Nutritional Intervention for Joint Health

Role of Collagen Hydrolysate in Cartilage Metabolism & Regeneration

BERLIN, Oct. 17 -- There are nearly 70 million people in the United States affected by arthritis and related joint health conditions. Health experts estimate that there will be a dramatic increase in the prevalence of joint disease over the next 20 years as the population of Americans living beyond their 70s is expected to double. Degenerative joint diseases, such as osteoarthritis (OA), have many causes but there are currently no cures, only palliative treatments to reduce pain and disability. It is therefore prudent to examine promising and relatively inexpensive interventions -- including nutrients and proteins such as collagen hydrolysate -- that may help slow down the onset of disease, improve symptoms and delay disease progression.

To recognize the advances in nutrition research (and OA) and discuss its relevance, health care professionals specializing in joint health gathered at an educational session titled, "Role of Collagen Hydrolysate in Cartilage Metabolism & Regeneration" at the eighth annual World Congress on Osteoarthritis held in Berlin, Germany.

Nutrition and Joint Health

Osteoarthritis is a progressive, degenerative joint disease characterized by a breakdown of the joint's cartilage (tough, flexible connective tissue), causing bones to rub against one another, which may lead to loss of movement and pain. Degenerative joint diseases have many causes including normal wear and tear of the cartilage with age, overweight or obesity, acute or chronic stress to the cartilage, joint abnormalities or mal-aligned joints and infectious or neuropathological changes.

A focus on weight management and the nutrients beneficial to joint health may help in the fight against joint diseases. The United States may be particularly vulnerable to joint trauma from overweight and/or obesity, since 64 percent of all American adults are either overweight or obese, with numbers expected to rise dramatically within the next decade. In addition, physiology of the body's joints shows that obtaining a balanced diet that contains dietary protein, vitamins C and D, and minerals calcium and phosphorus can contribute to normal development of the cartilage and joint tissues required for healthy movement.

Though additional clinical research is necessary to identify efficacy of various dietary supplements, accumulating research on beneficial nutrients and their association with joint health brings several to the forefront. One of the more promising supplemental nutrients to date is collagen hydrolysate. Collagen is the most abundant protein in the body and gives structure to tendons, cartilage tissue, bones and connective tissue; collagen hydrolysate (CH) is collagen derived from animals and is similar in composition to that found in human cartilage.

Other nutrients have also been cited in joint health research. Dr. Kristine Clark, PhD, RD, a sports nutritionist with Pennsylvania State University Orthopedics presented the findings of a meta-analysis on glucosamine and chondroitin reported in the Journal of the American Medical Association (2000). Authors reviewed more than 15 double blind randomized, placebo controlled trials of four weeks or more and concluded that glucosamine and chondroitin trials on people who suffer from OA demonstrate moderate to large benefits in terms of pain measurement. She added, "Studies on dietary supplements have generated numerous options for people with degenerative joint disease. Further research on CH should only continue to provide new opportunities."

Why is collagen hydrolysate helpful for osteoarthritis?

Research suggests that CH can stimulate the synthesis of collagen, which is important for maintaining healthy joints. Steffen Oesser, PhD, of the Department of General Surgery and Thoracic Surgery, University of Kiel, Germany, provided a summary of CH findings as presented at the conference. In order to determine whether CH can, in fact, reach and affect the joint tissue, scientists at the University of Kiel studied the absorption rate and accumulation levels of collagen hydrolysate in subjects by monitoring its uptake in the body. Results indicated that upon rapid intestinal absorption of supplemental CH, subjects experienced a doubling in the quantity of the nutrient accumulated within their cartilage tissue as compared to the control group. The findings imply that CH does reach the tissue and long-lasting accumulation is possible.

The next phase of the research was to determine whether CH may positively affect the joint tissue once it has accumulated. This would require one of two actions to take place: inhibition of the degradation of the supportive joint tissue and/or stimulation of new cartilage cells to compensate for naturally degraded tissues. In a cell culture model, researchers have been able to demonstrate that the presence of CH in the culture stimulated collagen production. When compared with collagen that is naturally present in the cells, the native collagen did not lead to this stimulatory effect. The supportive joint tissues were also stimulated to reproduce when in the presence of CH, implying that CH may be able to reduce degenerative changes in the joint tissue. Dr. Oesser highlighted that, "These are significant findings because we are beginning to learn that collagen hydrolysate is not only reaching the targeted joint tissue, but we are able to observe that its presence can also create a positive change in the joint."

Additionally, Hans-Konrad Selbmann, PhD, from the German University in Tuebingen, presented the findings from his review of the literature on collagen hydrolysate and its effect on joint health. Among his research, including 16 clinical studies, two within the last decade stand out as highly significant double blind, placebo controlled clinical studies. The first was a study from 1991 by Adam, et al., which compared four treatments (CH, gelatine, a gelatine-glycine-calcium-fluid combination and albumin proteins) to reduce the patients' levels of pain and their need for pain medications. The study found that all three of the gelatine treatments were effective and significantly superior to the protein supplementation.

The second study Dr. Selbmann featured was that by Moskowitz, et al. Moskowitz's multinational study of subjects in the United States, Germany and in the United Kingdom was a two-arm, double blind design, using 10 grams of CH daily or placebo for 24 weeks. Evaluation of three primary efficacy variables -- pain, physical function and overall evaluation -- indicated that all variables showed a significant improvement in the German subjects. However, there were no significant differences for the total study group across the three variables, indicating that there are multinational influences that couldn't be standardized in the study protocol. Dr. Selbmann concluded that, "The efficacy results in these studies demonstrate a distinct clinical impact of CH in patients suffering from OA that warrants further clinical trial and examination."

Where can collagen hydrolysate be found? How much is recommended?

Collagen hydrolysate is a special type of gelatine with particular physiological role and is produced directly from collagen. There are currently no official dietary guidelines or recommendations for quantity of collagen hydrolysate that will benefit health. However, based on the research, a benefit has been shown by taking 10 grams of collagen hydrolysate for at least three months. Because of the constant breakdown and regeneration of collagen, research shows that if people stop taking collagen hydrolysate altogether, the symptoms may reoccur.

Collagen hydrolysate may benefit those at risk of degenerative joint disease, and particularly osteoarthritis. Such at-risk populations include older individuals, especially those over the age of 50; individuals who are overweight; individuals whose occupational activities predispose them to osteoarthritis, including athletes and those involved in mechanical stress on cartilage.

The OsteoArthritis Research Society International (OARSI) organizes the 2003 World Congress on Osteoarthritis.

GELITA Health Initiative has sponsored this educational symposium. GELITA is the world market leader in all relevant gelatine application areas with subsidiaries on every continent and more than 2,300 employees worldwide. To generate new insight and to extend knowledge, the GELITA Health Initiative (GHI) was founded as a resource for information related to joint and bone health and collagen hydrolysate.

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