Joint health brochure

Lamberts

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Nutrition focus on:

Joint Health

FOR PROFESSIONAL USE ONLY

Nutrition focus on:

Joint Health More than 7 million adults in the UK (15% of the population) have long-term health problems due to arthritis and related conditions.

Osteoarthritis is usually age related and commonly affects people over 50, while the joint inflammation and pain caused by rheumatoid arthritis frequently occurs much earlier in life.

In people suffering from osteoarthritis, joints gradually lose their cartilage (the smooth, gel-like shock absorbing material) that prevents adjacent bones from touching.

Most commonly affected are the fingers, knees, hip, neck and spine. The onset is often gradual, marked by mild joint stiffness and pain, especially in the morning and following rest.

Rheumatoid arthritis is a chronic disorder in which the cartilage and other tissues in and around the bones become inflamed and damaged. Symptoms include fatigue, weight loss, low fever and joint stiffness, followed several weeks later by red and painful swollen joints (wrists, fingers, knees, ankles, and feet) that may feel warm.

Osteoarthritis may be the result of decades of joint wear and tear, though genetic factors, excess weight and impairments in the body’s ability to repair cartilage may also play a role. In rheumatoid arthritis, the immune system attacks the body’s own joints and associated tissues - the so-called autoimmune reaction. In some people this inflammatory condition, which often appears between the ages of 20 and 40, may be the result of genetic predisposition.

Although osteoarthritis and rheumatoid arthritis have different causes, there are many similarities in the supplements used by practitioners.

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Glucosamine Glucosamine is essential for maintaining healthy cartilage, the smooth tissue that lines joints. There are no edible food sources of glucosamine, so when our bodies fail to manufacture sufficient natural glucosamine, supplementation is useful to help maintain joint mobility.

One recent study indicated that glucosamine may be particularly useful against arthritis in the knee.

Two earlier studies found that glucosamine was at least as effective as ibuprofen for relieving many different types of arthritis symptoms.

Whilst glucosamine is available in various forms, glucosamine sulphate is the form that has been repeatedly and successfully used alone in studies.

It has an exceptional absorption rate of 90 - 98%.

The recommended dose is 750mg of glucosamine sulphate (equivalent to 1000mg glucosamine sulphate 2KCl), twice daily.

Chondroitin Chondroitin sulphate is an important structural component of cartilage, the tough tissue that lines the surfaces of bones, and forms a major part of the extra-cellular matrix that provides much of cartilage’s resistance to compression. Chondroitin is thought to attract fluid into the cartilage and this enhances its elasticity. It is also believed to inhibit the proteolytic enzymes that break-down cartilage.

Chondroitin sulphate is now a popular supplement worldwide, following a number of positive studies, and is usually combined with glucosamine as this compound works in a different but complimentary way.

Suggest 100mg daily but it is worth noting that a common practice with chondroitin supplements is to use preparations that are just 20% chondroitin, but the label declares this as if it is 100% chondroitin. Therefore a supplement declared as ‘400mg chondroitin sulphate’ is often just 80mg of chondroitin sulphate.

Incidence of arthritis and joint pain Do you have or have you ever had arthritis or joint pain?

Yes, have arthritis or joint pain

%

Aged 15-24

10%

Aged 25-34

Aged 35-44

Aged 45-54

Aged 55-64

Aged 65+

11%

18%

32%

49%

54%

Base: Adults aged 15+ in Great Britain (2,031) Source: MORI

MSM Many practitioners see methylsulphonylmethane (MSM) as a perfect partner to glucosamine. It is a key component of cartilage and plays an important role in joint health.

There is no dietary requirement for MSM but several studies have indicated that MSM supplements may be useful for some people as part of a joint care regime.

Some companies currently supply petrochemical MSM but there are some MSM products which are naturally sourced and the preferred form for practitioners. The suggested dose is 1000mg of MSM daily.

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Multivitamins & Minerals Several nutrients are necessary for the conversion of the fatty acids found in fish oil including the B vitamins and zinc. This is why most practitioners also recommend taking a high strength multi alongside fatty acid supplements.

Fish Oil The beneficial ingredients of fish oil are two fatty acids, EPA and DHA. These are omega 3 fatty acids, which as shown from clinical studies, are important in helping to maintain joint mobility.

In a complex process EPA and DHA are converted into prostaglandins that exert an anti-inflammatory effect. Research suggests that we need a daily supplement of fish oil of the order of 2 to 3 grams for impaired joint movement.

