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Move It!

Bone, Joint, and Muscle Health Bone, Joint, and Muscle Health
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Maintaining the ability to be active without pain or limitation is the goal for millions of Americans. Considering three key areas that contribute to movement can help.

We all marvel at performance athletes such as gymnasts, even though many of us don’t feel the need to be that flexible or powerful. However, for millions of Americans with some type of discomfort issue, the idea of moving without the limited mobility or discomfort is always top of mind.

The skeletal system, articular (joint) system, and musculature all work together in harmony, and to varying degrees. Consumers are becoming savvy, wondering if, for example, a bone-support supplement is enough.

Consider that we all perform conscious and subconscious movement: the first involves such activities as going to the refrigerator to start making that summer salad; the latter involves placing a hand on a refrigerator shelf and drumming on it with fingers while concentrating on what exactly needs to go into that salad. And while it may appear at first blush that the latter can’t possibly cause any pain, for those with any ailment from shoulder bursitis or elbow rheumatoid arthritis, or pulled tendons and ligaments, that simple act can cause quite the wince.

“For most people,” asserted Oliver Wolf, global marketing and communication, GELITA, headquartered in Germany, “healthy aging is associated with staying active and mobile because, once we lose our autonomous ability to run, walk or drive in a car, we lose our personal freedom.”

And any consumer may experience issues with muscles, soft tissues, joints and/or bones in any combination at once.

“We are starting to see a shift in thinking away from the reductive view of health, and toward one which is more holistic and understands the body as highly interconnected,” observed Tim Hammond, vice president sales and marketing for Washington-based Bergstrom Nutrition. “So instead of focusing on one aspect of health, like joint pain or muscle strength, consumers now view the ability to remain healthy and active as the end goal and are starting to gravitate toward products that improve well-being and functionality.”

Indeed, Eden Somberg MS, LAc director of business development, AIDP in California, strongly agreed that healthy and active consumers of all ages have created a robust market demand for nutraceutical products that support their lifestyles. She has observed significant changes on retailer shelves that were dominated by simple calcium capsules and fish oil soft gels but have been overtaken by “flavorful stick packs, effervescent powders, chocolate chews and gummy formats with brighter, broader consumer appeal, great taste and resulting brand loyalty.”

In essence, then, form supports function. The next challenge is considering how to effectively address—formulate—cohesively for this interrelated condition-specific trio. Typically and sensibly, nutraceutical products are formulated to address each issue. This remains a viable formulation option, as, for example according to Nena Dockery, technical services manager for Stratum Nutrition based in Missouri, there are distinct needs. Middle-aged women are primarily concerned with maintaining healthy bones, and young athletes tend to be primarily interested in maintaining, and building, strong muscles. Further, she observed, consumer interest in joint-support products usually emerges following years of wear and tear that noticeably affects movement. “Often, however, consumers don’t realize how connected these three areas—bones, muscles and joints—actually are,” she said.

Another reason that products still need to remain a singular condition support is that the amount of active ingredients needed to impart efficacy is usually so large that it is frequently prohibitive for a formulator to develop a combination product that can live up to label claims. Plus, there are cost constraints regarding formulating products containing well-researched ingredients.

Therefore, stated Dockery, for the purpose of formulating to support healthy mobility, the ideal product may possibly be packaged as a system or pack. “But this would require education regarding the advantages of viewing healthy overall movement as the ultimate goal,” she noted.

Max Motyka, consultant to Utah-based Albion agreed. “Products formulated to support good mobility need to be placed into systems or packs because the effective dosages of ingredients known to help bone, joint, and muscle support can’t normally be placed in a single dosage unit,” he explained. “In addition, different ingredient groupings can be targeted at particular mobility problems, and so they needed to be in different packs. Some of the ingredients need to be in soft shell capsules in large volume, and a variety of other dosage issues.”

Movement Through the Ages

It was not too long ago when joint and bone support supplements were considered for “old people,” and muscle-support products were the province of “bodybuilders.” So much has changed, and quite rapidly so.

Baby Boomers do remain the ultimate audience for bone and joint support supplements—as the concept of being able to remain active and discomfort free is paramount to this age group. “For Baby Boomers, products that can increase mobility and decrease pain are most important,” observed Hammond. “For Gen-Xers, the priority is health maintenance and disease prevention. And Millennials view bone, joint and muscle support as a critical part of a broader lifestyle, also valuing products that appear more natural and less pharmaceutical,” he said.

According to Sue Hewlings, PhD, chief science officer for IgY Nutrition of Oklahoma, The prevalence of osteoarthritis increases dramatically with age and is projected to increase at an even greater rate as a result of the disproportionate aging of the population and increased life expectancy. WHO (World Health Organization) states that 25 percent of adults 65 and over suffer from a musculoskeletal condition, and OA (osteoarthritis) affects approximately 9 percent of American adults by the age of 60.

