Loosening Inflammation's Grip

Inflammation afflicts a wide swath of Americans. According to the Centers for Disease Control and Prevention (Atlanta), nearly 46 million people in the United States suffer from arthritis and painful joint swelling. But other conditions linked to inflammation, such as cardiovascular disease (CVD) and asthma, strike millions more and cost tens of billions of dollars per year to treat.

'Everyone has aches and pains, especially as they age, and few of us took care of ourselves when we were young or understood the natural aging process,' says Joe Archer, vice president of sales and marketing at All American Pharmaceutical (Billings, MT).

While aging baby boomers are the principal victims of inflammation, younger people also are struggling with inflammation-related conditions. Inflammation affects people who live sedentary lifestyles as well as people who exercise strenuously.

In fact, joint disease is the number-one condition that consumers say they would like to treat or prevent with natural supplements, says Paul Dijkstra, CEO of InterHealth Nutraceuticals (Benicia, CA), citing statistics from the Natural Marketing Institute (Harleysville, PA).

'That makes sense, because many people are concerned about the side effects of over-the-counter (OTC) and prescription products that offer temporary relief,' Dijkstra says. 'Instead, they seek out natural remedies that they can take on a regular basis that offer long-term benefits.'

What Is Inflammation?

Inflammation, which causes swelling, redness, and pain, can be the body's natural response to injury. Although it's often associated with arthritis, inflammation sometimes manifests itself in other ways as well.

'Inflammation happens not only in the joints, but also in the arteries, in the brain, and in other tissues of the body,' says Jason Theodosakis, MD, PhD, a clinical assistant professor at the University of Arizona's (Tucson, AZ) College of Medicine.

Recent clinical studies have shown that inflammation is also a risk factor for various stages of atherosclerosis as well as metabolic syndrome, which precedes type 2 diabetes, adds Baldur Hjaltason, EPAX AS's (Lysaker, Norway) sales manager for North America, Japan, and China. 'Certain chronic diseases have long been recognized as inflammatory diseases,' he says.

While excessive inflammation is bad, a little inflammation may be OK. 'We don't want to wipe out inflammation,' Theodosakis says. 'We want to moderate it. There's a place for inflammation, such as in injury or in fighting infections and cancer. But that's low-level inflammation, not the type of chronic inflammation that many people have because they are overweight or have a poor diet.'

Demand for Solutions

Supplemental Approaches to Inflammation

Most consumers are familiar with glucosamine and chondroitin. But a number of other supplements may also combat inflammation, offer relief for joint discomfort, or address other related health concerns.

Arth-X Platinum is a blend of glucosamine, chondroitin, MSM, herbs, enzymes, and ionic sea minerals, according to Trace Minerals Research (Ogden, UT) director of science and research Chris Meletis. 'The best products on the market focus on the multidimensional approach to joint health,' he says. 'The long-term approach nourishes cartilage tissue, while lessening the inflammatory process that, if not controlled, can cause huge damage to joints and surrounding tissue.'

Bio-Astin is an astaxanthin ingredient grown in a natural outdoor production system. 'Many other astaxanthin products aren't stable when put into consumer formulas,' says Bob Capelli, vice president of sales and marketing at Cyanotech Inc. (Kailua Kona, HI). 'Cyanotech is one of the few suppliers to take all necessary steps to ensure stability: supercritical, solvent-free CO2 extraction, and then microencapsulation into a tablet-grade beadlet. Also, the HPLC analytical method developed by Cyanotech is the only method to be accepted by any government agency.'

C3 Complex is derived from the ground, dried root of turmeric, an ayurvedic ingredient used for centuries as a spice, preservative, and coloring agent. According to Sabinsa Corp.'s (Piscataway, NJ) vice president of scientific and medical affairs Vladimir Badmaev, MD, PhD, turmeric root is also 'a rich source of phenolic compounds with versatile anti-inflammatory and antioxidant action.'

EPAX fish oils are concentrated to contain high amounts of the omega-3 eicosapentaenoic acid (EPA). Baldur Hjaltason, EPAX AS's (Lysaker, Norway) sales manager for North America, Japan, and China, notes that EPAX oils can be blended with other ingredients or sold on their own in soft-gelatin capsules. 'All EPAX products are condition specific and supported by clinical work,' Hjaltason says. 'Furthermore, they are ultrapurified and have lower maximum limits regarding pollutants and oxidative products than the competition and national regulations.'

GLPH-1 is a potent botanical yeast extract that has demonstrated anti-inflammatory and immune-boosting activities, according to Garrett Lindemann, PhD, founder and CEO of Gourmetceuticals (Big Horn, WY). 'Research confirms that GLPH-1 is known to activate and expand the immune system's white blood cells, which translates into immune-boosting and anti-inflammatory activity in various settings,' Lindemann says.

Kre-Celazine is a patented ingredient consisting of Kre-Alkalyn bonded to esterified fatty-acid carbons. According to Joe Archer, vice president of sales and marketing at All-American Pharmaceutical (Billings, MT), Kre-Celazine enhances cell membrane integrity and suppresses inflammatory cell function. 'Kre-Celazine is a researched anti-inflammatory that attacks the problem and isn't just a Band-aid,' Archer says.

OptiMSM is a proprietary form of MSM that provides sulfur, a building block of joints, cartilage, skin, hair, and nails; and methyl groups, which support biochemical processes in the body. 'MSM is a naturally occurring nutrient found in small amounts of many foods,' says Roma Bergstrom, CEO of Bergstrom Nutrition. 'As a dietary supplement, MSM is synthesized. When made correctly, it is identical to that found in nature.'

