Stroke Archive

Men may avoid activity because of their knee pain, but movement is exactly what they need.

It is perhaps the ultimate exercise catch-22: it's hard to move with knee osteoarthritis, but moving helps relieve osteoarthritis knee pain.

More than 30 million Americans have osteoarthritis, the most common kind of arthritis. While osteoarthritis can affect the hips, lower back, neck, and fingers, it occurs most often in the knees. In fact, an estimated 10% of men ages 60 and older have symptoms of knee osteoarthritis.

On call

Q. My breasts have begun to feel swollen and seem larger. What could cause this, and should I be worried about any potential health issues?

A. Swollen breasts in men are almost always caused by either one or both of two conditions: excess fat deposition in the breasts, or growth of actual glandular breast tissue (gynecomastia). Fatty deposition occurs in overweight men and is always present in both breasts. With gynecomastia, the breasts have a firm or rubbery consistency. While it usually affects both breasts, it can affect one breast much more than the other.

Myasthenia gravis (MG) is a rare neuromuscular disease that impairs the transmission of nerve signals to muscles, causing temporary weakness of affected muscles. While treatment is complex, recently updated guidelines have added to the understanding of MG and are improving approaches to treatment.

Inflammation plays a central role in healing, but left to run wild, this process can lead to arthritis, heart disease, and Alzheimer's.

Image: Ingram Publishing/Thinkstock

Inflammation is like a fire in your body you cannot see or feel. "It's a smoldering process that injures your tissues, joints, and blood vessels, and you often do not notice it until significant damage is done," says Dr. Andrew Luster, of the Center for Immunology and Inflammatory Diseases at Harvard-affiliated Massachusetts General Hospital. The damage might show up as arthritis, heart disease, stroke, and even Alzheimer's disease.

However, inflammation is not evil per se. It has an important role in how your immune system keeps your body safe and healthy. "The goal is to keep inflammation in check and not let the fire run wild," says Dr. Luster.

Think of inflammation as the body's natural response to protect itself against harm. There are two types: acute and chronic. You're probably more familiar with the acute type, which occurs when you bang your knee or cut your finger. Your immune system dispatches an army of white blood cells to surround and protect the area, creating visible redness and swelling. The process works similarly if you have an infection like the flu or pneumonia. So in these settings, inflammation is essential—without it, injuries could fester and simple infections could be deadly.

Chronic inflammation

But chronic inflammation can also occur in response to other unwanted substances in the body, such as toxins from cigarette smoke or an excess of fat cells (especially fat in the belly area). Inside arteries, inflammation helps kick off atherosclerosis—the buildup of fatty, cholesterol-rich plaque. Your body perceives this plaque as abnormal and foreign, so it attempts to wall off the plaque from the flowing blood. But if that wall breaks down, the plaque may rupture. The contents then mingle with blood, forming a clot that blocks blood flow. These clots are responsible for the majority of heart attacks and most strokes.

On call

Q. Years ago, my doctor told me a skin growth on my back was a seborrheic keratosis. Now I have more, and they seem to be multiplying over time. Is there any way to prevent them?

A. Seborrheic keratoses are raised, rough lesions that appear as a waxy brown, black, or tan growth. This common skin condition often shows up after age 50 on the trunk, back, face, or neck. The good news is that even though keratoses can increase in number over time, they aren't cancerous or contagious.

News briefs

Fried foods carry heart risks in part because they spur inflammation. But how many servings of crispy French fries does it take to raise your risk for cardiovascular disease? Not many, suggests a large analysis published online Jan. 18, 2021, by the journal Heart. Scientists pooled the findings of 17 studies on fried foods and problems like heart attacks, clogged coronary arteries, heart failure, and stroke. The studies included more than half a million people. Researchers also looked at the data from another six studies assessing the association of eating fried food and dying prematurely. Those studies involved more than 750,000 people. People who ate the most fried foods each week were 28% more likely to have heart problems, compared with people who ate the least. Each additional 114-gram (4-ounce) serving of fried foods per week bumped up overall risk by 3%. But the analysis failed to show that people who ate lots of fried foods were more likely to die prematurely. Besides provoking inflammation, fried foods are often also high in sodium as well as harmful saturated fats. If you choose to indulge in them, do it sparingly. And avoid foods fried in animal fats; instead, choose foods fried in vegetable oils.

Image: © Amarita/Getty Images

In the journals

Regular exercise is good medicine, but more may be better, suggests a study published online Jan. 12, 2021, by PLOS Medicine. Scientists asked more than 90,000 people without heart disease to wear a fitness tracker for a week to measure the duration and intensity of their physical activity. Five years later, they found that the most active people were less likely to have had a heart attack or stroke or be diagnosed with heart disease.

That's no surprise, but the researchers also discovered that risk continued to shrink as weekly minutes of activity and intensity rose. People who exercised the most and at the highest intensity had the best odds of maintaining good cardiovascular health. Guidelines recommend people get 150 to 300 minutes of moderate-intensity exercise per week, but these findings suggest that trying to do a little extra — whether in time, intensity, or both — offers more reward.

Ask the doctor

Q. My doctor told me I should get a home monitor to keep tabs on my blood pressure. Which number is most important in the reading, the top or the bottom one?

A. This question comes up often, perhaps because doctors and patients alike tend to pay more attention to the top (first) number, known as systolic pressure. It reflects the amount of pressure inside the arteries as the heart contracts. The bottom (second) number, diastolic pressure, is always lower since it reflects the pressure inside the arteries during the resting phase between heartbeats.