Dr. James Paci and Dr. Robert Trasolini pose with orthopedic implants. Photo from Northwell Health
The sports medicine team at Huntington Hospital’s orthopedics department has introduced two biologically advanced implant procedures designed to improve outcomes for patients with knee injuries and early joint degeneration.
Orthopedic surgeon and sports medicine specialist Robert Trasolini, DO, recently performed the hospital’s first BEAR® (Bridge-Enhanced ACL Restoration) Implant procedure on an 18-year-old male athlete, offering a promising new alternative to traditional ACL reconstruction. The BEAR implant is a collagen-based device that, when combined with the patient’s blood, forms a collagen matrix that protects and supports the healing ligament. It contains biological signals that stimulate the ACL to heal, preserving the body’s own tissue rather than replacing it with a graft.
“This is a tremendous advancement for younger, active patients,” said Dr. Trasolini. “The BEAR implant not only restores stability to the knee but does so in a way that supports the body’s natural healing process, potentially reducing recovery time and improving long-term joint health.”
In a separate milestone, James Paci, MD, director of orthopedic surgery and sports medicine for Suffolk County at The Orlin & Cohen Orthopedic Group at Northwell, performed the hospital’s first CartiHeal Agili-C™ implant procedure on a 52-year-old female patient. The coral-based implant acts as a biological scaffold for patients with cartilage lesions who have not yet reached the stage requiring a total knee replacement.
The implant is designed to buy patients 10 to 15 years of pain relief and function before more invasive surgery might be necessary. Made from natural coral, the implant encourages bone marrow elements to migrate into the lesion, promoting the regrowth of cartilage over 6 to 9 months.
“This technology fills a significant gap in our treatment options,” said Dr. Paci. “For the right patient, typically someone too young or active for a knee replacement but dealing with painful cartilage defects, the Agili-C implant offers a bridge that restores function and improves quality of life.”
“These breakthrough procedures reflect Huntington Hospital’s ongoing commitment to delivering advanced, evidence-based orthopedic care to our community,” said Adam Bitterman, DO, chairman of orthopedic surgery at Huntington Hospital. “Innovative treatments like these not only enhance recovery outcomes but also support the long-term joint health and quality of life for our patients.”
If an amusement park suddenly changed the criteria that would allow visitors to ride on a roller coaster or log flume, the number of potential customers would suddenly climb.
The same holds true for the number of people whom doctors are diagnosing with autism.
Over time, health care professionals have changed the definition of autism, recognizing the heterogeneous nature of a diagnosis that is often different from one individual to the next.
Debra Reicher. Photo courtesy Stony Brook University
Recently, Robert F. Kennedy Jr., the head of Health and Human Services, suggested that he planned to share a detailed analysis of autism by this September to explain the increase in the number of people who receive such a diagnosis.
Based on numerous reports, Kennedy indicated he would present research findings at the end of the summer that explains why and how the number of cases of autism and other childhood chronic diseases has risen.
“The biggest, most widely agreed reason for the increase in numbers is the broadening of the diagnostic criteria,” said Debra Reicher, Clinical Psychologist and Assistant Professor at the Renaissance School of Medicine at Stony Brook University.
Over her 35 years in the field of autism, Reicher said the definition of autism has changed.
“We are getting better at diagnosing people at the higher end of the spectrum,” she said.
When Reicher started in the field, about 80 percent of those diagnosed with autism also had an intellectual developmental disorder or cognitive delay. That is currently closer to 40 percent.
“We are getting better at identifying people who have good cognitive skills,” and who have autism, Reicher added.
Over time, the male-female gap has also narrowed. Historically, boys and men were more likely to receive an autism diagnosis.
Clinicians are getting better at understanding the presentation of autism in females, who have different symptoms that can fly under the radar.
Girls are more likely to “mask or camouflage” autism, which physicians might miss, Reicher added.
Matthew Lerner
People are also more aware of autism as a diagnosis.
“Young parents are tracking their child’s development and are asking their pediatricians questions,” Reicher said. That leads to earlier detection.
On a smaller but not insignificant level, some studies suggest that older ages of fathers can also contribute to autism.
“Advanced paternal age is a statistically significant predicator of increased rates of autism,” said Matthew Lerner, Research Associate Professor and Research Director of the Autism Initiative at Stony Brook University.
