Articulating Discomfort
Bone & Joint Health
The desire for unimpeded mobility is more common among adults than ever. Here’s how to help ensure your clients remain active.
Aches and pains. It seems as though everyone over age 40 has them. Many people just shrug it off as “ah, I’m getting old,” and just carry on. But they don’t have to give into the symptoms of the wear and tear of their articular systems.
As a practitioner, you likely hear many of your patients/clients exclaim, “I’ve got these pains now, not like when I was younger.” Of course, if the individual is significantly overweight/obese, the primary goal is to steer him/her on a weight loss regimen to reduce the stress on the joints and on the musculoskeletal system. But even the most svelte and robustly healthy middle-aged adults will experience the morning stiffness, twinges, lower backache, etc. that are newly regular for them.
Your patients/clients want to rest when they want to—not when their joints make that decision for them, and they are thus quite invested in the joint supplement category. According to market research firm Mordor Intelligence, the bone and joint health supplements market is projected to grow at a CAGR of 6.6 percent from 2019-2024. This bodes well for you as a practitioner because your clients/patients will be open to new supplement suggestions.
Further research from branded ingredient supplier Lonza (SORD report, 2019, with Natural Marketing Institute) found that more than 70 percent of dietary supplement consumers are likely to take a joint health supplement. It is well-established that joint health becomes more of a priority for many people as they age, but the industry at large is still getting to grips with the fact that joint health is important to consumers at every stage of life. Lonza’s research also shows that an almost equal percentage of Millennials (37 percent) and Baby Boomers (38 percent) are likely to be interested in protecting their articular system. The report also reveals that younger adults—Generation Z—are better informed and more proactive in turning to natural remedies, dietary supplements and healthy habits than previous generations, and are thus likely to seek to protect their joint function in tandem with rigorous fitness routines.
Julia Craven, vice president of education and innovation for The Enzymedica Group (Florida), agreed. She elaborated that while younger generations understand preventive self-care, pro-inflammatory indulgences are an obstacle to maintaining good joint health as they will age. “Culturally, we regard pro-inflammatory foods as rewards—the fried foods, sugary treats, that extra glass of wine are encouraged. In the context of a nutrient-rich diet, the occasional indulgence can be consumed with little harm. However, our culture says, ‘more is better’ and ‘you deserve it.’ Many of us overindulge with little awareness of the far-reaching impact to our joints and other aspects of health.”
She added that in tandem, numerous jobs require sitting behind a computer for long hours, minimizing movement throughout the day. Even if individuals engage in rigorous exercise while not working, the detrimental effect of long periods of inactivity are not fully offset.
As these generations move fully into middle age, the results of their lifestyle choices emerge. “It may be anything from a mild ache or subtle loss of motion to a more pronounced joint issue that can really have an impact on the ability to keep moving and overall quality of life,” Craven stated.
More recently and in the foreseeable short-term future, you may be dealing with more complaints about muscle and joint pain, according to Jolie Root, senior nutritionist and educator, Carlson Laboratories, Illinois. Lockdowns have been causing more people to be sedentary, as people are working from home at their computers in back-to-back virtual meetings, sitting for hours at a time. Those who do not have easy access to parks or more open outdoor environments are not working out as often, and many fitness centers are closed or limited. “Too many hours spent sitting combined with the weekend warrior approach to making up for those hours leads to injuries and loss of muscle and joint strength,” she said.
According to research by the Centers for Disease Control and Prevention (CDC), one in four American adults sit for more than eight hours a day and four in 10 are physically inactive. Habitual lack of physical activity often results in delayed onset muscle soreness (DOMS). Craven explained, “DOMS results in uncomfortable and stiff muscles, is commonly felt after unaccustomed or strenuous exercise. While muscle strains induced by exercise are quite common in athletes, individuals with a lack of muscle fitness, and weak muscles as a result of aging, muscle and joint discomfort can also be the result of free radical damage and oxidative stress.”
Indeed, pointed out Cheryl Myers, chief of scientific affairs and education at EuroMedica, Inc. (Green Bay, WI), quality of mobility largely reflects the patient’s/client’s work and life situation. For instance, patients/clients who work in sedentary jobs may experience joint issues more quickly in younger adults. “Many Millennials may still think of themselves as young (and they are), but there are more and more obstacles to daily physical activity than just a few years earlier: work projects, young children, home improvement and all of the other daily aspects of living,” she illustrated.
