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Exercise Is a Necessary Treatment for All Types of Arthritis

Arthritis is classified into three types: inflammatory, degenerative, and traumatic. Your doctor first checks to see if you have a history of trauma that damaged your joint. If you don't, he does a host of blood tests looking for a source of inflammation (an overactive immunity): various diseases, infections or the deposition of crystals in the joint fluid. If he finds none of these, he announces to you that you have osteoarthritis, which means that he doesn't have the foggiest idea what is causing your joint pain. He then does X rays and MRIs. If the cartilage is gone and a bone at the joint touches the end of the opposing bone, he may recommend a joint replacement. If the cartilage is intact, the major treatment is exercise (Current Pain and Headache Reports, December 2011: 15(6):423-30).

Regardless of the cause of your joint pain, inactivity will increase damage to the joint. If you don't move that joint, you can expect it to degenerate to the point where the joint loses its ability to move through its full range of motion. When you stop using a joint, the muscles around it grow weak and the tendons stiffen. This leads to further joint damage and lack of mobility. Of course, you should not pound on, or apply too much force on damaged joints because too much force can break more cartilage, leading to a joint replacement.

DO NOT RUN WITH ARTHRITIS IN KNEES OR HIPS. Running is almost always contraindicated if you have joint damage in the legs, hips or lower back because during running, your foot hits the ground with a force that is transmitted up your leg all the way to your back. The faster you run, the greater and more damaging the force of your foot strike. If you want to run with joint pain, you must run very slowly, and even then, you are still transmitting the foot strike force up your leg and into your back.

BEST SPORTS FOR ARTHRITIS: The safest sports for people with painful joints are those that do not involve foot strike force. Cycling is done in a smooth rotary motion. Swimming helps protect your joints because of the buoyancy of the water. Exercise equipment such as elliptical trainers or stair steppers will allow you to move your joints without pounding on your feet. Any of these activities help you to strengthen the muscles around the damaged joints and keep the tendons flexible. Whatever sport you choose, the same rules of training that athletes use apply to you:

BACKGROUND BEFORE PEAKING: Start out by pedaling, walking or swimming very slowly and stop if your muscles feel heavy or hurt. Stop even if you have just started your workout for that day. When you can pedal, walk or swim for 30 minutes a day without increasing your joint pain, you are ready to start training.

STRESS AND RECOVER: If you do not exercise intensely enough to feel some burning in your muscles, your muscles will not get stronger. You have to work hard enough to damage muscles because healing strengthens them. Athletes take a harder workout on one day in which they feel a burning in their muscles. When you exercise hard enough to feel sore on the next day, you should go slowly for as many days as it takes for the muscles to heal and the soreness to go away. The normal soreness you feel 8 to 24 hours after you have taken an intense workout is called Delayed Onset Muscle Soreness (DOMS).

THE DIFFERENCE BETWEEN DOMS AND AN INJURY: DOMS is symmetrical; you feel the same soreness on both sides of your body. Also, DOMS does not worsen with easy exercise. Stop exercising immediately if the pain does not improve as you continue to move. If your discomfort increases as you exercise, you have an injury or are headed for an injury.

IF YOUR JOINTS HURT TOO MUCH TO EXERCISE: If your joint pain is so severe that you cannot exercise, you need to find some way to have your joints moved for you. Go to a physical therapist who will move your joints for you and use massage, heat, cold or electrical stimulation to help you regain the ability to move the joints. Allowing your joints to stay in one position without daily movement will cause further joint damage and make your arthritis pain worse.


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Eating Fruit Helps to Prevent Diabetes; Fruit Juice Increases
Diabetes Risk

A study following 200,000 men and women for 24 years found that those who ate lots of blueberries, apples, and pears had a 23 percent reduced risk for developing diabetes (American Journal of Clinical Nutrition, published online February 22, 2012). Fruits are loaded with flavonoids which help prevent diabetes, heart attacks, and cancers. Fruits reduce your chances of developing diabetes, even though they are rich sources of sugar and raise blood sugar levels. Eating whole fruit does not raise blood sugar levels nearly as much as drinking fruit juice.

Whole fruits contain solid substances, such as fibers and pectin, which markedly slow the absorption of their sugar into your bloodstream. When you eat, the pyloric sphincter at the end of the stomach closes and the stomach muscles squeeze only a liquid soup into the intestines. Solid material is held in the stomach until it is small enough to pass with the soup into the intestines. An orange can take as long as five hours to pass into the intestines.

However, all sugars in liquid form pass immediately into the intestines to cause a rapid and high rise in blood sugar. When blood sugar levels rise too high, sugar sticks to the outer surface of cell membranes to destroy the cells. This is just the latest of many studies showing that fruits help to prevent diabetes, while drinking fruit juices increases risk for developing and worsening diabetes.


