Many risk factors can affect your bone and joint health including how much nutrients you are taking in, physical activity, gender, size, tobacco and alcohol use, family history, hormone levels and mental health conditions. A joint is defined as where two or more bones are joined together. Joints can be rigid (skull) or movable (knees, hips and shoulders). Many joints have cartilage on the ends of the bones where they come together. Cartilage assists with the movement and protection of bones, preventing them from rubbing against each other. Eating a healthy diet and physical activity is important for your joints as it helps build strong bones and muscles and avoids injuries. With a busy lifestyle it is often difficult to ensure you are getting the correct amount of nutrients to maintain healthy bones and joints. Therefore the use of supplements can help achieve optimal bone and joint health.
Osteoporosis is a condition where bone density is reduced. Bones become porous and brittle and are prone to fracture. Osteopenia is when your bone density is less than normal but not to the extent where it will break easily.
Hormone related disorders that can trigger osteoporosis include overactive thyroid gland, disorders of the adrenal glands, reduced amounts of estrogen and testosterone, disorders of the pituitary gland and overactivity of the parathyroid glands.Other factors that increase the risk of osteoporosis include a family history of osteoporosis, a body mass index (BMI) of 19 or less, high does use of steroids for a long period, eating disorders, malabsorption disorders, medicines used to treat breast and prostate cancer and long periods of being inactive. Women are also at risk of osteoporosis as they experience bone loss later in life due to menopause.
Exercise is important for bone health as it causes muscles to contract against the bones, which stimulates the bones to strengthen. Combining weight bearing exercises (walking and jogging) and resistance exercises (free weights and weight machines) are ideal to maintain bone health. It is recommended that weight bearing exercises should be done 3-4 times a week for at least 30 minutes and resistance exercises should be done 2-3 times a week. Discuss your exercise schedule with your doctor to make sure your plan is suited for your requirements.
A DEXA (Dual energy x-ray absorptiometry) scan measures the mineral content of the bones and bone loss. These results can be used to provide detailed information about your risk for osteoporosis and fractures. It can also measure your body composition (muscle mass and body fat).
Rheumatoid arthritis is an autoimmune disease, whereby the immune system attacks the synovial membrane that encases and protects the joints. Many joints are affected at one time. Osteoarthritis occurs when the smooth cartilage joint surface wears out and usually begins in one joint area of the body.
Many people make health decisions based on generalised recommendations without ever truly understanding their bodies. A genetic test provides you with valuable insights into individual priority areas that should be considered for successful and sustained health outcomes. We now know that your genes don't work in isolation. Your genes work with each other, and within the environment of your body. Their functioning can be improved with your daily choices of dietary intake and exercise, as well as your living environment and stress levels. Personalised recommendations using this holistic approach to health gives insight into improving your long term health outcomes and potentially enabling both better prevention and treatment of joint and cartilage disease.
Abnormalities of the joints of the spine, associated muscles, tendons, ligaments and bones can result in pain. NSAIDs (non-steroidal anti-inflammatory drugs) are often taken to help alleviate inflammation and pain. NSAIDs often have negative side effects with long term use, therefore supplementation with natural alternatives work in a similar manner to reduce pain and inflammation without causing harm to the body.
Natural alternatives to reduce inflammation: Omega 3 fatty acids are found naturally in fatty fish such as salmon, trout, pilchards, sardine, fresh tuna (not tinned) and mackerel. It is often difficult meeting daily omega 3 requirements, therefore supplements are a convenient and consistent source of omega 3. Research has shown that omega 3 polyunsaturated fatty acids are the most effective anti-inflammatory natural compounds available. The active ingredients in omega 3 (EPA and DHA) assists with disrupting the inflammatory pathway preventing inflammation. It has been shown that supplementation with omega 3 can reduce inflammation in synovial cartilage. The recommended dosage is 1.5-3g of EPA and DHA per day taken with meals.
Resveratrol is a class of plant micronutrients called polyphenols. It functions as an antioxidant which helps to reduce inflammation. Food sources of resveratrol include blueberries, peanuts and in the skin of grapes (red wine). Several studies have shown that resveratrol protects cartilage and reduces the inflammation in knee osteoarthritis. A recommended dosage ranges from 50-500mg daily.
