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Nutrition 2 (Semester II) > 17a. MSK - OA > Flashcards

17a. MSK - OA Flashcards

1
Q

What is OA?

A

Degenerative arthritis of the cartilage
Effects weight bearing joints
Over 45 yrs

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2
Q

Signs and symptoms of OA

A

Joint pain (worsened by activity/relieved by rest)
Joint stiffness
Swelling
Deformity (due to osteocytes)
Heberden’s nodes

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3
Q

What is the composition of the articular cartilage?

A

Extracellular matrix (water, collagen, proteoglycans)
Chondrocytes

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4
Q

What are proteoglycans made up of?

A

Glycosaminoglycan (GAG) chains

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5
Q

What are GAG chains bound to?

A

Hyaluronic acid

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6
Q

What is the first stage of OA pathophysiology?

A

Proteolytic breakdown of cartilage matrix

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7
Q

What happens during the proteolytic breakdown of cartilage matrix in OA?

A

Matrix metalloproteases (MMP) such as collagenase degrade the ECM, releasing fragments into synovial fluid
Triggers the release of inflammatory cytokines

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8
Q

What happens in OA as the level of proteoglycans starts to drop?

A

Cartilage softens and losing elasticity
Compromises joint surface integrity

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9
Q

What develops on the articular cartilage as the cartilage softens and loses its elasticity?

A

Fibrillations

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10
Q

What does the loss of cartilage result in?

A

Loss of joint space
Erosion of damaged cartilage, exposing underlying bone

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11
Q

What happens to the exposed bone once the cartilage has worn away?

A

Bone thickening
Osteocyte formation (bone spurs)

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12
Q

Causes and risk factors for OA

A

Age
Previous joint trauma
Overweight/obesity
T2D
Genetics
Nutritional deficiencies
Other joint diseases
Drivers of chronic inflammation

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13
Q

Why is increasing age a risk factor for OA?

A

Erosion of chondrocyte telomere length
Mitochondrial dysfunction
Inflammaging

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14
Q

Why is a previous joint trauma a risk factor for OA?

A

Associated with joint inflammation
Cartilage degradation

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15
Q

Why is being overweight/obese a risk factor for OA?

A

Mechanical load on cartilage

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16
Q

Why is T2D a risk factor for OA?

A

Insulin stimulates chondrocytes to make proteoglycans
(chondocytes can’t keep up)

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17
Q

Example of a chronic inflammatory driver that’s a risk factor for OA

A

Metabolic endotoxaemia

18
Q

Other joint diseases that are a risk factor for OA

A

Gout
RA

19
Q

Example of a nutrient deficiency that’s a risk factor for OA, and why

A

Vit D
Prevents articular cartilage erosion by regulating collagen turnover and bone metabolism

20
Q

Example of conventional medication for OA

A

NSAIDs
(to suppress symptoms)

21
Q

Why aren’t NSAIDs really ideal for OA?

A

Inhibit collagen matrix synthesis
Accelerate cartilage breakdown

22
Q

Nutritional approach to support OA

A

Naturopathic diet with focus on anti-inflammatory
Reduce arachidonic acid
Increase O3s
Hydration
Glucosamine sulphate
Chondroitin sulphate
MSM
C
D
E
K2
Tart cherry
Turmeric
Boswellia
Ginger
Devil’s Claw

23
Q

Why is glucosamine sulphate good for OA?

A

Proteoglycan synthesis
Inhibits MMPs

24
Q

Dosage of glucosamine sulphate to support OA

A

500mg 3/day

25
Q

Why is chondroitin sulphate good for OA?

A

Increases hyaluronic acid
(keeps synovial joints lubricated)

26
Q

Dosage of chondroitin sulphate to support OA

A

200-400mg/day

27
Q

Why is MSM good for OA?

A

Anti-inflammatory
Stimulates proteoglycan and hyaluronic acid synthesis

28
Q

Dosage of MSM to support OA

A

1g/day

29
Q

Why is vit C good for OA?

A

Required for chondrocyte protein synthesis (collagen)
AO properties

30
Q

Why is vit E good for OA?

A

AO
Synergist with vit C
Increases proteoglycan deposition

31
Q

Dosage of vit E to support OA

A

200-400iu/day

32
Q

Why is vit D good for OA?

A

Prevents articular cartilage erosion

33
Q

Why is tart cherry good for OA?

A

Anti-inflammatory
AO

34
Q

Dosage of tart cherry to support OA

A

Up to 3000mg/day

35
Q

Why is K2 good for OA?

A

Inhibits cartilage calcification

36
Q

Dosage of K2 to support OA

A

50-110mcg/day

37
Q

Why is boswellia good for OA?

A

Anti-inflammatory
Inhibits MMP release

38
Q

Dosage of boswellia to support OA

A

300mg 3/day

39
Q

Dosage of ginger to support OA

A

500-1000mg/day

40
Q

Why is Devil’s Claw good for OA?

A

Anti-inflammatory

41
Q

Dosage of Devil’s Claw to support OA

A

100-1000mg/day

42
Q

Lifestyle approach to supporting OA

A

Hydrotherapy
Epsom salts bath
Exercise - low intensity to increase joint circulation/strengthen surrounding muscles

Nutrition 2 (Semester II) (55 decks)

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