‘Supple’ and ‘pain free’ is how we would all like to be able to describe the way in which our body moves. The absence of joint stiffness or pain is something many may have once taken for granted. Reality can instead be filled with stiffness and discomfort which can significantly take from quality of life. When a person’s body doesn’t function as they wish, the psychological impact can be profound.
When we think of joint issues and loss of fluidity of movement we may immediately think of commonly discussed and afflicted joints such as our hips, knees and elbows. However, this is just the tip of the iceberg! The human body has an impressive 360 joints! That’s 360 potential problems if joint health is neglected or not prioritised.
As we age, a certain amount of wear and tear on joints is expected but joint issues can vary widely, spanning the odd painful niggle to very painful and debilitating chronic conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, bunions and gout. These diseases affect not only the joint itself but also the bones, ligaments, tendons, muscle and cartilage surrounding it.
With regards to prevention of joint problems, we know that inflammation plays a role in their onset and progression so reducing the amount of inflammation inflicted is the number one preventative measure. The research confirms that for specific conditions such as osteoarthritis, obesity is a modifiable risk factor, meaning we can do something to change the trajectory. With excess body fat comes associated inflammation1,2 and increased pressure on weight-bearing joints such as knees and hips.
While prevention of joint issues should be a focus, more often action is taken in reaction to joint complaints. Treatment options come with side-effects and practitioners also need to consider person-preference, cost, availability and time. Therefore, it’s none too surprising that many people consider using supplements in a bid to experience some pros without the cons. Supplements are often also considered in conjunction with the pharmacological or surgical route, in a bid to enhance the body’s response and help manage potential pitfalls of the disease or treatment.
Commonly recommended over-the- counter supplements for Joint Health and the research
1. Omega 3 fats. Fish oils have been shown to reduce inflammation and may be beneficial with regards to joint health. Research has suggested that fish oil-based supplements may help reduce pain in those with rheumatoid arthritis,3,4 while a randomised controlled trial (RCT) which ran over two years found that a low dose fish oil was more beneficial at improving pain, stiffness and physical function when compared to a high dose in those with OA.6 So, more is not always more.
2. Antioxidants vitamins A, C and E. While a 2007 Systematic Review declared the quality of the studies available was low and therefore no conclusive recommendations could be drawn, another study in 2012 found that vitamin E may be helpful for knee pain.7 Adding more nuts and seeds, which are rich in vitamin E, to the daily diet may provide more benefits.
3. Vitamin D. The evidence specifically for joint health isn’t strong due to inconsistencies in findings and quality of research.
However, vitamin D is linked with lowering inflammation and cytokine synthesis8 as well as increased muscle strength,9 which is vital to protect muscles from excessive wear and tear. A study showed that for people with knee OA, those that had adequate serum vitamin D levels (>50nmol/l) had significantly improved structural and functional outcomes compared with those who had insufficient status.10 Currently, the Irish Osteoporosis Society advises 70nmol/l as an adequate vitamin D level. Current HSE guidance on 15mcg per day for adults in Ireland remains best practice.
4. Collagen. A 2021 systematic review looked at the effects of Type II collagen supplementation on joint function and recovery from joint injuries and found that in all five studies collagen was successful in reducing joint pain, joint function, length of pain free strenuous exertion and reducing the need for alternative therapies especially when combined with a structured exercise programme.11
5. Turmeric. A 2021 systematic review that looked at the safety and efficacy of Curcuma Longa (turmeric extract) and curcumin on OA found that it was successful at relieving pain, joint stiffness and improving joint function. They advised at least 12 weeks use.12
6. Glucosamine and chondroitin. A systematic review that looked at supplements specifically for treating OA found that the most commonly used supplements for joint health, glucosamine and chondroitin were not clinically effective in reducing pain or improving physical function, even in the short term for people with OA.13
A food-first approach is always advised. Food is more than the sum of its parts. Supplements can never recreate the complexity of whole foods and dietary patterns. Changing what people eat, and when they eat it is likely to have a bigger impact that any one supplement. Our focus isn’t just on an anti-inflammatory dietary pattern but also a lifestyle that works in tandem. Supplements are likely to exhibit a greater response if used to supplement a holistic approach than a tool to help people dig upwards.
Furthermore, supplements may be considered in response to medications consumed by those with joint pain. For example, ongoing inflammation in the body can lead to iron deficiency. So, iron supplementation may need to be considered if that occurs. Additionally, steroids may be used as part of treatment. If that is the case, calcium-rich foods as well as other nutrients important for bone health like protein and vitamin K as well as vitamin D and magnesium need to be a focus.
Written by Hazel Windsor-Aubrey & Orla Walsh, Orla Walsh Nutrition
References available on request
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