Abdominal obesity, hypertension, and diabetes is destroying your knee

Marion Hauser, MS, RD

One of the most obvious ways to help a patient with degenerative knee pain and metabolic syndrome (Abdominal obesity, hypertension, and diabetes) is to help them understand that a healthy lifestyle can be extraordinarily beneficial to their knee pain.

One of the hardest things to convince a patient of is that they need to examine their food choices and lifestyle choices and make immediate and meaningful changes to help try to save their knee.

It is very likely that if you are reading this article, you have high blood pressure that is being controlled by medication, you are constantly challenging yourself to get rid of your “gut,” and you have diabetes. You also have moderate to severe knee pain and are losing your mobility and ability to function.

In this article, we are going to bring in researchers from leading medical universities and hospitals to reinforce this message that you must eventuate your situation if you want to avoid knee replacement.

Abdominal obesity, hypertension, and diabetes = knee pain and accelerated knee osteoarthritis

In October 2018, researchers in the journal Clinical Rheumatology (1) reinforced these findings.

The goal of the study was to take patients who had metabolic syndrome (Abdominal obesity, hypertension, and diabetes), and knee osteoarthritis and examine the patient’s clinical history, functional capabilities, and match that with scans and MRIs of their knees.

  • This study examined 60 patients – 55 being women
    • Every patient had been diagnosed with metabolic syndrome (Abdominal obesity, hypertension, and diabetes).
    • All patients had knee osteoarthritis documented by MRIs and scans
    • All patients were tested for pain, stiffness, and disability assessments
  • The findings:
    • If you have the components of metabolic syndrome, the abdominal obesity, hypertension, and diabetes, your knee pain was worse, your degeneration was worse, your functionality was worse.

The obvious conclusion? You will probably walk a lot better and feel a lot better if the issues of Abdominal obesity, hypertension, and diabetes are confronted.

If you have a big belly. Look down. You are looking at an inflammation processing plant. Your fat cells are pumping out inflammation to your joints

Dr. Karel Pavelka of the Czech Republic has published findings in the Fall 2017 issue of the Czech language journal Internal Medicine. Here are his bullet points:

  • It remains problematic that one of the main components of metabolic syndrome is obesity which in itself is a risk factor for osteoarthritis development in the weight-bearing joints.
    • Note: Research is now showing that obesity also causes osteoarthritis inflammation in non-weight bearing joints such as the hands.
    • It had been thought obesity caused joint degeneration because of weight load.
    • In research on patients with hand osteoarthritis and obesity, it was found that obesity cause inflammation leading to osteoarthritis, weight bearing had nothing to do with it. This is covered in our companion article Excessive weight and joint pain – the inflammation connection.
  • “Meta-inflammation.” Inflammation caused by metabolic syndrome.
    • Over the last decade, evidence has been shown that adipose (fat) tissue is a source for growing inflammation. Inflammatory cells in the fat: cytokines (small proteins that send pro-inflammatory and anti-inflammatory messages to damaged joints) and adipokines, which are also cell signaling messenger proteins secreted by fat cells which may cause inflammation of low-activity synovial tissue, sometimes also called “meta-inflammation,” go into high production in the presence of obesity.
  • “Adipose tissue-associated inflammation.” The changed secretion profile of pro-inflammatory adipokines is present in obese individuals, an older population and postmenopausal women, the populations at high risk for both metabolic syndrome and osteoarthritis.(2)

In other words, your fat cells are pumping out inflammation.

The message again: Your fat cells are pumping out inflammation

State Medical University researchers in Russia have published their observations on 164 patients with osteoarthritis. Eighty-two patients were diagnosed with Metabolic Syndrome, Eighty-two were not and used as controls.

In the 82 patients with Metabolic Syndrome, clear indications of the negative impact of the disorder were seen:

  • the frequency of joint injuries and multiple joint injuries.
  • the prevalence of synovitis (synovial inflammation of the knee),
  • and the intensity of joint pain and inflammation were significantly higher than in the non-Metabolic Syndrome group.(3)

Doctors in France, cited these same findings in their research on factors affecting joint healing and metabolic syndrome: They write in Current opinion in rheumatology:

  • Recent advances in the study of metabolic syndrome-associated osteoarthritis have focused on a better understanding of the role of metabolic diseases in inducing or aggravating joint damage.
  • This research gives emerging evidence that, beyond the role of common pathogenic mechanisms for metabolic diseases and osteoarthritis (i.e., low-grade inflammation and oxidative stress), metabolic diseases have a direct systemic effect on joints.(4)

In other words -abdominal obesity, hypertension, and diabetes  is destroying your joints as if it were a wear and tear disease.

