Bone and joint problems are the number one reason for doctor's visits in the United States. While there are several reasons a person might encounter joint problems (e.g., athletic injury, genetic predispositions), it also results from the normal wear and tear associated with getting older. In essence, our longevity outlasts our durability. We are living much longer and trying to stay active well into our later years and asking more from our bodies. Being active at an older age increases the risk for injury because with age, our musculoskeletal system becomes more vulnerable. Thankfully, there are ways to extend the warranty on our frames.

First and foremost, eating healthy and keeping the weight down is essential. Even one extra pound a person carries can multiply and feel more like five pounds to the joints. We also need to exercise. Beyond the countless other benefits, motion is lotion for joints and exercising builds muscle. The average adult loses six pounds of muscle per decade, but this can be reversed through strength training. So, a properly designed program of regular physical activity and proper nutrition can help maintain or restore musculoskeletal system structure and function.

Aside from lifestyle adjustments, several kinds of joint health supplements are available. I am a big believer in the use of glucosamine and chondroitin sulfate. Among the myriad supplements being marketed for joint health, these have the most research support. For instance:

• A 2015 study of 606 knee osteoarthritis patients across 42 centers in Europe with moderate-to-severe knee discomfort. The primary outcome reported was a 50% decrease in WOMAC pain at six months with no significant difference in response between the glucosamine/chondroitin sulfate group and the celecoxib (an NSAID or non-steroidal anti-inflammatory drug) group.[1] In other words, glucosamine/chondroitin sulfate was as effective as a prescription NSAID, according to researchers!

• A 2006 study sponsored by The National Institutes of Health (NIH) evaluated more than 1,200 people (ages 40 and older) who experienced knee discomfort within the past six months. It found the combination of glucosamine hydrochloride and chondroitin was effective in patients with moderate-to-severe joint discomfort.[2]

For retailers offering natural supplements and product lines, glucosamine and chondroitin sulfate are great options because they are both naturally produced by the body. There are brands that offer vegetarian options as well.

Non-steroidal anti-inflammatory drugs (NSAIDs) are a common remedy for the symptoms resulting from joint issues whether through over-the-counter options like ibuprofen, or stronger versions prescribed by a physician. While NSAIDs are helpful and necessary in some instances, their overuse in the long-term can have numerous negative consequences. In August 2015, the FDA strengthened its warning about potential negative side effects of NSAIDs including cardiac issues, stomach ulcers, gastric bleeding and renal troubles. Since many joint health issues aren’t fully “curable,” patients should pursue safer long-term strategies such as lifestyle modifications and also try a quality glucosamine and chondroitin supplement. Also remember to be patient, as it sometimes takes a month or two to see improvement with these methods.

It's important for consumers and retailers to understand what makes a quality supplement since there are real risks for both sides. Consumers should be protected from banned or harmful substances and they also don’t want to waste money on something that doesn’t work. Retailers can be caught up in lawsuits and damage their reputation if their suppliers are found to be deceitful in marketing or manufacturing.

When it comes to buying supplements, especially joint supplements, brand matters! Supplements that are tested by independent sources, such as the public health and safety organization, NSF International or Consumer Labs can verify that what is on the label is what is found in the product. If a product has this certification, it will appear on the label. Even if the right ingredients are there, keep in mind not all brands are created equal. There can be widely varying quality and purity levels of ingredients and manufacturers can choose what to use. Supplements that have undergone several independent peer-reviewed clinical studies are among the best options.

Nicholas A. DiNubile is an orthopedic surgeon and best-selling author of the FrameWork series of health and wellness books. He is Vice-President of the American Academy of Anti-Aging Medicine (A4M) and Chief Medical Advisor for the American Council on Exercise (ACE). For more information check out www.drnick.com and @drnickUSA on Twitter.

NOTE: The statements presented in this blog should not be considered medical advice or a way to diagnose or treat any disease or illness. Dietary supplements do not treat, cure or prevent any disease. Always seek the advice of a medical professional before adding a dietary supplement to (or removing one from) your daily regimen. WholeFoods Magazine does not endorse any specific brand or product. The opinions expressed in bylined articles are not necessarily those of the publisher.

Posted on WholeFoodsMagazine.com 1/6/2016

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[1] Hochberg MC, Martel-Pelletier J, et al. Combined chondroitin sulfate and glucosamine for painful knee osteoarthritic: a multicenter, randomized, double-blind, noninferiority trail versus celecoxib. Ann Rheum Dis. 2015 Jan 14.

[2] Clegg, DO, Red DJ, Harris CL, et al. Glucosamine, Chondroitin Sulfate, and the Two in Combination for Painful Knee Osteoarthritis. N Engl J Med. 2006; 354: 795-808.