Kate Miller takes a look at the causes of joint and bone problems and why their increasing incidence are driving customers to look for natural alternatives in health food stores
The aches and pains that plague us as we get older are often dismissed as just another sign of ageing. But for the millions of people living with conditions such as arthritis and osteoporosis, the problem is far more than the odd knee-click or twinge. And with rising obesity rates, sedentary, indoor lifestyles and poor diets, bone and joint-related problems are only getting worse, bringing with them conditions such as rickets, which has seen a fourfold increase in young people.
Dr Marilyn Glenville says that the situation is extremely worrying: “It’s a real problem. And the Govern-ment recommendation that all children under five and pregnant women supplement with 400ius vitamin D a day is not getting through.”
She says that they routinely do vitamin D checks at her clinic, and the results are “shocking”. “The wider population aren’t being checked because they’re being told that the tests aren’t available or are restricted.”
But while the issue of vitamin D deficiency is worrying, it is at least making the headlines because it affects children. The less headline-grabbing problem of joint and bone pain in the rest of the population is, for many, more insidious, as these rates are quietly growing to, what some claim are, epidemic proportions.
According to Arthritis UK, around ten million people live with the condition in the UK, while The National Osteoporosis Society reports that bone fractures caused by the osteoporosis occur every two minutes in the UK among the over 50s.
Dr Chris Etheridge, medical herbalist and Henry Potter Advisory Committee member, says that the most common problem affecting joint health is osteoarthritis – due to ageing and wear and tear on the joints. With bone health, it’s a condition called osteopaenia which leads to osteoporosis: “Osteo-paenia is a lowering of the normal bone density and is a precursor to osteoporosis – a progressive loss of bone minerals and mass that makes the bone less strong, increasing the risk of fractures.”
“Of the 38% of men using vitamins and minerals on a daily basis, 25% report that they are doing so to maintain joint health”
A widespread problem
Physiotherapist and sports scientist Paul Hobrough from the Simplyhealth Advisory Research Panel (ShARP), says that joint pain is widespread but is more common in older people: “Common joint pain is found in individuals of all ages, but the older we get the higher the percentage who report pains in the hips, knees and lower back.”
Cherry Active director John Carey points out that joint problems can also be prevalent in those doing physical labour: “A lifetime of physical activity is a major factor for developing the condition. A physical, manual job or overuse of the joints through sport are considered to increase the chances of development of this condition. Previous joint injuries can also be a factor.”
Conditions such as being pregnant can also put stresses and strains on joints, plus hormones such as thyroid or adrenal hormones may also have a detrimental effect.
According to Glenville, bone density problems and osteoporosis, in particular, affect one in two women compared to one in nine men, because of the changes to hormones as women get older. There are also family risks for both men and women, but men are usually affected because of the side-effects of medications such as steroids.
Etheridge says the increase in bone problems may be down to poor diet and the increasing level of obesity in the UK, as well as the recent increase in alcohol intake in older women.
Glenville says that rates of osteoporosis are increasing at an alarming speed: “When I first wrote my osteoporosis book the statistics were that one in three women over the age of 50 would get osteoporosis but by the time it was published the statistics were one in two. For osteo-porosis, we are less active than before and also dietary changes will affect both bone density and also increase the risk of osteoarthritis.”
For joint pain sufferers, a decrease in physical activity is often what they mistakenly believe will be good for them. In fact it’s the worst thing they could possibly do. According to a study commissioned by ShARP, people with joint complaints often get trapped in a cycle where lack of exercise exacerbates pain, leading to muscle wastage which in turn leads to weight gain, placing more stress on painful joints.
“Excess weight can put additional strain on the joints, so losing weight can be a factor to reduce swelling and pain,” says Carey. Which is all well and good, but I can imagine that many of you may balk at the thought of suggesting to your customers that they might want to drop a stone or two. You may want to leave that particular pleasure to your in-store nutritionist.
However, Carey also says that some people find certain foods to be triggers to joint pain, and a food diary can help in identifying and avoiding such foods.
Carey recommends omega-3 polyunsaturated fatty acids EPA and DHA for joint health as well as Mont-morency cherries, available in juice, dried fruit and powdered capsule formats.