In addition, Aparna Kalidindi, PharmD, BCPS, technical sales and marketing manager for Natreon, Inc. in New Jersey, pointed out that the growing incidence of obesity, sports injuries and consumer awareness has led to a growing market for joint health supplements. The joint health supplements market is predicted to hit $9 billion globally by 2017.

When it comes to younger generations, Hammond queried, “The bigger question that looms for the future is what effect the continued rise of obesity rates may have on Gen-Xers and Millennials?”

The younger generations are seeking to push the limits and maximize strength and performance while maintaining healthy weight, Somberg observed. This is where industry sees a surge in protein consumption in a wide range of formats—shake mixes, bars and beverages. “While healthy weight is a functional category that spans all generations, structural integrity of the body (of bones, joints and muscles) except in unusual cases, is correlated directly to age,” she said. “As populations age, we want to retain our mobility and strength. The current adult populations are physically active, educated and interested in solutions to extend and enrich quality of life.”

According to Wolf, teens and those in their 20s are endeavoring to stay healthy and fit; teenagers often turn to sport as a way to gain muscle mass, reduce weight or support body toning. “Young adults tend to push themselves, test their personal limits and set goals. To meet the needs of this target group, nutritional choices that enhance the positive effects of resistance training can play a key role,” he observed.

Steve Holtby, president and CEO of Soft Gel Technologies, Inc., in California, is one who also sees younger people more concerned today about maintaining fitness for long-term health. “Healthy aging isn’t an exclusive concern of just Baby Boomers and older consumers. Millennials are taking a personal interest in their health and are increasingly driving sales in health care categories. To Millennials, health is increasingly about living a happier life—they have a more holistic approach to health.”

Ingredient Options

When formulating a supplement support system for healthy mobility, there is a wide variety of science-backed, sophisticated raw materials to choose from.

Bone/Skeletal Support

AIDP: KoAct, described Somberg, is a patented calcium collagen chelate. “Calcium still provides the core strength here—and its structural integrity. And giving it a measure of flexibility and supporting the living tissues in the bone, is collagen,” she said. A year-long study of individuals taking KoAct resulted in statistically significant impacts on bone biomarkers and protection against bone mineral density (BMD) loss.

Albion: Calcium Bisglycinate Chelate is, according to Motyka, a fully reacted mineral chelate that is one of the most bioavailable forms of calcium. Each calcium molecule is bound to two glycine molecules through Albion’s patented chelation process, transforming it into an amino acid chelate that has nearly twice the absorption rate of calcium citrate or calcium carbonate, he pointed out. The amino acid chelating agents promote the assimilation of the calcium into the cells, which helps facilitate the Krebs energy cycle. The chelate structure is then confirmed through FT-IR spectroscopy testing.

DimaCal’s buffer capacity leads to significantly less gas creation and acid rebound than with calcium carbonate. Albion’s DimaCal is structured with two moles of calcium attached to one mole of malic acid. “Research studies showed DimaCal was significantly better absorbed than calcium carbonate and maintained elevated serum calcium levels for a much longer period of time. While not water-soluble, DimaCal is soluble at more acidic pH levels,” Motyka explained.

Because common foods and beverages typically reduce the absorbability of added calcium, Albion’s Calci-K is designed to fortify liquid food products; it blends calcium, potassium and phosphorus molecules into a patented, easily absorbed complex. Research results found that Calci-K’s absorption rate is not reduced when taken with milk, Motyka noted. Calci-K is also able to maintain complete dispersion in liquids at a pH between 3.5–8.0. No additional suspending agents are required.

Bergstrom Nutrition: OptiMSM displays a broad utility in healthy mobility, said Benjamin. He pointed to preliminary studies showing that MSM supports biochemical signaling that helps support development and density of bone.

GELITA: FORTIBONE said Wolf, stimulates osteoblast activity to increase the production of the extracellular bone matrix, which is the essential framework for calcium mineralization. In addition, it regulates the degenerative processes that affect bones by reducing osteoclast-based protease production. FORTIBONE supports overall bone stability and flexibility. Numerous studies, he asserted, have addressed the impact of collagen peptides (as found in FORTIBONE) on bone density, and in the metabolic and degenerative processes involved in bone formation and mineralization. As far as utilization, “As a clean label and easily digestible food product, non-allergenic FORTIBONE can be used in a wide variety of foods, such as dairy products, functional foods, food supplements and beverages,” Wolf said.

Peptan: According to Mai Nygaard, global director for Peptan, Netherlands, both in vitro and in vivo studies have revealed Peptan’s efficacy in improving bone metabolism and biomechanical parameters through stimulating the endogenous production of collagen and improving bone mass density and bone strength. An animal study indicated that Peptan collagen peptides help to restore bone mineral density and improve bone microarchitecture and solidity. In a follow-up study, Peptan exerted the same benefit on bone health in older animals. Peptan has also been found to trigger osteoblasts and to reduce bone resorption. “Bone health benefits can be further strengthened when combining collagen peptides with calcium and vitamin D to have a synergistic effect,” she suggested.

