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An active lifestyle has many health benefits from cardio protective effects to the disease risk reduction benefits a lean tissue mass provides, however active individuals may be more prone to ‘wear and tear’ of joints with a heavy training schedule. Cartilage and bone health are important for long term well-being and maintaining an active lifestyle. These ingredients are worth including in your daily supplement program, especially when undergoing periods of strenuous training and athletic competition, or for speeding up recovery from sports related injuries. As well as trialling supplements, it is also important not to over stress your joints by pushing too hard and taking care of your bone health too. Calcium, Magnesium, Vitamins D & Vitamin K are bone nurturing nutrients.
Vitamins & Minerals
Vitamin C is known for its’ immune support benefits during and after intense physical exercise in doses above 280mg, but it also contributes to normal collagen formation for the normal function of bones and cartilage. Doses from 80mg to 1000mg/ day would be beneficial, especially combined with collagen intake. Fresh fruits especially citrus fruits and berries; green vegetables, peppers and tomatoes are all sources of vitamin C. It is also found in potatoes (especially new potatoes and the skins of potatoes). Remember though Vit C can be lost during cooking at high temperatures. Copper & Manganese also contribute to the maintenance of normal connective tissues and therefore can be beneficial to cartilage (as cartilage is made up of connective tissues). Dietary sources of copper include shellfish, liver, kidney, nuts and wholegrain cereals. Manganese is present in plant foods such as vegetables, tea, cereals and nuts.
Glucosamine and Chondroitin
Glucosamine sulphate is an amino sugar found in the human body. Glucosamine is a major component of cartilage and it is produced naturally in the body, however there are no major food sources of glucosamine making it hard to obtain from our diets. In a person with joint issues, it is hypothesised cartilage is destroyed faster than it is synthesized. Glucosamine is often supplemented with chondroitin as it is argued they work synergistically. To supplement glucosamine, take 300 – 500 mg, 3 times a day, for a total daily dose of 900 – 1500 mg. Studies on athletes supplementing glucosamine are limited, but preliminary evidence suggests doses as high as 2000 to 3000mg of glucosamine sulphate may be able to slow joint degradation. This effect is most relevant for athletes participating in high impact sports, like running.
Chondroitin sulphate is a component of joint cartilage. It is said to work by stopping the degradation of cartilage and restoring lost cartilage. It also contains sulphur-containing amino acids, which are essential building blocks for cartilage molecules in the human body.
Chondroitin helps form proteins found in the cartilage and helps to attract fluid in the connective tissue found in cartilage. The fluid is important as it helps absorb shock as well as providing nutrients into the cartilage. Some studies show with age or intense training sessions, our bodies become less efficient at renewing connective tissue and maintaining levels of glucosamine and chondroitin. A recent Cochrane review concluded that Chondroitin may help improve quality of life in individual with certain joint problems. [i] Doses between 100-1200mg are commonly found in supplements.
Omega-3 fatty acid supplements have become popular for the joint health. Their clinical benefit is modest and long-term benefits need further evaluation. Nevertheless, fish oils at high levels providing 2.7-4g/day of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been shown to benefit on swollen and tender joints, grip strength and mobility. (Stanner et al 2009).[ii] We should all aim to eat 2 portions of fish a week, one of which should be oily (mackerel, salmon, fresh tuna, trout, herring). A portion should typically be around 140g. Vegetable sources of omega 3 (ALA- alpha linolenic acid) can be an alternative for vegetarians, but our bodies would need more of the ALA to get the beneficial effects. Supplementation can be useful to achieve higher doses to obtain the proposed benefits. Opt for omega 3 supplements (check labels on pack about 450mg EPA& DHA /day adult is a good amount) rather than cod liver oil, as omega 3 fish oils have a higher amount of the beneficial fatty acids.
Other ingredients commonly found in joint products:
Type II collagen (CII) is a peptide and component of joint cartilage and some studies show benefits to joint health. A study evaluated oral supplementation of un-denatured CII at 40mg a day (for four months) in participants was effective in improving knee range of motion (from 73.2º to 81º with no change in placebo) and a longer time for joint pain to occur during exercise and faster recovery, maximal benefits occurring three months after supplementation and maintaining this study. (Lugo JP, et al 2013) Doses between 5-10g are common in liquid products, but in tablets lower doses are used around 300-500mg. Meat and fish are good sources of collagen.
Botanical supplements such as curcumin, ginger and rosehip extracts may help benefit maintenance of joint health however the evidence on these products is not as strong, but they are some of the most studied herbals. The proposed benefits for ginger and curcuminoids from turmeric include ‘anti-inflammatory’ properties. Rosehip also contains vitamin C naturally.
MSM (Methylsulfonylmethane) and Hyaluronic acid are also found in supplements supporting joint function. MSM holds potential for joint health (not significantly different than Glucosamine sulphate). Some researchers argue it might just simply be a way to increase sulphur intake, and secondary to the improvements in collagen synthesis and oxidant defence it exerts benefits.
Low sulphur levels may also underlie why glucosamine sulphate, but not hydrochloride is argued to work, despite no differences in the way it is handled by the body. Supplementation of MSM tends to be taken at up to 3000mg daily, however doses around 500mg is more common in multi-ingredient products especially tablet formats. A decrease in exercise induced oxidation is noted with MSM supplementation. This is argued to be the underlying reason for reductions in muscle damage and soreness. Although more research is needed, the degree of reduction seems to be prominent, a 2011 study experimented 50mg/kg of MSM supplementation for 10 days in otherwise healthy untrained men subject to a prolonged cardiovascular exercise test was able to reduce all measured biomarkers of oxidation that were increased by exercise (Roohi B et al 2011). [iii]
Hyaluronic acid injections are advised by medical professionals to help treat medical joint problems, however the research into absorption of hyaluronic acid (or in the form sodium hyaluronate in many tablet supplements) and its benefits for joint health through supplementation is currently limited.
 Stanner S, Thompson R & Buttriss JL (eds) (2009) Healthy Ageing: The Role of Nutrition and Lifestyle. The Report of a British Nutrition Foundation Task Force. Wiley-Blackwell: Oxford
 Nakhostin-Roohi B, Barmaki S, Khoshkhahesh F, Bohlooli S. Effect of chronic supplementation with methylsulfonylmethane on oxidative stress following acute exercise in untrained healthy men. J Pharm Pharmacol. 2011 Oct;63(10):1290-4. doi: 10.1111/j.2042-7158.2011.01314. x.