen. Meanwhile, more rheumatologists who specialize in adult care are forced to deal with pediatric patients. Pediatric specialists hope to increase awareness and provide counsel to these physicians.

 

The doctors who have not obtained specialized education to work with children face critical challenges with performing exams and prescribing medications for younger, smaller patients. Also, these adult rheumatologists often do not consider how differently children metabolize medications. The doctors need to consider the particular emotional needs of the sick children as well.

 

Most of the physicians who do treat children report dealing mainly with older teens. Although many of these adult rheumatologists are confident in diagnosing the most prevalent rheumatologic disease (JIA), many lack confidence in treating it. This trepidation could carry significant ramifications. Doctors must consider the impact of inflammatory conditions on a child’s growth when devising treatments. They need to understand how to take advantage of the limited chances to make progress with these patients during their formative years.

 

The Arthritis Foundation estimates that about one in four children receives proper care from a pediatric rheumatologist. Eight U.S. states have none of these specialists, and five states have only one. The average age of these doctors is over 50 years, so their retirement is critically imminent.

 

This stark reality shapes an increasing dilemma of access, but rheumatologists remain hopeful. They point to the host of resources that the ACR and disease foundations provide to educate care providers and families. Pediatric rheumatologists are also standing together and reaching out to promote awareness to future physicians.

 

Originally posted at MichaAbelesMD.net

About Dr. Micha Abeles, Connecticut-Based Rheumatologist

Dr Micha Abeles

Dr. Micha Abeles, an accomplished rheumatologist in Meriden, Connecticut.

Throughout his career that spans more than four decades, Micha Abeles has not only attained board certification in rheumatology as well as internal medicine, but he has also acquired an impressive history of publications, papers, book chapters, and editorials. Many of these studies are still referenced today, and have set the groundwork for many other important discoveries in fibromyalgia, arthritis, lupus, and gout studies. He was instrumental in the clinical trials that eventually led to the development of two significant arthritis medications, Humira and Enbrel, and continues to serve as a dedicated physician to his patients as a private practitioner.

Micha Abeles began his career in medicine at the State University of New York at Buffalo (SUNY Buffalo) after completing his residency in internal medicine. From there, Micha enlisted in the United States Army has a major and chief of the outpatient department at the Fort Monroe U.S. Army base in Virginia. It was here that he received a commendation for his outstanding clinical skills, but also for his shining ability to maintain a positive morale on the base. He organized events such as chess and table pool competitions, which made a significant impact on the future of his career. Once leaving the army, Micha Abeles was given the opportunity to become a fellow of rheumatology at the University of Connecticut, thanks to his glowing recommendations. Although he didn’t know it at the time, this fellowship and eventual certification in rheumatology would soon shape the course of his career.

Post-fellowship, Micha Abeles became the Associate Director of the UConn Multipurpose Arthritis Center. This federally-funded grant allowed him to conduct numerous clinical trials sponsored by many pharmaceutical companies across the country. These studies brought attention and funds back to the university, as well as gave Dr. Abeles firsthand experience in running these trials before beginning his own original research.

It was in 1990 that Micha Abeles became the co-author to a fibromyalgia criteria paper, and it was at this time, for the first time, that fibromyalgia had truly been defined by medical professionals. This study then led to additional research. So many, in fact, that Dr. Abeles and his co-authors eventually produced thirty-seven publications, book chapters, and national presentations about fibromyalgia.

Currently, Dr. Abeles has become interested in antibody testing — one of his most recent publications showed that anti-nuclear antibodies (ANAs) were difficult to interpret, and that contradictory findings that were very common in laboratories made them even more challenging to understand. Micha Abeles has also co-authored several of the first papers that explained the use of methotrexate in rheumatoid arthritis and in eosinophilic fasciitis.

To stay up to date in rheumatology, Micha Abeles is a member of the American College of Rheumatology, which is a professional organization that globally represents rheumatologists and rheumatology health professionals, and also sits on the Connecticut Rheumatology Association Board of Directors.

When Dr. Abeles isn’t seeing patients or working on a new trial, he can be found reading up on the latest studies in arthritis, lupus, and the United States healthcare system.

 

Originally posted on Medium

These 3 Shoes May Be Contributing to Your Osteoarthritis

If you find your feet and calves are in pain after a long day at work, you may just shrug it off to spending too many hours standing. However, your feet and calves may be trying to tell you something — because that pain could be a sign of osteoarthritis. If you have the following three shoes in your closet, you may want to visit your doctor to check if you have osteoarthritis, because these shoes have been shown to contribute to the degenerative condition.