Obesity and Cancer

The National Cancer Institute has released a report showing that being overweight markedly increases risk for cancer. An earlier review of 221 studies showed that being more than 15 pounds overweight markedly increases risk for more than 20 different types of cancer, including breast, bowel, kidney, esophageal, thyroid, uterine, gallbladder, rectal, pancreatic and colon cancers, myeloma, leukemia, melanoma and non-Hodgkin's lymphoma (Lancet, Feb 17, 2008).

• Obesity causes inflammation and insulin resistance. Your immunity is supposed to be good for you. It kills germs that try to invade your body. However, if your immunity stays active all the time, the same antibodies and cells that kill invading bacteria and viruses, attacks your own tissues. This is called inflammation. The chemicals that dissolve the outer membranes of bacteria dissolve the outer membranes of your cells. Full fat cells release hormones that turn on your immunity to make it attack you.

• Fat cells make large amounts of estrogens which are associated with increased risk for breast, uterine, and other cancers.

• Obese people have increased levels of insulin and insulin-like growth factor-1 (IGF-1) that cause cells to grow. Cancer means that cells grow too much.

• Fat cells stimulate the production of hormones, such as leptin, that stimulate cells to grow.

• Fat cells stimulate production of tumor growth factors such as target of rapamycin (mTOR) and AMP-activated protein kinase.

CANCER CELLS HAVE DEFECTIVE MITOCHONDRIA: The cells in your body are like balloons full of fluid. Inside of cells are from a few to hundreds of little tiny chambers called mitochondria. Normal cells get their energy from the food that you eat from two major mechanisms:

• Glycolysis, the conversion of sugar to energy inside the cells but outside of the mitochondria and

• The Krebs Cycle, which occurs only inside the mitochondria.

Cancer cells have defective mitochondria, so they must get their energy primarily from glycolysis of sugar outside the mitochondria. Anything that raises blood sugar levels feeds cancer cells and increases the development and spread of cancer. The following raise blood sugar levels and increase cancer risk:

• Diabetes,
• Lack of exercise,
• Obesity,
• Abdominal obesity,
• Saturated fats from animals (block insulin receptors),
• Lack of fruits and vegetables, and
• Lack of fiber in the diet.

WHY DOES ABDOMINAL OBESITY INCREASE CANCER EVEN MORE THAN JUST BEING OBESE? If you store fat primarily in your belly, rather than your hips, you are at even higher risk for diabetes, insulin resistance and cancer (The Proceedings of the Nutrition Society, February 2012; 71(1):181-9). Full fat cells prevent the cells from responding to insulin, so insulin levels rise higher and higher. Insulin specifically causes fat to be deposited in the belly and around the organs inside your belly. People who have large, fat bellies and small buttocks usually have high levels of insulin, which means that they are already pre-diabetic or diabetic.

HOW EXERCISE HELPS TO PREVENT OBESITY: Resting muscles cannot remove sugar from your bloodstream without insulin. However, contracting muscles are different. They can remove sugar from your bloodstream without needing insulin. When you eat during or just after exercising, blood sugar levels do not rise too high, insulin levels do not increase significantly, and the sugar is being turned into energy, instead of filling fat cells (Science 1966; 152: 1248-1250). The more intensely you exercise, the greater the effect of muscles removing sugar from the bloodstream.

HOW A HEALTHFUL DIET PREVENTS CANCER: Fruits and vegetables are loaded with antioxidants, fiber, and other chemicals that help to prevent cancer. Fried foods contain burnt fat which is called Polycyclic Aromatic Hydrocarbons (PAH) that can cause cancer in animals and in humans. Red meat contains Neu5GC that turns on your immunity to cause inflammation that can cause cancer. Drinks and foods that contain added sugars raise blood sugar levels, raising raise insulin levels which can increase cancer risk.

Exercising, eating large amounts of fruits and vegetables, and restricting sugar-added foods and drinks, fried foods and red meat can help to protect you from developing cancer (Clinical and Experimental Pharmacology & Physiology, February, 2012;39(2):161-7).


Recipe of the Week:

Lebanese Soup

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March 25th, 2012
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About the Author: Gabe Mirkin, MD

Sports medicine doctor, fitness guru and long-time radio host Gabe Mirkin, M.D., brings you news and tips for your healthful lifestyle. A practicing physician for more than 50 years and a radio talk show host for 25 years, Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. He is board-certified in four specialties: Sports Medicine, Allergy and Immunology, Pediatrics and Pediatric Immunology. The Dr. Mirkin Show, his call-in show on fitness and health, was syndicated in more than 120 cities. Read More
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