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*Make simple changes to your diet and supplement programme

*Make simple changes to your diet and supplement programme. Osteoarthritis (OA) and cartilage loss are not inevitable consequences of growing older.

* Investigate food allergies. NSAIDs can make you more food-sensitive. Remove nightshades (potato, tomato, bell peppers, aubergine) from your diet.

* Increase your levels of antioxidants, particularly vitamin C, which is necessary for collagen synthesis. High levels can reduce the rate of cartilage loss by 70 per cent (Arthritis Rheum, 1996; 39: 648-56). Vitamin E (600 IU) can also help collagen breakdown in OA (J Am Geriatr Soc, 1978; 26: 328-30). Take both vitamins together.

* Take high doses of B vitamins, particularly niacinamide, or vitamin B3 (from 900 mg to 4 g, in divided doses), to increase movement in OA (J Am Geriatr Soc, 1955; 3: 927) - but only under medical supervision, as high levels can cause glucose intolerance and liver damage. Vitamin B12 and folic acid can help control pain (J Am Coll Nutr, 1994; 13: 351-6).

* Increase your levels of omega-3 fatty acids through fish, fish oils, omega-3 supplements and zinc.

* Supplement with Devil's claw (Harpagophytum procumbens), which can increase mobility (J Appl Nutr, 1987; 27: 45-50).

* Take boron, also shown to help with bone and OA (J Nutr Med, 1990; 1: 127-32). Dr Melvyn Werbach suggests that, as the minimum daily allowance for boron is still not established, patients should increase their consumption of boron-rich foods (vegetables such as soya, cabbage, lettuce and peas; fruits such as apples, dates, raisins and prunes; nuts, especially almonds, hazelnuts and peanuts).

* Try supplementing with glucosamine, the chief component of proteoglycans, a major building-block of cartilage, to rebuild damaged cartilage (Orthop Praxis, 1970; 9: 225). Research shows that it helps reverse the disease (Int J Tissue React, 1992; 14: 243-51; Clin Ther, 1980; 3: 260-72).

Glucosamine is often taken with chondroitin sulphate, one of the main glycosaminoglycans found in cartilage,as the two often work in synergy. However, when using intermuscular chondroitin, be wary of kidney/liver toxicity (Lancet, 1989; i: 1275).

* New Zealand green-lipped mussel extract may help (Lancet, 1981; i: 439).

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