Osteoarthritis (OA) of the knee joint is a crippling disease that affects the entire joint including the articular cartilage, bone, and soft tissues. It is the most common form of joint disease, and the main cause of musculoskeletal disability in the aging population group. OA is a very frustrating and painful condition that affects an individual's freedom of movement.

Osteoarthritis of the knee causes a roughening and thinning of the cartilage, the semi-hard tissue that sandwiches (cushioning) between the upper and lower leg bones. Knee cartilage is called 'meniscus' and forms a disk-like shaped cushion protecting the leg bones from impact during hinged movement. In the beginning stages of OA of the knee, and in progression of the disease, the meniscus develops cracks and gradually wears away. Physical symptoms resulting in pain, stiffness, grinding noises are noticed as bone rubs against bone.

Recently, a ten year nutritional study was conducted on 300 healthy, middled aged adults, who had no physical signs of knee joint pain or injuries. The study participants amounts and frequency of fruit consumption, as they are notably high in antioxidant vitamin C nutrition and water content, were estimated upon entry into the study period.

Ten years later, the study subjects were tested for cartilage volume, bone mass, cartilage defects and bone marrow lesions using magnetic resonance imaging (MRI). The lead investigative author of this published study, Yuanyuan Wang, Dept. of Epidemiology and Preventive Medicine, Monash University, Central and Eastern Clinical School, Alfred Hospital, Melbourne, Australia used MRI as a reliable visual tool to measure the results. MRI is currently the best, and most non-evasive, method of viewing joint structure in normalcy or in stages of disease.

This decade-long study indicated the impact of increased vitamin C levels on OA disease of the knee, by a lessening of bone marrow lesions, and reduction of bone size, both are important predictors of this disease, by 50 percent.

In a similar study conducted by Dr. Timothy E. McAlindon, a rheumatologist at Boston University Medical Center, published the results of an 8-year dietary investigation performed on 556 elderly individuals. McAlindon found those, whose knee x-rays showed signs of early stages of OA, were not as likely to experience the full-blown progression of the joint disease eight years later if their dietary intake and blood levels of vitamin D were higher than the recommended daily amount. Most of the participants in this study supplemented with vitamin D.

Dr. McAlindon, and other colleagues involved in this particular study, theorized that vitamin C may help repair and maintain collagen, a major component of cartilage. They also maintain a recognizable fact, among medical researchers, of vitamin D's positive, hormone-like affects on bone cells and growth, and that vitamin D may affect the surrounding bone material in joints as well. They agree that supplementation of vitamin D may be warranted for people who, geographically, live where they can not freely partake of it from the sun year round.

And, while I am in agreement with the importance of these promising new investigative studies, that focus on basic nutrient's protective and slowing down powers in relationship to joint disease with their increased intakes, why does adequate hydration levels seem to be, largely, ignored?

According to Dr. F. Batmanghelidj, M.D., Author of "Your Body's Many Cries For Water", states, "that arthritic joints and their pain are to be viewed as indicators of a water deficiency in the affected joint cartilage surfaces. In some arthritis pain, a salt shortage may also be a factor. The cartilage surfaces of bones in a joint contain a lot of water. The lubricating property of this 'held water' is used in the cartilage from the two opposing surfaces to freely glide over one another during joint movement".

While more dietary studies are certainly welcome, and would definitely be helpful in confirming earlier test study results, how might including the investigation of what most people drink every day have on the beneficial effects of nutrient therapy? Especially, as it is estimated that around three-quarters of the human population is walking around in a state of chronic dehydration. The reason seems to be because there are so many different types of home prepared (or manufactured) beverages competing with our voluntary choice in what to be drinking instead of pure water, and it is commonly considered not unimportant knowledge by most people, medically educated or not.

When a certain individual may not seem to be benefiting from nutrient therapy, alone, in the prevention of joint disease, how might increasing their pure water intake level effect the overall out come? As Dr. B points out, in his wildly popular self-help book, in his simplistic, educated, and 20 plus years of clinical experience using water as a medicine, water seems to be the glue-like fluid substance that binds all this other stuff together. Without adequate water levels inside the body, the healing effects of nature's basic nutrients will not be fully enjoyed or experienced.