Curcumin is an active component in turmeric, which has powerful anti-inflammatory effects and is a very strong antioxidant. It is known to inhibit inflammation by suppressing various inflammatory pathways. Curcumin has a low bioavailability due to its water insolubility, therefore it is important to consume a good quality supplement. Supplementation with this nutrient has been shown to be beneficial in treatment of arthritis. The recommended dosage of curcumin is 400 mg/day. Caution should be taken when using this product if the patient is on anticoagulant medications or high doses of non steroidal medications.
Green tea has strong antioxidant properties and is used in the treatment of arthritic disease. Polyphenolic compounds (catechins and epigallocatechin-3) found in green tea assists with prevention of cartilage breakdown. The recommended dosage of green tea extract is 250-400mg.
White willow bark from the white willow tree is known for its properties to reduce pain and inflammation. White willow bark works in a similar manner to that of aspirin and is a good alternative especially with patients suffering from gastric side effects from aspirin. This nutrient reduces inflammation by blocking the inflammatory pathways in the body. Patients with peptic ulcer disease, poorly controlled diabetes, hepatic or renal disorders should take caution and consult their practitioners before using this nutrient. The recommended dosage of white willow bark is 240mg/day.
Black pepper has been shown to be beneficial for inflammatory diseases accompanied with severe pain such as rheumatoid arthritis. Studies have found that Piperine, the compound that gives black pepper that sharp taste, prevents inflammation and is almost as effective as prednisone which is a common drug used to treat arthritis.Black pepper consists of 5-9% piperine. Dosages of 5-10mg of piperine are often taken together with supplements such as turmeric and resveratrol to enhance absorption.
Boswellia serrata resin (Frankincense) is a gum resin extracted from the Boswellia trees. This resin possesses anti-inflammatory, anti-arthritic and pain relief properties. It is commonly used in treatment of inflammatory joint disorders. Combining this nutrient with curcumin has shown to have beneficial effects similar to that of diclofenac (voltaren) in treatment of osteoarthritis. The recommended dosage is 300-500 mg two or three times a day.
Type Ⅰ collagen is the most common type of collagen found in the body. It is prevalent in connective tissue such as skin, nails and hair. It accounts for 90% of the body’s collagen stores. Type Ⅰ collagen is also common in most supplements as it has a wide variety of benefits. Research has shown that this collagen may be used to increase development of bone mineral crystals.
Type Ⅱ collagen is a less common type of collagen found in the body. It is the main component of cartilage in joints such as knees and wrists providing structure and flexibility. Studies have found that supplementation with type Ⅱ collagen helped to reduce pain in patients with osteoarthritis in conjunction with acetaminophen (Panado). Type Ⅱ collagen structure is loosely packed compared to type Ⅰ collagen, therefore the body breaks down and absorbs this collagen more easily. More research needs to be conducted for type Ⅱ collagen benefits on healthy joint inflammation response, rebuilding of damaged joint cartilage and increases in range of motion.
Type Ⅲ collagen is the second most common type of collagen found in the body. It contains a singular alpha chain, while type Ⅰ and Ⅱ collagen have multiple alpha chains. It is found in muscles, blood vessels and organs such as the intestines and uterus. Type Ⅲ collagen assists with wound healing. Bovine collagen supplements provide a good source of type Ⅲ collagen.
Type Ⅴ collagen is found naturally in the cornea and assist with transmission of light. This type of collagen works together with type Ⅰ and Ⅲ and is responsible for optimal fibrillary formation (definition) and tissue quality in the body. Type Ⅴ collagen assists with bone health by supporting the bone matrix.
Type Ⅹ collagen is responsible for bone formation and can be found in joint cartilage. It has been found that people with a high amount of type Ⅹ collagen have a high risk of developing rheumatological disorders affecting bone and cartilage.
Bovine collagen contains type Ⅰ and Ⅲ and is responsible for for skin elasticity and hydration. Marine collagen contains type Ⅰ and Ⅱ and is thought to improve skin and cartilage health, UV protection and skin healing, but more research needs to confirm this. Collagen from chicken contains type Ⅱ and the eggshell membrane contains type Ⅰ and Ⅴ. Chicken collagen assists with joint, cartilage and ligament health by supporting the body's inflammatory response.
