Knees and fat: New studies Implications for Pilates

Knees and fat: New studies Implications for Pilates

Two interesting studies to talk about today. Neither are Pilates specific but both are very relevant and important factors when considering overall health and wellness and as such both are totally relevant to all us Pilates teachers.

The first topic is arthritis in the knees, something that all Pilates teachers see in a large number of our clients. Well the latest opinion is that it is a preventable disease rather than an inevitable consequence of wear and ageing, a study has concluded.

The condition is twice as common today as it was before the Second World War, according to researchers who put the increase down to lifestyle changes such as diet or footwear, as well as people getting fatter and living longer. Osteoarthritis affects 8.8 million people in Britain alone aged above 45. More than 18 per cent of this group have the disorder in their knees. Yet scientists who studied more than 2,500 skeletons, from prehistoric hunter-gatherers to the present, discovered that rates of osteoarthritis had surged over the past few decades after centuries of stability.

Daniel Lieberman, professor of biological sciences at Harvard University and a senior author of the paper, said that many cases could be averted if doctors could determine what had driven the change over the past 70 years. The researchers are investigating whether factors such as physical inactivity, diets loaded with refined sugars, the shoes we wear and even the hardness of pavements could lie behind the increase.

“Knee osteoarthritis is not a necessary consequence of old age,” Professor Lieberman said. “We should think of this as a partly preventable disease. Wouldn’t it be great if people could live to be 60, 70 or 80 and never get knee osteoarthritis in the first place? Right now, our society is barely focusing on prevention . . . so we need to redirect more interest toward preventing this and other so-called diseases of ageing.”

Three quarters of those with osteoarthritis say that they are in constant pain. Treatment is generally limited to painkillers or steroid injections into the joint. For severe cases, the only further option is an artificial joint. In 2015 people with the condition accounted for 98 per cent of patients having a first knee replacement.

Ian Wallace, the study’s lead author, visited collections of human remains across the United States to look for the glass-like polish that the condition leaves on the thigh and shin bones over years of rubbing against each other. Rates of knee osteoarthritis among the over-50s appear hardly to have changed between the native Americans 3,000 years ago and the inhabitants of Ohio and Missouri in the first half of the 20th century. After the war, however, they more than doubled. The trend, set out in the journal PNAS, remained even after the researchers corrected for age and body-mass index.

“There are probably a lot of contributing factors,” Dr Wallace said, “but . . . two conspicuous ones are physical inactivity and the abundance of proinflammatory foods in our diet — especially really sugary things.”

Philip Conaghan, professor of musculoskeletal medicine and a spokesman for the charity Arthritis Research UK, welcomed the study. “The more we know about what causes it, the closer we will be to finding more effective treatments and even a cure,” he said. “We absolutely agree that there should be more focus on prevention.”

To me this is yet another example of the fact that we can and should control the “aging process” to a much greater extent than most people believe. It’s much more about lifestyle than people think, and as wellness professionals we should be stressing that and treating our clients holistically. This is the principle of “total health” that I have been teaching in PilatesEVO for the last 10 years.

The next study deals with the mantra “fat but fit” and goes a long way to prove that it is a myth that doctors should no longer perpetuate, scientists have said. Research involving more than 500,000 people across Europe suggests that carrying too much weight is a cardiovascular problem in its own right and doctors should recognise it as such.

Nearly two thirds of adults in Britain are overweight or obese. About a third of them show no obvious sign of ill health, such as high blood pressure or insulin resistance, leading some experts to call them “metabolically healthy”. Advocates of the theory include the singer Adele, who said that she “would lose weight only if it affected my health or sex life, which it doesn’t”, to the UK medical regulator, which tells GPs there is no need to instruct people to diet or exercise more unless they exhibit serious warning signs.

An international team of researchers has found, however, that overweight people face a greater chance of developing coronary heart disease (CHD), which kills 73,000 people a year in Britain, more than any other condition. The researchers tracked 366,000 women and 153,000 men between the ages of 35 and 70 in ten European countries, including the UK, for an average of just over 12 years.

During that period there were 7,637 cases of CHD. After stripping out other risk factors such as smoking, diet and exercise, the overweight but ostensibly healthy people were still 26 per cent more likely to have developed the disease than those of normal weight.

Camille Lassale, who led the study while at Imperial College London but who is now based at University College London, called on the National Institute for Health and Care Excellence (Nice) to overhaul its guidance. She said: “Regardless of the measurements of blood pressure, blood glucose or cholesterol and so on, if you have a patient who is overweight or obese it is always wise to tell them to lose weight. It’s particularly relevant here because the UK has a greater prevalence of overweight [people] and obesity than other European countries.”

The study, which is published in the European Heart Journal, also shows that even though the “fat but fit” did not necessarily meet the clinical criteria for health problems such as high cholesterol or triglycerides, they still had higher concentrations of these chemicals than people of normal weight. This led Dr Lassale and her colleagues to believe that the effects of being overweight catch up with most people eventually. “We think what happens is when you classify these people as metabolically healthy obese they are on their way to developing metabolic abnormalities,” she said.

Metin Avkiran, professor of molecular cardiology at King’s College London and associate medical director at the British Heart Foundation, which funded part of the research, said: “This study conclusively shows that being obese increases a person’s risk of developing heart disease, even if they are otherwise healthy.”

Knees and fat: New studies Implications for Pilates
Nothing really earth-shattering in these reports as they really simply confirm what many of us already knew or suspected. Total wellness and health remain the key components to a healthy and happy life. Exercise and diet will remain the key building blocks, and us as Pilates professionals have our part to play not only in treating people who are suffering with various complaints, but also helping them to avoid future issues. We often only see people when they are in later life and much of the damage has been done, but still, if we only treat the symptoms that we see, then we are failing our clients. It is never too late to change and make a big difference.

Chris is a wellness and fitnesss consultant. He is also the creator of PilatesEVO, a system that uses meditation, NLP, meridians and other influences to help imrpove teaching quality and results for clients.