Fortifying the Foundation: Supporting Bone & Joint Health

by Lisa Schofield | May 6, 2021

Something is only as strong as its structure—and in the case of bones and joints, structural integrity status is critical. Here’s a look at how supplements help preserve mobility.

We are getting back to work and back to life. If COVID-19 has any silver lining, it brought self-care and preservation to the spotlight—a potential boon for the natural health product industry.

Conventional perceptions of condition-specific supplements are metamorphosizing into fresh relevance. For example, the brain health category isn’t just for older people who want to reduce risk of dementia—brain support supplements are desirable tools for increasing studying and work productivity, gaming and sports endeavors.

Similarly, bone and joint health isn’t just for post-menopausal women who want to reduce risk of fracture in elderly years—it is now perceived as a category that promotes robust physicality and enduring grace of movement.

“Not only are consumers more interested in their health and wellness, they are going to be looking for opportunities to support their mobility,” emphasized Niki Kennedy, senior manager, strategic insights & analytics, Glanbia Nutritionals, Illinois. “Formulators should be thinking about the full spectrum of consumer mobility. Not only are over half (57 percent) of surveyed consumers in the U.S. more conscious about their weight but one in five consumers are exercising more than they did previously, according to FMCG Gurus COVID-19 survey conducted in February 2021. Proactive approaches to bone and joint health provide a unique opportunity now.”

Shil Kothari, CEO, IminoTech Inc., Nevada observes that the market for bone and joint health products is expanding, both in terms of demographics and consumer interests. “The traditional market of older consumers and the focus on relief and restoration has broadened to include younger consumers primarily interested in maintenance and issue prevention,” he stated.

However, he continued, the industry has not kept pace with the consumer shift toward prevention, especially for joint health. The industry’s leading products—glucosamine, chondroitin, certain vitamins and minerals and collagen—support the building blocks for joint repair, but they do little to address the inflammation that often causes joint damage. There are newer ingredients that have been researched and marketed expressly for the management of inflammation in joints.

“Although supporting the structure of the components of joints is critical to ensuring they remain viable, addressing high inflammation is a primary area of joint health that should not be overlooked or simply addressed with NSAIDs (non-steroidal anti-inflammatory drugs),” commented Annie Eng, CEO, HP Ingredients, Florida.

Market research statistics seem to support the renewed growth of the natural bone/joint support market. According to David O’Leary, commercial manager—Marigot Ltd. Cork, Ireland, the market is expected to continue at a CAGR of between 6 to 7 percent for the period 2019-2024. “Persistence Market data shows that the category was valued at $21,323.8 million in the year 2017, while by the end of 2026, the global market for bone and joint health supplements is likely to reach a valuation of $41,458.9 million,” he cited.

Zainulabedin Saiyed, PhD, associate director of strategic business development at California-based Lonza, asserted that “the market demand is compelling.” Lonza’s proprietary research indicates that 70 percent of dietary supplement consumers are likely to take a supplement for joint health, and the global, $10 billion joint health supplement market is projected to grow at a CAGR of 6.6 percent from 2019 to 2024.

Lonza’s research, he continued, shows that an almost equal percentage of Millennials (37 percent) and Baby Boomers (38 percent) are likely to be interested in joint health. He described, “While 50 to 65-year-olds look to maintain flexibility and seniors are likely to prioritize reducing joint pain and improving mobility, health-conscious Gen Z are better-informed than any previous generation about the importance of supporting health throughout life, including their joints. Many in Gen Z are looking for joint health solutions that support their active lifestyle, which may involve regular high intensity workouts with goals of beating their personal bests.”

All this said, preserving aging bones and joints remains a priority among millions, pointed out Richard Kozlenko, DPM of GCI Nutrients, California. “The bone and joint supplement category is immense with growing attention as the population ages and more understanding of how we must be far more proactive in protecting and managing bone and joint degenerative diseases such as osteopenia, osteoporosis and arthritis.”

He added that the category is not just tablets and capsules, consumers are supporting bone and joint health with functional foods such as bone broths and collagen.

Prior to the COVID-19 outbreak, collagen was one of the hottest ingredients as new applications were being studied and introduced, according to Samantha Ford, MS, director of business development, AIDP, Inc., California. She reported that marketers and brands were launching collagen beverages, snacks and functional foods, and condition-specific formulations with other actives for bone and joint support. “While consumers shifted focus to immunity, some of these products lost the fanfare. However, we are seeing customers returning to collagen as consumers continue to take control of their overall health,” she observed.

Collagen, which is primarily animal based, dominates the sector along with glucosamine/chondroitin but there is an emerging trend of plant-based bone- and joint-health ingredients, according to Karen Dhanraj, technical marketing and sales manager, Toronto, Canada-based Lallemand Bio-Ingredients.

