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Range of Motion: The Joint Support Category Stretches Its Muscles © NIE

 

By Victoria Dolby Toews, MPH

We’re in the middle of the “Bone and Joint Decade”—which the United Nations, World Health Organization, and 37 countries proclaimed as 2000-2010 in recognition of the global problem of musculoskeletal disorders such as arthritis. This global initiative intends to improve the lives of several hundred million people with bone and joint afflictions worldwide; nutritional support can be a key cornerstone toward this goal.

In this country, the “baby boomers who are entering their 50s and 60s and beginning to develop osteoporosis and arthritis are the most obvious group concerned about these problems, but statistics show that younger consumers are also taking bone and joint health quite seriously. Among the general population, 71 percent are concerned about preventing arthritis or joint disease and 41 percent say they or a household member is currently managing joint pain or stiffness. Also, arthritis and joint disease is the number one condition that consumers say they would treat (68 percent) or prevent (69 percent) with supplements,” according to Carole Ruhnke, senior marketing manager, InterHealth Nutraceuticals (Benicia, CA).

“Joint care is one of the better performing segments of the supplement market today. Current retail sales are estimated to be over $1 billion and there’s a growth rate of 5 percent every year,” enthused Scott Steil, vice president of sales and marketing, Humanetics Corporation (Eden Prairie, MN). He added: “The U.S. population is aging and it is a fact of life that joint health decreases with age. Fortunately for aging consumers, the number of ingredients that improve joint health continues to grow.”

“It makes sense that consumers are willing to try supplements to manage their joint pain and stiffness: they are searching for effective products that will not cause side effects such as the ones caused by many Rx and OTC products, including NSAIDs (nonsteroidal anti-inflammatory drugs). Given the concern about joint health among numerous age groups, and consumers’ desire to turn away from OTC and Rx products that often come with significant side effects, the market for dietary joint supplements is almost certain to grow substantially over the next several years. This consumer interest is also fueled by concerns regarding the safety of certain Rx options,” said InterHealth’s Ruhnke.

Joint Rebuilders

Glucosamine and chondroitin lead the way as well-researched dietary supplements supporting joint health—they actually rebuild ailing joint cartilage. Glucosamine and chondroitin’s roles within the joint are similar and complementary—contributing to the manufacture of an essential joint substance called proteoglycans, which in turn acts as a spongy material to hold water in the joint and provide a springy resiliency. They have a proven track record taken alone or in combination.

The scientific evidence underpinning these nutrients remains so rock-solid that some osteoarthritis experts go so far as to contend that these supplements should be the first treatment attempted for osteoarthritis—definitely before the use of NSAIDs or other side effect-ridden conventional treatments. When a group of scientists tracked down every study of glucosamine and chondroitin conducted over a 22-year period, their review of the data found that both glucosamine and chondroitin do, indeed, show exceptional effectiveness in treating osteoarthritis.1

SAMe (S-adenosylmethionine) has been another go-to dietary supplement for joint problems for several years. This nutrient, which is related to the amino acid methionine, originally captured research attention as a treatment for depression. Subsequently, its potential for osteoarthritis relief came to light. Several large trials have now examined the role of SAMe in osteoarthritis; it is clear that SAMe is at least as effective as NSAIDs.2

Helping Joints
Via Immune Support

Another route to improved joint health comes from a poultry source. “Derived from chicken sternum cartilage, InterHealth’s patented ingredient UC-II consists of undenatured (native) type II collagen, a dietary ingredient that works with the immune system to promote healthy joints and increase joint mobility and flexibility— without producing the deleterious side effects that are often found in OTC and Rx products,” explained Ruhnke.

Ruhnke described how UC-II helps joints via a process called oral tolerization which “helps the body to differentiate between foreign invaders, such as bacteria, and elements that are good for the body, such as nutrients […] in the case of UC-II, small amounts taken orally have been shown to turn off the immune response targeted at the type II collagen present in bone joint cartilage.” This has moved beyond theory, with a study with osteoarthritic dogs showing “[…] that UC-II decreased overall pain by 62 percent.”3

From Horse to Man

“MSM (methylsulfonylmethane) is a relative of DMSO. Both nutrients had their first clinical successes with veterinarians and large animal owners. Horses were probably the first beneficiaries of MSM’s anti-inflammatory effects,” shared Jeremy Appleton, N.D., CNS, co-author of MSM – The Definitive Guide (Freedom Press, 2003) and adviser to Bergstrom Nutrition. “After the successes of veterinarians, George Bergstrom formed Cardinal Nutrition to bring MSM to the human market in 1989. Since then, its popularity has steadily risen, so that it now occupies the top tier of nutrients considered for joint health. Part of the reason for this increasingly high regard is that, like glucosamine and chondroitin sulfates, there is double-blind research published in reputable medical journals to back up the claims,” Dr. Appleton stated.

Botanicals to the Rescue

Herbal remedies enjoy a long and reputable history as original medicines; increasingly modern science backs up these traditional healers with new understandings of how and why they work. Take the case of boswellia. This botanical was highly regarded by ancient Ayurvedic medical texts in India for many varieties of joint ailments. It remains in use for these types of problems even today.

“Boswellia serrata extracts exert anti-inflammatory activity by inhibiting 5-lipoxygenase (5-LOX), a key enzyme for the biosynthesis of leukotrienes from arachidonic acid. We have seen a dramatic increase in the market for Boswellia serrata extracts with the introduction of our 5-LOXIN product. 5-LOXIN(R) is a new, patent-pending boswellia extract standardized to 30% AKBA content, which is the most potent boswellic acid,” said Eric Anderson, brands manager for Morristown,NJ-based PL Thomas. In part, solid research accounts for this increase in popularity, such as “a recent randomized double-blind placebo-controlled study of boswellia in 30 patients for 8 weeks that reported significant decrease in knee pain, increased knee flexion, and increased walking distance. The frequency of swelling in the knee joint was significantly decreased,” Anderson reported.

