Nutrition for joints

First, remove what causes damage: sugar, flour, alcohol, and trans fats. This reduces inflammation and costs nothing. Second, provide building material: 1,6 g of protein per kg, which forms cartilage collagen, ligaments, and the surrounding muscles. Third, reduce inflammation with fats: omega-3 from fish or capsules. Fourth, support the bones: vitamin D based on test results, calcium from food, and K2. Only fifth come the specific supplements: collagen with moderate evidence, and glucosamine and chondroitin with weak evidence. Everything below fifth place is marketing.

Cartilage, ligaments, tendons, and muscles are protein. Women rarely eat 100-130 g of protein per day, and after 45 the synthesis threshold is higher. Without protein, neither collagen nor training works: there is nothing to build with. 30-40 g per meal, three times a day — meat, fish, eggs, cottage cheese. About the recommended amount — protein on a low-carb diet.

For rheumatoid arthritis, omega-3 reduces pain and the need for painkillers — this is included in the guidelines. For osteoarthritis, the evidence is more modest, but the mechanism is the same: EPA reduces inflammatory signals in the joint. The dose for active pain is 2-3 g of EPA+DHA per day, above the usual amount; oily fish three times a week or a concentrate. The effect appears after 2-3 months. Analysis — omega-3 for joints, evidence base — omega-3.

In studies, 10-15 g of hydrolyzed collagen per day reduced pain and improved function after 3-6 months in people with knee pain and in athletes. The effect is moderate, not for everyone, but real. Gelatin is the same collagen, ten times cheaper; 15 g with vitamin C one hour before training is a protocol used in studies on ligaments. Bone broth is pleasant, but contains little collagen in an unpredictable amount. Analysis — collagen and gelatin.

Dozens of studies, half funded by manufacturers, report an effect; in independent studies, it is at the placebo level or slightly above. The largest GAIT study showed that most people had no difference, while some people with severe pain had a small one. Practical conclusion: if you want, take glucosamine sulfate 1500 mg for three months; if it helps, continue; if not, do not waste your money. Analysis — glucosamine and chondroitin.

A joint rests on a bone, and after 45 bone loss accelerates. Take vitamin D based on test results up to 40-60 ng/ml, calcium 1000-1200 mg from cheese, cottage cheese, sardines, sesame, and greens, and K2 100-200 mcg — it directs calcium into the bones rather than the blood vessels. Strength training is essential; bones respond only to load. Analysis — vitamin D, K2, and bones; about bones after 45 — bones and muscles after 45.