It is similar for Gen-Xers, Myers added, although they may have been noticing some joint pain or other aches for some time now. “The common thread I see for both groups is that they may not have thought that they needed any nutrient support or practitioner guidance regarding joint aches and related issues. Of course, for anyone in either group who has a physically demanding job, there will be noticeable joint pain that impacts their waking hours, and very possibly, their sleep.”
Population studies suggest that members of Generation X report age-related pain and discomfort related to aging at a younger age than Baby Boomers, according to Céline Torres-Moon, science writer, Protocol For Life Balance, Illinois. “While there are only few publications about Millennials and joint health, it appears that the obesity rate of this generation is even greater than that of Generation X and this will most likely impact Millennials’ joint health,” she commented.
In a population survey (DePew and Gonzales, Population Research and Policy Review, 2020) comparing health status between Generation X and Millennials at the same age, more Millennials are more likely to have activity limitations (6.9 percent vs, 5.0 percent, respectively).
Walking it Out
In these unprecedented times, it is clear many of your patients/clients may likely be struggling with issues arising from inactivity, weight gain and joint/muscle discomfort (in addition to stress and low mood).
Recent studies point to the beneficial relationship between mild exercise, such as walking, obesity and conditions of joints in older people, which can also work for younger and obese/overweight patients/clients. One study published in the American Journal of Preventive Medicine (April 2019) shows that one hour a week of brisk walking can delay disability in adults with arthritis pain and/or stiffness in the major joints (knee, hip, ankle and foot). Lead author Dorothy Dunlop, professor of preventive medicine at Northwestern University Feinberg School of Medicine, emphasized that less than 10 minutes every day is “doable. This minimum threshold may motivate inactive older adults to begin their path toward a physically active lifestyle with the wide range of health benefits promoted by physical activity.”
Dunlop and her team analyzed four years of data from more than 1,500 adults in the National Osteoarthritis Initiative from Baltimore, MD, Pittsburgh, PA, Columbus, OH and Pawtucket, RI. The adults all had pain, aching or stiffness in lower extremity joints from osteoarthritis but were free of disability when they began the study. Their physical activity was monitored using accelerometers. Four years after the start of the study, 24 percent of adults who did not get the weekly hour of brisk physical activity were walking too slowly to safely cross the street, and 23 percent reported problems performing their morning routine.
This validates earlier work, such as a 2014 review published in the Journal of the American Academy of Orthopedic Surgeons which concluded from research on senior elite athletes who engaged in comprehensive fitness and nutrition routines were able to minimize decline in bone and joint health and maintain overall physical health. “An increasing amount of evidence demonstrates that we can modulate age-related decline in the musculoskeletal system,” said lead review author and orthopedic surgeon Bryan Vopat, MD. “A lot of the deterioration we see with aging can be attributed to a more sedentary lifestyle instead of aging itself.”
Obesity, even in childhood, can wreak havoc on weight-bearing joints. A 2018 unpublished study by the European League Against Rheumatism found that adult body mass index (BMI) significantly increased the prevalence of self-reported osteoarthritis (OA), knee OA or hip OA by 2.7, 1.3 and 0.4 percent per unit increase in BMI, respectively. Childhood BMI significantly increased the prevalence of self-reported OA, knee OA or hip OA by 1.7, 0.6 and 0.6 percent per BMI unit, respectively.
According to the CDC, an estimated 14 million older adults in the U.S. have symptomatic knee osteoarthritis, which is the most common form of osteoarthritis. Approximately two in five people with osteoarthritis—most of whom have it in their lower joints—develop disability limitations. Americans 18 years and older who are overweight or obese report doctor-diagnosed arthritis more often than adults with a lower BMI. More than 16 percent of under/normal weight adults report doctor-diagnosed arthritis; almost 23 percent of overweight and 31 percent of obese U.S. adults report doctor-diagnosed arthritis.
Supplement Suggestions
Depending on an official diagnosis of arthritis, type and status of disease, your patient/client can augment any allopathic therapy with lifestyle modifications, nutrition and dietary supplementation. There is a true plethora of dietary supplement options for joint health. Here are some examples.
Enzymedica’s Myomend contains a blend of proteolytic enzymes that work systemically to help break down oxidatively damaged proteins, speeding up recovery and promoting flexibility and mobility by accelerating tissue repair, according to Craven. MyoMend contains an array of vegetarian proteolytic enzymes including bromelain, papain, protease Thera-blend, serrapeptase, nattokinase and antioxidants to support muscle and joint health. It also contains rutin. “Rutin is known as a vital phytochemical which serves as an antioxidant and is associated with improvement of physical fatigue,” she said. “In combination, enzymes and rutin naturally accelerate muscle and tissue repair and provide optimal wellness and recovery.”
