Moderate Activity and Arthritis

Mild mannered Clark Kent strikes again. An article in the LA Times today, “Walk now to walk through arthritis later” details how steady moderate activity, specifically walking, can reduce the long-term effects of osteoarthritis. You don’t need to exercise to excess to be taking care of your health.

As always, I encourage you to click through and read the article for yourself. It’s full of good information and solid health science. The article quickly cuts to the chase:

While it may seem counterintuitive to move more when moving hurts, the new study suggests about one hour of walking per day, at an average pace of 100 steps per minute, may be the perfect dose to ward off the debilitating effects of osteoarthritis.

…White and colleagues set out to determine if the benefits of exercise could be achieved not just through regimented exercise programs, but through unstructured activities around the home and office. To do this, they used pedometers similar to the now ubiquitous Nike FitBit or Jawbone UP to tally participants’ daily steps. The researchers published their findings last week in the journal Arthritis Care & Research.

“I thought, heck, we have numbers for everything else — cholesterol, blood pressure — why can’t there be a number for the physical activity targets we want to hit?” White said.

An average pace of about 100 steps per minute works out to somewhere in the vicinity of walking 3 MPH. That’s actually a reasonably quick pace, not one that someone who isn’t a practiced walker will be able to do right away. I know it was a pace I had to work up to when I decided to learn how to walk. Even so, if you are able to walk for any length of time, you can work up to that time and pace.

Not everyone can walk like that, of course. My mother couldn’t. She had rheumatoid arthritis from a young age (24) and the pain of walking like that would have been too much. We also lived in a rural area with narrow, twisty roads, ditches instead of sidewalks, and crazy drivers zooming around way too quickly. It would have been dangerous to be out, especially in the dark, wet northwest winters.

For people who do live in walkable areas or who can get to such a place, now you have a study that shows how some regular, moderate activity done on a regular basis will provide you with yet more healthy results. Improving personal health and comfort doesn’t take heroic efforts (indeed, you’ll probably be more comfortable after a walk than a jog), but it does take a little attention and a bit of effort. If it was effortless, well, none of us would be sitting around reading blogs, would we?

The results of the study were pretty impressive (emphasis added):

For two years, the researchers tracked a group of adults in Alabama and Iowa who ranged in age from 50 to 79. Although some had signs of osteoarthritis at the start, none had problems with everyday activities like going to work, cooking dinner, or walking faster that [sic] 2 miles per hour — the speed needed to safely cross a neighborhood street, which scientists used as a cutoff for healthy performance.

Knee problems cropped up in about 150 of the roughly 2,000 participants before the study ended. These people either reported a limited ability to function normally or failed to pass the performance test of walking speed. The researchers also monitored the participants for physiological signs of osteoarthritis such as joint space narrowing or bony growths using knee X-rays.

When they analyzed the step data from the pedometers, they found a strong link between participants’ activity level and knee health. Their results suggest 6,000 steps marks an important threshold: 70% of participants who developed knee impairments walked less than this amount while 70% of those who remained healthy walked more.

This number held true even after the scientists accounted for all the other possible reasons why those who walked less might have developed problems, including age, sex, level of education, and how many physical signs of osteoarthritis they saw in their X-rays at the beginning.

Alabama and Iowa are not exactly hot beds of health culture, not like Colorado or California. The study subjects were pretty ordinary folks. They could all manage to walk 2 MPH when they started, so even my fat ass would have qualified for the study.  This is important that the study didn’t seek out athletes and set the participation bar pretty low. It shows that ordinary people can benefit from an easy form of activity.

What it also shows is how the “fitness” industry is selling an image of physical activity at odds with what can be done to achieve good health results. It is promoting a fashion of health (the sweat bands, the snug clothes, the gadgetry, the sleek, sexy clubs, the ideal of hard bodies) that has little to do with what makes a person’s health better. It’s promoting fitness consumption, not health, and doing so in a way that is intimidating and discouraging to many people. My obese body, even now, is not going to resemble the beautiful people pictured by the industry.

Increasing general levels of activity is what matters for your health:

The importance of this study, White said, is that it demonstrates how easy staying healthy can be. “This exercise is not like going to gym and putting on your sweats and sweating away. These are very attainable goals that can be met in the context of daily life by just walking a little bit more.”

Walking 6,000 steps is perhaps greater than “walking a bit more,” especially if you’re just starting out, but the Clark Kent vs. Superman message is clear – moderation, small changes, and doing what is easy really does good things for you. It won’t injure you, it isn’t uncomfortable and it’s not exercise in that this is activity that happens in the course of everyday life and is something that gives you intrinsic pleasure. It doesn’t set you up in an adversarial relationship with your body.

You don’t need to beat yourself up to take care of your health.

Anglachel

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