3.2.5. Metabolic syndrome, arthritis and inflammation

Arthritis o Types of arthritis (Note: open and read sections on Osteoarthritis (OA), Rheumatoid arthritis (RA) and Fibromyalgia)

Arthritis means inflammation of a joint or joints. Inflamed joints are often red, hot, swollen, and tender. It describes more than 100 conditions that affect the joints or tissues around the joint. Specific symptoms vary depending on the type of arthritis. Symptoms may include: Pain or aching. Stiffness. Swelling. Redness. Less range of motion. You can relieve pain and improve joint function by learning and using five simple and effective arthritis management strategies.

Risk factors for arthritis

Certain factors have been shown to be associated with a greater risk of arthritis. Some of these risk factors are modifiable while others are not. Non-modifiable risk factors Age: The risk of developing most types of arthritis increases with age. Gender: Most types of arthritis are more common in women; 52% of all adults with arthritis are women. Gout is more common in men. Genetic: Specific genes are associated with a higher risk of certain types of arthritis, such as rheumatoid arthritis (RA), systemic lupus erythematous (SLE), and ankylosing spondylitis. Modifiable risk factors Overweight and Obesity: Excess weight can contribute to both the onset and progression of knee osteoarthritis. Joint Injuries: Damage to a joint can contribute to the development of osteoarthritis in that joint. Infection: Many microbial agents can infect joints and potentially cause the development of various forms of arthritis. Occupation: Certain occupations involving repetitive knee bending and squatting are associated with osteoarthritis of the knee.

Fibromyalgia

Fibromyalgia, or fibro, can affect the muscles and soft tissues throughout the body. Fibromyalgia is a long-term or chronic condition and may occur on its own or with other conditions such as rheumatoid arthritis. Symptoms may include: Widespread muscle pain (all over, or in many parts of the body). Fatigue (tiredness). Multiple tender areas. Depression. Trouble thinking, such as confusion, memory lapses (forgetting), and trouble concentrating.

Metabolic syndrome o Metabolic syndrome overview

Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke. The term "metabolic" refers to the biochemical processes involved in the body's normal functioning. Risk factors are traits, conditions, or habits that increase your chance of developing a disease. In this article, "heart disease" refers to coronary heart disease (CHD). CHD is a condition in which a waxy substance called plaque builds up inside the coronary (heart) arteries. Plaque hardens and narrows the arteries, reducing blood flow to your heart muscle. This can lead to chest pain, a heart attack, heart damage, or even death.Metabolic Risk Factors The five conditions described below are metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. You must have at least three metabolic risk factors to be diagnosed with metabolic syndrome. A large waistline. This also is called abdominal obesity or "having an apple shape." Excess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips. A high triglyceride level (or you're on medicine to treat high triglycerides). Triglycerides are a type of fat found in the blood. A low HDL cholesterol level (or you're on medicine to treat low HDL cholesterol). HDL sometimes is called "good" cholesterol. This is because it helps remove cholesterol from your arteries. A low HDL cholesterol level raises your risk for heart disease. High blood pressure (or you're on medicine to treat high blood pressure). Blood pressure is the force of blood pushing against the walls of your arteries as your heart pumps blood. If this pressure rises and stays high over time, it can damage your heart and lead to plaque buildup. High fasting blood sugar (or you're on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes. Overview Your risk for heart disease, diabetes, and stroke increases with the number of metabolic risk factors you have. The risk of having metabolic syndrome is closely linked to overweight and obesity and a lack of physical activity. Insulin resistance also may increase your risk for metabolic syndrome. Insulin resistance is a condition in which the body can't use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it's used for energy. Insulin resistance can lead to high blood sugar levels, and it's closely linked to overweight and obesity. Genetics (ethnicity and family history) and older age are other factors that may play a role in causing metabolic syndrome. Outlook Metabolic syndrome is becoming more common due to a rise in obesity rates among adults. In the future, metabolic syndrome may overtake smoking as the leading risk factor for heart disease. It is possible to prevent or delay metabolic syndrome, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome requires long-term effort and teamwork with your health care providers.

Osteoarthritis

Osteoarthritis (OA) is the most common form of arthritis. The cartilage and bones within a joint begin to break down in people with OA. These changes cause pain, stiffness, and even disability. OA usually develops slowly and gets worse over time. Symptoms may include:a man holding his hand in pain Pain or aching. Stiffness. Decreased range of motion. Swelling.