Protocol For Life Balance’s Ache Action is formulated to relieve minor aches and pains caused by overexertion. According to Torres-Moon, it consists of three standardized botanical extracts: willow bark extract standardized to 14 percent salicin, ginger root extract standardized to a minimum of 5 percent gingerols, and AprèsFlex, a standardized extract of the gum resin of Boswellia serrata standardized to 10 mg 3‐O‐Acetyl‐11‐Keto ß‐Boswellic Acid (AKBA).
“Maintenance of a normal balance of key immune mediators has been shown to play a key role in healthy cardiovascular function, as well as in joint health,” said Torres-Moon. “By helping to support a balanced response to these signals, the herbal components of Ache Action may assist in the maintenance of healthy joints and may help to relieve occasional minor pain resulting from overexertion or stress. Willow bark and ginger extracts have a long history of use in alleviating occasional minor aches and pains due to overexertion, and this traditional use has been confirmed by a multitude of randomized clinical trials.”
Aprèsflex has been evaluated in three double‐blind, randomized, placebo‐controlled human clinical trials, according to its manufacturer, PLT Health Solutions (New Jersey). In these studies, 50 mg Aprèsflex consumed twice daily (100 mg total) resulted in a significant pain reduction compared to placebo and improved joint function as soon as five days and remained statistically significant for pain and joint function up to 90 days.
Also containing Aprèsflex is Carlson’s Enhanced Mobility, a high-potency blend of four of branded joint health ingredients, Root described. Apresflex joins CurcuWIN enhanced curcumin extract to manage inflammation, as well as Gingever ginger and Cheery PURE tart cherry for antioxidant protection in joints.
Euromedica’s Collagen Joint Complex contributes to preserving joint cartilage by managing inflammation, according to Myers. “The breakdown of collagen and joint structure is a primary reason for pain, so addressing that structural issue—which has inflammatory components, too—is foundational to treating joint disease and/or damage,” Myers explained.
Collagen Joint Complex features five ingredients targeting reduction of inflammation that damages joint structures (like 5-lipoxygenase pathway inflammation that is a hallmark of osteoarthritis and rheumatoid arthritis) to help strengthen cartilage, and to preserve joint-building components. The ingredients include type II collagen, glucosamine and chondroitin, hyaluronic acid and Euromedica’s own BOS-10 boswellia.
The ingredients in this formula are well-known, long used and have a platform of human clinicals showing efficacy. For example, Myers noted, in one clinical study, the type II collagen was used in conjunction with acetaminophen and tested against acetaminophen alone in two groups of volunteers with osteoarthritis. The group using type II collagen had significantly less knee pain, better knee flexibility and better walking scores.
Additionally, chondroitin and glucosamine have been shown to be equal to celecoxib (Celebrex) for stopping knee pain. Even the chondroitin alone has been objectively shown to reduce pain sensation on MRI brain scans of patients in a clinical study. A clinical study of healthy, active people found that type II collagen helped them exercise longer without pain, alleviate pain from exercise and improve knee extension.
Hyaluronic acid (HA), another glycosaminoglycan, is another popular supplement in the joint care space where it used to be available by injection only. According to Myers, clinical work with supplemental HA has been promising. In a three-month study, HA same ingredient not only relieved muscle pain and reduced synovial fluid pooling in knees, it helped regenerate muscle. Additionally, hyaluronic acid relieved knee pain faster and more effectively and reduced the pooling of synovial fluid, compared to acetaminophen, as well. A one-year clinical study of adults younger than 70 showed that supplementing with HA improved joint pain and muscle aches by 75 percent in eight weeks.
As younger adults become more aware of preserving their joint function, you can set them on the path to ensure they maintain an active lifestyle into elderly years.
Healthy Take Aways
• The bone and joint health supplements market is projected to grow at a CAGR of 6.6 percent from 2019-2024.
• Habitual lack of physical activity often results in delayed onset muscle soreness (DOMS).
• According to the CDC, an estimated 14 million older adults in the U.S. have symptomatic knee osteoarthritis.
• In combination, enzymes and rutin naturally accelerate muscle and tissue repair and provide optimal wellness and recovery.
• A clinical study of healthy, active people found that type II collagen helped them exercise longer without pain, alleviate pain from exercise, and improve knee extension.
For More Information:
Enzymedica, www.enzymedica.com
Euromedica, Inc., www.euromedicausa.com
J.R. Carlson Laboratories Inc., www.carlsonlabs.com
Protocol For Life, www.protocolforlife.com