Research: Your big belly is causing your joint swelling

University researchers in Australia write in the journal PLoS One (Public Library of Science one) of the established risks obesity plays in osteoarthritis.

The researchers fed Wistar rats a high-carbohydrate, high-fat diet for a period of 8 and 16 weeks. The study showed that obesity induced by this diet is associated with spontaneous and local inflammation of the synovial membranes in the rats even before the cartilage degradation.

  • In other words, there was no joint damage, but the diet caused inflammation

This was followed by increased synovitis and increased macrophage infiltration (immune cells are now invading the areas causing swelling and edema) into the synovium and a predominant elevation of pro-inflammatory M1 macrophages (A specific type of immune cell).

  • In other words, obesity is causing the swelling

This study demonstrates a strong association between obesity and a dynamic immune response locally within synovial tissues before cartilage degradation.(5)

  • In other words, the joint environment is eroding

The problems of managing insulin

Doctors writing in the journal Medical hypotheses offered evidence making a connection between insulin, inflammation, and joint pain here are the bullet points of their findings.

  • High levels of insulin in obesity and metabolic syndrome can induce numerous complications.
    • Insulin can increase proliferation of chondrocytes (Cartilage building blocks) but can also simultaneously prevents their differentiation into specific type of cells. In other words, the building blocks of cartilage multiple but do not differentiate – that is, become cartilage. They become duds.
  • Decreasing insulin levels can prevent osteoarthritis progression and/or improve the treatment process.(6)

Reducing circulation insulin levels can be achieved in many cases with health-professional guided lifestyle and dietary changes.

Eating foods that maximize healing

The same researching team cited above also examined the recent advances in the knowledge of osteoarthritis and its association with obesity and metabolic syndrome through systemic mechanisms.

Type 2 diabetes has been described in two (studies) as an independent risk factor for osteoarthritis.” In these animal studies, diabetic rodents display a spontaneous and a more severe osteoarthritis than their non-diabetic counterparts.

The negative impact of diabetes on joints could be explained by the induction of oxidative stress and pro-inflammatory cytokines (systemic low grade inflammation) and by joint tissues exposed to chronic high glucose concentration. 7

The message here is simple: Abdominal obesity, hypertension, and diabetes = knee pain and accelerated knee osteoarthritis. The choice to do something about it is yours.

If you have questions about metabolic syndrome and osteoarthritis joint pain, get help and information from our Caring Medical staff

1 Abd EL, Shaat RM, Gharbia OM, Boghdadi YE, Eshmawy MM, El-Emam OA. Osteoarthritis of knee joint in metabolic syndrome. Clinical rheumatology. 2018 Jul 23:1-7. [Google Scholar]
2 Pavelka K. [Osteoarthritis as part of metabolic syndrome?] Vnitr Lek. 2017 Fall;63(10):707-711. [Google Scholar]
3 Vasilyeva LV, Lakhin DI. Clinical features of osteoarthritis in patients with metabolic syndrome. Terapevticheskii arkhiv. 2017;89(5):65. [Google Scholar]
4 Courties A, Sellam J, Berenbaum F. Metabolic syndrome-associated osteoarthritis. Curr Opin Rheumatol. 2017 Mar;29(2):214-222. [Google Scholar]
5 Sun AR, Panchal SK, Friis T, Sekar S, Crawford R, Brown L, Xiao Y, Prasadam I. Obesity-associated metabolic syndrome spontaneously induces infiltration of pro-inflammatory macrophage in synovium and promotes osteoarthritis. PLoS One. 2017 Aug 31;12(8):e0183693. doi: 10.1371/journal.pone.0183693. eCollection 2017. [Google Scholar]
6 Askari A, Ehrampoush E, Homayounfar R, Bahramali E, Farjam M. Serum insulin in pathogenesis and treatment of osteoarthritis. Med Hypotheses. 2017 Feb;99:45-46. [Google Scholar]
7 Courties A, Sellam J. Osteoarthritis and type 2 diabetes mellitus: What are the links? Diabetes Res Clin Pract. 2016 Dec;122:198-206. doi: 10.1016/j.diabres.2016.10.021. Epub 2016 Nov 5. [Google Scholar]

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