As you sit at your basecamp looking at the summit in front of you, let’s talk about risk factors for the journey ahead. If you know about these factors, then you will have the ability to minimize the potential impact they may have in time.

There is no greater factor studied when it comes to joint degeneration, then the effect that excessive weight has on joint health:

  • Obesity is one of the strongest predictors for development of joint pain and osteoarthritis.1
  • Excessive weight alters the function of your joints, and how they can handle the force in time, ultimately causing damage to the joint.
  • Beyond the pure mechanics of excess weight on the joint, there are inflammatory and metabolic (chemistry) characteristics brought about by obesity that will affect your joints as well.2
  • Obesity, as a component of metabolic syndrome, is contributing directly to the progression of joint disease in OA.3,4
  • Obesity itself has a bearing on the amount of reported pain, often very disproportionate to duration of disease or severity of radiographic findings.5

I illustrated earlier that supporting your triangle of health, to restore and maintain wellness, is dependent on physical factors. Routine and purposeful exercise is an essential element to maintain strength, function, and an ideal body weight to limit excess mechanical and metabolic impact on the joint.

Now for some tough news. Try as you might, there is simply no way to “out exercise” poor nutrition.

An example. You ever get on that treadmill or elliptical machine and see how many calories you can burn in a session? How many calories did you crank out in your most rigorous session? 400, 500, or more?

Now how many calories are in a 12-ounce can of soda, a couple of beers, or a few slices of pizza? Quite a few more.

It’s a losing battle from the start as many will attempt to “out exercise” poor nutrition as a way to lose weight. The deck is stacked against you with this approach. The impact from poor nutrition is not only the biggest modifiable risk factor for development of obesity, but through association, joint pain and development of osteoarthritis.

More than 1 in 3 adults are overweight or obese, and the number of people with joint pain and osteoarthritis is growing on the same trajectory.

Thinking about your nutrition and exercise with purpose to accomplish the desired outcome for your health is an approach however that will work when you apply some consistent effort. This is going to take some work on your part, but it is totally doable with a little planning and practice.

Changing the focus of your nutrition to foster the healthiest environment within the body is without question the most difficult challenge for patients I see in my practice. However, it is also the most rewarding in how quickly the benefits will be seen, felt, and manifest in the function of your body.

You must do this if you are to shift your body into a regenerative, healing state, and out of an inflammatory, degenerative, and painful state. Taking supplements alone will not work if the proper fundamental nutrition is not first in place.

So why haven’t you heard more about the impact of nutrition on your joints?

“People are fed by the food industry, which pays no attention to health, and treated by the health industry, which pays no attention to food.”  – Wendell Berry
Let’s put you on the right path with a few core concepts:

Eat real food

This means incorporating as little refined, processed, and chemical foods in your diet as possible. The convenience of mechanically/genetically/chemically altered, fat and sugar laden, processed and packed ready-to-eat foods over the past several decades I believe is in large part responsible for the widespread erosion of health in this country.

The fix. Eat real food. Simple as it gets.

Evaluate for possible food (or environmental) allergies or sensitivities

The ability of one food to be health promoting for one person, but harmful to another, speaks to our chemical uniqueness. This topic has been the subject of multiple books over the past several years, including one written by yours truly – The Pain Free Diet.

It is also nearly impossible to identify all potentially problematic foods without lab testing. I routinely get a very specific food and environmental allergy/sensitivity test as part of the work-up for constructing a regenerative nutrition plan for my patients.

[The Food and Drug Administration (FDA) food allergen law requires food manufacturers to clearly label foods containing the top 8 food allergens – milk, eggs, peanuts, tree nuts, wheat (gluten), soy, fish, and crustacean shellfish.]

Evaluate for vitamin, mineral, and micronutrient deficiencies

Even if you are eating a wide variety of health promoting foods, it is possible to develop some shortcomings in your nutrition. Some routine labs can more completely evaluate this to make sure you are getting everything your body needs.

Eliminate inflammatory foods

In my practice the following foods tend to show up time and time again on food allergy/sensitivity testing, and I believe are huge contributing factors to ongoing inflammation and joint pain:

  • Refined food products containing artificial sweeteners, coloring, and preservatives
  • Sugar
  • Dairy
  • Grains containing gluten, particularly wheat
  • Soy

Putting it all together here is how we will begin constructing an optimal nutrition plan to support joint health:

Step 1: Simplify and Clean Up Your Nutrition by Removing

  • CRAP (calorie rich and processed) foods
  • Inflammatory foods
  • Genetically modified foods

Step 2: Test, Rather Than Guess

  • Consider food/environmental allergy/sensitivity testing and vitamin and mineral testing to customize your nutrition needs (I will teach you a little more about these tests a bit farther down the path)

Step 3: Optimize Your Diet

  • Eat organic, especially the dirty dozen, whenever possible
  • If you have to be selective with your budget, you can eat non-organic from the clean fifteen list
  • Wash all produce thoroughly to remove pesticides, herbicides, and packaging/shipping residues (chemicals that will inflame your immune system and joints)

Unraveling the positive contributions of nutrition, as well as the negative metabolic factors of an inflammatory, obesity state has been the focus of research dating back decades. It is nice to see that there has been a renewed interest in recent years.

The choices you make regarding your nutrition and maintenance of an ideal body weight is so incredibly critical to the long-term health of your joints.

Now go stock up a shopping cart with some healthy stuff,

P.S. You can take a much deeper dive on this subject by checking out the book I wrote a couple of years back, The Pain Free Diet.


  1. Thijssen E, van Caam A, van der Kraan PM. Obesity and osteoarthritis, more than just wear and tear: pivotal roles for inflamed adipose tissue and dyslipidaemia in obesity-induced osteoarthritis. Rheumatology (Oxford) 2015;54(4):588-600.
  2. Loeser RF, Goldring SR, Scanzello CR, Goldring MB. Osteoarthritis: a disease of the joint as an organ. Arthritis Rheum 2012;64(6):1697-707.
  3. Scotece M, Conde J, Gomez R, et al. Beyond fat mass: Exploring the role of adipokines in rheumatic diseases. Sci World J. 2011
  4. Otero, M et al. Leptin, a metabolic hormone that functions as a pro-inflammatory adipokine. Drug New Prospect 2006
  5. Stone, AA, Broderick JE. Obesity and pain are associated in the United States. Obesity. 2012

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