Product Insight

Read below for glucosamine and chondroitin details, product characteristics, Elations safety facts, and more! If you have a question about Elations that isn’t answered here, please use the submission options to the right.

Clinical Evidence on Glucosamine/Chondroitin
Calcium Citrate Malate (CCMT)
Boron
Absorbability
Product Ingredients

Clinical Evidence on Glucosamine/Chondroitin

Clinical study of the effectiveness of glucosamine/chondroitin for osteoarthritis and other joint conditions has been made difficult by the lack of patent protection for these dietary supplements, which therefore disqualifies them from receiving pharmaceutical company funding for research. Nevertheless, numerous small clinical studies have shown evidence of glucosamine/chondroitin effectiveness. A meta-analysis of these studies (McAlindon, T.E., “Glucosamine and Chondroitin for Treatment of Osteo-Arthritis,” JAMA, 3/15/00, enclosed) concluded:

“These agents [glucosamine and chondroitin] have been tested in a number of clinical trials that are widely interpreted as demonstrating efficacy for osteoarthritis.” … “Trials of glucosamine and chondroitin preparations for osteoarthritis symptoms demonstrate moderate to large effects, but quality issues and likely publication bias suggest that these effects are exaggerated. Nevertheless, some degree of efficacy appears probable for these preparations.”

In February 2006, the results of the $15 million landmark National Institute of Health’s (N.I.H.) Glucosamine Arthritis Interventional Trial (G.A.I.T.) study of 1,583 patients with osteoarthritis were published in The New England Journal of Medicine. The results:

From National Institute of Health Website

“For a subset of participants with moderate-to-severe pain, glucosamine combined with chondroitin sulfate provided statistically significant pain relief compared to placebo--about 79 percent had a 20 percent or greater reduction in pain versus about 54 percent for placebo. According to the researchers, because of the small size of this subgroup these findings should be considered preliminary and need to be confirmed in further studies.”

From New England Journal of Medicine

“Results for the primary outcome in this [the moderate-to-severe] stratum, which included 22% of the patients in the trial, indicated that combined treatment [1,500 mg glucosamine and 1,200 mg chondroitin] was significantly more effective than placebo (24.9 percentage points higher, P=0.002). … Similarly, the OMERACT-OARSI response rate ranged from 26.4 percentage points higher with combined treatment (P=0.001) to 10.0 percentage points higher with chondroitin sulfate (P=0.24), as compared with placebo.”

An overview of the results can be found at http://nccam.nih.gov/research/results/gait/

The N.I.H. study investigators recommended additional research among the moderate-to-severe group to confirm their findings. The European G.U.I.D.E. study of 318 patients with symptomatic knee osteoarthritis compared the efficacy of glucosamine sulfate (alone, without chondroitin) versus acetaminophen. While the glucosamine sulfate used in this study was slightly different than the glucosamine HCl used in the N.I.H. study, the pharmacokinetics of glucosamine are similar and there’s been no head-to-head studies to suggest that glucosamine sulfate performs any more effectively than glucosamine HCl. The results were shared in abstract form at the American College of Rheumatology in November 2005 (and are not yet published):

“Results showed that both glucosamine sulfate and acetaminophen had greater efficacy than placebo use in reducing pain. [Note: this is among total population, not just among moderate-to-severe sufferers] However, patients taking glucosamine sulfate appeared to experience more relief than did those on acetaminophen.”

“Once-daily 1500 mg oral doses of glucosamine sulfate might be the preferred treatment for symptoms of knee osteoarthritis,” summarizes Gabriel Herrero-Beaumont, MD, Director of the Rheumatology Department, Jiménez Díaz Foundation - CAPIO, Madrid, Spain. “Based on these results, physicians who typically recommended acetaminophen may well find their patients gain more comfort taking glucosamine sulfate.”
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Calcium Citrate Malate (CCM™)

CCM™ is composed of calcium in combination with two organic acids, citric acid and malic acid, commonly called “fruit acids” because of their natural abundance in fruits. It is currently available via products bearing the FruitCal™ mark such as Tropicana Pure Premium Orange Juice with Calcium, Beech-Nut baby and toddler juices with Calcium. Numerous published studies support greater CCM absorption than milk or calcium carbonate and include:

A study among women age 21-30 showing calcium absorption from CCM was 26% greater than that of calcium carbonate, a common dietary supplement, and 30% greater than that of milk. (Smith KT, Heaney RP, Flora L, Hinders SM. “Calcium Absorption from a New Calcium Delivery System (CCM). Calcified Tissue International (1987); 41:351-52.
A study among older women average age 57 which showed CCM absorption was 39%, a level 30-50% greater than typically found in milk (Andon MB, Peacock M, Kanerva RL, De Castro JAS. “Calcium Absorption from Apple and Orange Juice Fortified with Calcium Citrate Malate (CCM).” Journal of the American College of Nutrition (1996); 15:313-316.
A study among children (average age 14) which showed calcium absorption from CCM was 37% greater than for calcium carbonate (Miller JZ, Smith DL, Flora L, Slemenda C, Jiang X, Johnston CC Jr. “Calcium Absorption from Calcium Carbonate and a New Form of Calcium (CCM) in Healthy Male and Female Adolescents”, American Journal of Clinical Nutrition (1988); 48:1291-94).

