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Insider Arthritis Tips, November 2008
November 15, 2008

"Character consists of what you do on the third and fourth tries." -- James Michener, Author

Table of contents


What's the role of weight loss in arthritis?

Special Announcement-Complimentary Teleseminar

Tip of the month


The fall is a bittersweet time of year. The traffic on route 15 at Motter Avenue near my office gets worse signifying the beginning of a new school year. When we’re young and in school, we don’t realize how good we have it. You go to class, you study, you have fun, and somebody else pays the bills. Little wonder that so many young people wind up being professional students!

But reality eventually sets in. School is sort of the appetizer before the main course... work. Our oldest child, Becky is working in the real world. We’re proud of her. She is supporting herself after graduating from college. Jeffrey, our second child is back at NYU hoping to make a big splash on Broadway someday. If anybody can do it, he can. Benji is a senior in high school and preparing for college. And little Emily (not so little anymore) is in the 7th grade.

Seeing them reminds me of when I was their age. It was a different time then. After school, we would do our homework and then play until dark, coming home when our mothers yelled for us. We didn’t lock our doors. When I was a kid, for a time we had the Sealtest milkman bring us fresh milk “with cream on top” and the eggman would bring us farm fresh eggs.

It’s not like that any more. And a mentor of mine, Dan Kennedy mentioned the same thing. He said, “A lot is being said in this presidential campaign about the need to put the past behind us and move forward. I think it might be better to move backward in time in many ways. This country is a poorer, less civil, less livable, and less admirable country than it was 40 to 50 years ago. “

The childhoods my kids had and have – a house filled with technological marvels, in which they are prisoners, never chased outside and told to roam in the neighborhood, play in the woods, and be home before dark; out in their own yard only with a wary adult watcher’s eye, shuffled to and from supervised activities. I had no computer, no flat screen TV, no special summer camp. I had the playground, the fence behind our house that led to the backs of stores and factories, a trek up the hill to the local dump where my friends and I could always find something “useful.” We traveled by foot or by bike through the whole neighborhood, wandering into and out of friend’s houses, playing softball, making Pinewood Derby cars in the Cub Scouts...

Compared to my kids, I think I had the better deal.

What's the role of weight loss in arthritis?

Patients with arthritis, particularly osteoarthritis (OA), need to maintain weight at an ideal level. Ideal body weight is dependent on what your body mass index (BMI) is.

To calculate ideal body weight, here is how to calculate body mass index or BMI.

The formula is:

BMI = weight (in pounds) x 704 divided by [height (in inches) X height (in inches)]

Weight categories: BMI

Underweight <18.5

Normal 18.5-24.9

Overweight 25-29.9

Obese >30

Why is weight so important for arthritis? Studies have shown that overweight or obese women who lose about 11 pounds (2 BMI units) decrease the risk of having OA of the knees by 50 per cent.

Gaining 11 pounds increases the risk of knee OA by 28 per cent.

While the correlation with symptoms is still uncertain, it seems clear that there is added stress on the body with excess weight.

For instance the force exerted on the hip and knee during walking is about three times one’s body weight. Overweight and obese people could conceivably be increasing damage to cartilage. Alteration of gait- the way one walks- would also have detrimental effects on the weight-bearing joints. Obese people do tend to alter their gait.

Some evidence suggests that obese people also have circulating hormones and growth factors that also could aggravate the development of OA.

Weight loss is simple… but not easy. Essentially you have to take in fewer calories than you use up. That means a combination of diet and exercise is what is required.

It may be as simple as avoiding high fat snacks and limiting portion size. Men over the age of 50 should reduce caloric intake to 1,800 calories a day while women over the age of 50 should limit their caloric intake to less than 1,400 calories a day. If this is combined with a moderate exercise program, weight should come off at a rate of 1 to 2 pounds a week.

Exercise is key. Exercise not only helps with weight control but it can also strengthen the muscles that protect joints. You should start slow but aim for 30 to 40 minutes 6 days a week as an eventual goal.

Aerobic exercise such as walking, riding a stationary bike, using an elliptical trainer or cross country ski machine may all be helpful. Swimming is another great form of exercise as is a rowing machine. (Avoid using a rower if you have low back problems.)

Weight training is helpful. And stretching should also be considered as an important component of any exercise program. Tai chi is a useful form of exercise for some people.

Water exercise appears to be the single best form of exercise for people with arthritis. The buoyancy of the water relieves stress on joints. Because of buoyancy, people with arthritis can improve flexibility, perform movements, and even do strength training without the impact these exercises would have on the joints on land.

The water temperature should be warm. The warmth creates a soothing environment for painful joints. The warmth also relaxes muscles and improves blood flow.

It’s important to get medical clearance from your physician before embarking on any kind of exercise program. A physical therapist can help design a good water exercise program for you. Spend at least 10-15 minutes warming up and stretching before starting your exercise program.

Special Announcement-Complimentary Teleseminar

For Arthritis Sufferers Only...

"Make This Your Best Year Ever!"

Discover Seven Little Known Secrets to Transform Your Health With the …
• Right Exercise
• Right Diet
• Right Stress Busters…

…That Most Doctors Don’t Know About!

o Learn how to blast away those pesky food cravings!
o Feel great with these common sense exercise tips for arthritis patients!
o Ratchet down fatigue without drugs!
o Clobber stress with this single fastest fix!

Join me on the phone Tuesday evening, January 13, 2009 at 7 PM Eastern Time in the comfort of your own home. Register NOW! (The number of phone lines we can accommodate is limited) Register by calling Michelle at 301 624-1164 or online at this link:

(If you have trouble with the link, just copy and paste it into your browser by copying the link, going to your browser and hitting "control" and "v")

If you have any questions, contact us at

Tip of the month

How to use ice

Physicians often recommend ice. The reason is that proper icing can reduce swelling and also has an analgesic effect. The proper way to use ice is to wrap the ice source in a thin towel so that the ice does not contact the skin directly. The ice should be placed on the affected area for 20 minutes, then off for 20 minutes.

That’s it for this month. Hope it’s been helpful.

I'll be back next month with more news.

Nathan Wei, MD, FACP, FACR

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Insider Arthritis Tips A monthly ezine on arthritis written by a nationally known board-certified rheumatologist with tons of excellent and useful information for anyone interested in arthritis

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