The traditional Asian spice may beat over-the-counter remedies at managing your pain. 10/19/2020
Do your knees hurt? Almost 20 percent of Americans over 45 years old suffer from knee osteoarthritis, a condition marked by the breakdown of joint cartilage and ongoing pain.
Getting older and putting on weight can contribute to the problem, but are not the entire explanation, according to a fascinating study of skeletons dating back thousands of years. Since about 1950, knee osteoarthritis has become about twice as common as it was historically. One reason may be our relatively high-carbohydrate diets (Wallace et al., 2017).
As you may already know, over-the-counter pain remedies are only mildly helpful and there’s no approved drug that has been shown to be effective.
The good news: in September, the Annals of Internal Medicine reported new evidence that volunteers taking extracts of the Indian spice turmeric over 12 weeks reported less pain and took fewer other pain remedies than a placebo group (Wang et al., 2020).
Interestingly, despite the pain reduction, there were no structural changes observed in the knees themselves. But that’s not as surprising as you might think: much research shows that people with bone abnormalities that are similar on X-rays can have dramatically different levels of pain.
In other words, pain is often its own problem, quite apart from a breakdown in structure. In such cases, pain’s source is inflammation, an immune response.
Turmeric and Inflammation
As early as 1937, Western scientists noticed that the most bioactive compound in turmeric, curcumin, was effective against inflammation of the gallbladder, and since then evidence has been accumulating that it fights inflammation of different kinds (see “Curcumin: Miracle or Myth?”).
It also intrigues researchers as a potential tool that may lower risks of a variety of serious conditions and some infections (Mbese et al., 2019). Among its many effects, it appears to work like exercise to widen the blood vessels (Jager et al., 2014).
In a literature search that turned up eight clinical trials of curcumin products for osteoarthritis, they beat placebo but didn’t outstrip nonsteroidal anti-inflammatory drugs (though you might find a supplement is easier on your digestive system) (Perkins et al., 2016). The doses varied from 1 to 2,000 mg a day.
Should You Eat More Turmeric?
This versatile spice, a staple of Asian cooking for thousands of years, turns a collection of bland vegetables into a delicious dinner. The root (Curcuma longa) looks like ginger root, but is smaller, with deep orange to brown skin. Inside, the root’s flesh is usually intensely orange.
Ground into powder, turmeric makes dishes bright yellow to deep orange, depending on the variety. You’ve seen it in yellow dal, the Indian lentil dish, and in Indian curries of all kinds. You’ll also see and taste it in Iranian khoresh dishes (based on onions caramelized in oil and turmeric), the traditional Moroccan spice mix ras el hanout, and dishes from South Africa, Cambodia, Indonesia, and Thailand.
Just know that the turmeric we eat mainly leaves our bodies unmetabolized, and the part we do absorb turns into water-soluble forms that are well, watered-down. So a daily curry may help you in ways we don’t yet understand, but it isn’t working in the same way as a high-quality supplement optimized for absorption.
As with many remedies based on traditional foods, the challenge is to create a formulation or derivative that will be more absorbable and effective (Jager et al., 2014).
Scientists have focused on curcumin, which includes three antioxidants called curcuminoids. As a supplement, curcumin is safe at doses of up to 10 grams a day (Abdollahi et al.,2017). Note: The spice turmeric is only two to three percent curcumin. Extracts tend to be 95 percent curcumin.
Fat is Where It’s At
We need to consume curcumin with fat to obtain its nutrients — whole turmeric root actually contains oil. Traditionally the spice was also mixed with coconut oil, ghee, or olive oil.
In mice, researchers loaded tiny molecules of fat, called nanoparticles, with curcumin and saw a decrease in pro-inflammatory compounds called cytokines in their blood (Wang et al., 2015).
Black pepper, and a compound extracted from it called piperine, also seems to boost the bio-availability of turmeric and curcumin.
So it’s a good idea to find a supplement that includes compounds to improve absorption.
But a turmeric-flavored salmon curry with coconut milk, slightly sweet or as spicy as your family craves, has its own charms, and we recommend this version as well!
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Aggarwal BB, Yuan W, Li S, Gupta SC. Curcumin-free turmeric exhibits anti-inflammatory and anticancer activities: Identification of novel components of turmeric. Mol Nutr Food Res. https://pubmed.ncbi.nlm.nih.gov/23847105/ Published September, 2013.
Jäger R, Lowery RP, Calvanese AV, Joy JM, Purpura M, Wilson JM. Comparative absorption of curcumin formulations. Nutr J. https://pubmed.ncbi.nlm.nih.gov/24461029/ Published January 24, 2014.
Mbese Z, Khwaza V, Aderibigbe BA. Curcumin and Its Derivatives as Potential Therapeutic Agents in Prostate, Colon and Breast Cancers. Molecules. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6930580/ Published November 30, 2019.
Perkins K, Sahy W, Beckett RD. Efficacy of Curcuma for Treatment of Osteoarthritis. J Evid Based Complementary Altern Med. https://pubmed.ncbi.nlm.nih.gov/26976085/ Published March 14, 2016.
Sun J, Chen F, Braun C, et al. Role of curcumin in the management of pathological pain. Phytomedicine. https://pubmed.ncbi.nlm.nih.gov/30195871/ Published April 17, 2018.
Wallace IJ, Worthington S, Felson DT, et al. Knee osteoarthritis has doubled in prevalence since the mid-20th century. Proc Natl Acad Sci U S A. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584421/ Published August 14, 2017.
Wang Z, Jones G, Winzenberg T, et al. Effectiveness of Curcuma longa Extract for the Treatment of Symptoms and Effusion-Synovitis of Knee Osteoarthritis : A Randomized Trial. Ann Intern Med. https://pubmed.ncbi.nlm.nih.gov/32926799/ Published September 15, 2020.
Wang J, Wang H, Zhu R, Liu Q, Fei J, Wang S. Anti-inflammatory activity of curcumin-loaded solid lipid nanoparticles in IL-1β transgenic mice subjected to the lipopolysaccharide-induced sepsis. Biomaterials. https://pubmed.ncbi.nlm.nih.gov/25890744/ Published March 20, 2015.
Xu XY, Meng X, Li S, Gan RY, Li Y, Li HB. Bioactivity, Health Benefits, and Related Molecular Mechanisms of Curcumin: Current Progress, Challenges, and Perspectives. Nutrients. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6213156/ Published October 19, 2018.