First and foremost I need to start this with a disclaimer: I am not a doctor and nothing in this article can be taken as specific medical advice. Certain foods and chemicals can interact with some medications and these can have very serious effects. As with any changes in lifestyle, diet, supplementation or exercise, you would do well to consult with your own medical professional before making any significant changes.
A career in Landscape Photography has often been described as a lifestyle profession, in that you are more or less always at work. My wife and I don’t take vacations per se, we are either leading participants on photography tours, or we’re at home. Perhaps once a year we will take off for a few weeks on our own, but this is more often than not a reconnaissance trip, scouting out areas we’re interested in photographing.
In December 2016 two things happened; I turned 50, and was suffering from the worst period of chronic knee pain I’d ever endured. It hadn’t quite reached levels where I couldn’t walk at all, but leading clients down to the beach and back on the Isle of Eigg came at a cost. I was eating handfuls of Ibuprofen and Paracetamol to control inflammation and pain, I had to spend my evenings with my leg elevated, often iced, and daily courses of electro-acupuncture as well. All this to make walking possible with knee supports and still feeling wretched most of the time. The reason was confirmed when we returned home and x-rays diagnosed early stage Osteoarthritis.
The rest of this article outlines the key areas in which I have address lifestyle, nutrition and exercise since January. Hopefully the information below may go some way to helping readers find paths to their own solutions to mobility, inflammation treatment and prevention, and an overall higher quality of life.
Putting on some extra weight as we get older is very much an accepted consequence of life; responsibilities, pressures on time, work, entertaining, vacations and diet all have massive consequences on how much weight we have to carry around. We only have to read a newspaper or watch the news to realise that there is a serious epidemic of weight gain overtaking the first world countries. More processed foods, saturated trans fats, refined carbohydrates and generally less exercise all play their part in the tipping of the scales. When we’re travelling, eating healthy can be a challenge!
For treating knee pain, my first goal was to tackle those extra pounds. When you walk across level ground, the force on your knees is the equivalent of 1½ times your body weight. That means a 200-pound man will put 300 pounds of pressure on his knees with each step. Add an incline, and the pressure is even greater: the force on each knee is two to three times your body weight when you go up and down stairs, and four to five times your body weight when you squat to tie a shoelace or pick up an item you dropped.
In the UK we have the NHS and their website is excellent in many ways for diagnosis of common ailments and to a source of information on health and nutrition.
One of the most common ways to monitor weight and general health has been with a Body Mass Index rating (BMI) : Gender, Height and Weight are used to give a number, and that number is an indication of your general healthy weight.
The biggest flaw with this number is it pays no consideration to muscularity. If I had another 10kg of lean muscle on my frame, a BMI calculator would have me as overweight.
2: Body Fat %
This has been my go to indicator of healthy weight this year, and even though I have not had it tested in a lab, as long as I am comparing like for like measurements using the same criteria I have had a number to monitor and watched it come down steadily. Jumping on a set of scales in January equipped with bioelectrical impedance analysis (BIA) indicated my estimated BF% was c22.5%.
At the time of writing it is now 14% and I have dropped 12kg in weight. In stress terms on my knees that is a reduction of between 18-60kg per step!
Has that made a difference to my knee pain – You bet it has, in conjunction with many other factors!
There are so many myths and nonsense written about this essential topic. Food Pyramids, Macronutrient ratios, so called “health foods” and RDA’s; it’s simply a minefield of misinformation. Let’s highlight a few of these:
- You can eat as much as you want if it’s healthy: No you can’t. If you were to sit at the table all day and chow down 6 bananas, a handful of almonds, 4 mangoes, a kilo of grapes, a whole turkey breast, a vat of cottage cheese, plus green veg and a good portion of sweet potato, you’ll probably put on weight. I say probably because it depends on your metabolic rate and how many calories a day you burn just being you.
- A calorie is a calorie: Not all calories are created equal, your body requires varying degrees of the key three Macronutrients on a daily basis: Proteins and Dietary Fats are Essential for muscle repair, brain and cell function and a host of other functions that keep you alive and healthy. Carbohydrates, while not essential to that same degree, are the bodies easiest source of fuel, as all carbs break down to Glucose.
