As I sat in the physical therapy office awaiting my husband this past week, I felt utterly depressed.

Besides the soap operas playing on the television and the drab red-colored walls, the cross-section of people rehabbing just astounded me.

Enter a woman in her late 50’s, about 60 pounds overweight, warming up on the treadmill.

Two physical therapists were working on separate patients, both overweight themselves.

A woman in her early 60’s, about 70 – 80 pounds overweight, was in for post-knee replacement therapy and barely churning the bike pedals.

As she lay down on the table to ice after some of her exercises, she started complaining about her bad hip as well: “I shouldda just done the 2-for-1 instead…”  And proceeded to grumble about how she would have to go back for a new hip once her knee healed.

My mind instantly flashed back to my corporate medical technology days 1.5 years ago, when I attended a knee replacement surgery with a rep in Reading, United Kingdom.

An 80-yr old was having a knee replacement at the time, and with a white sheet covering the person’s body from the waist up, all I could see was the dilapidated leg propped up to be operated on.

The British doctor walked in and we exchanged introductions, and he proceeded to chip, saw, and make the necessary cuts to the knee.

Between the chunks of bone and blood flying everywhere, the hours and precision it took, and the doctor cracking light-hearted jokes with me during the procedure, I wondered if there was any other way to prevent this situation in the first place!?

Hip & Knee Replacements, Anyone? 

Joint replacements have been the newest thing since sliced bread for Baby Boomers, with knee replacements jumping from 264,311 in 1997 to 621,029 in 2009.

There were 288,471 total hip replacements in 2009, too, with nearly half of the people under 65 years of age!

What’s the cause of the surge, you ask?

The lifestyle of the baby boom generation, as Mathias Bostrom, MD, orthopedic surgeon at New York’s Hospital for Special Surgery explains:

“They’re not willing to be sedentary or change their lifestyle… Their joints are beat up and they’re living longer, and they want joints that let them do the things they’re used to doing.”

Baby Boomers are also more active and feel more entitled to maintaining their current, active lifestyles, making them more apt to opt for a replacement much earlier in life.

Weighed Down

And while age is the overriding risk factor for osteoarthritis (OA), the most common joint disease for older individuals, obesity has been a recent focus because of its preventability in OA.

In fact, about 23% of the 10-year growth in total knee replacements can be can be explained by increasing obesity and population.

That’s what I kept wondering about the crop of rehab folks walking in; could their fate have been prevented via better nourishment (physical, mental, spiritual)?

And then, there’s the expert physical therapists in their late 30’s and early 40’s slowly heading down the same fated pathway, but still, perhaps, impervious to the future implications of extra weight creeping onto their own bodies, too.

According to Dr. Nicholas DiNubile, a Philadelphia surgeon,

“Every extra pound you carry registers as five extra pounds on your knees.

So, for the woman in the P.T. office about 70-80 lbs. overweight, her knees are feeling like a whopping 350-400 lbs. of extra weight!

Brutal. And painful.

One study found that obesity is strongly associated with the need for a total joint replacement among adults less than 60 years old.

Two theories have been proposed to explain this link:

1) The biomechanics theory proposes that obesity causes repetitive and increased force on the joint leading to degeneration of the cartilage and bone.

2) Excess fat may enhance irregular growth and inhibit repair of the articular cartilage.

Another Australian study followed 40,000 initially healthy Melbourne residents for up to 15 years, and found that those in the top quartile of body mass index were 3.44 times as likely to undergo primary joint replacement in later years than those in the bottom quartile.

With the impact of obesity on OA, what about looking at the increase in hip and knee replacements from a nutritional standpoint?

Nutritional Shift = Contributing Factor? 

Because, despite advances in medical care, I’d argue that part of the spike is due to a major shift in nutritional changes from previous generations that pills just can’t replace.

Regardless of extra weight or not:

1) We are consuming far less of the nourishing, traditional whole foods that our ancestors did generations ago.

2) The nutrient content of the foods that we do consume is far less than it was four generations ago.

Traditional Foods of Our Ancestors

Even though the average life span has increased slightly over the past 200 years (probably due to emergency room care, artificial life support, medicine, vaccines, accident prevention), Wise Traditions reports the percentage of people living a long time may have actually gone down. (1)

  • Percentage of Americans aged 100 in 1830: .020
  • Percentage of Americans aged 100 in 1990: .015
  • Percentage of people living today expected to live to 100: .001

In fact, our great-great-great-great-great-great-great grandmothers had it right.

