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| Nutrition and Joint Health |
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By Jason
Theodosakis, M.D. |
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A diet that includes a wide variety of foods in quantities
that promote a healthy weight can help improve and maintain
joint health.
Research shows that maintaining a healthy weight can
help alleviate wear and tear on joints, and that weight
loss can improve joint health for overweight or obese
people. Excess weight increases the amount of stress
placed on the joints, which can lead to impaired mobility
and flexibility over time.
It is also well known that the types of foods in one's
diet may affect joint health deterioration of healthy
joints. Antioxidant-containing foods that include vitamins
A, C and E as well as selenium are believed to promote
joint comfort and provide numerous other health benefits.*
Many different foods provide antioxidants, including
most fruits and vegetables, oils from certain fish and
seeds, and whole grains.
A second type of food that affects joints are certain
oils. In particular, the omega-3 fatty acids found in
coldwater fatty fish are believed to help limit flare-ups
and boost the immune system.* The best sources of these
fats are salmon, tuna, mackerel, anchovies, herring
and sardines. It is recommended that meat or poultry
be replaced with fatty fish meals at least twice a week.
Nuts and seeds are also a good source of the healthier
types of certain oils and should be included in the
diet on a regular basis; however, they are high in calories
so quantities should be kept small.
If it is not possible to obtain enough of the important
nutrients from foods, taking dietary supplements, such
as glucosamine and chondroitin, may be helpful. Exercise
is also a vital component of a joint health regimen.
Therefore, maintaining healthy joints will require attention
to both diet and physical activity on an ongoing basis.
About Dr. Theodosakis: Jason Theodosakis, M.D. is an
arthritis and sports medicine specialist and author
of the New York Times best-selling book, The Arthritis
Cure (St. Martin's Press, revised 2004). |
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| Ask the Doctor |
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| What
are the best dietary supplements for promoting healthy
joints? |
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| There are dozens of supplements promoted for joint health.
Glucosamine and chondroitin are by far and away the best
researched and most widely used. Newer to the US compared
to Europe, The European Authority for Rheumatology (EULAR)
has classified these two supplements as category 1A (highest
rating) for all interventions for both the level of evidence
and strength of recommendation (see reference 1). Millions
and millions of people worldwide have benefited from the
daily use of these two dietary supplements. Recent clinical
research shows that the combination of glucosamine and
chondroitin yielded a synergistic effect in those of greatest
need (see reference 2). Furthermore, compared to other
interventions, the safety record of these two dietary
supplements is unparalleled. |
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| What's
the best way to use glucosamine and chondroitin? |
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First of all, make sure the right amount is taken. Most
of the research on the supplements involves the daily
dose of 1,500 mg of glucosamine and 800 mg to 1200 mg
of chondroitin. Taking these supplements all at once is
preferred to splitting them up throughout the day, but
it doesn't appear to matter if they are taken with or
without food.
Second, the supplements should be used long-term. Unlike
the use of some alternative preparations, the beneficial
effects from glucosamine and chondroitin are enhanced
by continued and long-term use.
Third, understand that changes in joint health are
not necessarily indicative of how well the supplements
are performing. In fact, even without noticeable changes,
people are still able to reap the benefits of using
glucosamine and chondroitin for the health of their
joints.**
It helps some people to think of glucosamine and chondroitin
for the joints in the same manner that they think of
calcium and vitamin D for bone health.* The effects
and benefits might take a while and may not even be
obviously noticeable, but the long-term benefits are
certainly well documented (see reference 3).*
Finally, ensure the quality of the product and that
it is made in accordance with the guidelines set forth
in the Good Manufacturing Practices (GMPs). Make sure
to stick with a quality name brand product, preferably
the leader in the category. This way you'll be assured
that you're getting the greatest benefit for the health
of your joints. |
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| NIH GAIT Findings Debated at ACR
2006 |
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"The Great Debate: Perspectives on Glucosamine
and Chondroitin Sulfate" took place at The 70th
Annual Meeting of the American College of Rheumatology
(ACR) on November 14th in Washington D.C.
