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Nutrition for Aging Bones and Muscles

Aging Bones Aging Bones
Longevity By Nature

People of all ages want support for their musculoskeletal health.

In 2022, the World Health Organization (WHO) estimated about 1.71 billion people have musculoskeletal issues worldwide.

“Musculoskeletal conditions are the leading contributor to disability worldwide, with low back pain being the single leading cause of disability in 160 countries,” WHO said in the report.

A 2022 report from The Harvard Gazette stated that around 53.6 million Americans have osteoporosis and/or low bone mass with two million osteoporosis fractures occurring annually. That number is expected to climb to three million by 2040 and cost an estimated $95 billion per year.

Rosia Parrish, a naturopathic doctor based in Boulder, CO, said bone health provides the structural framework of the body and is important for both physical support and protecting the internal organs.

Dr. Parrish, who specializes in fertility, added bone, joint and muscle issues can lead to hormonal imbalances and a loss of energy, drive, libido and motivation. “Bones are a significant reservoir of a complex system of minerals, not just calcium and magnesium, but these two are important and essential for many bodily functions and chemical processes in the body, including the hormonal regulation necessary for conception,” she said.

State of the Market

Mona Rosene, MS, RD, global director of scientific affairs at ChromaDex (Los Angeles, CA) said the market is expected to grow with a compound annual growth rate (CAGR) of 9.5 percent to a valuation of 17.17 billion in 2032.

According to data from the National Health and Nutrition Examination Survey (NHANES), 78 percent of American adults will be overweight or obese by 2030.

“People who are obese have a higher likelihood of developing osteoarthritis,” said Joe Brunner, president of Endurance Products Company (EPC, Sherwood, OR). “The numbers are staggering and suggest more people are likely to explore supplements for bone, joint and muscle health.”

Hank Cheatham, vice president of Daiwa Health Development (Gardena, CA), added that the rising prevalence of chronic diseases, an aging population and the popularity of plant-based remedies are some of the many factors expected to drive the market. “As a result of environmental awareness, trends led by young consumers, and greater knowledge about wellness, many of today’s consumers are demanding greater transparency in the products they produce,” Cheatham said. “More consumers want to know where their products come from and what their ingredients are.”

Brian Keenan, ND, DOM, LAc, education manager at Ayush Herbs (Redmond, WA) agrees with Cheatham that the aging population is a major factor. He said the aging population (over 65 years old) is expected increase by as much as 47 percent by 2050. “Additionally, anti-aging and wellness trends for younger adults are still booming with everything from collagen peptides to ashwagandha for endurance athletes becoming popular,” Dr. Keenan said. “More and more people are looking at their body in a holistic way and focusing on quality of life and ease of movement.”

Yunpeng Ding, director of research and development, human nutrition at Norway-based Aker BioMarine, noted that the market can be looked at from both the active nutrition and healthy aging perspective. “As a society at large, age-related health care costs are expected to increase massively over the following years,” Ding said. “Therefore, a growing body of science is helping us better understand how we can impact and improve the life quality of an aging population.”

Ding added active nutrition is “on the move” with no signs of stopping.

“The [active nutrition] category has become one of the largest mass market areas with further growth predicted in years to come, including elite athletes, weekend warriors and those looking to keep their body moving and healthy for as long as possible,” Ding said.

Dr. Parrish agrees with Ding about the growing active nutrition category. She observed an increased number of women in fitness and strength training. “With more women in activities like weightlifting, there is a growing demand for supplements that cater specifically to their nutritional needs for muscle recovery and bone strength,” she said. “This shift has prompted the market to offer a variety of products tailored to the unique requirements of women in fitness.”

Xavier Berger, global marketing manager, mobility and joint health at Gnosis by Lesaffre (France/Milwaukee, WI) explained that there is an opportunity to engage with the younger demographic, particularly those in their 20s and 30s. “In our late thirties, muscle strength and performance start declining and maintaining muscle health is a natural extension of the mobility market, not merely in the muscle-building sports segment,” Berger said.

Bone, Joint and Muscle Issues

The Centers for Disease Control and Prevention (CDC) forecasts that by 2040, there will be 78 million arthritis patients, of which 34 million will have activity limitations.

“Osteoarthritis will affect most people during their lifetimes, many to the point where a knee joint or hip joint replacement with a costly and difficult surgery after enduring years of disability and pain,” Cheatham said. “Damage to the cartilage surfaces is associated with failure of the joint, but that damage only becomes obvious very late in the disease process, and cartilage is just the outermost layer in a complex assembly of tissues that lie deep below the surface.”