Premature babies, who are much more likely to survive today than they were even a few decades ago, can also receive an autism diagnosis as they develop.
More support
At the same time, health systems are not only more actively screening for autism, but they are also providing more support and benefits.
By offering people and their families services, these health care systems are providing people with autism care, making a diagnosis a potential starting point for more care.
“If somebody was diagnosed with autism in the 1980s, there weren’t a lot of things that folks could do,” said Lerner, who is also Associate Professor and Leader of the Life Course Outcomes Program Area at the AJ Drexel Autism Institute at Drexel University.
Some research also suggests a correlation between environmental exposure or pollutants and the incidence of the condition.
Researchers, however,caution that a correlation doesn’t necessarily indicate a causation, which is a significant challenge in the world of science and medicine.
A correlation may or may not be relevant in the context of a disease or the treatment for it. Researchers who can conclude based on larger and statistically significant samples a cause between something like environmental exposure and a disease can reduce the likelihood of a condition.
To be sure, despite considerable chatter through online forums, the Internet and people who have limited or no medical expertise, people in the autism field have not seen any evidence that vaccines for diseases like measles have any connection with autism.
The studies that were done in the 90s and early 2000s that suggested a potential link between autism and vaccines were biased and were eventually retracted in a journal, Reicher said.
“Research shows no difference in the rates of autism between vaccinated and unvaccinated children,” she added.
Some new or expectant mothers are hesitating to give their children a measles, mumps and rubella shot.
Reicher urges parents to study the issue carefully and to provide the kind of protection that will prevent the spread of infectious diseases and the lifelong consequences of contracting measles.
Reicher suggested that some of the fear comes from the fact that MMR is given around the time physicians recognize the symptoms of autism.
“With vaccines, there’s no evidence to support” a connection with autism, Reicher added.
New research
Researchers and clinicians welcomed the possibility of new studies that might help the heterogeneous community of people with autism.
New work done with “rigorous science that have reputable approaches and ask meaningful questions” could be “fantastic” for people with autism and their support networks, Lerner said.
To be sure, Lerner doesn’t anticipate any major findings in the development of autism, particularly in the context of vaccines or any other speculation that researchers have tested for decades.
The notion that significant studies from around the world that thousands of researchers conducted over the course of decades would suddenly be overturned in the next four months “seems highly implausible,” he said.
Lerner hopes that any focus on autism research that the current administration conducts respects and adheres to the level of rigor necessary to make any changes in diagnosis, treatment or potential causes.
At this point, Reicher, who has spent decades working with a wide range of people with autism, has seen many people with autism live “wonderful, successful, fulfilling lives.” People with autism are “making huge contributions to the arts, to science and to everything in between.”
Understanding and enhancing an awareness of autism through well-documented and rigorous research could help some people with the diagnosis, although a one-size-fits-all approach won’t work for a larger population that has different symptoms and needs.
Most Americans consume far too much sodium — an average of 3400 mg per day, which is well over the 2300 mg per day recommended upper limit for teens and adults (1). It’s become such an issue that the FDA is working with food manufacturers and restaurants to drive these numbers down (2).
If you don’t have hypertension, what difference does it make? Sodium can have a dramatic effect on your health, regardless of your blood pressure.
It’s hard to avoid, with sodium hiding even in foods that don’t taste salty, like bread products and salad dressings. Other foods with substantial amounts of sodium include cold cuts and cured meats, cheeses, poultry, soups, pasta, sauces and, of course, snack foods. Packaged foods and restaurant meals are where most of our consumption occurs.
In contrast, only about two percent of people consume enough potassium in their diets (3). According to the National Institutes of Health, target potassium intake is between 2600 mg and 3400 mg for adult women and men, respectively.
How are sodium and potassium related?
A high sodium-to-potassium ratio increases your cardiovascular disease risk by 46 percent, according to a 15-year study of more than 12,000 participants (4).
A more recent analysis of over 10,000 participants followed for almost nine years tested sodium and potassium excretion, a more reliable measure of intake, and found that higher sodium excretion, lower potassium excretion, and a higher sodium-to-potassium ratio were all associated with a higher cardiovascular risk (5). Each daily incremental increase of 1000 mg in sodium excretion was associated with an 18 percent increase in cardiovascular risk.
