Can Anti-Depressant ‘Happy Pills’ Cure Osteoarthritis?

Can Anti-Depressant ‘Happy Pills’ Cure Osteoarthritis?

A drug designed to beat depression could provide effective, life-changing treatment for osteoarthritis of the knee, researchers have found.

Depression drug 'duloxetine', which increases the levels of feel-good chemicals (such as serotonin and noradrenaline) in the nerves, has also been found to ease arthritis pain in knee joints, say researchers at University of Maryland.

The treatment, which costs £22 for a month’s supply, was given to a group of osteoarthritis sufferers for 13 weeks – and placebo pills given to another group of participants.

Patients who took the drug reported a 33% drop in pain levels compared to those who took the placebo medication.

These findings were published in the Journal of Rheumatology.

A spokeswoman for Arthritis Research UK said in a statement: "We know that the class of drugs to which duloxetine belongs have a propensity to modify chronic musculoskeletal pain; back pain in particular, but it’s not clear if it works well in peripheral joint osteoarthritis.

"There have been a number of trials of this drug that have shown mixed results.”

Antidepressants are used in a number of pain-relieving medications to help treat conditions such as migraines, pelvic pain and nerve damage.

According to the Mayo Clinic, the drug's pain-killing mechanism is still not fully understood.

However, previous studies have shown that arthritis pain is often worse in patients suffering from depression - and those using an anti-depressant may benefit from decreased sensations of pain.

According to Arthritis UK, people with long-term arthritis are two to three times (20%) more likely to experience depression. And around 68% of patients admit that their depression is worst when the pain levels are highest.

Emer O’Neill, spokesperson for the coalition and chief executive of Depression Alliance said in a statement: “You are twice as likely to experience depression if you have a long term condition.

“Depression is a debilitating condition and having a double whammy of a long-term condition and depression has an undoubtedly serious effect on a person’s quality of life and health.

“As a coalition of charities, we are calling for equal importance to be given to the physical and psychological symptoms of long-term conditions. We must start treating those with chronic conditions as a ‘whole person’ – and not just their physical condition”

• Natural Ways To Strengthen Your Bones

• Try Soy-Based Foods

  Calcium-enriched soy foods, like tofu, contain as much as 861mg of calcium, which is a large proportion of your recommended daily allowance. Soy has a similar effect as oestrogen on the body, helping strengthen bones.

• Drink Milk

  Milk is one of the richest sources of calcium. One glass of milk contains 300mg of calcium.

• Go In The Sun

  Sunshine is a natural vitamin D stimulant. Without vitamin D, the body cannot absorb calcium, a crucial mineral which helps build healthy bones.

• Feast On Sardines

  Another rich source of calcium. Just 3 ounces of canned sardines has the same calcium equivalent as a cup of milk.

• Eat Yoghurt

  Eight ounces of milk contains the same amount of calcium than milk. Lactose and dairy-free products contain the same amount of calcium than its dairy counterpart.

• Cut Back On Salt

  A high intake of salt deprives the body of calcium - the vital mineral for maintaining healthy bones. The more salt that is consumed, the more calcium is flushed away through the urine. Sticking to a low-salt diet helps the body retain its natural calcium levels for longer.

• Go Nuts

  Peanuts (unsalted) and almonds are great sources of potassium, which helps protect against the loss of calcium in the body. Nuts are also excellent sources of protein and other vital nutrients that play a supportive role in building strong and healthy bones.

• Top Up On Your Greens

  Dark,leafy greens are packed full of calcium. Greens such as bok choy, Chinese cabbage and kale have the highest levels of the mineral.

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Art Markman, Ph.D.: When Do You Practice What You Preach?

Art Markman, Ph.D.: When Do You Practice What You Preach?

Philosophers and observers of human behavior have noticed that people often make moral claims that they cannot live up to. There are countless examples of scandals involving religious and political leaders who talk publicly about living up to high moral standards, but whose personal lives do not measure up. These observations have spurred a number of lines of psychological research.

In 1997, Jonathan Baron and Mark Spranca focused on a particular kind of moral statement that people make, called a "protected value." A protected value is a moral line that people say they simply will not cross. For many people, for example, abortion crosses a protected value of the sanctity of human life. For these people, they simply will not accept any violation of this value. A key sign that a protected value is threatened is that people experience a sense of moral outrage.

