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May 4, 2010

Supplementation with glucosamine and chondroitin associated with lower mortality over a 5 year period

Vitamin D status associated with physical function in older men and women

An article published online on April 21, 2010 in the American Journal of Clinical Nutrition revealed the discovery of University of Washington School of Public Health and Fred Hutchinson Cancer Research Center scientists of a lower risk of death from all causes among users of the arthritis supplements chondroitin and glucosamine over an average 5 year follow-up period. While previous research by the team, summarized in the July 24, 2009 issue of Life Extension Update, sought to determine the impact of multivitamins and vitamins C and E on mortality, the current investigation focused on the effect of less common supplements.

The study included 77,673 men and women between the ages of 50 and 76 who resided in western Washington. Dietary supplement use during the 10 years prior to enrollment was documented in questionnaires completed by all participants.

Over an average 5 years of follow-up, 3,577 deaths occurred. While none of the supplements evaluated in the study, which included individual B vitamins, magnesium, fiber and other supplements, were associated with an increased risk of dying over follow-up, adjusted analysis confirmed an association between the use of glucosamine and chondroitin with reduced risk. Glucosamine use that was categorized as low, as determined by infrequent or short duration of use, was associated with an 8 percent lower risk of dying, and high use with a 17 percent lower risk, while low and high use of chondroitin were associated with 12 and 17 percent reductions. A 17 percent lower adjusted risk of mortality was also observed for those whose use of fish oil was categorized as high, however, the researchers did not consider the finding statistically significant.

In their discussion, the authors remark that chondroitin and glucosamine may inhibit nuclear transcription factor kappa-beta (NF-kB) dependent pathways, and that abnormal regulation of NF-kB is associated with cancer and inflammatory diseases. They note that other antiinflammatory agents have been associated with reduced mortality; for example, aspirin use was associated with an 18 percent reduction in deaths in the Iowa Women's study. "Glucosamine and chondroitin may have antiinflammatory properties, and future studies that evaluate risk of death separately for those diseases with and without a chronic inflammatory cause, and with longer durations of follow-up and possibly functional studies, may increase our understanding of any potential benefit of glucosamine- and chondroitin-supplement use," they conclude.

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Health Concern Life Extension Highlight

Osteoarthritis

With osteoarthritis, the thin layer of cartilage between the joints gradually erodes and wears away. As the protective layer of cartilage vanishes, the bone beneath becomes pitted and uneven, and the structural integrity of the joint is destroyed. Movement can become extremely painful and, in the worst cases, people who have severe osteoarthritis can no longer take care of themselves on a day-to-day basis.

Effective treatment of osteoarthritis includes the protection of the cartilage and synovial fluid in the joint against further destruction. In addition, it is important to stimulate anabolic restoration of joint cartilage and synovial fluid. Chondroprotective agents are compounds the body produces to regenerate cartilage and maintain healthy joint function. Chondroprotective agents protect and restore joint cartilage by a variety of mechanisms. They enhance development of chondrocytes, enhance the synthesis of synovial fluid, and inhibit free-radical damage to proteins and joint cartilage degradation by autoimmune processes.

Glucosamine is a naturally occurring substance. It is synthesized by chondrocytes for the purpose of producing joint cartilage. In osteoarthritis, glucosamine synthesis is defective, and supplementation with glucosamine has proven to be beneficial. The body uses the supplemental glucosamine to synthesize the proteoglycans and the water-binding glycosaminoglycans in the cartilage matrix. In addition to providing raw material, the presence of glucosamine seems to stimulate the chondrocytes to produce more proteoglycans and glycosaminoglycans. Glucosamine also inhibits certain enzymes such as collagenase and phospholipase, which destroy cartilage. By blocking pathogenic mechanisms that lead to articular degeneration, glucosamine delays the progression of the disease and relieves symptoms, even for weeks after termination of the treatment. Among the natural therapies for osteoarthritis, glucosamine sulfate is probably the best known. Commercial sources of glucosamine are from the exoskeleton of certain shellfish and are available as glucosamine sulfate and N-acetylglucosamine.

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