Weight Management

Although the focus of this book is on exercise, basic nutrition and weight management affect joint and muscle health, and thus need to be addressed briefly. Obesity is a primary risk factor for developing arthritis, and even moderately overweight people develop knee arthritis more often than those who maintain normal weight (Felson and Zhang 1998). Weight loss can slow joint deterioration and pain. In fact, one study showed that a loss of 11 pounds decreased the risk of developing arthritis symptoms by 50 percent (Felson et al. 1992).

Exercise combined with dietary modification is the best way to lose body fat and improve your health. Radical diets may result in rapid weight loss, but studies have repeatedly proven that such diets are ineffective over the long run. Small, sustainable changes in basic diet are usually healthier, because they do not have a yo-yo effect on weight. Dietary guidelines focus on good, simple steps for a healthy diet (U.S. Department of Health and Human Services 2000). The guidelines include the following:

• Use the food pyramid as a guide to food selection.
• Choose sensible portions.
• Eat a variety of grains, fruits, and vegetables.
• Eat a diet low in saturated fats and cholesterol.
• Moderate your intake of sugars.

The American Dietetic Association has additional suggestions:

• Eat regular meals.
• Reduce, do not eliminate, your intake of certain foods.
• Balance your food choices over time.
• Know your diet pitfalls.

Some of these common sense recommendations are central for preserving health and making dietary changes. Skipping meals decreases concentration and can alter your body s regulation of sugar and food storage. As a result, you may find yourself eating too much when you do sit down to eat, or even storing more fat instead of losing any. One of the problems with some strict diets is that you must give up many foods, including ones that you really like. Many people feel they will not or cannot diet because of such strictures, or if they do try to diet, they eventually give up. The suggestion that you do not give up favorite foods but eat them less often, and in smaller portions, allows you to enjoy your diet instead of resent it.

The food pyramid, developed by the U.S. Department of Agriculture, is shown in figure 7.2. It identifies the nutritional groups and the number of servings recommended for each group. An important clarification is what constitutes a serving within each group. Table 7.1 lists sample servings. One way of making sure that you get a variety of foods from different groups is to select a variety of colors for each meal. For example, if you have a meal with baked chicken, mashed potatoes, and baked beans, the color scheme is bland-cream to brown. None of these foods is bad; they simply do not provide enough variety. If you substitute broccoli for the beans, you start to increase the color spectrum and thereby expand the selection from the pyramid.

Figure 7.2 USDA Food Guide Pyramid. Source: U.S. Department of Agriculture/U.S. Department of Health and Human Services.

A common contributor to excessive weight is taking portions that are too large; hence the guideline of choosing sensible portions. Even active athletes can have weight control problems, resulting from difficulty with choosing sensible portions. Exercise is a vital component of any weight management program, and it is most effective when combined with an appropriate diet.

As noted in the previous section, calcium is a valuable nutritional component for someone who is exercising and has arthritis. Good sources of calcium are milk, yogurt, and cheeses. Some fish (sardines and salmon) and vegetables (such as collards and broccoli) are also good calcium sources.

If you have problems maintaining a well-balanced diet, a registered dietitian can help. They can analyze your diet, identify nutritional deficits or excesses, and make specific recommendations for improving your eating habits. The section on resources at the end of the book lists several nutritional resources to help you find appropriate information and help.