Risk factors for metabolic syndrome

People at greatest risk for metabolic syndrome have these underlying causes: Abdominal obesity (a large waistline) An inactive lifestyle Insulin resistance Some people are at risk for metabolic syndrome because they take medicines that cause weight gain or changes in blood pressure, blood cholesterol, and blood sugar levels. These medicines most often are used to treat inflammation, allergies, HIV, and depression and other types of mental illness. Populations Affected Some racial and ethnic groups in the United States are at higher risk for metabolic syndrome than others. Mexican Americans have the highest rate of metabolic syndrome, followed by whites and blacks. Other groups at increased risk for metabolic syndrome include: People who have a personal history of diabetes People who have a sibling or parent who has diabetes Women when compared with men Women who have a personal history of polycystic ovarian syndrome (a tendency to develop cysts on the ovaries) Heart Disease Risk Metabolic syndrome increases your risk for coronary heart disease. Other risk factors, besides metabolic syndrome, also increase your risk for heart disease. For example, a high LDL ("bad") cholesterol level and smoking are major risk factors for heart disease. For details about all of the risk factors for heart disease, go to the Coronary Heart Disease Risk Factors Health Topic. Even if you don't have metabolic syndrome, you should find out your short-term risk for heart disease. The National Cholesterol Education Program (NCEP) divides short-term heart disease risk into four categories. Your risk category depends on which risk factors you have and how many you have. Your risk factors are used to calculate your 10-year risk of developing heart disease. The NCEP has an online calculator that you can use to estimate your 10-year risk of having a heart attack. High risk: You're in this category if you already have heart disease or diabetes, or if your 10-year risk score is more than 20 percent. Moderately high risk: You're in this category if you have two or more risk factors and your 10-year risk score is 10 percent to 20 percent. Moderate risk: You're in this category if you have two or more risk factors and your 10-year risk score is less than 10 percent. Lower risk: You're in this category if you have zero or one risk factor. Even if your 10-year risk score isn't high, metabolic syndrome will increase your risk for coronary heart disease over time.

Rheumatoid Arthritis

Rheumatoid arthritis, or RA, is an autoimmune inflammatory disease, which means that the immune system attacks healthy cells in the body by mistake, causing inflammation in the affected parts of the body. RA mainly attacks the joints, usually many joints at once. In a joint with RA, the lining of the joint becomes inflamed, causing damage to joint tissue that can result in long-lasting or chronic pain, instability, and deformity. RA can also have systemic effects, meaning that, in addition to joints, it can affect other tissues throughout the body and cause problems in organs such as the lungs, heart, and eyes. With RA, there are times when symptoms get worse, known as flares, and times when symptoms get better, known as remissions. The severity of RA varies. Symptoms may include: Pain or aching in more than one joint Stiffness in more than one joint. Tender, swollen joints. Weight loss. Fatigue, or tiredness. Fever.

Inflammation

Scientific papers (Note: the coach is not responsible for the level of detail in these scientific articles; however, peer-reviewed papers are a reliable source and may help with a conceptual understanding) § Prasad, S., & Aggarwal, B. B. (2014). Chronic diseases caused by chronic inflammation require chronic treatment: anti-inflammatory role of dietary spices. J. Clin. Cell. Immunol, 5(238), 10-4172. http://doi.org/10.4172/2155- 9899.1000238 • (Note: the coach is not responsible for the role of spices discussed in the above article; focus on the Introduction and Role of Inflammation in Chronic Disease) § Manabe, I. (2011). Chronic inflammation links cardiovascular, metabolic and renal diseases. Circulation Journal, 75(12), 2739-2748. http://doi.org/10.1253/circj.CJ-11-1184 o Video: Inflammation and Heart Disease: a PBS Production § https://youtu.be/5X-VTMF10VI

Inflammation

The coach recognizes that chronic inflammation is a common factor in most chronic diseases. Whereas acute inflammation is a healthy response to injury, chronic inflammation causes problems over time. Common and well-studied conditions associated with chronic inflammation include coronary artery disease, diabetes, obesity, arthritis, cancer, and Alzheimer Disease. Dietary interventions (see anti-inflammatory diet in Section 3.3), moderate exercise, and effective stress management are thought to be central in preventing inflammatory disease.

Diagnosis of metabolic syndrome

Your doctor will diagnose metabolic syndrome based on the results of a physical exam and blood tests. You must have at least three of the five metabolic risk factors to be diagnosed with metabolic syndrome. Metabolic Risk Factors A Large Waistline Having a large waistline means that you carry excess weight around your waist (abdominal obesity). This is also called having an "apple-shaped" figure. Your doctor will measure your waist to find out whether you have a large waistline. A waist measurement of 35 inches or more for women or 40 inches or more for men is a metabolic risk factor. A large waistline means you're at increased risk for heart disease and other health problems. A High Triglyceride Level Triglycerides are a type of fat found in the blood. A triglyceride level of 150 mg/dL or higher (or being on medicine to treat high triglycerides) is a metabolic risk factor. (The mg/dL is milligrams per deciliter—the units used to measure triglycerides, cholesterol, and blood sugar.) A Low HDL Cholesterol Level HDL cholesterol sometimes is called "good" cholesterol. This is because it helps remove cholesterol from your arteries. An HDL cholesterol level of less than 50 mg/dL for women and less than 40 mg/dL for men (or being on medicine to treat low HDL cholesterol) is a metabolic risk factor. High Blood Pressure A blood pressure of 130/85 mmHg or higher (or being on medicine to treat high blood pressure) is a metabolic risk factor. (The mmHg is millimeters of mercury—the units used to measure blood pressure.) If only one of your two blood pressure numbers is high, you're still at risk for metabolic syndrome. High Fasting Blood Sugar A normal fasting blood sugar level is less than 100 mg/dL. A fasting blood sugar level between 100-125 mg/dL is considered prediabetes. A fasting blood sugar level of 126 mg/dL or higher is considered diabetes. A fasting blood sugar level of 100 mg/dL or higher (or being on medicine to treat high blood sugar) is a metabolic risk factor. About 85 percent of people who have type 2 diabetes—the most common type of diabetes—also have metabolic syndrome. These people have a much higher risk for heart disease than the 15 percent of people who have type 2 diabetes without metabolic syndrome.