Collagen comes in many different forms including a powder, liquid and capsule type. The powder form generally consists of type Ⅰ and Ⅲ collagen and is 10g per serving. The liquid form also consists of type Ⅰ and Ⅲ collagen with 10g per serving. The capsule form consists of type Ⅱ collagen and is 1200mg per serving. There are exceptions to this, with a few products containing both type Ⅰ and type Ⅱ collagen but this tends not to be the norm.
The patented forms of collagen include Fortigel™, Peptan™ and AminoLock Sequence Technology™. It is important to look out for these types of collagen in products as they are scientifically based and of superior quality.
Fortigel™ is developed by Gelita and is an innovative ingredient for the regeneration of joint cartilage. Specific collagen peptides of Fortigel™have been proven to activate the growth of new cartilage by stimulating cells helping to ease joint discomfort and make the joints smooth and mobile. Fortigel™ stimulates a significant increase of cartilage tissue metabolism.
Peptan™ collagen, developed by Rousselot Health and Nutrition, is currently the world’s number 1 brand of collagen peptides (hydrolyzed collagen) confirmed by NutraIngredients State of the Industry Survey 2020. Hydrolyzed collagen is collagen that has been broken down into more easily dissolvable amino acids. This type of collagen has excellent digestibility and efficient absorption , making this product have a high bioavailability. This means that when Peptan™ is absorbed, it becomes highly available in our bloodstream, even as quickly as just one hour after intake.
AminoLock Sequence Technology™ developed by Genacol, provides a collagen that is ultra-hydrolyzed at less than one kilodalton (kDa), which is the lowest molecular weight in the world. Unlike hydrolyzed collagen (the body struggles to absorb), the peptides in AminoLock Collagen™ are small and cross the barrier of the digestive system more easily (superior bioavailability).
Unfortunately there are no vegetarian sources of collagen. However there are collagen booster products available that contain nutritional co-factors and specific amino acids which assists your body to build healthy and resilient collagen in conjunction with using the amino acids from your regular diet. These nutritional co-factors include vitamin C, zinc amino, chelate and manganese amino acid chelate, vitamin B6 and B7 and horsetail plant extract. The collagen booster products also includes the following amino acids source from clean, non-inflammatory plant-based sources: glycine and proline (2 main components of collagen), serine (involved in glycine formation), lysine (assists with conversion of collagen fibers in to their functional forms) and glutamine (important building block for collagen).
Collagen contains hydroxyproline amino acids which can increase the amounts of oxalate (waste product) in the body. Oxalates can cause kidney stones but the amount of hydroxyproline in collagen is unlikely to increase your risk. Patients with a history of having calcium oxalate kidney stones should avoid overuse of collagen supplements or adhere to the recommended dosage (5-6 g per day). Always consult your doctor if you are unsure if collagen supplements are safe for you. People with allergies to fish or chicken should also consult their doctor before taking supplements containing Type II collagen.
Calcium is a mineral that is associated with healthy bones and teeth. Food sources of calcium include dairy products (milk,cheese and yogurt), fortified plant based milks (almond, soy and rice), canned sardines with bones, almonds, winter squash, edamame beans and leafy greens (spinach, kale, bok choy and turnip). It is difficult for the body to break down calcium in the gut and absorption is often low from food sources, therefore supplementation ensures optimal absorption of calcium to meet daily requirements. Oxalates and phytates found in some plant foods (green leafy vegetables, soy products, tea, beans, nuts) bind to calcium and also reduce the absorption of this mineral. Therefore, it is important to avoid eating high oxalate and phytate rich foods with calcium. Studies have shown that higher intakes of calcium achieved through supplementation was associated with improved bone density and lowered the risk of hip fractures. The recommended dietary allowance (RDA) for calcium for women aged 19-50 years is 1000 mg daily, for women above 51 years is 1200 mg daily, for pregnant and lactating women 1000 mg daily, for men aged 19-70 years 1000 mg daily and men above 71 years 1200 mg daily.