Boron

The Physician’s Desk Reference excerpt on boron reviews the pharmacokinetic, epidemiological and clinical data demonstrating boron’s potential role in calcium metabolism and preventing osteoporosis and potential role in reducing osteoarthritis. Studies at the USDA Human Nutrition Research Center in Grand Forks suggest that boron plays an important role in preventing the loss of minerals such as calcium from bone. Clinical study has shown deficiency of boron in the diet results in loss of calcium and magnesium from the body. Studies have also shown that areas of the world where boron intakes are higher have lower incidence of osteoarthritis and in one published clinical trial, patients receiving 6 mg of boron had significantly greater improvement in their osteoarthritis symptoms than placebo. Similarly, unpublished Procter & Gamble studies indicate boron may increase the speed of action and effectiveness of glucosamine for arthritis. Attached is the article “Essentiality of Boron For Health Bones & Joints,” Environmental Health Perspectives (1994) Vol 102, Supplement 7.
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Absorbability

As a liquid, Elations is inherently more quickly absorbed than supplement pills which need to disintegrate and dissolve in the stomach before passing into the intestines. Further, the calcium in CCM has been shown to be more absorbable into the bone than the calcium used in calcium supplements (calcium carbonate and calcium citrate, specific references listed above). Elations uses high-purity, low molecular weight glucosamine and particularly chondroitin to further accelerate absorption (and to allow the product to be clear and good-tasting).
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Product Ingredients

Each 8 oz. bottle of Elations contains dietary supplement ingredients including:

1,500 mg Glucosamine, which reduces pain caused by joint inflammation, thickens joint fluid for better lubrication and helps form the building blocks of joint cartilage;

1,200 mg Chondroitin, which is a major component of joint cartilage, acts as an antioxidant to reduce joint damage, and stimulates cartilage production;

300 mg in the form of Calcium Citrate Malate (CCM™), a P&G-patented more absorbable form of calcium that is licensed to Elations, which is vital for strong, healthy bones, prevents bone loss, is needed to anchor the cartilage in bone for strong joints, and the deficiency of which can lead to aching joints, muscle cramps and arthritis;

3 mg Boron, an important dietary trace mineral found in plants, which helps the body utilize calcium, helps to build strong bone, joints and muscles.

The four key components of Elations (Glucosamine, Chondroitin, calcium and boron) are shown to be important for the development, structure, and function of a joint. Supplements are shown to make these components available to the joints. Meta-analysis published in JAMA, the NIH GAIT study and the European GUIDE study all support efficacy for glucosamine and chondroitin in improving joint comfort and mobility. Additional mechanism of action data noted below demonstrates how glucosamine and chondroitin contribute to improved joint health and mobility. All of this could be fairly characterized in consumer terms as rejuvenation.

Daily usage of Glucosamine and/or Chondroitin is the regimen used in most clinical trials, including the NIH GAIT and GUIDE studies cited above. Drinking Elations daily ensures that joint cartilage and joint fluid have an abundant, continuous supply of the essential building blocks needed to optimize joint health. Therefore, a daily drink that makes these components available to joints can be considered a way to “rejuvenate” joints every day, and something that should be consumed daily.

References to Specific Studies Which Support the Claim (refer to full bibliography for specific references)
1 RDA of Vitamin C and documented need for “collagenous structures”
4 RDA of calcium and need for continual resorption in bones
5 Biochemistry of glycoaminoglycans including Glucosamine/Chondroitin function in joints (cartilage, collagen, elastin, synovial fluid, ground substance)
15 Glucosamine and Chondroitin exhibit some degree of efficacy for osteoarthritis symptoms; Glucosamine and Chondroitin increase proteoglycan synthesis in articular cartilage; clinical studies researched (references 9-21 in the article) indicate daily treatment with Glucosamine and Chondroitin
28 Role of Glucosamine and Chondroitin as therapeutic agents in osteoarthritis
37 Glucosamine is well absorbed in bones and articular cartilage
45 Glucosamine helps relieve arthritic aches and pains
80-87 Boron contribution to joint and bone health as a mineral in the human diet
88-89 Glucosamine and Chondroitin reduce pain in subgroup of patients with moderate-to-severe knee pain; daily treatment with 1500 mg G and 1200 mg C (GAIT study)
90 Glucosamine reduces pain in patients with knee osteoarthritis, more than acetaminophen; daily treatment with 1500 mg G (GUIDE study)
92 Bioavailability of calcium as CCM is compared to other supplements
95 Normal joint function described including the role of cartilage, synovial fluid, and other components
96 Necessity of Glucosamine for joint function
97 Necessity of Vitamin C for the formation of collagen, the major structural protein of cartilage
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