“Collagen is en vogue and a valuable health promoting ingredient to develop successful nutritional products,” observed Angie Rimel, marketing communications manager North America, GELITA, Iowa. Rimel explained that the recent emergence of collagen’s popularity with consumers has increased the awareness of the importance of the intact composition of the collagen matrix proteins in the white tissue. The musculoskeletal system is connected and protected by a network of connective tissue (aka “white tissue”—fascia, tendons, ligaments, cartilage, bones and skin) formed mainly by the body’s most abundant protein: collagen.

One overlooked plant-based option for bone health is vitamin D. “The existing research proving equivalent efficacy of vitamin D2 to vitamin D3 is often overlooked,” stated Dhanraj. “While formulators may be most familiar with vitamin D3, which is chemically extracted from sheep’s wool, they should consider that their consumer base of vegetarians and vegans is expanding. Why not reach for the plant-based, vitamin D2?”

For example, he elaborated, “a natural vitamin D2 yeast is just as bioavailable and has the same effect on vitamin D blood levels as synthetic vitamin D3. It has been proven in many studies. This would allow the formulator to create an effective product suitable for all.”

Recent scientific literature shows value of zinc, magnesium and manganese in supporting bone health—and these are also available as plant-based natural options, according to Dhanraj, who explained that zinc is necessary for proper bone mineralization, magnesium has been proven to improve bone mineral density in menopausal women, and when combined with calcium, manganese (a co-factor for several enzymes in bone tissue) is more beneficial to menopausal women than calcium alone.

There are more reasons why turning the spotlight back onto formulating for bone and joint health has never been more timely—the slow return to full openings means people are getting out and about. Added weight after a year-long sedentary period can mean achy joints and reduced flexibility. “It’s a great time to develop supplements for any condition based on the needs of consumers coming out of COVID-19,” said Kennedy. “The majority are focused on getting active and healthy again and maintaining their health.”

Kothari agreed, citing a 2021 American Psychological Association survey of more than 3,000 U.S. adults, of which 42 percent reported undesired weight gain averaging 29 pounds over the past year since the start of the pandemic (Millennials reported the largest average weight gain—41 pounds). “Excessive weight is a bone and joint stressor, which may be compounded as individuals hit the gym and the trails to lose weight. We expect consumer demand for bone and joint health support to increase as consumers address unwanted weight gain of the past year,” he said.

Lalit Sharma, innovation manager food/nutraceuticals, Ohio-based Omya Inc./Omya International AG, underscored that there has never been a greater interest among the global population in healthy aging “due in part to the pandemic and increasing awareness of the need for preventative measures.”

Mintel research released in March 2021 summarized the market and noted that while approximately 200 million people worldwide have osteoporosis, over the past five years, only 1 percent of new product launches have carried bone health claims. In Dhanraj’s opinion, “this represents a significant gap between a serious global need and reality. It may be that glucosamine/chondroitin, MSM and calcium still dominate the dietary supplement shelves, but here is a real opportunity for functional foods to step in and service all populations.”

Rizo commented, “There are several factors that influence formulators when developing bone-support formulas. Following multivitamin and mineral products, bone support supplements have probably the longest history of use in the dietary supplement industry. Most of these products still focus on calcium content because of its known relationship to bone health and the bulk of research demonstrating a benefit from calcium supplementation.”

Structural Support

Calcium, the king of the bone health kingdom, and its relatives magnesium and zinc, along with BFF vitamin D, remain highly relevant for supporting long-lasting and proper bone structure. Isabel Gómez, global marketing manager, Lubrizol Life Science, Barcelona, Spain, explained that the company’s LIPOCAL microcapsules are a water dispersible micronized source of calcium coated with lecithin. According to Gómez, this delivery system increases calcium dispersibility and absorption, thus providing an easy enrichment of various types of foods, beverages and dietary supplements with this essential nutrient.

Lubrizol Life Science’s MAGSHAPE microcapsules, she added, are a highly concentrated magnesium source, which can be used in many different applications due to its stability, flowability, compressibility and pleasant taste.

When it comes to calcium utilization in supplements, form matters, asserted Mayuresh Bedekar, director product strategy—bioactives, Glanbia Nutritionals. He related that globally, 153k tons of calcium ingredients are being formulated into nutritional supplements with 36 percent of the new product launches between 2015-2019 containing calcium in the form of calcium carbonate. “However, these other forms of calcium are limited and do not fully provide the body with what bones need for proper support. Consumers are generally aware that calcium sourced from milk is good for the body but it also contributes a host of other beneficial minerals that provide balanced mineral support for bone health.”

Glanbia Nutritionals’ TruCal is a balanced milk mineral complex delivering calcium plus six other minerals (phosphorus, magnesium, potassium, zinc, iron and copper) for supporting bone health. TruCal, he said, is shown to help improve bone density and strength. The minerals are sourced from bovine milk, delivered in ratios similar to the composition of bone. This natural balance supports the growth and maintenance of the bone structure.