To improve your overall health, you might need to shift your sodium-to-potassium balance so that you consume more potassium and less sodium. And if you struggle with — or are at risk for — high blood pressure, this approach could help.
Why lower your sodium consumption?
Two studies illuminate the benefits of reducing sodium in high and normal blood pressure patients, ultimately preventing cardiovascular disease, including heart disease and stroke.
The first was a meta-analysis that evaluated data from 34 randomized clinical trials, totaling more than 3,200 participants. It demonstrated that salt reduction from 9-to-12 grams per day to 5-to-6 grams per day had a dramatic effect. Blood pressure in both normotensive and hypertensive participants was reduced by a significant mean of −4.18 mm Hg systolic (top number) and −2.06 mm Hg diastolic (bottom number) (6).
When looking solely at hypertensive patients, the reduction was even greater, with a systolic blood pressure reduction of −5.39 mm Hg and a diastolic reduction of −2.82 mm Hg.
The researchers believe that the more we reduce salt intake, the greater the blood pressure reduction. The authors recommend further reduction to 3 grams per day as a long-term target and hypothesize that the effects on blood pressure will most likely result in a decrease in cardiovascular disease.
In the second study, a meta-analysis of 42 clinical trials including both adults and children, there was a similarly significant reduction in both systolic and diastolic blood pressures (7). Both demographics experienced a blood pressure reduction, although the effect was greater in adults. Interestingly, an increase in sodium caused a 24 percent increased risk of stroke incidence but, more importantly, a 63 percent increased risk of stroke mortality. The risk of mortality from heart disease increased by 32 percent alongside an increase in sodium.
Isn’t too little sodium a risk?
Some experts warn that sodium levels that are too low can be a problem. While this is true, it’s very rare, unless you have a health condition or take medication that depletes sodium. Since sodium is hiding everywhere, even if you don’t add salt to your food, you’re probably consuming more than the recommended amount of sodium.
Why focus on potassium consumption?
In a meta-analysis involving 32 studies, results showed that as the amount of potassium was increased, systolic blood pressure decreased significantly (8). When high blood pressure patients consumed foods containing 3.5 to 4.7 grams of potassium, they experienced an impressive −7.16 mm Hg reduction in systolic blood pressure. Anything more than this amount of potassium did not provide additional benefit. Increased potassium intake also reduced stroke risk by 24 percent.
Blood pressure reduction was greater with increased potassium consumption than with sodium restriction, although this was not a head-to-head comparison. The good news is that it’s easy to increase your potassium intake; it’s found in many whole foods and is richest in fruits, vegetables, beans and legumes.
So, what’s the bottom line? Decrease your sodium intake and increase your potassium intake from foods to strike a better sodium-to-potassium balance. As you reduce your sodium intake, give yourself a brief period to adapt; it takes about six weeks to retrain your taste buds.
References:
(1) Dietary Reference Intakes for Sodium and Potassium. Washington (DC): National Academies Press (US); 2019 Mar. (2) fda.gov. (3) nih.gov. (4) Arch Intern Med. 2011;171(13):1183-1191. (5) N Engl J Med 2022;386:252-263. (6) BMJ. 2013 Apr 3;346:f1325. (7) BMJ. 2013 Apr 3;346:f1326. (8) BMJ. 2013; 346:f1378.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.
Nursing students use mannequins and hospital equipment to train for various health care challenges for future patients. Photo by Jeanne Neville/Stony Brook Medicine
Using immersive virtual reality that simulate real-world healthcare settings in a simulated hospital room, emergency room, intensive care unit or patient homes, nursing students use technology to train in a low-stress setting. Photo from Stony Brook Medicine
Nursing students use mannequins and hospital equipment to train for various health care challenges for future patients. Photo by Jeanne Neville/Stony Brook Medicine
By Daniel Dunaief
Dr. Patricia Bruckenthal Photo from Stony Brook School of Nursing
People put their lives in the hands of unseen airline pilots who have enhanced and sharpened their skills using simulators. These simulators can prepare them for a wide range of conditions and unexpected challenges that enhance their confidence on the fly.
The same approach holds true for nurses, who seek to help patients whose symptoms may change even as the nurse is working with several people at the same time.
