Natural Products Insider

MAY-JUN 2018

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16 INSIDER May/June 2018 Joint health is not much different for sports nutrition consumers than it is for the average person. Pain, stiffness and infl ammation are the symptomatic complaints in both populations, but dietary supplement companies selling to consumers in the United States are limited to talking about temporary discomfort from activities to avoid disease claims. Where sports nutrition consumers' joint concerns differ is in the regularity of strenuous activities and the need to recover quickly enough to maintain exercise and competition schedules. Joint Protection Building Blocks One approach to supporting joints for exercise is to deliver ingredients that are naturally found in joints, including the cartilage that protects the ends of the bones inside of joints. In joint health, glycosaminoglycans (GAGs) are polysaccharides that combine with certain proteins called proteoglycans to form hydrated gels that support connective tissues to help cushion joints. GAGs important to joint health include chondroitin sulfate, keratin sulfate, heparin sulfate and hyaluronan. A 2015 research review of 43 randomized, controlled trials on adults (N=9,110) with joint problems (knee, hip and hand osteoarthritis [OA]) found a small to moderate improvement in pain and associated symptoms with chondroitin sulfate supplementation versus placebo.¹ The researchers noted chondroitin improved knee pain by 20 percent; the benefi t was also seen when chondroitin was combined with glucosamine, a polysaccharide the body uses to make GAGs. Most GAGs are sulfated. In cartilage extracellular matrix (ECM), GAGs and proteins are connected by disulfi de bonds. Methylsulfonylmethane (MSM) is not a GAG, but can contribute sulfur to cartilage. A 2017 research publication showed a combination of MSM, glucosamine and chondroitin sulfate improved joint pain associated with OA, compared to both placebo, and glucosamine with chondroitin. 2 The researchers measured symptoms using visual analog score (VAS) and Western Ontario and McMaster osteoarthritis index (WOMAC) pain score, a standard questionnaire for scoring knee and hip pain, stiffness and function caused by OA. On its own, MSM helped manage post-exercise joint health. A 2017 research publication reported healthy female runners in the 2014 Portland half-marathon who took MSM (as OptiMSM ® , from Bergstrom Nutrition) 21 days prior to and two days following the race had reduced muscle and joint pain. 3 A subsequent study on half-marathoners confi rmed the signifi cance of this benefi t from OptiMSM supplementation, and concluded MSM may be effective at reducing exercise- induced joint pain. 4 Hyaluronan, known commonly in the nutritional market as hyaluronic acid (HA), is the only nonsulfated GAG in the joint, where it serves as a lubricant. Most research showing joint health benefi ts from HA involved injections into the joint space, but some studies show similar benefi ts from oral supplementation. A Japanese trial of knee OA patients demonstrated four weeks of oral supplementation with HA (as Hyabest ® J, from Kewpie Corp.) improved WOMAC scores. 5 A subsequent long-term trial found oral Hyabest supplementation for 12 months in OA patients improved Japanese Knee Osteoarthritis Measure (JKOM) scores, compared to placebo. 6 Researchers noted, the younger the patient, the better the response to HA. Eggshell membrane has become a popular dietary supplement source of GAGs—including chondroitin sulfate, HA and sulfated glycoproteins. Research showed natural eggshell membrane supplementation (as NEM ® , from Stratum Nutrition) reduced pain and stiffness in OA patients. 7,8 In addition, a recently published placebo-controlled trial showed NEM supplementation in healthy, postmenopausal women reduced exercise-induced cartilage turnover after one and two weeks of exercise. 9 The subjects experienced no immediate difference in joint pain, but supplementation resulted in improvements to immediate stiffness, recovery stiffness and recovery pain compared to placebo. In another trial, moderately active adults taking hydrolyzed water-soluble egg membrane (as BiovaFlex ® , from Biova Ltd.) for four weeks in a crossover format (treatment, washout, other treatment) had signifi cantly improved joint range of motion (neck, spine, hips and knees) compared to placebo. 10 Researchers further noted back pain was improved in the supplement group, as was joint function and comfort during both regular daily activities and increased physical activity. Sports Nutrition: Joint Health A primary focus for sports nutrition joint formulation is on ingredients found naturally in joints, including glycosaminoglycans (GAGs) like chondroitin and hyaluronic acid. Natural anti-inflammatories such as omega-3s and numerous botanicals comprise a growing category of joint health ingredients to watch for in sports nutrition research. More research is needed on active subjects undertaking exercise regimens to address the subtle differences between sports nutrition joint health and the wider joint market. Nutrition for Joints Discomforted by Exercise by Steve Myers INSIDER's Take One approach to supporting joints for exercise is to deliver ingredients that are naturally found in joints, including the cartilage that protects the ends of the bones inside of joints.

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