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Joint Health is Crucial for Women’s Health

Over the past year, we have seen the health and wellness market evolve at an incredible pace. According to Grand View Research, the global women’s health market size is expected to reach USD 47.8 billion by 2027. Growing awareness among women regarding nutritional requirements along with increasing consumer willingness to spend on health and beauty supplements is anticipated to drive the market expansion. 

Women experience unique health issues and concerns, from pregnancy and menopause to gynecological conditions, such as uterine fibroids and pelvic floor disorders. A number of health issues affect only women and others are more common in women. What’s more, men and women may have the same condition, but the effects are different when it comes to women. For example,  

  • Women are more likely to die following a heart attack than men. (1)  
  • Women are more likely to show signs of depression and anxiety than men. (2) 
  • Osteoarthritis affects more women than men. (3) 
  • Women are more likely to have urinary tract problems due to the way the female urinary tract is structured. (4) 

Consumers, both men and women, are increasingly turning to nutritional supplements as a means of complementing a healthy lifestyle of diet and exercise to optimize health. Supplements can offer support as an increasing number of older, female consumers look to stay healthy and active, and to delay the onset of age-related degeneration and illness. It is evident, according to Nutrition Business Journal’s May 2018 issue, that one such symptom of age, deteriorating joint health, has attracted the attention of nutritional supplement marketers responsible for new product development. Research shows supplements addressing joint health now account for approximately 4.5% of the U.S. supplement market.  

Measuring joint health is somewhat difficult, and usually isn’t considered unless there are symptoms of joint cartilage degradation, such as pain or stiffness. However, there are biomarkers that can be used to objectively determine both temporary cartilage turnover resulting from exercise, as well as excessive cartilage degradation, indicating more permanent damage to joint tissue. Some of these biomarkers, such as CTX-II (C-telopeptide fragments of type II collagen) provide a reliable indication of the level of cartilage breakdown resulting from exercise and wear and tear.  

CTX-II as an Effective Biomarker in Assessing Joint Pathology 

Cartilage is a form of avascular connective tissue found at distinct locations throughout the body. It is composed of specialized cells (chondrocytes) along with collagen fibers, water, non-collagenous proteins and proteoglycans. It is embedded within the extracellular matrix and is critical for structure and biochemical support to cells and tissues. Articular cartilage is the specific type of cartilage that surrounds joints and provides cushioning for the joints in response to the compressive forces required for movement. This type of cartilage is composed principally of Type II collagen and proteoglycans, mainly in the form of aggrecan, along with glycosaminoglycans such as hyaluronic acid, chondroitin sulfate and keratin sulfate.  

According to Nena Dockery, Scientific and Regulatory Affairs Manager at Stratum Nutrition, “Osteoarthritis results from the degeneration of articular cartilage and underlying bone, leading to pain, stiffness and swelling. It is one of the most common causes of disability among older individuals. The incidence of osteoarthritis is increasing worldwide, due to the increasing percentage of elderly in the general population, as well as to increases in the rate of obesity. (5) Therefore, there is a need for more accurate ways to follow the progression of arthritis from its onset. This has led researchers to investigate several potential biomarkers, particularly those that are related to cartilage and bone turnover, with the hope that early intervention, before there is visible damage to the joint, can improve outcomes.”  

Biomarkers are defined as “characteristics that can be objectively measured and evaluated as indicators of normal biological processes, pathogenic processes, or pharmacologic responses to therapeutic intervention.” Blood pressure and pulse rate are biomarkers as are the substances measured as part of complex laboratory testing. They are the most objective, quantifiable medical signs that modern laboratory science is able to measure reproducibly. (6) Clinical biomarkers can reflect the entire spectrum of a disease from its earliest manifestations to resolution of the disease or its terminal stages. Unfortunately, there are only a few biomarkers suitable for evaluating the progression of osteoarthritis, none of which are used routinely as diagnostic tools.  

Dockery continues, “Though CTX-II levels don’t appear to be predictive of the actual onset of OA, elevated levels may be an early indicator of future joint problems prior to the beginning of radiographic cartilage degradation. For example, overweight persons (BMI of >25) have approximately a 25% elevated CTX-II level. (7) This is a reflection of the continuous pressure placed on joints from additional weight. There also appears to be a strong inverse relationship between estrogen levels and CTX-II. As estrogen levels decline during perimenopause and particularly after menopause, CTX-II levels rise significantly. As a result, postmenopausal women may have levels substantially higher than age- and weight-matched premenopausal women. (7, 8) These results coincide, not only with the rising incidence of chronic rheumatic conditions such as OA, but also with the rise in joint pain reported to physicians by post-menopausal women, independent of diagnosed arthritis.” (9) 

The use of this biomarker to determine the effects of a dietary supplement ingredient provides an additional level of confidence in the potential benefits derived from that ingredient.    

The research on NEM®, Stratum’s branded eggshell membrane ingredient, has incorporated CTX-II to substantiate the benefits of NEM in protecting cartilage from degradation associated with exercise.  Evaluations of pain and stiffness have traditionally been the main criteria used to determine the effectiveness of supplements designed to improve joint health.  The use of an objective biomarker associated with cartilage breakdown further supports NEM’s already substantiated benefits to joint health. Research that demonstrates protection and preservation of a part of the body that is often susceptible to long-term repercussions of exercise stress is a major departure from the short-term benefits that are often seen. 


The joint health market is strong. An aging population is certainly a significant contributing factor to the growing need for joint health solutions. Increasingly more people desire to be active into middle age and beyond. Ease of movement and joint comfort are integral to an active, healthy lifestyle. But the 21st century senior citizen is not just content with being active. These individuals are vibrant and busy in all aspects of their lives. Therefore, they desire a supplement regimen that is convenient, easy to maintain, and takes their special needs into account. 




Agency for Healthcare Research and Quality. (2010). Cardiovascular disease and other chronic conditions in women: Recent findings. Retrieved August 3, 2012, from (PDF 263 KB). 

American Psychological Association. (n.d.) Gender and stress. Retrieved August 6, 2012, from 

Centers for Disease Control and Prevention. (2017). Arthritis-related statistics. Retrieved May 16, 2018, from 

National Kidney and Urologic Diseases Information Clearinghouse. (2010). Urinary incontinence in women. Retrieved August 6, 2012, from 

Zhang Y and Jordan JM. (2010) Clin Geriatr Med 26(3): 355-369. 

Strimbu K and Tavel JA. (2010) Curr Opin HIV AIDS 5(6): 463-466. 

Mouritzen U et al. (2003) Ann Rheum Dis 62: 332-336. 

Bay-Jensen AC et al. (2003) Arthritis Res Ther 11(1): R9. 

Magliano M. (2010) Maturitas 67(1): 29-33.