This strong reaction to violations of a protected value are felt most strongly when the value is challenged directly. In fact, research by Julie Irwin and Jonathan Baron in 2001 suggests that even people who hold a particular protected value will make tradeoffs related to it when they are not asked about it directly.

In their studies, some participants were people who expressed a protected value for saving the rainforest. When faced directly with the opportunity to purchase furniture made from wood harvested from the rainforest, these participants were unwilling to do so. However, if participants with this protected value were asked about how much money they would spend for a variety of pieces of furniture (some of which contained wood from rainforests), almost all of them expressed a price that they would actually be willing to pay. So, when the protected value was not made overt in the choice, it had a much weaker effect on people's behavior.

Even in less extreme circumstances, people's beliefs about their behavior often do not match their actual behavior. An interesting paper by Oriel FeldmannHall, Dean Mobbs, Davy Evans, Lucy Hiscox, Lauren Navrady, and Tim Dalgleish published in Cognition in 2012 explores this issue. They compared performance in hypothetical and real moral situations.

The studies focused on a game called Pain vs. Gain. In this game, one participant is given £20. A second participant is strapped into a chair where they will be given moderately painful electric shocks. On each of the 20 trials of the game, the participant can pay up to £1 to minimize the severity of the shock. If they give up 1£, then the other participant receives no shock at all. If they give up nothing, then the participant receives the most painful shock.

In the hypothetical version, the game is described to people, and they are asked how much money they would keep. In this condition, participants predict they will keep about £1.50. This prediction reflects people's general belief that they do not want to cause harm to other people.

In the real version of the game, participants actually played the game. At the start of the study, they met a second participant who was assigned to receive the shocks. They got to experience a mild shock to get a sense of what the other participant might feel. On each trial, they made responses on a computer of how much money they would give up on that trial using a slider to pick a value between £0 and £1. Then, they saw the effects of the shock on the other participant by video. In actuality, the other participant was a confederate who was never actually given a shock, but was acting as though they had. In this version of the experiment, participants actually kept about £12.50. In this study, the data from a participant was only used if that participant believed that the study was real and the other participant had actually received the shocks.

So, people's actual behavior differed quite a bit from what they would predict they would do.

In a second study, the researchers explored ways to make people's predictions more accurate. They reasoned that people have a hard time simulating what it is like to be faced with this choice, and so they fall back on a general rule like "don't harm other people" to predict what they would do. In this study, they created three other hypothetical versions of the game.

In one, the game was described in great detail, and participants were asked how much money they thought they would keep. In this case, participants thought they might keep about £4. In another version, the game was described, and participants actually played all 20 rounds of the game. In this case, they kept about £8. In a third condition, participants went through the entire scenario of meeting another participant and getting a sample shock, but then, they were told to imagine that the other participant was connected to the shock. Then, they played all 20 rounds of the game. In this case, participants kept about £12, which is about what the participants playing the real game kept.

This research is related to a lot of work on the consistency between people's attitudes and their behaviors. In essence, it is hard to predict what you are going to do in a situation if you are not experiencing that situation. When you say what you are going to do in a situation, you are making your best guess about it. However, it is hard for you to simulate all of the other factors that are going to influence your behavior. As a result, your predictions are often inaccurate. So, if you want to be as accurate as possible in predicting your future behavior, make the circumstances in which you make the prediction as similar as possible to the situation in which you will be acting.

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David Katz, M.D.: A New Kind Of Epidemic: FUN!

David Katz, M.D.: A New Kind Of Epidemic: FUN!

I was at the White House recently, for the 2012 Easter Egg Roll.

Before I get any credit I don't deserve for being among the chosen few invited to perform, I hasten to add I was there essentially as the unofficial photographer to the backup dancers for the invited act. The back-up dancers were three of my children. The main act was Kellee McQuinn, founder of KidTribe.

Kellee is a phenomenal performer, director, producer, and all-around force of nature.

She and I met not long ago when participating in a TEDx event for Mindstream Academy. We decided shortly thereafter to collaborate on a project funded by my non-profit, Turn the Tide Foundation, and tentatively called "Vitality Rap." The program will deliver empowering, inspiring, and surprising health messages to tweens and teens using music videos as the delivery vehicle -- with links to actionable programs that enable them to put their new awareness to work. The initial offering -- "Unjunk Yourself" -- is now in production, and got its pre-production premiere on the South Lawn of the White House.

