In recent years, collagen supplements have been heavily marketed in the beauty industry for their potential to enhance the appearance of skin, hair, and nails (1). Its increase in popularity has led to research suggesting that it also may improve joint pain and other aspects of musculoskeletal health.
Collagen is the most abundant protein in the human body and it serves various structural functions, forming part of a scaffold to provide rigidity to the surrounding tissue throughout various organs and body systems, and allowing cells to resist stress. Type I collagen predominantly provides structure to the skin, hair, and nails, while type II collagen is found in joint cartilage (2). Sufficient collagen levels are necessary for overall health, including cardiovascular, kidney, skin, and joint health. Diseases such as rheumatoid arthritis, lupus, osteogenesis imperfecta, and Ehlers-Danlos syndrome, where the body cannot produce or maintain proper collagen levels, highlight the importance of its function (3).
As we age, we produce less collagen, and the integrity of the collagen produced becomes compromised and loses some of its rigidity. This is because as we grow older, our collagen production decreases, and the collagen we generate loses its ability to maintain its firmness (4). This is one reason why our skin becomes wrinkled. Aging cartilage has also been linked to joint pain and the development of osteoarthritis (5). As such, there has been increased interest in collagen dietary and supplemental intake via direct ingestion or consumption of its components.
Collagen can be obtained directly from our diet by eating protein- or collagen-rich foods (1). Collagen is produced only by animals, so eating animal protein is the most direct way to obtain collagen. The amino acids that are most abundant in collagen are glycine, proline, and hydroxyproline, so eating foods containing these amino acids will also provide the building blocks your body needs to produce collagen. These foods include fish, poultry, meat, eggs, dairy, legumes, and soy. Additionally, vitamins and minerals such as vitamin C and zinc are essential for collagen production. Eating a balanced and healthy diet with ample fruits and vegetables is vital for supplying your body with enough of these macro- and micronutrients needed for native collagen synthesis. Consumption of collagen doesn’t directly contribute to higher collagen production, as any collagen consumed is first broken down into its component peptides and amino acids, which can be used by the body to build proteins for many different processes based on the body’s needs (4).
While the research topic is still in its relative infancy, reviews of several studies indicate that there are consistent positive effects of taking collagen for joint health (5). There are many forms of collagen supplements on the market, but for joint health, there are supplements that specifically contain type II collagen, which is linked to reducing joint pain (6).
Several studies and clinical trials have been conducted on the use of collagen by people who suffer from osteoarthritis. Currently, there are no drugs that can treat osteoarthritis directly, and the only option available to patients is the management of symptoms. The drugs that are currently used to manage osteoarthritis symptoms, such as NSAIDs and analgesics, can have unhealthy side effects when used for extended periods. The two primary kinds of collagen that are being studied as a potential treatment for osteoarthritis are native collagen and hydrolyzed collagen. Native collagen and hydrolyzed collagen are both obtained from cartilage, though through different processes. This difference allows native collagen to retain its structure. As a result, native collagen can suppress the body's immune response to its collagen. On the other hand, hydrolyzed collagen does not retain its structure, but contains biologically active peptides that can travel to joints and induce synthesis of cartilage. The varying composition of these two types of cartilages affects the dosages required to experience a positive effect (7). Multiple studies reported reduced pain and increased joint function in humans using 40 mg/day of native collagen derived from chickens. These trials were conducted over three to six months (8,9,10,11). Similar human studies were conducted on hydrolyzed collagen, though there was a much wider range of dosages and experimental designs. However, all studies using hydrolyzed collagen used a much higher daily dosage, ranging anywhere from 360 mg to 10 g per day. These studies were conducted over a similar time frame as the native collagen studies and also saw positive results in terms of reduced pain and improved function (12,13,14,15). Additionally, recovery of degraded cartilage was observed in one study, which is very promising (12). Overall, these studies indicate that collagen supplementation reduced joint pain and improved joint function in patients suffering from osteoarthritis.
There appears to be some indication that collagen supplements, both native and hydrolyzed, also improve joint pain in individuals without osteoarthritis (5, 7). There is also evidence suggesting that collagen supplements can be beneficial in sports, both in terms of exercise performance and injury recovery. The idea that collagen supplements used in conjunction with exercise are more effective is based on the theory of mechanotransduction, which refers to the idea that the mechanical stimulation that tissues undergo during body movements increases protein production and strength on the molecular level by manipulating the movement of ions. Additionally, studies have shown that collagen supplements aid in recovery from muscle soreness and discomfort following vigorous exercise (16).
Collagen supplements have also been used in the treatment of long-term sports injuries. Multiple studies have shown that the use of collagen supplements in conjunction with rehabilitation programs reduced the need for alternative therapy options in athletes with these injuries. Though athletes were not able to reach a pre-injury state, they did suffer fewer instances of re-injury and less pain than before the treatment, with many able to return to their activities. Increased supplementation of collagen could prove to be a useful tool, both for injured athletes and for healthy athletes who wish to reduce discomfort associated with exercise (16).
Collagen supplements are likely to be beneficial for those who may struggle to obtain it via their diet. This is true for vegans and vegetarians who do not eat animal products, the main source of collagen in the human diet. Rather than coming from animals, vegan collagen is recombinant human collagen that is made using genetically engineered yeast (17). Additionally, it may be easier for individuals to track and control their collagen consumption by taking supplements than it would be if they tried tracking dietary collagen alone. Dosages could be carefully controlled to achieve maximum benefits, which could be especially useful in treating injury and osteoarthritis. Studies have suggested that there are minimum thresholds that must be met to see a benefit, at around 40 mg/ day of native collagen and 5 to 10 g/ day of hydrolyzed collagen (7, 16).
Collagen is essential to the maintenance of healthy and pain-free joints (19). Studies have suggested that its inclusion in the diet, whether via supplements or direct consumption could be a powerful therapeutic in dealing with the rising number of joint issues due to sports and the obesity epidemic (16, 18). There are also potential applications for the sports and rehabilitation industries via its incorporation together with exercise programs. While more studies are needed to determine appropriate dosing and to further investigate the mechanism of action, incorporating collagen into your diet or taking supplements is a promising solution to treat musculoskeletal health issues including joint pain in athletes, older adults, and people with osteoarthritis. Maybe it's time to start taking collagen and get back out on the soccer field.
Written by Anika Kulkarni, BS and Natalie Gilmore, MS and edited by Stephanie Palacio, PhD and Aldrin V. Gomes, PhD.
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