In an initiative designed to provide in depth training to nurses throughout the state, while filling a shortage of these vital professionals, New York State recently announced a $62 million contribution to three nursing simulation centers: SUNY Buffalo, SUNY Canton and Stony Brook University. With $10 million of state funds that the university will match with $10.5 million of its own money, SBU will increase the number of nurses it trains.
“We are very fortunate here at Stony Brook that we get many, many qualified applicants for our nursing program [for whom] we have not, to date, been able to offer seats,” said Dr. Patricia Bruckenthal, Dean of the School of Nursing at Stony Brook. This will enable the school, as well as the other programs, to train more students.
Effective training
While Stony Brook offers nursing simulation training, the additional funds will greatly expand the size and scope of that effort.
The NEXUS-Innovation Center, which stands for Nursing EXcellence Using Simulation, will take about two years to build and will have a phased in enrollment approach. In the third year, the school will add 56 baccalaureate nursing students. In the fifth year, Stony Brook will have space for 80 more students.
The current simulation center is about 1,850 square feet, which includes a nursing skills lab, exam room and debrief/ flex room.
The new center will add 15,000 square feet.
The simulation center will have 16 hospital style beds, with all the equipment nurses would normally see in a hospital room, including suction, air, oxygen, otoscope, ophthalmoscope, monitoring, and a call bell system. The center will also have eight examination rooms.
The proposal also includes the design of an apartment with a laundry, kitchen, bathroom and shower, helping train nurses who will help people in residential settings.
Among other features, the center will have a control room where instructors and operators manipulate the AV equipment and patient simulations, observe and document performance, collect data and prepare for debriefing.
Bruckenthal is planning to hire a faculty member in the next few months to become simulation coordinator who will work with the Director of the Learning Resource Center.
Within the next two years, Stony Brook anticipates hiring one more nursing faculty Clinical Simulation Educator and one Simulation Operations Specialist, who will ensure that all technical aspects of the center are functioning correctly. This new hire will also troubleshoot equipment, while performing emergency repairs on equipment and arranging for vendor repairs.
All of this equipment and expertise provides opportunities to create scenarios that build expertise. The conditions can change, as a patient goes from an expected outcome to one in which the conditions rapidly deteriorate.
In addition to expanding capacity and giving nurses an opportunity to understand and react to patients who have a wide range of conditions they might not see during routine clinical training, the center will also enable these students to build their competence and confidence in a low-stakes environment.
“It provides for a safe learning environment,” said Bruckenthal. “Students can make mistakes without risking patient safety. It’s much less stressful.”
Future nurses can also continue to work in the simulation lab on a particular skill until they feel confident in their abilities.
Several studies have validated the effectiveness of educating and preparing nurses in a simulated setting.
A landmark study in 2014 conducted by the National Council of State Boards of Nursing compared the clinical competence of nurses in training across three groups: one that had no simulation training, a group with 25 percent of their clinical training replaced by simulation, and a third group with 50 percent clinical training through simulation.
The nursing certification pass rate scores were the same for all three groups. Simulation trained nurses performed as well or better in areas like critical thinking and clinical judgment.
Additionally, follow up studies showed that employers found that nurses trained using high fidelity simulation were just as effective as those who were trained in the clinic in areas including patient safety, communication and evidence-based practices..
The center can also pivot to provide nurses with training for expanding local health threats, such as a simulated version of a measles outbreak, Lyme disease or a spike in other conditions that might cause a surge in hospital visits.
“We can build and design cases that meet those needs,” said Bruckenthal.
The center can build in disaster training, giving nurses a chance to interact with colleagues in other health professions during any of a host of other scenarios. When interacting with other healthcare professionals, nurses can practices the SBAR technique, in which they describe the Situation, provide Background, give an Assessment, and offer a Recommendation.
The expanded simulation center will incorporate design elements such as soundproofing, lighting and ventilation and will align with the university’s goals towards sustainability and green-oriented design.
Long term commitment
Bruckenthal has been contributing to Stony Brook for 44 years, ever since she graduated from the nursing school in 1981.
Her first job as a nurse was at the newly opened hospital. She and Carolyn Santora, Stony Brook Medicine Chief Nursing Officer, have worked together since 1981 and went through the Stony Brook master’s program together. They have established the Stony Brook Nursing Alliance.