- Micronutrients: There are a host of minerals and vitamins that are essential to our daily health. Many of these are produced inside the body, but most are required through diet. Omega 3’s are a good example and must be sourced through things like fatty fish, flaxseed or in supplements.
You can eat fast food, candy and snacks all day and not put on weight, it’s been done in research labs by curious PhD researchers. You can loose weight on a diet of junk, but is this optimal for your health?
The key here is balance: My goal is health first, but everyone says that “Health is everything.”
The proof is in the doing, not the saying.
The best method of achieving a healthy body is with a lifestyle change. Is it easy, no! I am very strict with my nutrition; I stick to lower GI carbohydrates, lean protein sources like Turkey, Eggs, Cottage Cheese and Venison and essential dietary fats. For me I get roughly 30% from Lean Protein, 30% from Healthy Fats and the rest from good quality Carbohydrates. If I am super active, like on a long hike, I will up the Carb intake to a maximum of about 50% and reduce the healthy fats. My Protein intake stays almost the same every day, at around 115-130g or, 0.8-1g for every pound of Lean Body Mass (LMB = your weight minus the weight of your body fat)
The Three Bad Hombres!
Roughly 80% of foods stocked in supermarkets contain added sugar and various combinations of the above three.
There are some exceptions to this next statement, but on the whole it’s solid:
“Eat Real Food”
By real, I mean it has been grown, picked, reared and cooked from its raw fresh state. If it comes in a box, has been refined, deep fried, sugar added and otherwise molested – probably not the healthiest option!
The Seven Deadly Sins: This is far from a definitive list, there are many, many more sin foods than the 7 I list below: Alcohol, Doughnuts, almost every item on a drive-through fast food menu to name a few.
- Processed Meats: Smoking, curing, salting and preservatives are linked to increased risk of colon cancer. Lots of salt, fat and cholesterol, and very few nutrients.
- Fried Food: Fries (sweet potato or not—sorry!), chicken fingers, and onion rings are the default side dish to meals everywhere. Stuffed with trans fats these foods are simply artery clogging, calorie packed garbage!
- Potato Chips: For a start these are not great carbs and usually loaded with salt, artificial flavouring and other gunk, but potato chips, along with French fries contain acrylamide, a known carcinogen that is formed when foods are baked or fried at high temperatures. Estimated to cause several thousand cancers per year in the USA alone.
- Low Fat Foods: How come right? Makers of cookies, salad dressings, yogurt, and other foods labeled low-fat often supplement them with sugar, salt, and unhealthy fillers to add flavour and texture to otherwise bland processed products.
- Margarine: Though it’s billed as a cholesterol-free, healthy alternative to butter, margarine is the ultimate source of trans fats, which actually elevate cholesterol and damage blood vessel walls. So skip the fake stuff and go with olive oil or other monounsaturated fats.
- Soda: An average 330ml can of soda can contain 10 teaspoons of sugar. Common sense alone tells us this can’t be good for the body. Guaranteed insulin spike, followed by fat storage.
- Breakfast Cereal: Millions of dollars of advertising across the globe to start the day with a Healthy Breakfast. Most of them contain refined grains, added sugar, very little fibre and fewer nutrients.
4: Fat Loss Mechanisms
- Calorie Deficits: Long standing doctrine says if you eat less calories per day than you expend, then you will lose weight. The numbers are supposed to work out at 3500 calories being equal to 1 pound of weight. I measure my calorie intake and output every day with the aid of myfitnesspal.com and my Garmin Fenix 5 watch and in the past 7 days I have run up a deficit of over 4000 calories, but my weight has stayed the same. My body fat percentage however has dropped, and my lean body mass has increased. This is called Body Recomposition, and demonstrates why Body Weight alone is not the issue.
- Exercise: There is a saying that you will never out exercise a bad diet, and if you look at the numbers that’s easy to verify. A McDonald’s Big Mac, Large Fries, Large Soda and a McFlurry Desert weighs in at around 1559 Calories, or 80-100% of my average daily calorie intake. That’s just the calories, don’t get me started on the quality of the nutrients; added salt, high sugar and saturated trans fats. For a male weighing 154 pounds, you would have to jog at 5mph for 3 hours, or walk at 3.5mph for 5.6 hours to burn off those calories – that’s a lot of track time for a take out lunch!
