Where glucosamine and chondroitin were once the standard of care in joint nutrition, a new class of ingredients has stepped in to support cartilage, tendons, connective tissue, and more.
“The joint health category has been dominated by glucosamine for over 25 years, and chondroitin began to show up alone or in combination products with glucosamine around 15 years ago,” observes Nena Dockery, scientific and regulatory manager with Stratum Nutrition (Carthage, MO). She says that while these two ingredients still comprise the majority of joint health products, both have significant shortcomings. High daily dosage amounts, long duration of use for benefits, and issues with adulteration are just some of the reasons why consumer preference is shifting.
Safe, natural, and clean-label formulas are continuing to gain traction in the joint health category, with ingredients like collagen, turmeric, eggshell membrane, and methylsulfonylmethane (MSM) taking over considerable market share.
According to SPINS data on this category (U.S. Natural and Multi-Outlet (MULO) channel, 52 weeks ending July 12, 2020), collagen products have earned $198 million in consumer sales in 2020; turmeric $5 million; and MSM $2.6 million. Compare this to glucosamine-and-chondroitin combination products’ $215 million, glucosamine products’ $45 million, and chondroitin supplements’ $57,185. Meanwhile, a report by MarketInforming Healthcare estimates the North American eggshell membrane market was worth $11.8 million in 2019.1
As the joint health product space evolves, innovation among nutritional ingredients—in the form of science, new dosage and delivery methods, and unique branded formulas—is driving market growth.
Collagen has seen significant gains in recent years, with its benefits for joint health (as well as applications for “beauty from within” and bone health) spurring consumer interest.
Discussing the rise of collagen, Suhail Ishaq, president of BioCell Technology (Irvine, CA), says the company’s clinically studied BioCell Collagen offers a unique composition that mirrors human articular cartilage.
“Dietary supplement manufacturers and formulators are seeking clinically studied, branded ingredients to include in their products that enable them to make reliable and more specific claims,” he notes. “At a 2-g dosage, the BioCell Collagen ingredient is clinically proven to promote joint comfort and mobility, and cartilage and synovial fluid health, and boost hyaluronic acid. These are marketable claims that consumers can understand.”
BioCell Collagen is composed of hydrolyzed collagen type II peptides, chondroitin sulfate, and hyaluronic acid. The ingredient’s matrix is not a formula or blend of individual ingredients but rather a naturally occurring composition.
In a 2014 pilot randomized, double-blind, placebo-controlled study of recreationally active people, participants took 3 g of BioCell Collagen over six weeks before an upper-body bench press challenge.2 The study found that participants experienced favorable improvements in stress resilience and recovery after bouts of intense resistance exercise, without any reported side effects.
Nitta Gelatin (Morrisville, NC) offers multiple clinically tested collagen ingredients specifically designed for joint support in both the sports nutrition and healthy-aging segments.
“Our global technical teams have been at the forefront of research illuminating collagen’s mechanisms of action within the body, and we use that insight to concentrate the ‘active’ portions of the ingredient, specifically the dipeptides proline-hydroxyproline (PO) and hydroxyproline-glycine (OG), in our products,” says Liz Clarke, CFS, technical marketing manager, Nitta Gelatin North America Inc.
The company’s Wellnex collagen peptides are developed using proprietary manufacturing processes. Nitta Gelatin holds global and domestic patents (JPB 4490498, WO-A1-2010/038323, U.S. 8227424.B2) for collagen peptides containing high levels of bioactive dipeptides for joint support.
Clarke adds that Wellnex collagen peptides for joint health serve a dual function because they offer both a specific health benefit and also act as a dietary protein. “Adding collagen peptides to everyday foods is a quick and easy way to support joint function without contributing to the pill fatigue that consumers may experience with other joint supplements,” she states. “The versatile nature of Wellnex collagen peptides allows for unique applications in the functional food space, including bars, shots, gels, gummies, and more.”