Bruckenthal is energized by the opportunities ahead.
“Nursing is one of those careers where you can always keep yourself new and find new and exciting opportunities,” she said.
In the early days of her nursing career, she recalled that nurses weren’t exposed to all the types of conditions they might face in various settings.
“Having the opportunity to have nurses practice in this low risk environment and build that confidence and skills is a better way to prepare nurses to be ready for the work force,” she said
With nurses involved in so many aspects of patient care, Bruckenthal dreams of creating a nursing innovation incubator.
Nurses can offer insights into developing innovative ways to improve health care, whether working with biomedical engineers or biomedical informatics and can help design human-centered technology. Such a center could allow nurses to learn more about technology and business while enabling them to become leaders and entrepreneurs.
“Nurses have a problem-solving mindset,” Bruckenthal explained. “Sustainable and scalable solutions are really going to take a joint effort between educators, clinicians and industry partners.”
Save the date! Catholic Health Mobile Outreach Bus will be in the parking lot of Emma Clark Library, 120 Main St., Setauket for free health screenings on Thursday, May 15 from 10 a.m. to 2 p.m. Registered nurses will provide blood pressure, cholesterol, body mass index, glucose and cardiac screenings, along with patient education and referrals as needed. Last screening begins at 1:45 p.m. No appointments are necessary, there are no fees, and insurance is not required. Questions? Email [email protected].
Get ready for a day of family fun, fitness, and community wellness as The Shoppes at East Wind, 5768 Route 25A, Wading River presents their first annual Family Health & Wellness Day, a motivating FREE event designed to inspire healthy living and bring our community together, on Saturday, May 17 from 11 a.m. to 5 p.m.
This exciting event blends health education with hands-on experiences for all ages. Enjoy high-energy fitness classes, soothing mindfulness sessions, and expert insights into healthy living—all while exploring the offerings of local health and wellness providers.
“We’re inspired to launch this inaugural event at The Shoppes,” said Charlotte Coté, Marketing Director at East Wind. “It’s about living well, supporting local businesses, and showing families all the incredible health resources right here in our own backyard.”
Highlights Include:
Live CPR & safety demos with the Wading River Fire Department
Narcan training by East End THRIVE
Meet representatives from the North Fork Breast Health Coalition
Learn natural calming techniques for kids from Wellspring of Life Acupuncture
FITNESS SESSIONS SCHEDULE:
11:00 AM – Pure Barre Pop-Up Class
12:30 PM – Family Yoga with Margot
1:30 PM – Singing Bowls & Meditation with Andrea
2:30 PM – Acupressure for Kids: Live Demo
SPECIAL GUESTS:
The Wading River Fire Department will be onsite with a full ambulance, offering demonstrations and valuable family-focused safety education. “We’re proud to support this community event,” said Denis Gluck, 3rd Assistant Chief. “It’s an opportunity to connect with families and share lifesaving skills like CPR and water safety.”
Don’t miss this energizing day of wellness, discovery, and connection! Whether you’re looking to boost your fitness routine, explore holistic health options, or just enjoy a fun day out with the family, Family Health & Wellness Day is the place to be.
The Shoppes at East Wind opened in October of 2016 with 28 free standing specialty shoppes connected by brick-paved walkways. The quaint walking village features a variety of local merchants, including jewelers, artisan goods, custom clothing, yoga instruction, an ice cream parlor, pizza shop, bakery, candy store and full-service restaurant. A custom-made indoor pavilion serves as the centerpiece of the courtyard, housing a stunning, one-of-a-kind carousel with hand-carved horses and fantasy figures. EastWindLongIsland/Shoppes
Mather Hospital in Port Jefferson has been nationally recognized with the Healthgrades 2025 Outstanding Patient Experience Award™ for the fifth year in a row (2021-2025) for delivering an exceptional patient experience. Mather is one of four hospitals in New York to receive the award and among the top 5% of hospitals in the country for patient experience for a second consecutive year.
This honor from Healthgrades, an online resource for information about physicians and hospitals, reflects Mather Hospital’s ongoing commitment to compassionate, patient-centered care. Each year, Healthgrades evaluates more than 3,000 hospitals across the country to identify those that consistently provide an exceptional experience from the patient’s perspective.
