Twin research found heredity accounted for a small share of knee osteoarthritis. A former Mayo Clinic rheumatologist says the larger driver should be noticed
YORBA LINDA, CA, UNITED STATES, October 19, 2026 /EINPresswire.com/ — Patients diagnosed with knee osteoarthritis often assume they inherited it. Research on twins suggests that is largely not the case.
Dr. Nisha Manek, a rheumatologist who spent 12 years on the faculty at Mayo Clinic in Rochester, Minnesota, reviewed twin research in London that examined knee X-rays in identical and non-identical women.
Twin studies allow researchers to separate inherited traits from environmental ones, because identical twins share their genes and non-identical twins do not. If a condition is largely inherited, it appears far more often in identical pairs.
“We asked whether the strong link between obesity and knee osteoarthritis is explained by shared genes. That is, do people inherit the risk for both together, or can the link be modified through weight and lifestyle?”
“We were searching for a gene, because osteoarthritis is so prevalent,” Manek said. “Pick anybody on the street and a good proportion of them have osteoarthritis of the knee. The question was whether we could find something genetic to work with.”
The research found that genetics contributed very little.
“What contributes is weight, mechanics and metabolic factors,” Manek said. “What you are eating and what you are doing. That was a significant finding at the time, and I do not think it has reached patients even now.”
Manek said the practical consequence is that patients receive a diagnosis without a sense of what they can do about it.
“If a patient believes it is in their genes, there is nothing to act on,” she said. “It becomes something that happened to them. The research points the other way. It points at the things within reach.”
She said the finding sits awkwardly alongside the current discussion of weight in her field.
“There are colleagues in rheumatology who would put GLP-1 medication in the water supply, and I am not exaggerating,” Manek said. “I have said on stage that I am neutral to cautious. Those medications buy someone a window of three to six months. What matters is what they do with that window.”
She said her position is frequently misread in both directions.
“I am not opposed to these medications, and I do not prescribe them,” Manek said. “What I tell people is to be careful with the word “amazing” they hear from other enthusiastic doctors, and to pay attention to what is on their plate while the window is open.”
Manek left Mayo Clinic in late 2011 to study energy medicine and consciousness research from a physics perspective. She is the author of “Bridging Science and Spirit” and works with a small number of clients on the relationship between inflammation, environment, and stress.
You can learn more about Dr. Manek here: https://www.nishamanekmd.com
*Manek NJ, Hart D, Spector TD, MacGregor AJ. The association of body mass index and osteoarthritis of the knee joint: an examination of genetic and environmental influences. Arthritis & Rheumatism. 2003 Apr;48(4):1024-9. doi: 10.1002/art.10884. PMID: 12687544.
Dr. Nisha Manek
Nisha Manek, MD
+1 5072695252
nisha@nishamanekmd.com
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