Dr. Parrish added aging, overuse, poor nutrition, inadequate physical activity, genetics and exposure to certain chemicals or heavy metals can cause health issues.

Rosene agrees with Dr. Parrish adding that as people age, they lose bone mass and density, a major issue especially for postmenopausal women.

“Fluid in the joints can also be lost in aging. Cartilage wears away in the joints, especially the hip and knee,” Rosene said. “When the fingers lose cartilage, it results in bony swelling known as ‘osteophytes’ with age, which causes stiffness.” Rosene also said sarcopenia is a common issue affecting those 60 and over. It results in a gradual loss of muscle mass, strength and function and leads to increased frailty, falls and fractures.

Berger said a balanced lifestyle, proper nutrition and regular exercise can all contribute to the health of bones, joints and muscles.

“Hands down, a healthy diet tops the list of lifestyle habits needed to maintain healthy bones, joints and muscles,” Brunner noted. “Regular exercise, especially weight-bearing exercise, is a close second. So, efforts to help people eat right, stay active and keep their body weight in check are key.”

Dr. Keenan agreed there are nutritional, hormonal, natural aging and genetic factors at play, but believes flexibility and frequency of movement are chiefly important. “Sedentary lifestyles have been likened to smoking cigarettes with good reason,” he said. “As we age, if we do not continuously provoke our body to stay flexible and mobile, it will begin to stiffen, and joints will become unstable as the muscles that stabilize them also weaken.”

Integrative and Alternative Solutions

As everybody’s body responds differently, it is up to natural practitioners to provide a holistic approach to find the best treatments for their patients.

Aker BioMarine relies on practitioners to educate their patients about the safety and uniqueness of ingredients and products to support joints, muscle health and healthy aging.

“There is no question that practitioners are the gatekeepers to important information when it comes to preventative health solutions,” Ding said. “As more and more people turn to ingredients and products that support their health and well-being, there will be a greater demand for products with tangible and result-driven benefits (backed by science).”

Drs. Keenan and Parrish said it is important to provide a holistic approach, namely understanding physical and mental limitations of every patient. “Nutrition is at the forefront of our strategies, where we provide tailored dietary counseling that focuses on a balanced intake of essential nutrients, addressing specific health conditions and promoting overall well-being,” Dr. Parrish said. Dr. Parrish also recommended the use of specialty lab testing, supplements, botanical medicines and personalized fitness plans.

“This expertise along with a strong doctor-patient relationship can go a long way to helping patients stay healthy and active,” Brunner said. “Plus, the popularity of telemedicine and the convenience of virtual dispensaries like FullScript has made it even easier to provide quality patient care.”

Consumer Trends

In addition to the aging population and increasing obesity rates, the rising cost of health care and more confidence in dietary supplements are some of the many ways consumers are trying to stay healthy.

Ding said one in three consumers claim to be “proactive” in preventing health issues in the most important areas including heart, bone and joint health. “Interestingly, one positive outcome of the recent COVID-19 pandemic is it has inspired people to be more proactive and prioritize their health,” Brunner said.

Cheatham added the demand for natural remedies has evolved, particularly in the older population because of increased possibility for bone density reduction, osteopenia and osteoporosis. “The aging population has also become more aware of physical fitness, exercise and natural remedies accounting for the growing demand for natural products which offer relief from muscle pain, strain and cramping,” Cheatham said.

Dr. Parrish observed a growing trend in “cycle-syncing fitness” in women in which they tailor their routines to their body’s natural rhythms. “We are also seeing more research for women and fitness, and hopefully seeing continued research with cycle-syncing, since women go through several distinct phases of their cycle every month,” she said.

Berger added some of the most common trends consumers look at are quality, trust, efficacy and clinical validation. “Beyond proof of efficacy, consumers are increasingly opting for natural and ‘free from’ ingredients and look for this to be conveyed in product information,” Berger noted. “Excessive lists of additives are less attractive for the increasingly educated consumer.”

Dr. Keenan said vitamin D is seeing a renewed interest even though it’s been available for a long time. More patients are asking about vitamin D and high-quality supplements as well as drinks and powders as a form of delivery. Purity and sustainability are also growing concerns. “Especially in the bone supplement space, heavy metals are a chief concern as they are concentrated in those supplements (and any supplement really),” he explained. “Moreover, consumers are more aware of the impact supplements and concentrates can have on the planet and are asking for more proof and messaging around sustainability.”

Products and Ingredients

While there are a plethora of products and ingredients available to consumers, it can often be difficult to decide which ones are best.

Ding said glucosamine, omega-3 fatty acids and curcumin are some of the most popular supplements for pain, stiffness and osteoarthritis symptoms. With many omega-3 options on the market, he said it is important to understand not all of them are created equal.