Their grass roots knowledge passed down from generation to generation about unrefined, whole and natural foods, and preparation techniques that maximized nutrients was a sacred understanding for survival and longevity.

Processed foods that have a lifespan of a dog?

Unheard of back in the day, yet they’ve become “the new normal” for this generation.

Catherine Shanahan, MD, summarizes our plight in Deep Nutrition perfectly:

“Today, at every stage in the process of producing food, we do things differently than our sturdy, self-sufficient ancestors did, wasting opportunities to provide ourselves with essential nutrients at every turn.

We fail to fortify and protect…the soil. We raise animals in unspeakably inhumane and unhealthy conditions, fill their tissues with toxins, and color the meat to make it appear more appetizing…Much of the nutrients, bioconcentrated over the animal’s life, are thrown to waste…Once in the kitchen, the consumer takes one last swing at whatever nutrition has survived, through overcooking and the use of cheap, toxic oils.

Finally, since we’ve not been told that certain vitamins and minerals are more bioavailable when combined with acids or fats, many of them pass right through us.”

We simply aren’t consuming near the nutrients that we could or should be to nourish ourselves.

The Decline in Nutrient Content

Expanding further, farming techniques have drastically changed as well, and with it, the quality of the soil and its crops.

1) Pesticides and herbicides are in heavy use, with about 80,000 chemicals in circulation today. About 2% of these chemicals serve their purpose in killing
bugs, but our water, air, soil and bodies suffer majorly because of it.

Affecting the mineral content of the soil, the ability of plants and animals to produce vitamins and nutrients from the soil is greatly affected as well.

2) Genetically modified organisms (GMOs) are common worldwide, where scientists can cut and paste genes from one living organism to another, creating a new genetic make-up of an organism.

Used to increase crop yields and to grow more food, GMOs manipulate life processes that wouldn’t otherwise occur naturally, and potentially set off a domino effect of changes in the ecosystem.

Lacking research, inadequate regulation in safety assessment, and posing a greater risk of food allergies, GMOs are a prime example that technological advances don’t always equal health advances.

3) And then there’s irradiation, approved by the FDA in 1997, which passes food under radioactive cobalt gamma rays to kill bacteria and increase the shelf-life of a food.

While some claim that it makes food safer to eat, it doesn’t completely destroy all the toxins, and it aids in nutrient depletion of B vitamins, antioxidant vitamins A, C, E, and some unsaturated fats.

Let’s look at an overall synopsis:

  • One report showed that packs of sliced green beans have only 11% of the vitamin C claimed on the package.
  • Another report comparing mineral levels of 27 fruits and veg from 1930-1980 found modern produce to be depleted by about 20%; calcium dropping 46%, magnesium 23%, iron 27%, and zinc 59%.
  • Iron has decreased 47% in meat and 60% in milk from 1930-2002. (2)

Preventable Pain, Overweight & Injuries: Food is Medicine

So, how does all of this information correspond to our health and the health of our joints?

Through the generations of nutrient changes in our food, our cartilage, joints, connective tissues, bones, brain and organs have been negatively affected. There are increasing issues with fertility, too.

The good news?

The choices each of us makes daily can improve and may even reverse some of damage done to our joints, tissues, and whatever components of our health that have been altered.

It starts with ONE CHOICE at a time (baby steps, right? Think of Bill Murray in What About Bob.) Remember that every extra pound that you lose is 5 lbs. less on your knees!

Lay off the sugar.

Lay off pro-inflammatory vegetable oils.

Cut out processed, packaged, and junk foods (including soda!).

Maximize nutrient intake and absorption by increasing your intake of:

  • Organic
  • Seasonal
  • Local
  • Fresh
  • Whole foods (food that hasn’t been altered or processed!)

Think of food (and muscle!) as medicine.

It is NOT too late to remove inflammatory foods and introduce these healing, whole foods to feel vibrant and to better contribute your gifts and abilities to the world!

Though each of us has a different genetic predisposition to whether or not we are fated for a joint replacement (or whatever the health issue), you can choose do your part to minimize, delay, and improve that predisposition by the choices you make TODAY.


1. Wise Traditions, Vol. 8, No. 1, 2007, p. 13.

2. Shanahan, Catherine and Luke Shanahan. Deep Nutrition: Why Your Genes Need Traditional Food. Big Box Books: Lawai, HI, 2009.