The amount of calcium in the diet is only part of the calcium efficacy equation—the other part being bioavailability, Sharma pointed out. In 2020, Omya launched Omyaforte 100, a highly bioavailable source of calcium that offers a higher elemental calcium content and greater bioavailability, which has been shown in a recent peer-review study, he described.” Our ingredient contains 39 percent elemental calcium—almost twice as much as calcium citrate, which contains just 21 percent. Thanks to a patented recrystallization process, Omyaforte100 offers a new mineral composition and structure with high porosity, which allows for faster access to gastric juices in the stomach. The accelerated dissolution in acidic environments results in a quicker release of calcium ions, which are then ready to be absorbed into the bloodstream via the small intestine,” he explained.

Marigolt’s Aquamin is a natural, marine-sourced multi-mineral obtained from the cytoskeleton of the red algal Lithothamnion species. “Over the course of the aquatic plant’s life minerals are accumulated from the seawater and stored in the plant—74 components have been identified,” he said.

O’Leary explained that Aquamin has been extensively tested in human studies and proven to be rapid and effective at supporting comfort and movement, as well as promoting further walking distance and range of motion activities. Aquamin has also been shown to reduce the requirement for NSAID by up to 50 percent in subjects with moderate to severe joint degradation.

Calcium forms—gluconate, lactate and phosphate—need to be considered, advised Steve Holtby, president and CEO, Soft Gel Technologies Inc., California. He explained, “For people and others low in stomach acid, the ionized forms of calcium, such as chelate and citrate, tend to be more soluble and have a greater absorption rate.”

Holtby added that calcium citrate has other characteristics to consider as well—it is much more absorbable than calcium carbonate but contains only half as much elemental calcium and must be taken in larger quantities, resulting in larger pills. Calcium citrate can be used individuals taking acid-lowering drugs who may not be able to absorb calcium as easily.

Vitamin D, of course, is necessary for structural integrity of bone, but vegans may have problems attaining it, especially in wintertime. But there is a vegan friendly D, said Dhanraj: “Lallemand is the only company in the world who can make a vitamin D yeast. It’s completely natural and suitable for plant-based diets, either as a supplement or for food fortification. Lalmin brand of vitamin D is dried, fermented and inactivated whole cell yeast (Saccharomyces cerevisiae) containing naturally elevated levels of vitamin D. Subjected to UV-light under controlled conditions; the active yeast is able to produce vitamin D2 from its endogenous ergosterol. This is the same process that happens in human skin when we go out in the sun.”

Other Lalmin brand ingredients that can support bone health formulations include Lalmin Magnesium (containing 4 percent magnesium), Lalmin Zinc (containing 5 percent zinc) and Lalmin Manganese (containing 5 percent manganese). Dhanraj explained that magnesium contributes to electrolyte balance, affecting neurotransmission and muscle contraction, including heart muscle contraction. Adequate levels of magnesium are essential for the absorption and metabolism of vitamin D and calcium thereby supporting healthy bones and teeth. Zinc supports the mineralization of bone, and maintenance of skin, hair and nails. It’s known for strengthening the immune system and is also important for normal vision and reproduction. Manganese is a co-factor for several enzymes found in bone and is essential for the maintenance of bones and connective tissue. It also protects cells from oxidative stress.

GCI Nutrients’ Silidyn (choline orthosilisic acid), said Kozenko, allows for formulating supplements to focus on the architectural cells of bone mineral structure. This is the target area of various pharmaceuticals such as bisphosphonates, which may be necessary and offer solutions but also may have problematic side effects. GCI Nutrients’ Silidyn Choline orthosilisic acid was shown to upregulate osteocyte and bone mineralization, also the de novo synthesis of collagen one, which forms bones and tendons. “This is particularly ideal for people of vegan diets who would not partake in using animal collagen or bone broth,” he emphasized.

LJ100 Tongkat Ali (Eurycoma longifolia) from HP Ingredients, is an innovative ingredient that has been shown to support healthy bone structure—it is an herb, making it distinctive in this sub-category. For example, according to Eng, researchers found that LJ100, rich in active quassinoids, helped reduce degenerative changes of trabecular structure by improving bone volume, trabecular number and separation. A second study showed a significant inhibition of cells differentiation and maturation of osteoclasts as well as a significant down-regulation of RANKL-induced TRAP activity and expression of MMP-9, cathepsin-K, TRAP, NFATc1 and generation of superoxide and enhanced superoxide dismutase activity was observed in E. longifolia-treated cell cultures. “Results of another study suggested that LJ100 exhibited superior efficacy in stimulating bone formation via up-regulating the expression of various mitogenic proteins. And, in a six-week study, rodents given LJ100 showed restored bone volume in the femora,” Eng related.