For example, Aker BioMarine offers Superba Krill Oil, a product made from a combination of omega-3 fatty acids (EPA and DHA), choline and astaxanthin.

“Healthy aging is connected to the health of our cells and krill oil phospholipids work at a cellular level,” Ding said. “Inside our cells we find phospholipids, a natural, integral part of the cell membrane that helps maintain the strength, flexibility and integrity of those cells and their membranes.”

Gnosis is well-known for its MenaQ7 (vitamin K2 as MK-7) line of products. The line combines a mix of bioactive ingredients and is close to becoming a “one-size-fits-all” solution.

MenaQ7 has been shown to positively affect bone health in both children and adults. A three-year long study in postmenopausal women showed a 180 mcg dose significantly decreased circulating inactive osteocalcin as well as increasing bone mineral content, density and strength, Berger said.

Rosene recommends eating a healthy diet consisting of whole foods and balanced amounts of proteins, carbs and fats. She said more people should be taking vitamin D for bone support.

“Yes, calcium is also important, however in the U.S., vitamin D is not consumed in sufficient amounts,” Rosene said. “Americans aged two and over are getting less than 30 percent of the recommended amount of vitamin D.”

Rosene added other products could include vitamin B3, collagen for joints, protein and branched-chain amino acids (BCAAs) to ensure protein synthesis of muscle health.

“A unique form of vitamin B3 known as Niagen (patented nicotinamide riboside or NR) has been shown to increase NAD+ and mitochondria in muscle when supplementing 1,000 mg a day for five months,” Rosene said. “Niagen NR is the most efficient and high-quality NAD+ precursor available and is backed by [more than] 30 published clinical studies.”

Daiwa offers Daiwa Joint Health, a product making use of Univestin as its active ingredient. Univestin is a proprietary complex derived from Scutellaris baicalensis used in traditional Chinese medicine and Acacia catechu used in ayurveda.

“Daiwa Joint Health modulates multiple reactions at once, helping to prevent joint problems from escalating,” Cheatham said. “As a result, processes that cause joint discomfort are neutralized more rapidly, and some are prevented all together.”

Ayush Herbs offers various products that often combine calcium, vitamin D, collagen, glucosamine, chondroitin and magnesium. One of its newest products is Calcium + Cofactors which combines calcium, vitamin D, boron, zinc and strontium with Cissus quadrangularis, a popular ayurvedic herb.

“When it comes to some of the staples of bone health and joint health, such as and calcium and vitamin D, there are several meta-analyses of several studies that have found favor, so these are very well supported by research,” Dr. Keenan said. “Some of the unique herbs, such as Cissus quadrangularis, have fewer studies, but there are human trials that have shown some mild benefit as well.”

EPC offers two popular products for joint health, Endur-Flex Glucosamine Chondroitin and Cal-Mag Complex.

According to Brunner, Endur-Flex supports the body’s production of proteoglycans, large molecules required to maintain, rebuild and repair cartilage tissue and lubricate joints. Glucosamine has also been shown to exert a chondroprotective action in intense joint loading athletes such as soccer and rugby players.

Cal-Mag Complex provides a source of calcium, magnesium and vitamin D, three major essential nutrients that are often not consumed in adequate amounts.

“Like other products in our EPC line, Endur-Flex and Cal-Mag Complex are made using our special wax-matrix tablet technology,” Brunner said. “This technology offers the advantage of a controlled release of nutrients over several hours that resembles the process of food digestion.”

Bones, joints and muscles are important regardless of age. They can affect anyone and often cause significant quality of life issues. However, through a combination of holistic medicine, education and healthier lifestyles, there is a path forward for everyone.

“Without expertise in the field, it’s difficult for a person to evaluate the quality of individual studies… and using ‘Dr. Google’ to search for medical information seldom goes well,” Brunner concluded.

Healthy Take Aways

• Approximately 1.7 billion people suffer from musculoskeletal issues worldwide.
• More than 50 million people suffer from osteoporosis and/or low bone mass.
• Around 78 percent of Americans will be overweight or obese by 2030.
• By 2040, there will be an estimated 78 million arthritis patients.
• Bone, joint and muscle issues can lead to hormonal imbalances.

For More Information:

Aker BioMarine, www.akerbiomarine.com
Ayush Herbs, www.ayush.com
ChromaDex, www.chromadex.com; www.truniagen.com
Daiwa Health Development, www.dhdmed.com
Endurance Products Company, www.endur.com; www.enduranceresearch.com
Gnosis by Lesaffre, www.gnosisbylesaffre.com; www.menaq7.com