Video Blog: Dr. Kam Shojania on lifestyle factors to maintain joint health
My career has been most at UBC. I've trained at UBC in medicine and internal medicine, rheumatology, and then I became faculty whereupon I became head of rheumatology at UBC and also St. Paul's and VGH. My career is mainly seeing patients, but also teaching and doing research at the Arthritis Research Canada, which is our largest freestanding arthritis center in Canada.
We have an aging population, and that impacts one type of arthritis. The most common type is osteoarthritis, which gets worse as we get older, and it affects many of us. The other types, however, like lupus and rheumatoid don't change with age and actually affect younger people, so younger women and men. With one type of arthritis, osteoarthritis, it is going to be a tsunami with the aging population. If we want to keep active and mobile into our 80's and 90's and even 100's, then there need to be some changes in our lifestyle.
Sometimes, when a patient sees me for arthritis, they will preface it by saying they aren't really keen on taking a medication. After assessing them, I may say, "You know, your type of arthritis is best managed by lifestyle measures," and then I go through the exercise and the weight loss and the lifestyle changes they need to make, and, at the end, some of them will say, "Isn't there just a pill I can take?" While that's an amusing anecdote, it does hold true for a number of patients that I see. Lifestyle measures are particularly difficult to change.
With regards to weight, a 10-pound weight loss for overweight people can translate into a 25% reduction in the need for a total knee replacement. That's huge both for the patient, but also for our system. If we could reduce the number of knee replacements, we can save a lot of money.
Sometimes, we talk about a cure for arthritis, but I think the important thing is there are many types of arthritis, some in fact we can cure. One of the common types of arthritis in men is gout, which is totally preventable now, so there's one down.
If we look at rheumatoid arthritis, we have amazing new treatments over the past 15 years that basically can put it into remission and using old treatments early can actually put it into remission, older, less expensive treatments, so not two down yet, but getting there. If we look at osteoarthritis, however, we are not that close to preventing it yet.
Osteoarthritis is the most common type of arthritis that we often get. Many of us will get it, and it happens more as we get older. Younger people get it if they've had a traumatic injury to a knee, for example, or a back. However, one of the big factors for osteoarthritis is obesity and muscle deconditioning.
In treating osteoarthritis, we don't have a pill that's going to slow it down. The pain medications for osteoarthritis leave a lot to be desired. The best way to manage it is by lifestyle measures. This is particularly hard, but, on the plus side, these lifestyles measures of exercise, achieving appropriate weight, help other conditions as well like diabetes, cardiovascular risks, cancer even. I think that, in the hopes of improving their joint symptoms through lifestyle measure, we are going to achieve a lot of other benefits.
Other tips in preventing joint diseases, I think one of the biggest factors in rheumatoid arthritis, which, remember, these are all different types of arthritis, but rheumatoid arthritis, if you can quit smoking, it reduces the risk of even developing rheumatoid arthritis significantly.
Here's another one for rheumatoid arthritis that most people don't know about, but gingivitis or inflammation of the gums is associated with more with the onset and severity of rheumatoid arthritis. Flossing your teeth and having good dental care, also, smoking makes gingivitis worse, too, but good dental care reduces the risk of rheumatoid arthritis.
Going to gout, which is another type of arthritis, completely separate from these other two I've mentioned, high fructose corn syrup makes it worse or increases gout, so sugary sodas and even fruit juices with high ... supplemented with high fructose corn syrup are not good for gout. Preventing gout is, again, no fast foods, reducing sugary drinks. Cherries, for example, are good for gout, so these little tips as you said that can help different types of arthritis.
In the Arthritis Research Canada, we have a number of outstanding research projects looking at ways for people to cope better with their arthritis, reduce symptoms and even prevent arthritis, also looking at ways of getting the inflammation out. We call that knowledge transfer, because there's lots of great research, but how do we get that knowledge to people? If people are interested, they can go to the website, www.arthritisresearch.ca and look for information or ways to help.
One other tip I forgot to mention was a BC government website called HealthLink BC. Now, if people are interested in looking at lifestyle measures, up on the left, there's weight loss, diet and exercise, and there's ... They have them for different age groups and different conditions, so I urge people to go there. It's free. It's our provincial program, and it's very useful.