Wednesday, 08 December 2021

Healthy joints: Stay ahead with nutraceuticals

14 May 2021 | Opinion

By Dr. Anish Desai, Founder of IntelliMed Healthcare Solutions

Dr. Anish Desai, Founder of IntelliMed Healthcare Solutions

Dr. Anish Desai, Founder of IntelliMed Healthcare Solutions

As per data from The National Center for Chronic Disease Prevention and Health Promotion 46 million Americans have been diagnosed with arthritis or another joint condition by a health care professional.

A recent analysis of NHANES III (National Health and Nutrition Examination Survey) data found that approximately 35% of women and men aged 60 years and above had radiographic osteoarthritis (OA) of the knee. In a Chinese population aged ≥60 years, the prevalence of knee OA was 22% in men and 43% in women, and this prevalence was 45% higher than that in the US white population. In a Japanese rural population, the prevalence of knee OA was 30% in women and 11% in men. OA has been affecting 15 million adults annually with prevalence ranging 22% to 39% in India.

Arthritis, an umbrella term for more than 100 different conditions, affects the joints and other parts of the body. It is one of the most chronic health problems, causing joint pain, inflammation, stiffness and reduce mobility, limiting daily activities such as walking, bending, etc. People at risk of joint problems are those with obesity, infections, smoking, older people, joint injuries, lifting weight on a daily basis. The most common form of the disease is osteoarthritis (OA), also called degenerative joint disease.

While traditional treatment for osteoarthritis typically involves drugs for reducing pain and inflammation such as anti-inflammatory medications, analgesics (pain-killer), surgery, as well as focusing on healthy body weight and regular physical activity, the nutritional and dietary interventions are an increasingly popular complementary approach—especially among those who prefer non-pharmacologic treatment options. Throughout life, people may experience joint health issues, and they are increasingly searching for nutraceutical products to manage their condition.

Nutraceuticals have been known to treat and prevent many joint-related disorders. Basically, the nutraceutical is a food or food component that claims to have health benefits, including treatment and prevention of disease. They are used along with traditional medicines as supportive therapy or alone in managing a variety of diseases and deficiencies.

It is important to understand the basic structure of joints before considering the role of nutraceuticals in OA. A Joint can be defined as a point where two bones are being connected. A joint is made up of a). cartilage (tissue that covers the surface of a bone in the joint), b). ligament (supports the movements of the joint), c). synovial Membrane- seals the joint, and d). synovial fluid (joint lubricating fluid secreted by the synovial membrane)

Osteoarthritis is caused by the breakdown of cartilage and bones from wear and tear resulting in pain and inflammation. Therefore the integration with nutraceutical compounds in the diet increases the treatment options for patients with established OA beyond traditional rehabilitation, medications, and surgical strategies.

Nutraceuticals for joint health

Some of the most commonly used nutraceuticals in joint pathology include glucosaminechondroitin, omega-3 fatty acid, Curcumin, collagen, krill oil, gamma-linolenic acid, and avocado-soybean unsaponifiable. There have been several clinical trials aiming to elucidate the efficacy of these products and the results have been variable.

Physicians prescribe nutraceuticals based on strong clinical evidence. A recent article suggested that nutraceutical supplementation of patients with knee/hip OA may lead to an improvement in pain intensity and physical function.

Some of the nutraceuticals used for osteoarthritis include:

  1. Fish oil (omega-3 fatty acid)
  2. Glycosaminoglycans (GAGs) - glucosamine sulfate, chondroitin sulfate, and hyaluronic acid
  3. Olive oil
  4. Boswellia serrata
  5. Turmeric (Curcumin)
  6. Ginger
  7. Rosehip
  8. Nigella sativa
  9. Devils claw
  10. Methionine
  11. Undenatured Type II Collagen

Growing emphasis on maintaining active lifestyles, expanding market of nutraceuticals, coupled with rising consumer awareness of the importance of preventive care has led to the use nutraceuticals for joint health. Nutraceuticals seem to play a role in processes that affect articular cartilage. In osteoarthritis, the structural integrity of cartilage is impaired. Nutraceuticals may play a role in the balance of build-up and break down chemicals/signals in joints.

The benefits of nutraceuticals in improving joint health is attributable to their anti-inflammatory, anti-oxidant and chondroprotective action. Obtained from natural sources, these nutraceuticals reduce pain and stiffness, improve joint mobility.

Pharmacological actions of nutraceutical in Osteoarthritis

Nutraceuticals

Potential role

Anti-inflammatory

Anti-Oxidant

Anabolic

Anti-catabolic

Structural substrate

Fish oil

+++

-

-

+++

++

GAGs

+

+

++

+++

+++

Olive oil

+++

++

+

-

+

Methionine

-

+++

+

+

++

Undenatured collagen

+

-

+

+++

+++

Curcumin

++

+++

+

+

+

Quercetin

+

+++

-

-

+

Wogonin

++

+++

-

-

++

Botanical Extracts

 

 

 

 

 

ASU

+++

+

-

-

++

Green Tea

++

+++

-

-

+

Boswellia

+++

++

-

-

++

Ginger

++

+

-

-

+

Devils Claw

++

++

+

+

++

(Action: none “-”, Low “+”, Moderate “++”, High “++”)

Future prospects

Clinical trials of nutraceuticals are encouraging. However, more well-designed clinical trials are needed to ascertain efficacy and long-term safety of plant derived nutraceuticals. This approach will help in recommendation of nutraceuticals for OA treatment alone or in combination with traditional medicine.

Research from animal, cellular and clinical  OA models shows that nutraceutical supplementation may represent a significant adjuvant strategy in the management of OA patients, with or without the synergistic integration of conventional therapy, that could eventually be delivered at lower doses, thus reducing side effects.

In a nutshell, nutraceuticals have beneficial effects on joint pain and improves the quality of life of the patient. This can be considered as a strategic tool for the management and prevention of osteoarthritis as they have less side effects and lower costs. Scientific validation from different studies demonstrate that such a strategy not only improves clinical symptoms but also determines regression of disease. Thus, it is beneficial to integrate nutraceutical compounds for treatment of joint disorders beyond traditional rehabilitation, medications, and surgical strategies.

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