“These have also been shown to possess anti-inflammatory properties and have a growing follow- ing among osteoarthritis sufferers,” says Carey. “Carti-lage contains substances related to glucosamine and chondroitin, and taking supplements of these natural ingredients may nourish damaged cartilage.”
Co-founder of the Primary Care Rheumatology Society and GP, John Dickson, believes rosehip has much to recommend it and is an advocate of GOPO – a compound found in the rosa canina species of rosehip which has had good trial results. Participants in the trials reported significant reduction in pain and stiffness in the knee and hip, plus a reduction in inflammation compared to the placebo.
Consultant rheumatolo-gist Dr Rod Hughes says of GOPO: “The evidence base for the use of glucosamine in the treatment of osteoarthritis is still in evolution, whereas the evidence supporting the benefits of GOPO as a treatment for osteoarthritis appears to be consistent.”
According to Mintel, bone health is a driver among supplements, even among men. Of the 38% of men using vitamins and minerals on a daily basis, 25% report that they are doing so to maintain bone health – more than the 22% taking them for heart health.
Etheridge says that sufficient calcium, magne-sium, vitamin D and protein are essential to help reduce the chances of osteopaenia/osteoporosis. A low acid diet, high in vegetables, vitamins C and E and zinc, can be beneficial in reducing the symptoms of osteoarthritis. According to Glenville, while the first nutrient for osteoporosis that usually comes to mind is calcium, retailers should be making sure that customers know the vital role others such as magnesium, vitamin C, vitamin D, zinc and boron also play in bone health.
Etheridge says that some customers can get confused between osteoarthritis and osteopaenia, due to the similarities in their names, meaning that sometimes they ask for help with the wrong condition. Therefore, he says, it is vital that customers are carefully questioned by retailers before recommendations are given.
For osteoarthritis Ether-idge recommends fish oils, vitamins C and E, zinc and glucosamine. “Potter’s Herbals Joint Pain Relief can be very helpful at reducing symptoms,” he says, and recommends Potter’s Comfrey Cream to reduce pain and stiffness. “
A recent study has shown that comfrey can also help to ease the pain of arthritic joints by as much as 42%.” For osteopaenia/ osteoporosis he suggests calcium, magnesium and vitamins C, D and K. However, he says these should not be taken at the same time of the day as any prescription medication to avoid interactions. “Soya isoflavones can be very helpful, but should only be used under the guidance of a medical herbalist or nutritional therapist. There is continuing research on the role of soya products and vitamin K in the prevention and treatment of osteopaenia/ osteoporosis, and in the use of comfrey and ginger in controlling the pain of osteoarthritis.”
For Glenville it’s all about the quality of products, especially when it comes to supplements: “I want capsules rather than tablets because tablets contain binders and also with the capsules I want to have no excipients, ie no fillers, anti-caking agents or lubricants, which are to help manu-facturing and are not in the consumers’ best interests. Also, botanicals should be organic where possible, and in terms of bone health to have calcium in its citrate form rather than carbonate.” Carey says that retailers should be stocking products that have clear research-backed evidence to show efficacy for joint problems and ones that have a strong anecdotal evidence base: “For example, CherryActive Concentrate and Capsules are made with 100% Montmorency cherries and are backed with an extensive research programme into their efficacy.”
Because many of the mainstream drugs prescribed for these conditions have side-effects, retailers may see customers coming in for help with these, and often digestive problems, too.
Glenville says: “Often if people have side-effects on their prescribed medicine, which they must always tell their GP about, the GP prescribes another pill to deal with those as well, and you sometimes find that it’s at that point, that people want to look down another route.”
Natural solutions are the future
As for the future, Glenville says that disillusionment with mainstream medicine is only going to drive more people with these conditions down the complementary path and into health food shops.
According to the National Osteoporosis Society there is a real problem with the way doctors are dealing with people with these conditions, leading to many people being simply unaware they have a bone density problem because doctors don’t discuss it with them. A survey by the charity found that a fifth of female patients surveyed had not been diagnosed with osteo-porosis until they had had three or more broken bones, and one in ten of these said that they had never discussed osteoporosis or bone health with the medical professional treating the fractures. The charity says that after the first break, one in eight people go on to break another bone within a year, and one in five within five years.