A recent study conducted at Josai University (Sakado, Japan) investigated the effect of 5 g daily of Wellnex collagen peptide supplementation on sports-related joint and muscle pain in healthy long-distance runners.3 Results of the double-blind, placebo-controlled, randomized study demonstrated a significant reduction in knee pain, and a reduction in muscle breakdown markers, in as little as four weeks. “We already had a substantial body of evidence supporting Wellnex collagen peptides’ benefits on those suffering from osteoarthritis,” notes Clarke. “The results of this most recent study open the doors to more opportunities in the sports nutrition world, which is an exciting place to be right now.”
Meanwhile, IDF (Springfield, MO), part of Diana in the Symrise Nutrition Segment, offers chicken bone broth ingredients that are high in collagen protein to support joint health. “Our ingredients are available in multiple formats (concentrated, liquid, and dry) and flavor profiles for use in savory beverages, functional foods, supplements, and more,” explains Becky Rademacher, IDF product manager.
The company believes the versatility of its ingredients are providing new and convenient ways for consumers to get their daily collagen. “Bone broth has long been touted by athletes and nutrition experts, and collagen has come to be recognized as the missing protein for joint benefits and more,” says Rademacher. The company’s CHiKPRO Collagen is soy-, dairy-, and gluten-free; Certified Paleo by the Paleo Foundation; keto-friendly; and rich in type II collagen.
Demand for turmeric (Curcuma longa)—and its primary bioactive chemical compound curcumin—has skyrocketed in recent years. Between 2017 and 2018, sales of turmeric overall grew by 30.5% in the mainstream MULO channel data alone, earning $93 million in that channel in 2018, according to SPINS data featured in the American Botanical Council journal HerbalGram.4
Perhaps turmeric’s prominence in the joint health space stems from its natural, plant-based roots. In the Council for Responsible Nutrition’s (CRN) 2019 Consumer Survey on Dietary Supplements, 72% of dietary supplement users expressed confidence in the quality and safety of herbal and botanical formulas, while 50% of total supplement users reported taking such products—increasing their usage by 19% since 2015. CRN attributed this growth to breakout botanical ingredients like turmeric, as well as green tea and CBD. The same survey also found that 20% of supplement users take a nutritional formula for joint support.5
To meet this increasing consumer demand, suppliers are developing scientifically supported, high-quality turmeric and curcumin ingredients.
Once such formula—Meriva curcumin phytosome from Indena (Milan, Italy)—has demonstrated support for healthy joints and bones in five human clinical studies.
Francesca de Rensis, marketing director of Indena S.p.A., highlights the bioavailability of the company’s formula as a unique benefit, calling the ingredient “the first bioavailable form of curcumin designed from nature.” Indena utilizes a lecithin system inspired by the traditional use of turmeric in milk (often called “golden milk”).
A recent in vitro study examined the effect of microbiota on the biotransformation of curcumin. The Meriva formulation with lecithin had an impact on the biotransformation of curcuminoids by providing a more efficient production of active curcuminoid metabolites in comparison to the unformulated ones. This, says de Rensis, “is opening new perspectives in the investigation of curcuminoids’ bioavailability and effectiveness.”6
A more bioavailable formula leads to more tangible results from the formula, notes de Rensis. “Due to an aging population and increased stress with busy lifestyles, the maintenance of our long-term health plays an ever-increasing role. As the health benefits of curcumin—and specifically Meriva—in joint health have been demonstrated, Indena has focused on how Meriva offers lifelong support for the body’s natural defenses against low-level chronic inflammation.”
Sabinsa Corp.’s (East Windsor, NJ) Curcumin C3 Complex is yet another clinically studied curcumin brand, with over 150 published papers supporting safety and efficacy. More recently, the company has made strides in developing a wide range of curcumin delivery systems to address various applications and to meet market demands.
Shaheen Majeed, president worldwide, Sabinsa, believes new delivery systems like beverages and gummies are fueling growth in the joint health space. “We predict that curcumin’s market share will keep growing in a variety of categories, including joint health, because it works,” states Majeed. “We’re focused on more science on reductive metabolites as we continue to drive the understanding of curcumin’s many uses and benefits. We’re just scratching the surface.”
