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40 HEALTH ARTHRITIS FROM PAGE 39 of the burden of all musculoskeletal disorders until now. The findings are accessible in Arthritis & Rheumatology1, an official journal of the American College of Rheumatology. Two thirds of Australian adults are overweight Estimates show that 65 per cent of Australian adults are overweight or obese, according to the Garvan Institute of Medical Research. The direct health costs of obesity are estimated to exceed $2 billion annually. Men have higher rates of overweight and obesity. The federal government’s Ten to Men longitudinal study2 on male health revealed that the proportion of Australian males classified as overweight or obese increases with age: in 2013/14 around 20 per cent of boys aged 10–14 were overweight or obese, 60 per cent of men aged 25–34, and more than 70 per cent of men aged 35–57. It doesn’t end there, with kilograms often piling on middle-aged men as they get older. The study, which used data collected between 2013 and 2016, also shows that Aboriginal and Torres Strait Islander boys and young men are almost twice as likely to be overweight or obese. The study also highlights that ongoing or persistent overweight and obesity is associated with a much higher likelihood of a range of other chronic health conditions, such as arthritis, diabetes and respiratory conditions. This underscores the need for health interventions to help Australians, especially males, to better manage their weight for optimal health outcomes. Complementary strategies to manage arthritis Ms Marine says many complementary strategies to manage arthritis can be used in addition to the medications available. The “important part” of such strategies, she adds, is “making healthy food choices and managing weight”. This, she says, is due to extra body weight increasing the stress on many joints, particularly the knees, hips and lower back. “Pharmacists can stress to patients and customers that losing some excess kilograms will lessen the stress on their joints, reduce pain and make mobility easier.” As to what diet to follow, Ms Marine underscores that to date no diet has been proven by research to cure arthritis. Based on this, she advises that a “cautious approach” be taken to special diets or supplements claimed to cure arthritis. “Arthritis symptoms for the most part vary from day to day, making it tricky to determine if a change in symptoms is due to a change in diet or just coincidence,” she said. “At times people report feeling better after eliminating certain food, but that could be attributed to an individual food intolerance. “A dietitian or doctor would be best suited to provide dietary advice. “Just cutting out whole food groups based on a personal hunch could lead to a nutritional deficiency. “The best advice I can give here is for pharmacists and their assistants to promote a healthy, balanced diet, high in fresh fruits and vegetables with wholegrains, healthy fats and lean animal or plant protein, to maintain general health and avoid medical issues. This may also help overweight or obese people to lose weight and maintain a healthy weight.” A 2017 paper published in Frontiers of Nutrition3 highlights legumes, certain fruits, whole grains and spices as generating some interest as a way of managing rheumatoid arthritis. As to osteoarthritis, consuming omega-3 fatty acids has been shown to be favourable. Ms Marine highlights that it’s not surprising much of the research surrounding nutrition in arthritis management focuses on anti- inflammatory foods, as some types of arthritis are inflammatory.” Certain foods have been shown to trigger inflammation, while others can suppress it, she says, citing the examples of antioxidants in vegetables and monounsaturated fats in nuts, which both fight inflammation. She also points out that Mediterranean diets have come to the fore as being favourable for people suffering from rheumatoid arthritis and other chronic conditions, as these diets tend to keep foods that trigger inflammation at bay while focusing on foods that can help suppress inflammation. “Although research isn’t yet conclusive, it’s most certainly the case that the Mediterranean diet is a good place to start in the quest to consume more fruits, vegetables, nuts, wholegrains, seeds and legumes as well as the meat protein sources that are such an integral part of the Australian diet,” she said. According to Ms Marine, the right fats are important when it comes to a good diet. “The evidence indicates that consumption of foods with healthy fats rather than foods with unhealthy fats could play a role in lessening the symptoms of arthritis,” she said. “While these effects are modest compared with medicines, the upside is that healthier fats don’t have any serious side effects.” Healthier dietary fat spans RETAIL PHARMACY • JAN/FEB 2021