“This award speaks directly to the dedication and compassion of our entire team at Mather Hospital,” said Kevin McGeachy, President, Mather Hospital. “We are honored to receive this recognition, which reinforces our mission to put patients first in every aspect of their care.”
To determine recipients of the Outstanding Patient Experience Award, Healthgrades analyzed data from the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey submitted by hospitals across the U.S. The 2025 award is based on HCAHPS survey data collected from January 2023 to December 2023. Only hospitals that submitted at least 100 patient surveys during this time were considered.
Healthgrades applies a scoring methodology to 10 patient experience measures, including communication with nurses and doctors, responsiveness of hospital staff, explanation of medications, and cleanliness and quietness of the hospital environment. Mather’s performance across these metrics reflects its success in creating a healing and supportive environment for patients and their families.
For example, 84% of Mather’s patients reported that their room and bathroom were “always” clean, and nurses “always” communicated well, while 89% of patients reported “yes” that they were given information about what to do during their recovery at home.
Anissa Abi-Dargham, MD. Photo by Jeanne Neville, Stony Brook Medicine
Anissa Abi-Dargham, MD, SUNY Distinguished Professor of Psychiatry and Radiology, and the Lourie Endowed Chair of the Department Psychiatry and Behavioral Health in the Renaissance School of Medicine (RSOM) at Stony Brook University, will receive the 2025 Award for Research in Psychiatry from the American Psychiatric Association (APA).
According to the APA, the Award for Research in Psychiatry recognizes a single distinguished contribution, a body of work, or a lifetime contribution that has had a major impact on the field and/or altered the practice of psychiatry.
Dr. Abi-Dargham is being recognized by the APA with the Award for Research in Psychiatry for her distinguished contributions over her career to schizophrenia research, which has had a major impact on the field. She will receive the award at the APA’s annual meeting on May 19 in Los Angeles.
“I am very honored and grateful to receive this award and be able to present the work of many trainees and collaborators I have had the privilege to work with over the course of my career,” says Dr. Abi-Dargham, also Associate Dean and Associate Vice President for Clinical and Translational Science at the RSOM.
“It is a pleasure to work with such talented and dedicated scientists and to contribute to the discovery process,” she adds. “This award is very meaningful, particularly at a time when research is facing many challenges.”
At Stony Brook since 2016, Dr. Abi-Dargham’s clinical and research expertise is in molecular imaging, pharmacology, schizophrenia, and addiction. The broad focus of her research within the RSOM is to advance the understanding of the neurobiology of severe mental illness, with one approach being investigation of molecular markers and their functional significance as measured with multi-modal imaging approaches.
The Setauket resident also oversees a multidisciplinary team with expertise in several types of neuroimaging techniques used in tandem to address important questions about brain mechanisms and schizophrenia.
During the APA annual meeting, Dr. Abi-Dargham will deliver a lecture to the nation’s APA members titled “Misfiring signals: Dopamine Dysfunction in Schizophrenia – From Neural Pathways to Behavioral Manifestations.”
Pictured with Suffolk County Legislator Rob Trotta (right) are from left, St. Catherine of
Siena Medical Center’s President Chris Nelson, Chief Nursing Officer Karen T. Fasano,
and Assistant Vice President of Nursing Elizabeth McNulty.
Suffolk County Legislator Rob Trotta recently recognized the nurses at St. Catherine of Siena Medical Center in Smithtown during Nurses Week.
National Nurses Week began May 6 and ends on May 12, Florence Nightingale’s birthday, which celebrates all nurses and the important work they do in our community. The theme this year was “The Power of Nurses.” The theme emphasized the incredible impact that nurses have and their essential role in health care.
St. Catherine of Siena Medical Center held a special “nurses flag raising” ceremony at its main entrance to the hospital and will do so each year as an annual event. Suffolk County Legislator Rob Trotta presented officials from St. Catherine of Siena with a proclamation and thanked all the nurses for their tireless dedication, compassion and outstanding patient care.
Reducing dairy consumption can decrease inflammation
By David Dunaief, M.D.