One addition to the company’s curcumin portfolio was Curcumin C3 Reduct, a standardized extract obtained by hydrogenating the curcuminoids from the rhizomes of the turmeric plant. Curcumin C3 Reduct is a colorless formula crafted to eradicate the yellow staining property associated with curcumin, while retaining the product’s benefits. This format also supports better stability, the company claims.
Curcumin C3 Dispersible is another new offering from Sabinsa, delivering a minimum curcuminoid content of 60%. It can be used in ready-to-drink beverages, powdered formulations, and chewable and dispersible tablets.
Additionally, Sabinsa developed uC3 Clear, a water-soluble curcumin formula designed to overcome the challenges some consumers experience with solid dosage delivery systems such as poor disintegration, slow dissolution, or difficulty swallowing.
Nutritional support from the membrane of eggshells has also been shown to bolster connective tissue and joints.
Stratum Nutrition manufactures and supplies NEM-brand eggshell membrane, a partially hydrolyzed eggshell membrane that’s developed through a patented enzymatic process. “The natural eggshell membrane is predigested just enough to begin digesting its fibrous membrane and release its nutritional content,” explains Dockery.
This select partial digestion enables the valuable components within NEM to benefit the joints in two different ways. “First, the combination of partial digestion and the body’s own digestive processes ensures that the bioactive components within NEM are optimally bioaccessible for absorption through the intestinal wall and utilization in joint tissue,” she explains. “And, secondly, the predigestion releases peptides, specifically collagen peptides, that interact with the gut immune system to indirectly modulate the immune response to joint inflammation via oral tolerance. This two-prong functioning would not be possible if NEM were either fully hydrolyzed or unhydrolyzed.”
A recently published clinical trial evaluated the efficacy of NEM in the reduction of joint pain, stiffness, and functional disability in 70 patients with mild to moderate knee osteoarthritis.7 After just 10 days, researchers reported statistically significant improvements in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, Visual Analog Scale (VAS) pain, and Lequesne Algofunctional Index pain. At the conclusion of the two-month study, WOMAC pain was reduced by 52%, VAS pain by 49%, and Lequesne Algofunctional Index pain by 39%.
Another ingredient, also derived from eggshell membrane, is manufactured by Biova (Johnston, IA) under the trade name BiovaFlex. This water-soluble eggshell membrane is produced by a patented process that separates the membrane from the shell of the egg, leaving a high-protein ingredient with elevated collagen, elastin, and glycosaminoglycans (GAGs) content.
A clinical study with a robust 88-person subject size found positive results for supplementation with BiovaFlex in those with osteoarthritis, leading to reduced stiffness and improved performance in the six-minute walk test within five days.8 The double-blind, placebo-controlled trial examined the subjects with osteoarthritis over 12 weeks and found that daily consumption of BiovaFlex water-soluble chicken eggshell membrane hydrolysate “significantly enhanced average individual physical capacity (walking distance and ability), reduced stiffness by the fifth day of supplementation (with the greatest benefit seen by the most compromised individuals), and was maintained over 12 weeks,” the researchers reported.
Methylsulfonylmethane (MSM) is an organic sulfur-containing compound with extensive research supporting its use in the area of joint health, mobility, and active aging. Science suggests the ingredient’s sulfur content and donation help the body maintain healthy connective tissues.
OptiMSM from Bergstrom Nutrition (Vancouver, WA) is backed by numerous preclinical and clinical studies for safety and efficacy.
“Extensive research has shown MSM decreases joint pain, improves stiffness and swelling, and increases the range of motion and physical function of individuals with osteoarthritis9-13,” explains Tim Hammond, vice president of sales and marketing for Bergstrom Nutrition. “The reduction of joint pain has also been noted in healthy athletes.14” The ingredient’s mechanism of action likely includes its ability to decrease proinflammatory cytokines, reduce oxidative damage, and supply a rich source of sulfur15-18, he adds.