Until I took my nutrition under control I was still an above average exerciser, my daily steps averaged out at over 8000, so hardly a couch potato. But, given point C above, without decent nutrition and a calorie deficit, exercise alone won’t halt the decline.
5: Strength Training
Muscle is calorifically expensive, in that making it and moving it around expends a lot of energy. A great way to burn more calories 24 hours a day is to build muscle. You can do this in the gym, or at home. I prefer the latter, as our nearest gym is 20 miles away. Without big weights to move around, I have found bodyweight exercises to be the very best form of strength training. Three times a week I follow this routine:
Pull-ups | Chin-ups | Deep Squats | Push-ups | Leg Raises | Planks
I have a pull-up bar on my office door and that’s all the equipment I need. For bad knees, the worst thing for them is immobility. The stronger they are, the better they are. I am at a stage now where I can go for a fast 5km run on a hilly course and not have any knee pain at all. Stronger knees, stronger tendons and ligaments and 12kg lighter makes for a very happy photographer!
No habit in contemporary society comes with more baggage than our evening tipple. The justifications for drinking are many; from relaxation and socialising to the belief that red wine is the elixir of life and must be consumed to benefit from those powerful antioxidants! For my battle with OA and knee pain, I decided to quit alcohol completely.
Firstly, the risk of stomach bleeding with anti-inflammatory medications such as Ibuprofen increases with alcohol, and secondly, my diet improves when I abstain from beer and wine.
I live on a very controlled calorie intake every day; consuming 2150 calories on my three training days and 1510 on the four rest days. 250ml of Red Wine contain 228, two small Belgian Beers a whopping 382. When calories matter, I choose to get them from good sources, rather than empty ones.
Also, the way the body deals with alcohol seriously disrupts your metabolism, making fat loss harder. Your liver gets busy metabolising the alcohol to get rid of it (It’s essentially a poison). Your body will burn off any calories from alcohol first before burning off food intake, or body fat. Recent research suggests drinking alcohol will increase your appetite and food intake, particularly associated with fattier foods.
Fattier diet, Fatty Liver Syndrome, Higher Blood Pressure, Dehydration, Increased appetite, slower metabolism, more sedentary lifestyle, less exercise, empty calories: None of that sounds good! I don’t miss it.
Finally, I’ll cover a short list of things I take on a daily basis to aid nutrition and further help reduce inflammation.
- Omega 3 Fish Oil: 4 x 1000mg capsules a day, two in the morning and two in the evening.
- Glucosamine Sulphate & Chondroitin Sulphate; 2 x 500mg in the morning
- Organic Turmeric: 2 x 1420mg capsules daily. The king of natural anti-inflammatories. Also acts as a blood thinner, so do not take if on medication.
- ArthroMax with Theaflavins & ApresFlex: 2 in evening. Joint supplement.
- Centrum Performance MultiVitamin: One Daily after workout.
- Cinnamon: A teaspoon sprinkled in black coffee.
7: Closing Thoughts
No single factor above in isolation is the answer. I am convinced that it is the combination of all the above actions that mean my knees don’t bother me at all, sure they still ache occasionally if I overdo it, which I am genetically predisposed to doing! But the chronic pain and inflammation has gone.
I know myself from a lot of research how difficult it is to find good, reliable information about health, nutrition, mobility and exercise. All I can say about all this information is it has worked for me, everyone is different and it may take a few months to find what works for you. Hopefully this article will save you some time and give some pointers if you’re suffering mobility issues due to excess body fat or age-related joint issues. I’ve listed a few resources below that I have found particularly useful.
Build Muscle without Weights: David Nordmark
Body by Science: Doug McGuff M.D & John Little
Homemade Muscle: Anthony Arvanitakis
Bigger, Leaner, Stronger: Michael Matthews
The Complete Guide to fasting: Jason Fung M.D.
http://leangains.com – THE site for 16:8 Intermittent Fasting