Do collagen supplements work for the joints? Spanish specialists respond
Santiago Segura, Spanish actor and film director, surprised with his words about collagen supplements in an interview with La Vanguardia, following a question about how he takes care of himself at 59 years old. He explained that for a while he had taken this supplement, but stopped when he read that taking it for bones and joints “is like eating a computer to become smarter.” What is true about this? Why do so many older people take this protein as a supplement? What scientific evidence exists regarding its effects?
In 2021, almost 2 billion euros were spent worldwide on collagen supplements, which are attributed benefits such as improving skin, hair, nails, and especially joints, especially in older people or those with physical wear and tear. Collagen is the most abundant protein in our body and is part of the structures of these mentioned body parts (skin, hair, joints…). “It is part of the connective tissue and that is its function, the connective,” explains Jordi Mestres, a doctor and member of the Catalan Society of Family and Community Medicine.
Supplementation doesn’t make sense. If you have a balanced diet, the necessary intake is already guaranteed”
Mestres adds that “supplementation actually doesn’t make sense, because the body breaks down collagen as a supplement and absorbs the amino acids. If you have a balanced diet, the intake is already guaranteed. Also, there is no consensus to claim that taking collagen supplements is appropriate.”
In a similar vein – and even more forcefully -, Julio Basulto, a nutritionist and member of the Nutrition Working Group of semFYC (Spanish Society of Family and Community Medicine), takes a stance. He asserts that “since 2011, it is not allowed to attribute alleged benefits on joint health to collagen (actually, hydrolyzed collagen) (this is also the case for glucosamine, chondroitin, or hyaluronic acid). And this is not permitted thanks to a scientific opinion from the European Food Safety Authority (EFSA). From this, we can conclude that in Europe it is allowed to state that collagen is not useful for maintaining joint health, reducing joint pain, improving joint mobility, or regenerating joints.”
Since 2011, it is not allowed to attribute supposed benefits on joint health to collagen (actually, hydrolyzed collagen)”
Collagen fibers from the human body observed through electronic microscopy
There are voices suggesting that this view of the EFSA is outdated, but in the latest review (October 2023) by UpToDate, it “discourages the intake of hydrolyzed collagen, glucosamine, or chondroitin sulfate to prevent or treat rheumatic diseases (disorders in joints, bones, cartilage, ligaments, tendons, and connective tissue),” according to Basulto. UpToDate is a reputable medical reference entity that empowers professionals with the evidence and appropriate recommendations so they can make the best decisions.
These statements contrast with the experience of many older people who take collagen supplements on the recommendation of a healthcare professional. One such case is Elies Solé, who is 77 years old and has been taking collagen for 15 years. “I take it because the orthopedic surgeon recommended it to me. I was starting to have early signs of arthritis, and he said it could help me. I think it has worked quite well for me, especially for my joints, knees, and elbows, which I now have more and more problems with at 77. In addition to the orthopedic surgeon, all the doctors I mention these problems to recommend collagen to me.”
I take it because my orthopedist recommended it to me. I was starting to have early signs of arthritis, and he said it could help me”
Santiago, aged 77, has been taking it for about five or six years, as recommended by “a friend who had knee surgery. The pharmacist told me that it sells a lot and works very well. The bottle explains that it’s indicated for joint health. I’ve never mentioned it to the doctor, but I’ve had knee pain for a few years, and they told me it could work,” he says. His testimony is similar to that of many other elderly people who take supplements of this product because they have heard about its benefits in some advertisement.
Gloria Sabater, PhD in Pharmacy, specialist in anti-aging medicine, genetics, and nutritional genomics, and member of the Royal Academy of Pharmacy of Catalonia (RAFC), is the technical director of Salengei, a company that manufactures dietary supplements “for healthy aging.” Sabater asserts that many scientific publications speak about the benefits of collagen, citing a 2021 review which concludes that “the loss or defect of collagen can lead to skin aging and other diseases. Collagen treatments have shown effective improvements in skin hydration and elasticity, medical scaffold treatment, osteoarthritis, and rheumatoid arthritis in many clinical studies.”
Sometimes it is the same doctors or nutritionists who recommend taking them. It is not necessary to undergo previous tests”
Sabater states that collagen is indicated for “individuals who, due to various circumstances in their lives, whether it be aging, sports injuries, or sometimes purely for aesthetic maintenance reasons, wish to improve the condition of their skin, bones, joints, etc. Sometimes it is doctors or nutritionists themselves who recommend taking them. It is not necessary to undergo previous tests, but it is important to know or have a clear idea of what type of collagen you need.”
According to Dr. Mestres, in some reviews of studies, it is observed that people who take these supplements “also perform other positive actions for their health: they are active, engage in physical activity, do not smoke, are committed to taking care of themselves, and what is probably benefiting them is everything they do in addition to taking collagen.”
According to Sabater, one of the problems is talking about collagen in general. “When discussing joints, skin, or bones, it is not the same type of collagen, nor are there only a few amino acids responsible for all the repair work. That’s why when we talk about effectiveness, we have to consider the context of the formula and its ingredients for a specific application rather than individual ingredients or amino acids.”
Is it indicated in specific cases?
According to the sources consulted, there is a divergence of opinions on the effect of collagen on joints and bones, but is it unanimously indicated in any specific case? “There are diseases that can cause a deficiency, such as scurvy in the past, and also Ehlers-Danlos syndrome, where one of the pathologies is the lack of sufficient collagen production; these individuals present joint hypermobility and ligament laxity, they can easily twist an arm and must take care of their joints,” explains Mestres.
Additionally, the doctor explains that if a person does not have a balanced diet, “what could be useful is a complex with different elements such as vitamins, magnesium, zinc, collagen… but it will always be more advisable, if possible, to have a proper diet that provides us with all the necessary nutrients.”
Bone broth
Indicated foods
According to Gloria Sabater, “to stimulate collagen synthesis, it is essential to consume foods rich in key amino acids such as glycine, proline, and lysine, in addition to having a diet that includes enough vitamins and minerals that act as cofactors in its production”. For example, according to the doctor in pharmacy, “we should eat bone broth, an excellent source of natural collagen and essential amino acids; gelatin, which contains collagen-derived peptides; cuts of meat rich in connective tissue, such as beef stew; pork, or chicken”. Mestres adds to these recommendations eggs (with high nutritional value in their proteins) and gelatinous fish such as sardines, mackerel, or salmon.