Dr. David Dunaief
Osteoarthritis (OA) can disturb your mobility, mood, and sleep quality, making it difficult to perform daily activities, which can affect your quality of life. Most often, it affects the knees, hips and hands. Acetaminophen and nonsteroidal anti-inflammatory drugs, such as ibuprofen or naproxen, are common first-line medications to help treat arthritis pain. Unfortunately, they do have side effects, which become more pronounced with long-term use.
While medications might relieve your immediate pain and inflammation symptoms, they don’t slow osteoarthritis’ progression. However, there are some approaches that can ease your pain without reaching for medications. Some might even help slow your OA’s progression.
The effect of losing weight on OA pain
Weight management is important to any OA pain management strategy. In a study of 112 obese patients, those who lost weight reported that their knee symptoms improved (1). The study authors also observed disease modification in this population, with a reduction in the loss of cartilage volume around the medial tibia.
The relationship was almost one-to-one; for every one percent of weight lost, there was a 1.2 mm3 preservation of medial tibial cartilage volume, while the opposite occurred for study participants who gained weight. A reduction of tibial cartilage is often associated with the need for a knee replacement.
Does vitamin D help ease OA pain?
In a randomized controlled trial (RCT), vitamin D provided no OA symptom relief, nor any disease-modifying effects (2). The two-year study of almost 150 men and women raised blood levels of vitamin D on average to 36 ng/ml, which is considered respectable. Researchers used MRI and X-rays to track their results.
In another study of 769 participants, ages 50-80, researchers found that low vitamin D levels – below 25 nmol/l led to increased OA knee pain over the five-year study period and hip pain over 2.4 years (3). The researchers postulate that supplementing vitamin D might reduce pain for those who are deficient, but that it will likely have no effect on others.
What about dairy?
With dairy, specifically milk, there is conflicting information. Some studies show benefits, while others show that it might contribute to the inflammation that makes osteoarthritis pain feel worse.
In the Osteoarthritis Initiative study, researchers looked specifically at joint space narrowing that occurs in those with affected knee joints (4). Results showed that low-fat (1 percent) and nonfat milk may slow the progression of osteoarthritis in women. Compared to those who did not drink milk, patients who did saw significantly less narrowing of knee joint space over a 48-month period.
The result curve was complicated, though. For those who drank fewer than three glasses a week up to 10 glasses a week, the progression of joint space narrowing slowed. However, for those who drank more than 10 glasses per week, there was less benefit. Men and those who consumed higher fat products, such as cheese or yogurt, saw no benefit.
However, the study had significant flaws. The 2100 patients were only asked about their milk intake at the study’s start and were asked to recall their weekly milk consumption for the previous 12 months – a challenging task.
In a study of almost 39,000 participants from the Melbourne Collaborative Cohort Study researchers found that increases in dairy consumption were associated with increased risk of total hip replacements for men with osteoarthritis (5).
Is diet or exercise better for reducing osteoarthritis pain?
Diet and exercise together actually trumped the effects of diet or exercise alone in a well-designed, 18-month study (7). Patients with osteoarthritis of the knee who lost at least 10 percent of their body weight experienced significant functional improvements and a 50 percent pain reduction, as well as inflammation reduction. This was compared to those who lost a lower percent of their body weight.
Researchers used biomarker IL-6 to measure inflammation. The diet and exercise group and the diet-only group lost significantly more weight than the exercise-only group, 23.3 pounds and 19.6 pounds versus 4 pounds. The diet portion consisted of a meal replacement shake for breakfast and lunch and then a vegetable-rich, low-fat dinner. Low-calorie meals replaced the shakes after six months. The exercise regimen included one hour of a combination of weight training and walking “with alacrity” three times a week.
To reduce pain and possibly improve your OA, focus on lifestyle modifications. The best effects shown are with weight loss which is most easily achieved with a vegetable-rich diet and exercise. In terms of low-fat or nonfat milk, the results are controversial, at best. If you don’t eliminate dairy, stay on the low end of consumption, since it can increase inflammation.
References:
(1) Ann Rheum Dis. 2015 Jun;74(6):1024-9. (2) JAMA. 2013;309:155-162. (3) Ann. Rheum. Dis. 2014;73:697–703. (4) Arthritis Care Res online. 2014 April 6. (5) J Rheumatol. 2017 Jul;44(7):1066-1070. (6) Nutrients. 2021 Feb 4;13(2):506. (7) JAMA. 2013;310:1263-1273.
Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.