ParActin is a patented extract of the immune-boosting herb Andrographis paniculata. 'ParActin focuses at the root of inflammation by naturally inhibiting nuclear factor kappa B (NF-κB), a key regulator of our inflammatory response system,' says Annie Eng, president of HP Ingredients (Bradenton, FL).

UC-II is a patented, undenatured form of type 2 collagen that has been shown to promote healthy joints and increase joint mobility and flexibility, says Paul Dijkstra, CEO of InterHealth (Benecia, CA). 'UC II works in a very unique way to reduce not only the symptoms related to pain and stiffness, but also the inflammation that causes these problems to occur in the first place,' Dijkstra says. 'Another significant advantage is its small dosage of 40 mg per day.'

Thanks to the baby boomer population and the growing number of younger Americans struggling with joint problems and other health conditions, demand for inexpensive natural products that address inflammation is robust. This is particularly so among consumers who distrust OTC and prescription drugs, says Annie Eng, president of HP Ingredients (Bradenton, FL).

'We see growth in the joint-health and inflammation category, as preserving bone and joint health to protect against osteoporosis and arthritis are prime concerns among aging baby boomers,' Eng says. 'In addition, with the recall of Vioxx and other drugs, consumers are searching for natural alternatives and supplements.'

'Joint health is among the largest dollar-sales segments of the supplement industry,' agrees Roma Bergstrom, CEO of Bergstrom Nutrition (Vancouver, WA). 'The core consumers of these products are active but aging baby boomers who want to address their chronic problems with safe compounds that don't have the risks associated with OTCs or prescription drugs.'

While OTCs and nonsteroidal anti-inflammatory drugs (NSAIDs) are effective, many consumers think twice when confronted with their side effects, says Vladimir Badmaev, MD, PhD, vice president of scientific and medical affairs at Sabinsa Corp. (Piscataway, NJ).

'NSAIDs are useful medications for the management of pain,' Badmaev says. 'However, the prolonged use of NSAIDs can result in gastrointestinal irritation and potentially fatal gastrointestinal irritation and bleeding. The new class of anti-inflammatory drugs, selective COX-2 inhibitors, was developed to reduce the gastrointestinal side effects and complications. But COX-2 NSAIDs have been associated with an increased risk of cardiovascular side effects and there are now concerns that this increased risk may extend to all NSAIDs.' Badmaev adds that the abuse of addictive prescription pain medications is also on the rise.

On the other hand, many people believe that supplements have fewer side effects than NSAIDs and can be used longer, notes Garrett Lindemann, PhD, founder and CEO of Gourmetceuticals (Big Horn, WY). 'The perception is that natural products are safer and more tolerable than pharmaceutical products,' he says.

'Natural products help support natural anti-inflammatory pathways in the body,' explains Chris Meletis, director of science and research at Trace Minerals Research (Ogden, UT). 'The concept of working with the body by nourishing and gently nudging biochemical pathways to lessen inflammation is without question the natural way to approach any health condition.'

This perception is highly significant to consumers. In fact, safety, tolerability, and the ability to provide long-term relief are areas where supplements really shine, says the University of Arizona's Theodosakis, who also serves as a consultant for Bergstrom Nutrition.

'In the nonherbal realm, glucosamine, chondroitin, and MSM are good examples because their long-term use is safe, especially compared to drugs,' Theodosakis says. 'Some supplement studies evaluate long-term use that is two, three, or even eight years in duration. Long-term safety is critical because people with chronic joint problems tend to use supplements for years, and many people are using supplements as preventative agents.'

Don't Forget Exercise and Diet

While NSAIDs and supplements may have their place in addressing inflammation, experts note that exercise and diet also can play supportive roles. Although it seems counterintuitive, several studies show that weight-bearing exercise actually protects joints by boosting levels of glucosaminoglycan in joint cartilage. Other studies have shown that strength training and aerobic exercise can modestly improve joint function and reduce discomfort.

Diet is also a key factor behind inflammation, says Theodosakis. 'The kinds of foods that we eat in the United States, such as processed food, fast food low in omega-3s, and foods with a high glycemic index, actually help increase the level of inflammation in the body,' he says.

For instance, in the March 2007 issue of Psychosomatic Medicine, Ohio State University (Columbus) researchers reported that people with a high ratio of omega-6 to omega-3 fatty acids had high blood levels of interleukin-6 and tumor necrosis factor alpha, two cytokines involved in inflammation. And in a separate but related study, University of Michigan (Ann Arbor, MI) researchers wrote in the August 3 issue of the Journal of Biological Chemistry that proinflammatory compounds called prostanoids cause less pain and swelling when they are derived from omega-3–rich fish oil than when they are derived from vegetable oil.

Just the Beginning

Baby boomers are highly active and prize their mobility, making them particularly motivated to seek solutions for inflammatory health problems.

'There is no doubt that as our population ages, more people will need help for sore joints and tendons,' says Bob Capelli, vice president of sales and marketing for Cyanotech (Kailua Kona, HI). 'People are living longer and want to stay active as long as possible, so the market for natural anti-inflammatories is certain to grow for at least the next 10–20 years.'

'As the population continues to age, and as consumers continue to look for long-term relief, we will see increased demand for natural products that relieve not only the symptoms of joint problems, but the root cause as well,' agrees InterHealth's Dijkstra.

The baby boomer generation is unique, not only in terms of its desire for mobility, but also because of its sheer size and buying power. The growing number of people looking for answers to inflammation at pharmacies, health food stores, farmer's markets, and gyms presents both a challenge and an opportunity.

'We are looking at 77 million people rapidly approaching retirement age in the baby boomer generation alone,' says Gourmetceuticals' Lindemann. 'This is the largest generation in history. They are a progressive generation that embraced the use of organic and natural products from very early on. Ultimately, we are seeing the beginning of a trend that will continue to grow.'