Confusion about main-stream treatments of these conditions has also been compounded by the about-turn by NICE on recom-mendations on the use of paracetamol for pain. According to John Dickson it’s an interesting turn of events, as: “Basically NICE has said that only 14 out of 100 people respond to paracetamol for this type of pain and therefore it’s a placebo for most. There’s nothing wrong with a placebo if it’s safe, but paracetamol is not safe.”
“Only in August 2013 the statement from NICE read ‘NICE has warned GPs against prescribing paraceta-mol for patients with osteoarthritis after its experts said they were ‘extremely concerned’ about the links of higher doses to cardio-vascular, gastrointestinal and renal adverse events,” says Glenville.
And as well as the confusion from NICE about mainstream medicine, tight legislation surrounding health claims isn’t helping customers either, says Carey: “With the EU Health and Nutrition Regulations, many products that may be useful cannot make any claims, which has led to confusion among retailers and consumers.” He says that retailers can read up on current research on products and recommend those that have a strong research backing.
Helen Galpin, founder of the Nutrition Centre, says that the legislation hasn’t affected them as much as they thought it would: “We train our team so hopefully they have knowledge to share, and we also have scientific research to back the products up,” she explains. “We are aware that we cannot say that this product will cure you, so we say this may be useful, or other customers have found that this helps.”
Glenville says that talking generically can aid retailers to help their customers fill in the blanks on the infor-mation available on the products. “It’s a shame though, when the botanical ones like turmeric have good clinical trial evidence but can’t make a claim. The public can’t see what it can do from the container.” She recommends that retailers who don’t have one already, look into having a specific joint and bone section in store: “It’s only going to increase. Osteo-porosis in women especially – there is an epidemic going on,” she warns.
Joint Health Listings
BetterYou Magnesium Oil Joint Spray contains a concentrated solution of the purest known magnesium chloride. With a transdermal application Magnesium Oil has been proven to deliver this essential mineral up to 5 times faster than oral means. Magnesium is key for skeletal strength, normalised muscle function, energy production and the body’s ability to detox. The added glucosamine in the spray helps to promote cartilage health whilst the menthol and wintergreen oils have a cooling and calming effect. Ideal for application onto joint and muscle areas as an aid to stiffness and discomfort. Contains up to 800 sprays per bottle. www.betteryou.com
Produced using the finest quality organic tinctures and other natural plant based ingredients, Helios Rhus tox & Ruta cream is traditionally used to soothe stiff aching joints and muscles and help with strains and sprains. Free from lanolin, artificial preservatives and petroleum derivatives the cream is suitable for the most delicate skin. For further details please contact Roz Crompton.
CherryActive is a range of premium quality nutritional supplements designed for the modern lifestyle. CherryActive products are 100% natural and packed full of antioxidant-rich Montmorency cherries and contain no sweeteners, preservatives, flavourings or added sugar. Available in concentrate and capsule forms our products are chosen by consumers serious about maintaining good health and optimising their fitness training.
Nature’s Answer Glucosamine Chondroitin with MSM formula combines Glucosamine with other substances important for the resiliency and maintenance of healthy cartilage, such as Chondroitin, MSM and other joint friendly nutrients. Quik-Sorb® is an exclusive blend of herbs known to enhance delivery of nutrients to the body. Glucosamine is produced by the body and distributed in cartilage and connective tissue. Chondroitin sulfate helps cartilage retain water. Clinical studies of glucosamine have demonstrated it is an effective treatment for helping with symptoms linked to joint and muscle pain. Glucosamine also increases the formation of lubrication materials inside the joints and slows the activity of enzymes that cause joint destruction as well as aiding joint repair.
