Special edition: Joint health

Science: The emerging ingredients for joint health

By Stephen Daniells

- Last updated on GMT

Related tags: Joint health, Osteoarthritis

In the fourth part of our series on joint health, we look beyond glucosamine and chondroitin to the next generation of joint health ingredients.

Yesterday, we looked at the science supporting the joint health benefits of glucosamine and chondroitin, as well as omega-3 fatty acids. Today we look at other ingredients emerging in the area of joint health as alternatives to the natural product industry’s big hitters, or the pharmaceutical solution of non-steroidal anti-inflammatory drugs (NSAIDs), and their undesirable side effects.

Pine bark extracts

Several studies also report the potential of extracts from French maritime pine bark to reduce inflammation and pain associated with osteoarthritis. German researchers first reported such effects in 2006 using the branded Pycnogenol ingredient. The researchers looked at inhibition of the cyclooxygenase, COX-1 and COX-2 – enzymes that are well known to be responsible for inflammation and pain – and reported statistically significantly inhibition of both enzymes. (Biomedicine and Pharmacotherapy​, Vol. 60, pp. 5-9).

Two years later, Italian researchers reported in Phytotherapy Research​ (Vol. 22,pp. 518-523) that supplements of the pine bark extract may reduce the pain associated with arthritis of the knee by about 55 per cent. The study was a randomised, double-blind, placebo-controlled trial involving 156 patients with osteoarthritis and also indicated an improvement in all osteoarthritis symptoms by 56 per cent.

From trees to eggs to seaweed

With the joint health market growing it is no wonder that alternatives to the glucosamine/chondroitin combinations are emerging. At the tail-end of last year, Australian scientists reported that an extract from the shea tree​ (Vitellaria paradoxa​) may exert anti-inflammatory effects and reduce markers of osteoarthritis. The ingredient, called SheaFlex 70, was tested by researchers at the Australian Centre for Complementary Medicine Education and Research in Brisbane. The study was funded by BSP Pharma, the holder of the worldwide rights for the ingredient, and the findings were published in Phytotherapy Research.

Another emerging ingredient is an extract from the membrane of an eggshell​. According to findings from a randomised, multicenter, double-blind, placebo-controlled trial, a daily dose of 500 milligrams was found to not only reduce joint pain, but also stiffness, with effects noted after only ten days. The study, which was funded by Missouri-based ESM Technologies and uses the company’s ingredient, was published in Clinical Rheumatology​.

Irish company Marigot have also been investing in supporting the potential joint health benefits of its red seaweed​ ingredient. A trial published in the open access Nutrition Journal​ found that the natural, multi-mineral ingredient derived from the red seaweed Lithothamnion Corallioides​ may allow osteoarthritis sufferers to reduce their use of NSAIDs by 50 per cent.

Daily doses of Marigot’s Aquamin ingredient allowed patients with osteoarthritis of the knee to partially withdraw their use of non-steroidal anti-inflammatory drugs (NSAIDs), while also producing improvements in the range of motion of the knee, and during walking exercises, stated the article.

Others are also looking at seaweed extracts and Australian researchers recently reported that a blend of three seaweed extracts could improve measures of pain, stiffness, difficulty with physical activity and overall symptom severity were recorded following 12 weeks of supplementation (Biologics: Targets & Therapy​, 2010, Vol. 4, pp. 33-44). The study used Marinova’s Maritech branded ingredient, and is composed of extract of Fucus vesiculosis​ (85 per cent), Macrocystis pyrifera​ (10 per cent) and Laminaria japonica​ (5 per cent) plus vitamin B6, zinc and manganese. Marinova funded the research.

California’s InterHealth has also been funding research into the effects of its un-denatured type II collagen​ ingredient known as UC-II. Results of a recent trial by scientists from the University of California Davis report that the effects were superior to those recorded in previous clinical investigations for glucosamine and chondroitin.

Writing in the International Journal of Medical Sciences (​2009, Vol. 6, pp. 312-321), the UC Davis scientists reported that a daily dose of UC-II (40 mg) performed better than a combination of glucosamine (1500mg of glucosamine HCl, USP Grade) and chondroitin (1200mg, USP Grade), for reducing pain, stiffness and immobility associated with osteoarthritis.

New Jersey-based Proprietary Ingredients has also been building the science behind its cetylated fatty acid ​branded ingredient Celadrin. The ingredient has been reported to offer an alternative to NSAIDs when taken orally (J. Rheumatol.​ 2002, Vol. 29, pp. 1708-1712), and efficacy has also been reported for a topical application J. Rheumatol.​ 2004, Vol. 31, pp. 767-774). Results of a randomised clinical trial presented at the Scripps Integrated Medical Conference in San Diego in 2007 reported that the ingredient was effective at reducing knee pain in subjects with moderate osteoarthritis, compared with placebo.

Extracts from the Ayurvedic herb Boswellia serrata​ plant, also known as frankincense, have also shown potential to reduce inflammations and relieve the symptoms of arthritis of the knee. Boswellia serrata​ has a long history of use as an anti-inflammatory in Ayurvedic medicine. The extract contains boswellic acids including acetyl-keto-beta (AKBA), thought to be the most potent anti-inflammatory constituent.

Finally, an ingredient more at home in the bone health market – vitamin K​ – may also have potential in for reducing the risk of osteoarthritic knee problems by 40 per cent. Results of an epidemiological study published in Arthritis and Rheumatism​ (2006, Vol. 54, pp. 1255-1261), noted an association between high vitamin K intake and a lower incidence of osteoporosis.

The impact of regulation

Despite this considerable body of science, and particular support for glucosamine and chondroitin, this has not translated into a European Union-approved health claim. The reason being that osteoarthritis is not a healthy condition and that the evidence, therefore, shows no benefits for the maintenance of normal joints in humans.

The implications of these opinions for the joint health market will be discussed in the final article on the series, when NutraIngredients examines the regulations surrounding joint health.

To read the first part of this series, Glucosamine market reaching maturity​, please click here​.

To read the second part of this series, Supply: Joining the glucosamine supply gaps​, please click here​.

To read the third part in this series, Science: The benefits of glucosamine and omega-3​, please click here​.

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