HP Ingredients’ ParActin Andrographis paniculata contains andrographolide, a natural NF-kB inhibitor, significantly decreased osteoclast formation in the bone marrow via suppression of RANKL, which are responsible for making osteoclasts, according to Eng. In one placebo-controlled study, those in the ParActin group showed a significant increase in bone mass, trabecular thickness and number, and a decrease in trabecular separation compared to control mice. The authors concluded that andrographolide inhibits estrogen deficiency-induced bone loss in mice and may have supplemental potential for osteoarthritis. In an unpublished study, andrographolide induced osteoblast mineralization via COX-2 expression, showing a mineralizing effect on the bones with the increase of calcium deposits.

In an in-vitro study, A. paniculata suppressed RANKL-mediated osteoclast differentiation and bone resorption in vitro and reduced the expression of osteoclast-specific markers, including tartrate-resistant acid phosphatase, calcitonin receptors and cathepsin K.

Collagen is a star supplement as it also pulls double duty for beauty and skin health. And, as with so many other biochemicals, collagen production diminishes as we age.

According to Rimel, GELITA offers a diverse and versatile portfolio of bioactive collagen peptides to support white tissue health: FORTIBONE for improving bone mass density and supporting bone stability and flexibility. It promotes bone health and stimulates the anabolic process to produce new collagen. To support joint health and mobility, GELITA’s FORTIGEL is an innovative ingredient for the regeneration of joint cartilage as it stimulates production of collagen tissue in the cartilage. TENDOFORT collagen peptide nourishes tendons and ligaments.

KoACT is a patented collagen and calcium chelate from AIDP, which Ford said has been designed to improve bone strength by addressing the bone organic matrix. It provides calcium and collagen through a unique process that models natural bone structure, resulting in a synergistic effect of both nutrients into the bones, creating superior bone strength. “It is a step further than only supplementing with calcium, as in most bone health supplements currently on the market,” she commented.

AIDP, she added, also offers KollaGen II-xs, a type II avian sternum collagen that promotes healthy joint cartilage. Its proprietary, patented technologies maintain the integrity of the long chain amino acids that comprise the type II collagen, ensuring the body’s enzymes recognize the precise genetic code for maximum assimilation for ultimate joint health. KollaGen II-xs is standardized to provide 55 to 70 percent collagen type II and naturally contains 30 to 45 percent mucopolysaccharides (chondroitin, glucosamine and hyaluronic acid), the major components of joint cartilage. KollaGen II-xs supplies the body with more hyaluronic acid than any collagen products on the market, according to the company.

Lonza launched UC-II Non-GMO (genetically modified organism) Made with Organic Collagen, its new joint health ingredient “designed to resonate with consumers who care just as much about the efficacy of their supplements as they do about how they are made,” described Saiyed. UC-II Non-GMO Made with Organic Collagen is a joint health supported by numerous studies, and is clinically proven to reduce joint discomfort, and improve joint strength and flexibility in small once-daily, easy-to-swallow dose. “UC-II collagen’s proposed mode of action is to initiate immune cascades that use the body’s natural repair mechanisms in the joints, signaling your body to rebuild and repair joint cartilage,” he added.

Stratum Nutrition (Carthage, MO) manufactures and supplies NEM eggshell membrane, a partially hydrolyzed eggshell membrane ingredient for joint health applications. According to Jacqueline Rizo, Stratum Nutrition’s content coordinator. NEM is the only eggshell membrane ingredient supported by 16 research studies, including four randomized placebo-controlled trials (two of which are healthy person trials); four open label clinical trials (three of which are independent trials); veterinary trials, including one canine RCT; and a wide range of supporting in-vitro and in-vivo mechanism of action studies.

“In addition to the subjective endpoints like joint pain and stiffness, recent healthy population clinical trials have included objective endpoints via CTX-II, a cartilage degradation biomarker, giving the results additional credibility and substantiation. As a result, The Natural & Non-Prescription Health Products Directorate of Health Canada (NNHPD) recently approved updated cartilage protection claims, including one that specifically addresses CTX-II,” Rizo reported.

IminoTech’s Q-actin is a patented cucumber extract that clinical research shows can help support healthy joints. It is an iminosugar, an emerging class of biologically active carbohydrates that play an important role in the modulation of certain cellular functions. According to Kothari, a randomized clinical study shows that Q-actin improves joint function and reduces discomfort significantly better than glucosamine-chondroitin. “The trial evaluated 122 subjects with mild to moderate joint complaints over six months,” he said. “Participants taking 20 mgs of Q-actin daily showed significant improvement over those consuming 2,700 mgs of glucosamine-chondroitin.”

The opportunity to carve your space out in the expanding mobility-health category remains vigorous. So—get moving! NIE