Stratum Nutrition: ESC eggshell calcium contains around 37 percent elemental calcium in the form of calcium carbonate; but unlike most calcium carbonate ingredients, Dockery pointed out, it also naturally contains transport proteins that help ensure that the calcium is bio-accessible for intestinal absorption.

“One of the biggest advantages of ESC is its inherently low levels of lead and other heavy metals. Most naturally derived calcium forms also contain unacceptable levels of heavy metals, particularly lead, which must be removed during processing,” she explained. “ESC does not have to be subjected to additional processing as these heavy metals are present in levels 50 times less than the stringent California Proposition 65 minimums.”

Joint Support

AIDP: KollaGen II-xs, according to Somberg, is a patented and clinically researched highly bioavailable type II collagen, processed to maintain the intact forms of collagen compounds to support healthy cartilage integrity and synergistic function. KollaGen II-xs “is easily water soluble, providing an opportunity for inclusion in beverages and powder formulations,” Somberg noted.

Bergstrom: According to Benjamin, results from a double-blind, placebo-controlled study of 100 individuals with knee or hip OA, that was recently published in The Journal of Orthopedics, showed distilled MSM significantly improved all WOMAC subscale and SF-36 daily living scores after 26 weeks of supplementation. The authors concluded, “MSM improved all physical symptoms in the WOMAC scale during the short interventions without any adverse events.”

GELITA: “Comprising optimized Bioactive Collagen Peptides, FORTIGEL has been scientifically proven to measurably stimulate the synthesis of cartilage tissue,” stated Wolf. “After oral administration, FORTIGEL passes the mucosa, enters the bloodstream in an intact form and subsequently accumulates in the joint cartilage. Once in the cartilage, FORTIGEL stimulates the cartilage cells (chondrocytes) to increase the production of both collagen and proteoglycans—the two major components that make up approximately 90 percent of cartilage’s dry mass.” FORTIGEL is suitable for use in most foods, including dairy products and drinks, as well as in dietary supplements.

IgY Nutrition: According to Hewlings, IgY Max is much like a prebiotic in that it changes the composition and activity of the microbiome. IgY antibodies contained in IgY Max help the body eliminate only the harmful bacteria and leave the good microbes intact. IgY antibodies are antibodies from chicken eggs. They work by significantly reducing harmful bacterial adhesion and growth in the GI (gastrointestinal) tract, helping to minimize inflammation by decreasing cytokines and HSCRP. “In an open label study, individuals with arthritis showed significant improvement in Physician Global Assessment score after 30 and 60 days of taking 4.5 g IgY max daily,” she noted. “Further, improvements remained 30 days after the individuals stopped taking the product.”

Natreon: AyuFlex is a vegetarian, organic, non-GMO (genetically modified organism) joint product developed from the ayurvedic ingredient Terminalia chebula, which is an edible fruit. According to Kalidindi, results of a study that compared AyuFlex to placebo in moderately osteoarthritic subjects (The Asian Journal of Pharmaceutical and Clinical Research) demonstrated that consumption of AyuFlex 500 mg twice daily for 12 weeks resulted in significant improvements in WOMAC scores compared to placebo (36 percent reduction vs. 4.52 percent in placebo), knee swelling index and VAS pain, stiffness and disability. The therapeutic benefit was evident in as short as four weeks.

In addition to the study in moderately osteoarthritic patients, there are two randomized, double-blind placebo controlled crossover studies that were completed to examine the analgesic activity of AyuFlex in healthy human volunteers. In these studies, subjects were given a single 1,000 mg dose of AyuFlex and subjected to a hot air pain model or a mechanical pain model. AyuFlex demonstrated analgesic activity by showing a significant increase in both force and time for pain threshold and pain tolerance (statistically significant at p < 0.001 compared to placebo). “Based on an in-vitro study, the most likely mechanism of action is via COX-1, COX-2, and 5-LOX inhibition,” Kalidindi said.

Peptan: A double-blind placebo-controlled study of 94 women with diagnosed knee OA showed that 8 g of Peptan daily significantly improved joint comfort and functionality, Nygaard noted. The Peptan consumption resulted in a significant decrease of the WOMAC score, and the women recorded an improvement of 37 percent in joint pain score, 44 percent in stiffness score and 22 percent in function score.

Soft Gel Technologies Inc.: Perluxan, a proprietary hops extract, is backed by several human clinical trials, including a 14-day double-blind trial in OA patients that found Perluxan effective at relieving chronic joint pain compared to placebo, Holtby reported. The study also showed a fast-acting effect on mean pain relief: significant improvement over placebo could be measured only two hours after the first ingestion.

