Saturday, 19 March 2016

Most Common Disease of elder: The Clinical trials and Studies of Musculo-Skeletal disorders(MSDs) - Polymyalagia Arthritis (Rheumatica): The Do and do not’s list

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. A community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home. Musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia


                  Polymyalagia Arthritis (Rheumatica)

Polymalagia Arthritis is defined as a condition a common inflammatory rheumatic disease which causes pain, stiffness and tenderness in large muscles, including muscles shoulders and pelvic girdle as a result of the presence of a synovitis in proximal joints and periarticular structures.
                The Prevention and management 

The Do and do not’s list
 People may want to know what they can do to protect themselves against the early onset.

1. Reduce intake of saturated and trans fat and increase intake of omega 3 fatty acids
Limited studies have conform the effectiveness of dietary fatty acids (ie, oleic acid and alpha-linolenic acid) in reduced biomarkers of inflammation(91).
 Dr. Li Z and the research team at the Jilin University showed that ω3-polyunsaturated fatty acids (ω3-PUFAs) not only have beneficial effects on cardiiovascular function but also promoted the docosahexaenoic acid (DHA) in reduced inflammative risk(93).
 The results of over 13 double-blind, placebo-controlled studies involving a total of more than 500 people suggest that omega-3 fatty acids may improve symptoms of rheumatoid arthritis. It appears to work is by decreasing the production of inflammatory chemicals(94). 

2. Increasing the ratio of (n-3) : (n-6) PUFA
 The industrial elocution induced Western style diet in over consumption of ω6 polyunsaturated fatty acids (PUFA) over many decades  has been found to distort the ratio of ω3:ω6 fatty acids, one of the leading cause of chronic inflammatory diseases, including Polymyalgia Rheumatica(PMR)(92).
 Increased ratio of (n-6) : (n-3) PUFA are found to promote chronic inflammatory diseases such as nonalcoholic fatty liver disease (NAFLD), cardiovascular disease, obesity, inflammatory bowel disease (IBD), rheumatoid arthritis, and Alzheimer’s disease (AD)(95).

3. Increase intake of fruit and vegetable
Consumption of fruit and vegetable is found to associate in reduced the over expression of inflammation and oxidative stress of that have found to induced chronic inflammatory diseases risk of stroke, coronary heart disease, etc,...(96)
A cross-sectional study of ≈1200 Puerto Rican adults aged 45-75 y, in assessed FV intake with a food-frequency questionnaire, suggested, but not quantity, appears to be important in reducing inflammation(97).

3. Avoid high glycemic index diets
 High glycemic index diets with low fiber content are rich in trans fat has showed to induce over activation of the immune system, causing excessive production of pro-inflammatory cytokines of that promoting inflammatory diseases(98).

4. Reduced intake of pro inflammatory foods, such as sugar, dairy products, red meat and processed, meat, alcohol, artificial ingredients, refined products, etc,.... According to the study by University of Hertfordshire Over consumption of fat content, especially from saturated fat, and cholesterol and reduced the intake of whole-grain foods, fruits, and vegetables, accompanied with the high amount of sugar, dairy products, red meat and processed, meat, alcohol, artificial ingredients, refined products, etc.  in Western diet are found to be the leading causes of metabolic syndrome(99) inducing risk of chronic inflammatory diseases(100).

5. Increase in take of anti inflammatory foods, such as fresh vegetables and fruits, seeds and sprouts whole grain, fish, turkey, chicken, legumes, etc(98).

6. Stop smoking
Smoking is associated with 39% of risk of Polymyalgia Rheumatica(101), according to the study of 28 patients with RS3PE and 123 with pure PMR by the Kameda Medical Center.

7. Moderate exercise
Moderate exercise enhances immune function in fighting against inflammation and and reduced inflammatory (interleukin-6 [IL-6], C-reactive protein [CRP]) markers in attenuated risk of
Polymyalgia Rheumatica(PMR)(102).

8. Etc.

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(91) The effect of weight loss and dietary fatty acids on inflammation by Devaraj S1, Kasim-Karakas S, Jialal I.(PubMed)
(92) Effects of the Dietary ω3:ω6 Fatty Acid Ratio on Body Fat and Inflammation in Zebrafish (Danio rerio). by Powell ML1, Pegues MA2, Szalai AJ2, Ghanta VK3, D'Abramo LR4, Watts SA3.(PubMed)
(93) ω3-polyunsaturated fatty acids suppress lipoprotein-associated phospholipase A2 expression in macrophages and animal models vt Li Z1, Ren W1, Han X1, Liu X1, Wang G1, Zhang M1, Pang D1, Ouyang H1, Tang X1.(PubMed)
(94) Overview of Omega-3 Fatty Acid Therapies by J. Chris Bradberry, PharmD and Daniel E. Hilleman, PharmD(PubMed)
(95) Health implications of high dietary omega-6 polyunsaturated Fatty acids by Patterson E1, Wall R, Fitzgerald GF, Ross RP, Stanton C.(PubMed)
(96) Fruit and vegetable consumption and its relation to markers of inflammation and oxidative stress in adolescents by Holt EM1, Steffen LM, Moran A, Basu S, Steinberger J, Ross JA, Hong CP, Sinaiko AR.(PubMed)
(97) Greater variety in fruit and vegetable intake is associated with lower inflammation in Puerto Rican adults. by Bhupathiraju SN1, Tucker KL.(PubMed)
(98) [Role of diet on chronic inflammation prevention and control - current evidences].[Article in Portuguese] by Geraldo JM1, Alfenas Rde C.(PubMed)
(99) [Dietary factors and metabolic syndrome].[Article in Portuguese] by Steemburgo T1, Dall'Alba V, Gross JL, Azevedo MJ.(PubMed)
(100) A gut microbiota-targeted dietary intervention for amelioration of chronic inflammation underlying metabolicsyndrome by Xiao S1, Fei N, Pang X, Shen J, Wang L, Zhang B, Zhang M, Zhang X, Zhang C, Li M, Sun L, Xue Z, Wang J, Feng J, Yan F, Zhao N, Liu J, Long W, Zhao L.(PubMed)
(101) Clinical characteristics of patients with remitting seronegative symmetrical synovitis with pitting edema compared to patients with pure polymyalgia rheumatica by Kimura M1, Tokuda Y, Oshiawa H, Yoshida K, Utsunomiya M, Kobayashi T, Deshpande GA, Matsui K, Kishimoto M.(PubMed)
(102) A Systematic Review of the Acute Effects of Exercise on Immune and Inflammatory Indices in Untrained Adults by Brown WM1, Davison GW1, McClean CM1, Murphy MH1.(PubMed)


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