Kellee and KidTribe were invited back to the Easter Egg Roll for the third year in a row, and after watching Kellee's performances (with, if I am allowed to express the potentially biased view of a parent, the very able back-up performances of my kids!) -- I can see why. She is an engaging, high-energy performer, and can do things with a hula-hoop that truly seem to defy gravity. My own efforts with a hula-hoop, in contrast, serve only to confirm that gravity is totally in charge.

Kellee reports going down two dress sizes as a by-product of her virtuoso hula-hooping. She also states -- with the kind of conviction that makes you believe it must be true -- that vigorous hula-hooping for 10 minutes burns the same calories as running a mile. I'm looking for the report of that randomized trial, and will get back to you when I find it. But for now, let's take it on faith.

Here's the part for which faith is not required, because I offer a firsthand account: What Kellee and KidTribe did on the White House South Lawn was highly contagious.

With each of the many performances throughout the day -- to sequential, lottery-winning crowds of roughly 6,000 Easter Egg Roll guests at a time -- a forest of hula-hoops was strewn across the lawn. The music began. Kellee -- with Valerie, Natalia, and Gabriel -- took to the stage. The hoopla commenced.

And then, inevitably, one by one, two by two, and group by group, people picked up the hoops. They shook, they shimmied, and in many cases, they hooped quite admirably. Few, I confess with some chagrin, were as hopeless as I. (I plan to keep my day job...)

But even those who couldn't hoop -- or didn't get a hoop -- danced alongside those who could, and did. Young, old; lean, heavy; adept, and not so much. They were all moving, and loving it.

And there were no hoops to jump through. There was no cajoling, coaxing, or coercion. There was no hullabaloo. Just fun, on public display. Just the up-side of peer pressure. A contagion of hip-swinging, calorie-burning fun.

Often -- too often, perhaps -- we clinicians, researchers, and public health practitioners speak of health as if it requires jumping through hoops. And in many ways, of course, it does.

Eating well in the modern world is hard. We are surrounded by a wide array of tempting food choices of suspect influence on health. We are exposed to the constant goad of food marketing. We may well be subject to foods willfully engineered to ensure that we "can't eat just one."

We are, as well, beneficiaries of ever more technology that does all the things that muscles used to do. We are victims of increasingly hectic schedules that squeeze physical activity out of the daily routine of adults and children alike.

And we confront these modern challenges with a Stone Age physiology perfectly suited for an entirely different world. A world in which calories were relatively scarce and hard to get, and physical activity -- called survival -- was unavoidable. Everybody did it every day.

We find ourselves in a modern world in which physical activity is scarce and hard to get, and calories are unavoidable. And with no native defenses against caloric excess or the lure of the couch -- never having needed them before. So we are all too readily undone by this foreign, toxic, modern world of our own devising.

Jumping from where we are to the native conditions of the Stone Age to which we are adapted involves one heck of a hoop!

We professionals also tend to talk about the costs of not making that leap. I tell this tale routinely, both on the page and at the podium.

It is a tale of epidemic obesity among adults and children alike. It is a story of the transformation of adult-onset diabetes into a pediatric epidemic of Type 2. It is a story of proliferating cardiac risk factors in ever-younger people. It is even a story of a rising rates of stroke in 5- to 14-year-olds. It is not a fun story. It is a story that might even imply: To hell with fun!

Up to a point, we professionals are quite right to note how hard getting to health can be through the obstacle course of the modern day -- for adults and children alike. We are right to report, and repeat, the dire consequences of poor use of forks and inadequate use of feet that constitute the status quo. We are right to clamor for changes in both programming and policies to help pave the way so that health might be diverted from the road far too seldom taken, to a path of lesser resistance.

But there is another story to tell about health, and it is fun. It's all about fun. The antidote for "to hell with fun" may just be: To health, with fun!

Healthy people have more fun. People having fun might accidentally get healthy. We can get health in the pursuit of pleasure, and pleasure in the pursuit of health. Peer pressure can have an up-side!

The fun story is what I saw on the South Lawn of the White House. I was invigorated and inspired by what I saw -- and hope that with words and pictures, I can to convey some small measure of that infectious energy.

Getting to health can seem like jumping through hoops. But do the hula with one, and you see a very different picture. Have fun -- put it on display in front of some kids, your own or anyone else's -- and you will likely find yourself at the center of a movement. Make it fun that involves movement, and you will likely find yourself at the epicenter of not only infectious fun, but a contagion of health promotion as well.

Here's to that epidemic!

-fin

Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefoundation.org

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