Studies show that those with rheumatoid arthritis who take daily fish oil supplements have fewer tender joints and less morning stiffness. The first improvements were usually noticed after 12 weeks, and this increased further after 18 to 24 weeks of supplementation.

The omegas 3’s are also being researched because for many people their dietary intake has fallen to a point that is low enough to be affecting their health.

This is why the Government recommend that we eat some oily fish, such as mackerel, once a week, and many nutritionists think that it should be as often as twice or three times a week.

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Turmeric The key active constituent in turmeric is curcumin, which is found within the root of the plant, and it is this part which is responsible for its bright yellow colour.

Studies have already shown how the key active constituent, the curcumins, in turmeric can inhibit the compounds involved in the inflammatory response. Consequently, practitioners often combine turmeric with glucosamine sulphate to combat joint problems such as stiffness.

Bromelain

Similarly, turmeric is increasingly being added to formulations for back problems. However, almost all of these formulas provide only token levels of this spice. And to be of use you need to add a relevant level of turmeric root in extract form, which is why it is important to use a high strength product. 500mg of root extract, standardised to provide 95% curcumins, is the level generally used in studies.

Bromelain, an enzyme derived from the stem of fresh pineapples, is probably best known for its use as a digestive aid, especially to assist in the digestion of fatty or high-protein meals.

Recent research however, has turned many experts’ attention to its use for helping joint health. It is believed to inhibit the body's production of prostaglandins associated with inflammation and pain whilst promoting the formation of those with an anti-inflammatory action.

Bromelain can also work well when taken in conjunction with turmeric so many practitioners recommend taking the two products alongside each other. Bromelain appears to aid the absorption of curcumin, the active compound in turmeric.

To be of use a product must contain at least 2000 gelatin-dissolving units (GDUs) per gram, which is why it is important to use a high strength product that contains this relevant level.

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Vitamin C Vitamin C is needed for the manufacture of collagen, the protein that forms connective fibres in tissues such as ligaments, cartilage and muscles. In addition, cartilage cells appear to depend on high concentrations of vitamin C. It is also an antioxidant needed to protect cells, including those of the joints, from damage.

Our daily requirement for vitamin C is higher than for any other water-soluble vitamin. Ideally, vitamin C needs to be taken in small amounts throughout the day and night because it is rapidly lost from the body. However, this is not always convenient, which is why time release vitamin C tablets (where the vitamin C is gradually released over approximately 6 hours making the product longer acting), are so popular amongst practitioners.

Other antioxidants such as vitamin E can also be used to help protect cells, including those of the joints. 400iu once daily of natural source vitamin E is the suggested dose.

Ginger This versatile root has an incredible range of applications that have proved useful to mankind. In particular, it is renowned for its usefulness for many gastrointestinal complaints. More recently however, ginger has soared in popularity with practitioners for use in helping maintain healthy joints.

One study, showed that two-thirds of the volunteers (all with osteoarthritis of the knee) given ginger pills reported relief from pain - significantly more than those taking a placebo.

The suggested daily dose is the equivalent of 14 grams of fresh ginger root. Taking it in supplement form avoids the fuss and mess associated with preparing fresh ginger.

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Prescribers Guide to Joint Health NUTRIENTS

Suggested Daily Dose

Glucosamine

750mg of glucosamine sulphate, twice daily Equivalent to 2000mg glucosamine sulphate 2KCl per day.

Chondroitin

100mg of Chondroitin Sulphate Choose marine sourced chondroitin as opposed to bovine chondroitin, which typically comes from the trachea of cattle.

MSM

1000mg Look for a natural source of MSM as opposed to petrochemical MSM.

Fish Oil

1100mg of Pure Fish Oil, twice to three times daily Use fish oil that gives a guaranteed level of 700mg of omega 3’s and which quotes levels of EPA & DHA at about 360mg and 240mg respectively.

Multivitamin & Mineral Complex

A broad-spectrum multivitamin and mineral complex Several nutrients are necessary for the conversion of the fatty acids found in fish oil including the B vitamins and zinc. This is why most practitioners also recommend taking a high strength multi.

Turmeric

500mg root extract once or twice daily Use turmeric that is standardised to contain 95% curcumins.

Bromelain

500mg three times daily (1 between each meal) for one week. Thereafter a maintenance dose of 500mg daily can be taken for 3 to 6 months The enzyme activity level should be 2000 GDU/g.

Vitamin C

1000mg of vitamin C daily A time release formula makes the product longer acting.

Ginger

120mg of standardised extract Equivalent to at least 14 grams of fresh ginger root.

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