A second double-blind, randomized parallel design trial was conducted on 19 healthy subjects, who received a single dose of ibuprofen (400 mg), a soft gel containing hops resin (450 mg) or a capsule containing hops in powder form (300 mg 4x/day). Both supplement forms were standardized for hops alpha acids (150 mg). Levels of COX-1 and COX-2 were monitored at regular intervals over nine hours after the initial dose. “The hops preparations were as effective as ibuprofen at inhibiting COX-2, but had significant COX-1 sparing activity over a nine-hour period,” Holtby stated. It was interesting to note that the hops resin soft gel was only administered once, whereas the hops powder capsules were administered in four divided doses over a nine-hour time period.”

Soft Gel Technologies Inc.’s Injuv is, according to Holtby, proven to be a highly bioavailable oral form of hyaluronic acid (HA). Numerous studies have shown that HA has favorable impact on relief of discomfort and joint function after intraarticular injection, “found to be equal to or better than the relief obtained through the use of NSAIDs and steroids, with longer lasting results,” he said. Recent research also indicates that HA has chondroprotective and/or chondrostimulating effects. Additional studies have demonstrated HA’s positive effect on the cell-mediated immune response associated with inflammation in individuals with temporomandibular joint disorders.

Stratum Nutrition: NEM eggshell membrane, Dockery described, is a minimally processed, food-derived ingredient composed mostly of a unique matrix of proteins and peptides, including several types of collagen. Within this matrix are also various glycosaminoglycans including chondroitin sulfate, keratin sulfate and hyaluronic acid. NEM is supported by numerous published clinical research for benefits to joint comfort and flexibility. “The published studies consisting of open label pilot trials, independent open label trials, and a randomized, placebo-controlled trial have all revealed statistically significant positive outcomes,” she said. “In addition, multiple published in vitro and in vivo studies have begun to elucidate the mode of action for NEM’s anti-inflammatory benefits, and theorize the involvement of an oral tolerance mechanism. Most recently, animal studies have demonstrated chondroprotective benefits of NEM supplementation.”

Muscle Support

Bergstrom Nutrition: There have been a couple of recent studies that suggest OptiMSM helps relieve muscle soreness following exercise, according to Benjamin. Additionally, data has shown that MSM reduces creatine kinase, a marker of muscle damage that typically arises from exercise. “Data just presented this year at Experimental Biology suggests that OptiMSM may directly alter skeletal muscle response to stress and injury and serve as an ergogenic aid to protect skeletal muscle from injury,” Benjamin noted.

GELITA: A clinical study involving GELITA’s BODYBALANCE, which contains specific Bioactive Collagen Peptides, was recently published in the British Journal of Nutrition. Wolf stated that this was the first study to investigate the effects of collagen peptides on body composition and muscle strength. “The main finding of the study was that GELITA’s specific collagen peptides further increased the benefits of resistance training in elderly people with sarcopenia (muscle wasting).”

Compared with placebo, participants in the collagen-supplemented group showed a significant increase in fat-free mass (+4.2 kg compared with +2.9 kg) and muscle strength (+16.5 Nm compared with +7.3 Nm), as well as a statistically significant reduction in fat mass (-5.4 kg compared with -3.5 kg). “The study results demonstrated that the combination of resistance exercise and supplementation with BODYBALANCE was well suited to strengthen muscular power and both fight and prevent sarcopenia,” Wolf concluded.

IgY Nutrition: In one study, noted Hewlings, individuals who consumed 4.5 g of IgY Max for 10 days exhibited increased muscular strength and endurance, decreased muscle soreness and enhanced muscular repair. This is an attractive outcome not only for younger generations who want to attain physical fitness, but for older generations who want to maintain healthy mobility in an active lifestyle.

Peptan: Nygaard pointed to a two-year-long study that demonstrated that supplementation with a mix of collagen peptides, BCAA (branched chain amino acids) and arginine decreased the injury rate for tendons, ligaments, joints and muscles. “Similar results were also reported for collagen hydrolysate, with further studies demonstrating a significant increase in collagen fiber diameter indicating improved strength and a faster return to play after injury,” she described.

Of course, there are many more quality ingredients formulated and researched for healthy mobility, be it targeting bones, joints or muscle health. When adults can remain active, moving at free will without too much discomfort, they can and will accomplish so much more as they age. NIE

For More Information:
AIDP, (866) 262-6699
Albion, (800) 453-2406
Bergstrom Nutrition, (360) 693-1883
GELITA, www.gelita.com
IgY Nutrition, (405)242-5381
Natreon, (732) 296-1080
Peptan, www.peptan.com
Soft Gel Technologies Inc., (800) 360-7484
Stratum Nutrition, www.esmingredients.com

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