Mother always said to eat your Wheaties, and a new study on knee pain may give us some insight into the relationship between fiber and joint pain. The answer seems to be that fiber can decrease body weight and keep inflammation under control. Before I share the study findings, let’s review how weight and inflammation can lead to knee pain.
Obesity is the number one issue on our top-ten causes of cartilage loss. Wear-and-tear forces on our knees increase four times for every extra pound we carry, and this can cause cartilage loss, leading to knee arthritis, knee pain, and even an increased risk of knee replacement. The good news is that even if you are already overweight, losing weight will help your knee arthritis and knee pain, with each pound loss decreasing the forces on the knee fourfold.
There are a couple of biochemical reactions that can have an impact on weight and knee pain as well. Metabolic syndrome plays a part in cartilage loss by destabilizing its structure. Common characteristics of metabolic syndrome are obesity (typically with a pear- or apple-shaped body), early-onset diabetes, and high blood pressure. Metabolic syndrome also causes low-level, chronic inflammation. Leptin is a hormone that regulates body weight by telling your brain you’re full when you are eating. The more overweight you are, the less your brain recognizes this message. This results in higher levels of leptin, and high levels of leptin are associated with more knee arthritis.
So obesity can have a triple-whammy effect on knee pain: the biomechanical effect of simply having more weight for your knees to carry and the biochemical effects of both metabolic syndrome and high levels of leptin.
Chronic inflammation can lead to some devastating diseases, including cancer, strokes, and heart attacks. It also fuels the fires of arthritis (inflammation of the joint), and getting inflammation under control goes hand in hand with keeping your weight optimal when you are addressing knee pain. As you age, chronic inflammation, when left unaddressed, will build up in your body. Conditions that contribute to chronic inflammation include prediabetes or diabetes, sleep problems (e.g., apnea), poor diet or eating foods you are sensitive to, bad genes, bad gut bacteria, and lack of activity or exercise.
It’s important to note here that there is another form of inflammation that is good for and helpful for repairing tissue. This is acute inflammation. We don’t want to stifle acute inflammation as its job is to bring healing cells into an injured area. Once the healing is complete, acute inflammation will typically subside; however, inflammation can become chronic and problematic, especially if there are issues such as those listed above.
In order to address joint pain, you need to make sure your weight is at optimal levels and eliminate chronic inflammation. This can be accomplished through the adoption of a healthy lifestyle and diet.
In the new study on dietary fiber and knee pain, researchers “assessed whether fiber intake was associated with knee pain development patterns” in almost 5,000 subjects who were followed in the Osteoarthritis Initiative for eight years. Results showed that subjects were almost twice as likely to be in the highest pain group if they had a low-fiber diet, and, more specifically, that a high-fiber diet (25g a day) led to lower risks of moderate and severe knee pain. The simple conclusion here: eat your fiber!
Understanding the relationship between dietary fiber and joint pain, how do you get 25 grams of fiber in your diet each day? There are many healthy food sources that will get you there, including beans (particularly black beans and lima beans), lentils, broccoli, blackberries, avocados, and bran flakes (remember those Wheaties I mentioned earlier?). It just takes a little Google browsing to find the foods highest in fiber. While one apple with skin, for example, only has 5 grams of fiber, one medium avocado contains about 14 grams. Eating five apples in one day certainly isn’t recommended, but a sliced avocado on a salad, one apple, and a serving of black beans is doable.
Another good source for a fantastic and easy-to-follow healthy-lifestyle plan can be found in Nutrition 2.0, a guide to healthy eating written by our own Dr. Pitts. His book takes you through the balance of carbohydrates, proteins, and fats; misunderstood nutrition topics; supplements; specifics for weight loss; exercise; mental and spiritual health; and so much more. You can download it for free at the link above.
The upshot? While something you may have never considered, the conection between fiber and joint pain is interesting. The foundation of a healthy lifestyle is a proper diet, and a proper diet with high fiber may help you manage weight and inflammation, and, therefore, knee pain. Eating your Wheaties…and your avocados and lima beans…may please your mother, but it may just please your knees even more.
About the Author
Christopher J. Centeno, M.D. is an international expert and specialist in regenerative medicine and the clinical use of mesenchymal stem cells in orthopedics. He is board certified in physical medicine as well as rehabilitation and in pain management through The American Board of Physical Medicine and Rehabilitation.…