During this session, a panel of renowned joint health
medical experts discussed last year's controversial
findings of the National Institutes of Health (NIH)
Glucosamine/Chondroitin Arthritis Intervention Trial
(GAIT), which, among other findings, concluded “combination
glucosamine and chondroitin is effective in treating
moderate to severe knee pain due to osteoarthritis (OA)"
(see reference 4).
While those who conducted the study concluded that
the overall test results did not indicate the efficacy
of combination glucosamine and chondroitin, a pre-defined
group encompassing patients with moderate to high pain
showed 79.2 percent effectiveness (highly statistically
significant) versus celecoxib (Celebrex) at 69.4 percent,
which was not statistically significant versus placebo
at 54.3 percent.
Jason Theodosakis, M.D., MS, MPH, a member of the steering
committee for the $14 million NIH study, argued the
position that the combination of glucosamine and chondroitin
is effective in reducing pain and improving functional
ability in patients with osteoarthritis. Dr. Theodosakis
reviewed the totality of the evidence on glucosamine
and chondroitin, two substances given the highest level
of recommendation and strength of evidence by the European
Union's main governing body in Rheumatology, EULAR.
Critics of glucosamine and chondroitin have pointed
to the few studies that did not reveal a significant
benefit compared to placebo. Dr. Theodosakis showed
that these studies cannot provide evidence against the
supplements due to several serious design flaws, including:
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Insufficient duration of study |
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Insufficient or improper dosing of glucosamine |
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Uncontrolled use of active medications |
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Recruiting of subjects with mild pain to start
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| A Joint-Healthy Recipe |
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| The following recipe provides significant quantities
of multiple beneficial nutrients including omega-3 fatty
acids and antioxidants: |
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| Lemon
Salmon with Olives |
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| Prep Time: 10 minutes |
| Total Time: 20 minutes |
| Serves: 4 |
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| Ingredients: |
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1 1/3 cup brown rice, uncooked |
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2 cups (16 oz) fat-free, low-sodium chicken stock
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4 6-ounce pieces of raw salmon |
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2 lemons |
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12 stuffed green olives |
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1/2 teaspoon black pepper |
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48 fresh asparagus spears |
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8 cups mixed salad greens |
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2 whole tomatoes |
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8 tablespoons fat-free salad dressing, favorite
flavor |
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8 teaspoons dry roasted, unsalted sunflower seeds |
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| Preparation: |
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Preheat oven to 450°F. Prepare rice according
to package directions, replacing 16 ounces of the water
(2 cups) with chicken stock.
Meanwhile, place salmon on foil-lined baking sheet.
Cut lemons into 1/3-inch slices; cut olives into 1/4-inch
slices. Place lemon and olive slices over salmon. Sprinkle
with freshly ground pepper to taste. Pull up the sides
of the foil and add 8 Tbsp. water. Cover with foil,
folding edges together, and seal edges securely. Cook
salmon for 8 to 12 minutes or until fish flakes easily
with fork.
While salmon is cooking, trim and steam asparagus
spears in microwave or on stovetop until crisp-tender.
Serve salmon, rice and asparagus with a crisp salad.
To prepare salad, wash and chop greens and tomato; toss
with dressing and sunflower seeds.
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| Nutrition
Information per Serving: |
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Calories: 620 |
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Calories from Fat: 120 |
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Total Fat: 14g |
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Saturated Fat: 3g |
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Cholesterol: 80mg |
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Sodium: 780mg |
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Total Carbohydrate: 77g |
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Dietary Fiber: 12g |
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Protein: 49g |
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| Millions of Americans Have Concerns
with Joint Health |
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| Osteo
Bi-Flex® Advanced with Joint Shield™ Can Promote
Joint Comfort* |
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For the millions of Americans concerned with joint
health — ranging from joint comfort to concerns
about joint mobility — a revolutionary new formula
is now available from Osteo B-Flex®,
the #1 Doctor Recommended Joint Care Brand.**
Osteo Bi-Flex® Advanced is the only leading brand
with Joint Shield™. It includes the leading joint
care ingredients Glucosamine HCl, Chondroitin Sulfate,
MSM, Manganese and Vitamin C, and then adds 5-LOXIN®
— a potent extract of Boswellia serrata,, which
is 10 times more concentrated than typical Boswellia
extracts.* |
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| Source:
Jason Theodosakis, M.D. |
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