Osteoflex® Plus – Keeping you Flexible Osteoflex®Plus tablets, an optimum formulation providing a combination of Glucosamine and Chondroitin, which helps the body repair damaged cartilage and lubricate the joints. Vitamin C and Turmeric are incorporated in the formula for their powerful anti-inflammatory properties. Osteoflex® Plus has the added benefit of Hyaluronic Acid, helps to improve joint health – especially cushioning of the joints and to improve the quality of synovial fluid that acts as a lubricant, shock absorber and helps to maintain the structural and functional characteristics of the cartilage matrix. Osteoflex® Plus retails at £17.99 for 30 tablets. Contact HealthAid Ltd on 0208 426 3400 for purchase and stockist information or visit www.healthaid.co.uk
When it comes to bone health Calci-D-min has it covered! Based in Aquamin™, our plant derived (from red algae, Lithothamnion species) mineral complex supplies calcium, magnesium and over 70 trace elements in a highly absorbable form. To this we have added 1000iu vitamin D3 along within vitamins K1 and K2 known for their curtail role in bone formation and support. Calci-D-min contains 16 other bone specific nutrients all of which play an important role in the overall functionality of this unique product. Calci-D-min has been given the full approval if the Vegetarian Society (UK).
Terranova Glucosamine, Boswellia & MSM Complex
Terranova Glucosamine, Boswellia & MSM Complex is a specially designed formula for active, ageing or injured people. A natural formula that can really make a difference in maintaining healthy joints. Contains anti-inflammatory Boswellia Resin, Nettle, Turmeric Root, Ginger Rhizome and Root to prevent swelling around the joints as well as antioxidant rich Celery Stalk & Leaf and Stabilised Rice Bran. As with all Terranova products, the emphasis is on holistic synergy within the formulas which are created with ethically sourced ingredients and are suitable for both vegetarians and vegans.
Syno-Vital is manufactured to the highest standard by Modern Herbals. Made of pure HYALURONAN, it is one of the most water-loving molecules in nature. Hyaluronan exists in the body but as we age we produce much less. Syno-Vital is a specialised form of liquid HA in an easy to use 5ml liquid sachet which is readily absorbed and utilized by the body. Hyaluronan helps to increase the viscosity of the synovial fluid and so can help to cushion the joints and improve flexibility. As we get older, we produce less Hyaluronan in the body and topping up your HA may help to ease joint problems.
The UK’s leading nutritionist and women’s health expert Dr. Marilyn Glenville PhD has formulated a brand new Vitamin D3 Nutrition Support spray in association with The Natural Health Practice. This easy to take, family friendly vitamin D3 spray helps contribute to the maintenance of normal bones and muscle, as well as normal function of the immune system. Each spray will supply 400iu of Vitamin D3. Vitamin D3 Support is special in that it contains only completely natural ingredients including vitamin D3, olive oil, peppermint oil and natural vitamin E (d alpha tocopherol). It does not contain any preservatives such as potassium sorbate or any sweeteners.
Backache and Joint Ache relief Natures Aid JointEeze® is a licenced Traditional Herbal Remedy for Devil’s Claw root. JointEeze® is used for relief of backache, rheumatic or muscular pain, and general aches and pains in the muscle and joints, based on traditional use only. Each JointEeze® tablet contains 300mg of extract from Devil’s Claw root (equivalent to 1050 – 1500mg Devil’s Claw root). JointEeze® is available in 90 film-coated tablets (1 month supply) and is suitable for vegetarians and vegans. RRP £11.95. For further information call Natures Aid on 01772 686231 or visit naturesaid.co.uk.
A new exceptionally high quality organic omega oil, suitable for vegans. The best on the market for quality and freshness and contains high levels of Omega 3,6,9. Vitona Oil of Life Premium is composed of organic unrefined flaxseed oil, organic evening primrose oil and vegetarian DHA. It is the only vegetarian omega oil to contain EFSA approved DHA levels, produced and extracted directly from the algae Schizochytrium sp., in a sealed cultivation system. Daily intake of two small tablespoons gives the recommended amount of 250ml DHA, which has been show to contribute to the maintenance of brain function, heart health and healthy vision. Available direct & Revital
WALK, RUN, CLIMB, PLAY – You Can! Solgar, the company that led the way in Glucosamine Chondroitin, brings you the next generation in joint health. Solgar® 7 increases joint mobility and flexibility, helping reduce inflammation*. It combines powerful anti-oxidants and nutrients to create a fast-acting approach for joint stresses related to physical activity*. Solgar® 7 combines these nutrients in one easy-to-swallow vegetable capsule, which won the prestigious “Best New VMS Product” at the Natural & Organic Awards in April. * Vitamin C helps collagen formation for the normal function of cartilage and bones, and helps protect cells from oxidative damage.