Looking ahead, Hammond says he was excited to see new products featuring OptiMSM with other popular joint health ingredients like collagen, hyaluronic acid, curcumin, and Boswellia serrata. “The broad utility of MSM, along with its relatively low cost and safety, provides formulators with options in creating new products for a new generation of consumers looking for alternatives to glucosamine and chondroitin.”
- MarketInforming Healthcare report. “Eggshell Membrane Product Global Market Status and Trend Report 2014 – 2026.” Published March 2019. Accessed here.
- Poster presentation. Lopez HL et al. “Effects of BioCell Collagen on connective tissue protection and functional recovery from exercise in healthy adults: a pilot study.” Journal of the International Society of Sports Nutrition, vol. 11, suppl. 1 (December 1, 2014): 48
- Kimira Y et al. “The effects of collagen peptide supplementation on knee joint health: a double-blind, placebo-controlled, randomized trial in healthy university students belonging to a running club.” Japanese Pharmacology and Therapeutics, vol. 49, no. 9 (September 2019): 1455-1462
- Smith T et al. “Herbal Supplement Sales in US Increase by 9.4% in 2018.” HerbalGram, issue 123 (2019). Accessed here.
- Council for Responsible Nutrition. 2019 Consumer Survey on Dietary Supplements. Accessed here.
- Bresciani L et al. “The effect of formulation of curcuminoids on their metabolism by human colonic microbiota.” Molecules, vol. 25, no. 4 (February 19, 2020): 940
- Damjanov N et al. “NEM brand eggshell membrane in the treatment of pain and stiffness associated with knee osteoarthritis: an open label clinical study.” The Journal of Arthritis, vol. 8, no. 5 (2019): 1000287
- Hewlings S et al. “A randomized, double-blind, placebo-controlled, prospective clinical trial evaluating water-soluble chicken eggshell membrane for improvement in joint health in adults with knee osteoarthritis.” Journal of Medicinal Food, vol. 22, no. 9 (September 2019): 875–884
- Kim LS et al. “Efficacy of methylsulfonylmethane (MSM) in osteoarthritis pain of the knee: a pilot clinical trial.” Osteoarthritis and Cartilage, vol. 14, no. 3 (March 2006): 286-294
- Pagonis et al. “The effect of methylsulfonylmethane on osteoarthritic large joints and mobility.” International Journal of Orthopaedics, vol. 1, no. 1 (June 2014): 1-6
- Usha PR et al. “Randomised, double-blind, parallel, placebo-controlled study of oral glucosamine, methylsulfonylmethane, and their combination in osteoarthritis.” Clinical Drug Investigation, vol. 24, no. 6 (2004): 353-363
- Debbi EM et al. “Efficacy of methylsulfonylmethane supplementation on osteoarthritis of the knee: a randomized controlled study.” BMC Complementary and Alternative Medicine. Published online June 27, 2011.
- Withee E et al. “Effects of MSM on exercise-induced muscle and joint pain: a pilot study.” Journal of the International Society of Sports Nutrition. Published online September 21, 2015.
- Lubis AMT et al. “Comparison of glucosamine-chondroitin sulfate with and without methylsulfonylmethane in grade I-II knee osteoarthritis: a double-blind randomized controlled trial.” Acta Medica Indonesiana, vol. 49, no. 2 (April 2017): 105-111
- Rizzo R et al. “Calcium, sulfur, and zinc distribution in normal and arthritic articular equine cartilage: a synchrotron radiation-induced X-ray emission (SRIXE) study.” The Journal of Experimental Zoology, vol. 273, no. 1 (September 1, 1995): 82-86
- Kim YH et al. “The anti-inflammatory effects of methylsulfonylmethane on lipopolysaccharide-induced inflammatory responses in murine macrophages.” Biological & Pharmaceutical Bulletin, vol. 32, no. 4 (April 2009): 651-656
- Ahn H et al. “Methylsulfonylmethane inhibits NLRP3 inflammasome activation.” Cytokine, vol. 71, no. 2 (February 2015): 223-231
- Richmond VL. “Incorporation of methylsulfonylmethane sulfur into guinea pig serum proteins.” Life Sciences, vol. 39, no. 3 (July 21, 1986): 263-268