Research with botanicals such as boswellia continues, with a human clinical study on 5-LOXIN based on nearly 100 participants currently underway; results from this are expected before the end of the year, PL Thomas’s Anderson shared.

Another fascinating botanical with scientific support is Decursinol-50™, a product derived from the root of Korean angelica, a plant that has been used in Eastern medicine for more than a thousand years. As Michael Jeffers, VP sales & marketing for JLM Industries, Inc. (Tampa, FL) explained: “The best and brightest ingredient we have seen is Decursinol-50 TM which we launched in March, 2006. With full human clinical studies it is the only holistic remedy available to the US market that manages the pain pathway via the brain. All other remedies work topically or as an anti-inflammatory, which addresses the pathway to pain via the spine. Our strategy is to combine with glucosamine, thus this synergistic combination will address joint relief on multiple fronts.”

The research body of MSM stands on solid ground, such as a recent “randomized, double-blind clinical trial, published in the world’s leading osteoarthritis journal that found MSM (OptiMSM, Bergstrom Nutrition, Vancover, WA) significantly reduced pain and improved activities of daily living in people with osteoarthritis of the knee. They took 3,000 mg twice daily for 12 weeks, and pain levels were still decreasing at the end of the study,” noted Dr. Appleton.

In addition, “two studies from Japan, published in the last two years, have shown that MSM is a powerful anti-inflammatory agent, and can even modify the genetic expression of inflammatory mediators that are involved in a host of autoimmune diseases,” said Dr. Appleton.

Quelling Inflammation

Inflammation of a joint is the body’s natural response to damaged joint tissue, but this inflammation brings with it additional problems. Several dietary supplements address this key issue of subduing inflammation. “MicroLactin® is the product offered by Humanetics to meet this unmet market need of quick pain and inflammation relief,” commented Steil.

“MicroLactin is a unique milk protein concentrate, that produces a significant reduction in joint pain, and stiffness, resulting in improved joint function. It works by reducing the build up of neutrophils (inflammatory cells) in sore joint space…Our clinical data showed that MicroLactin improved joint health in two weeks (statistically significant),” Steil said.

MicroLactin has been the subject of two published, randomized, double-blinded, placebo-controlled clinical trials in subjects with clinically diagnosed osteoarthritis. Both trials provided statistically significant improvement in all measures of joint function versus a placebo—with significant improvement experienced in as little as two weeks of use. 4-5

New Promise for Relief

Some new products just entering the supplement scene come with great potential for joint relief. Next Pharmaceuticals already has several patented natural ingredients under its belt and is now debuting a new ingredient: Citrofen™. “We have been working on this product for about eight years and in my opinion, there is nothing currently in the marketplace that can compete with the results” seen with Citrofen, said Bob Garrison, president and CEO of Carlsbad, CA-based Next Pharmaceuticals.

“We just completed a double-blind clinical trial on the third generation of our anti-inflammatory called Nexrutine®. We are calling this iteration Citrofen™. It is a patented proprietary combination of an extract from Phellodendron amurense and an extract from orange peel. In this double-blind, placebo-controlled clinical trial with 80 overweight and normal subjects with knee osteoarthritis Citrofen™ demonstrated a highly significant reduction in the LAI. LAI is a standard index for measuring pain or discomfort at rest and during various activities,” shared Garrison.

Another recent product launch, by DSM Nutritional Products, is a patented ingredient called HIDROX®, which is a unique combination of olive polyphenols, containing especially hydroxytyrosol. “Animal and human clinical studies show that HIDROX may help support healthy joints by improving joint flexibility and movement,” explained Caroline Brons, senior marketing manager at DSM Nutritional Products (Parsippany, NJ).

With the numbers of joint diseases set to balloon as the Baby Boomers age, it is clearly the right time to get into the joint support category and help provide a measure of relief to this sea of discomfort. NIE

 

References:

1. Richy F, Bruyere O, Ethgen O, et al. Structural and symptomatic efficacy of glucosamine and chondroitin in knee osteoarthritis: a comprehensive meta-analysis. Arch Intern Med 2003;163(13):1514-22.
2. Najm WI, Reinsch S, Hoehler F, et al. S-adenosyl methionine (SAMe) versus celecoxib for the treatment of osteoarthritis symptoms: a double-blind cross-over trial. BMC Musculoskelet Disord 2004 Feb 26;5:6.
3. D’Altilio M, Gupta RC, Peal A, et al. Safety and Therapeutic Efficacy of Denatured Type II Collagen Alone, and in Combination with Glucosamine and Chondroitin in Arthritic Dogs, 45th Annual Meeting of the Society of Toxicology, San Diego, CA, Volume 90:1, Abs 1682, Pg 344, March 2006.
4. Zenk JL, Helmer TR, Kuskowskl MA. The effects of milk protein concentrate on the symptoms of osteoarthritis in adults: An exploratory, randomized, double-blind, placebo-controlled trial. Curr Ther Res 2002; 63(7).
5. Colker CM, Swain M, Lynch L. Effects of a milk-based bioactive micronutrient beverage on pain symptoms and activity of adults with osteoarthritis: A double-blind, placebo-controlled, clinical evaluation. Nutrition 2002;18:388-392.

 

For More Information:

• Bergstrom Nutrition, (888) 733-5676
• DSM, (973) 257-8288
• Humanetics, (952) 937-7660
• InterHealth Nutraceuticals, (800) 783-4636
• JLM Industries, (813) 632-3300
• Next Pharmaceuticals, (760) 602-4224
• P.L. Thomas, (973) 984-0900