Keep Obesity And Knee Osteoarthritis From Shortening Healthy Years Of Life

An estimated 10 million Americans suffer from knee osteoarthritis (OA), making it one of the most common causes of disability in the US. Because of obesity and the effects of knee OA, Americans over the age of 50 will together lose the equivalent of 86 million healthy years of life, concluded researchers at Brigham and Women's Hospital (BWH), who investigated the potential gains in quality and quantity of life that could be achieved averting losses due to obesity and knee OA. Their findings were published in a recent issue of Annals of Internal Medicine.

"Reducing obesity to levels observed in 2000 would prevent 172,792 cases of coronary heart disease, 710,942 cases of diabetes, and 269,934 total knee replacements," said Elena Losina, PhD, lead author of the study and co-director of Orthopedics and Arthritis Center for Outcomes Research in the Department of Orthopedic Surgery at BWH. "All told, it would save roughly 19.5 million years of life among US adults aged 50-84."

Experts have long known that knee osteoarthritis is on the rise among Americans, due in part to the growing obesity epidemic and longer life expectancy. Obesity and knee OA are among the most frequent chronic conditions in older Americans. However, how that translates into years of healthy life lost has not been accurately estimated. Dr. Losina and colleagues used a mathematical simulation model to assemble national data on the occurrence of knee OA, obesity and other important conditions such as coronary heart disease, diabetes, cancer and chronic lung disease. Their analysis examines the contribution of both obesity and knee OA to losses in quantity and quality of life. It also evaluates how those losses are distributed among racial and ethnic subpopulations in the United States.

"There are 86 million healthy years of life at stake, a disproportionate number of them being lost by Black and Hispanic women," said Jeffrey N. Katz, MD, Director of the Orthopedics and Arthritis Center for Outcomes Research at the BWH and a senior author of the study. "These staggering numbers may help patients and physicians to better grasp the scale of the problem and the potential benefits of behavior change."

Changes You Can Make Now

Being physically active and eating a healthy diet are keys to a healthy lifestyle. To lose weight, you need a combination of less calories taken in through food and more calories used up, often with the help of an increase in physical activity.

Simply cutting out sources of empty calories can result in weight loss. For instance, replace all soda with water. If you drink 12 ounces of soda a day'just one can—making this change will result a loss of more than 12 pounds in a year. Increase your physical activity by 30 minutes a day—just by walking—and you may be able to double the amount of that weight loss.

Need to lose more? The more smart changes you make, the greater your weight loss.

Other healthy switches are:

• Replace full-fat milk, yogurt and cottage cheese with fatfree versions. This also saves you from eating unhealthy fats as well as extra calories.
• Replace one dessert per day with a serving of any fresh fruit.
• Replace one starch, such as a slice of bread or a serving of potatoes, with a salad and low calorie, fatfree dressing.

Follow these guidelines to get the nutrients you need when cutting back on calories:

• Eat fruits and vegetables in all different colors to get a wide range of vitamins, minerals and other nutrients. For example, eat dark green vegetables, such as broccoli, kale, and other dark leafy greens; orange vegetables, such as carrots, sweet potatoes, pumpkin and winter squash; and red vegetables like red bell peppers, beets and tomatoes.
• Include foods that contain fiber such as fruits, vegetables, beans and whole grains—eat brown rice instead of white rice and oatmeal instead of processed cereals.
• Eat lean cuts of meat and poultry. Trim away excess fat and remove skin from poultry before cooking.
• Pay attention to portion sizes, especially at restaurants. Smaller portions equal fewer calories.
• Season your food with lemon juice, herbs and spices, rather than using butter and salt.

Try these lifestyle tips to keep you on track:

• When you go grocery shopping, plan ahead by buying a variety of nutrient-rich foods for meals and snacks throughout the week.
• When making a sandwich for lunch, use whole-grain bread or a whole-grain wrap rather than white bread for more fiber.
• When eating out, opt for steamed, grilled or broiled dishes instead of ordering fried or sauteed choices.
• When you'll be out and need to take along snacks, choose fresh fruit, cut-up vegetables, string cheese sticks or a handful of unsalted nuts; avoid less healthful snack choices like chips.

Weight loss seems to get harder as we age. Often our calorie needs aren't as great as they were when we were younger, and weight gain can result from eating the same number of calories you used to if you're now getting less exercise. Talk to your doctor about determining your calorie needs for both losing and maintaining weight. It's a challenge to adjust to eating less food than you're used to, but the reward is enjoying a longer and more agile life.