High Heels

Formally defined as any shoe higher than two inches, podiatrists and osteoarthritis experts agree that not only are these shoes bad for people with arthritis, but for anyone in general. “They’re hard on the arch and ball of the foot and can wear down joints,” says Bryan West, a podiatric surgeon based in Michigan.

Even more bad news for women who love their high heels, these shoes have actually shown to cause osteoarthritis. A study from a group of Stanford University scientists suggests that the strain of wearing high-heels of at least three-and-a-half inches can prematurely age knee joints and could contribute osteoarthritis.

Moral of the story — it’s best to leave those high heels on the sale rack and find a more comfortable shoe.

To see which other shoes can contribute to your osteoarthritis, check out Micha Abeles’ blog here.

Running is Good for Your Joints

According to a new scientific review from the Journal of Orthopedic & Sports Physical Therapy, researchers discovered that moderate levels of recreational running may support healthy knee and hip joints, reports an article from Time Magazine.

The researchers conducted a meta-analysis that combined data from 17 previous studies about recreational running and its effects on hip or knee arthritis, otherwise known as osteoarthritis (a.k.a., degenerative joint disease, or “wear-and-tear” arthritis). With a total of 114,829 people studied, the researchers found that only 3.5 percent of recreational runners developed osteoarthritis during their period of study. In addition, the researchers found that those who were not recreational runners had a 10.2 percent chance of developing osteoarthritis. This means that people who ran moderately had a lower chance of developing osteoarthritis than people who did not run at all.

In addition, a 2016 study conducted by Matt Seeley, Ph.D, associate professor of exercise science at Brigham Young University, found that running for 30 minutes reduced inflammatory proteins around the knee joint. He states that “running at a recreational level can be safely recommended as a general health exercise, with the evidence suggesting that it has benefits for hip and knee joint health.”

So, what does this mean for people with, or are susceptible to, osteoarthritis? To find out more, check out Micha Abeles’ website here.

Medicines May Help to Prevent Arthritis

Every year The European League Against Rheumatism (EULAR), which is an E.U.-based organization that represents the patient, healthcare professional and professional societies of rheumatology, holds the Annual European Congress of Rheumatology. This forum serves as a space where rheumatology professionals can connect with patient organizations, as well as to learn and engage with other professionals in rheumatology, all to achieve progress in the care of people who suffer from various autoimmune and inflammatory diseases.

This year’s conference took place in Madrid, Spain. Among the thousands of presentations, one scientific session that stood out to me (in my review of the gathering) was a meta-analysis conducted by Bruno Fautrel, MD, PhD, of the Departments of Epidemiology, Rheumatology and Clinical Immunology (from Pierre and Marie Curie University in Paris), and his colleagues. Their study suggests that the best way for patients with pre-rheumatoid arthritis to prevent a full onset of rheumatoid arthritis is to intervene with early therapy.

Patients who have pre-rheumatoid arthritis are at an important point in their medical care because this is the ideal time period to prevent full onset of rheumatoid arthritis. Patients and their providers should take into consideration contributing risk factors, such as smoking and obesity, and adjust their lifestyle accordingly. However, Fautrel and his colleagues conducted a meta-analysis of people with the disease and found that medical treatment could effectively prevent progression to rheumatoid arthritis.

To read more about the findings of this meta-analysis, visit Micha Abeles’ blog here.

About the Decision not to Take Osteoporosis Medications

Multiple factors contribute to the decision not to take osteoporosis medications, with fear of adverse events topping the list, say researchers in a paper published online in the Journal of the American Pharmacists Association.

In the study, researchers collected information about 790 participants in the Patient Activation After DXA Result Notification study who had received prescriptions for new or different osteoporosis medications after a dual-energy X-ray absorptiometry scan. Participants were interviewed at baseline and 12 and 52 weeks after their DXA scans, and researchers collected information such as patient demographics, health history, health habits, prior osteoporosis diagnosis or treatment, osteoporosis knowledge using the “Osteoporosis and You” scale, osteoporosis health beliefs, and osteoporosis self-efficacy.

Read the rest of this blog on Micha Abeles’ website here.

Millennials are Already Getting Arthritis

The Centers for Disease Control and Prevention determined that 54 million adults are diagnosed with arthritis, and not all of them are elderly as you would typically imagine. About 8 million millennials have been diagnosed with arthritis as well!

So what’s the cause of millennials getting diagnosed with this condition? It’s a combination of technology usage and excessive workouts that put too much use on their joints.