Vitamin D is a fat soluble vitamin and is found in animal food sources such as salmon, herring, sardines, cod liver oil, canned tuna and egg yolks. Plant based sources of vitamin D include mushrooms which can synthesize vitamin D2 when exposed to UV light. Research suggests that Vitamin D also plays an important role in bone health as it regulates calcium in the blood by absorption of calcium from the gut. Vitamin D deficiency often leads to osteoporosis, fractures and mineralization defects which may lead to osteomalacia and muscle weakness in the long term, causing falls and fractures. Vitamin D supplementation may decrease bone turnover and increase bone mineral density.
Vitamin K is also a fat soluble vitamin and plays a function in assisting with blood clotting in the body. There is also evidence that this vitamin helps to keep bones healthy. Good sources of vitamin K include green leafy vegetables (broccoli and spinach), vegetable oils and cereal grains. Small amounts can also be found in meat and dairy products. Studies have shown that vitamin K can not only increase bone mineral density in osteoporotic patients but have shown to also reduce fracture rates.
Vitamin C (ascorbic acid) is an essential vitamin that must be obtained from the diet. It plays a role in growth, repair and development of all body tissues. Food sources of vitamin C include fresh fruit and vegetables, especially citrus fruits. This vitamin is known for its role in strengthening the immune systems but it also has an important function in bone health. Studies have shown that vitamin C was able to induce osteoblast (bone building) and inhibit osteoclast (bone breakdown) formation. Supplementation with vitamin C was found to reduce bone loss. Vitamin C is also needed for the synthesis and maintenance of collagen. It helps produce collagen as it has an active role in collagen synthesis.
Magnesium is an essential mineral found in the body. It is present in many foods (wholegrains, dark, leafy vegetables, legumes and nuts) and also as a dietary supplement. Magnesium serves as a cofactor in more than 300 enzymatic reactions, which include those responsible for blood pressure, glycemic control and the degradation of lipids. Magnesium also plays an important role in bone health. It has been shown that people with higher intakes of magnesium have a higher bone mineral density, which reduces the risk of osteoporosis and bone fractures.
Glucosamine and Chondroitin are structural components of cartilage (tissue that cushions the joints) and are produced naturally by the body. Research has shown that supplementation with glucosamine sulfate may provide some pain relief with people suffering from osteoarthritis of the knee. Oral glucosamine hydrochloride may reduce pain related to rheumatoid arthritis. As glucosamine supplements are derived from the shells of shellfish, there is a concern that this supplement may cause an allergic reaction in people with shellfish allergies. Chondroitin may also be effective in treatment of osteoarthritis. Studies have found that chondroitin may reduce the progression of osteoarthritis and also reduce pain associated with this disease.
S-adenosyl-methionine (SAMe) is a naturally occurring compound found in the body. It plays a vital role in the immune system, maintains cell membranes and helps to produce and break down chemicals (serotonin, melatonin and dopamine). Studies have shown that supplementation with SAMe, can help reduce pain associated with osteoarthritis. This nutrient has also been shown to improve fibromyalgia which causes muscle and joint pain.
Grape seed extract (GSE) is extracted from Vitis vinifera seeds and is rich in polyphenols (substances that are found in many plants and have antioxidant activity). Studies have shown that GSE has a positive effect on bone healing and improved mechanical strength of the healing bone. It has also been shown to have protective effects in osteoporosis, osteonecrosis (when blood supply to the bone is deprived) and inflammatory autoimmune arthritis.
Methylsulfonylmethane (MSM) is an organic form of sulfur which can improve various metabolic diseases when used as a dietary supplement. It is a potent antiinflammatory compound which reduces chronic inflammation and relieves pain. It is used as a dietary supplement with glucosamine and chondroitin sulfate to treat arthritis.
Serrapeptase is a proteolytic enzyme derived from the gut bacteria of a silkworm. Proteolytic enzymes break down proteins into amino acids. Serrapeptase breaks down non-living tissues in the body where there is inflammation and swelling, therefore reducing pain and inflammation. Studies have shown that this enzyme helps in the repair of bone lesions and speeds up the clinical healing process.