When President Richard Nixon signed Title IX into law in 1972, just one in 27 girls participated in high school sports; 40 years after the landmark statute put an end to discrimination on the basis of sex in federally funded education programs, that proportion had risen to about two in five, according to the Women’s Sports Foundation.

 In those same four decades, women’s participation in college athletics vaulted more than 600%.

Add to that the strides that female athletes have made in Olympic competition, World Cup soccer, and traditionally male-dominated pursuits like body building and basketball and the conclusion is clear: The days when “You play like a girl!” were an insult are over. After all, who 

 want to play like Serena Williams, or swim like Katie Ledecky?

But while women’s sports have come a long way, women’s sports nutrition still seems stuck in a pre-Title IX era wherein not nearly as much effort goes into understanding, let alone formulating for, the unique needs of athletic or even just active women as goes into doing so for men.

All of which suggests that it’s time for some affirmative action in the dietary supplement and functional foods space. As Bruce Brown, president, Natreon Inc. (New Brunswick, NJ), says, “As more women find opportunities to embrace a healthy lifestyle in everything from fitness routines to the foods they eat, sports nutrition brands will respond by investing in innovative ingredients with targeted benefits, rather than solely focusing on male-centered formulations.”

High-profile female athletes are only the tip of a spear launching women of all ages, sizes, and interests into active lifestyles that place as much emphasis on wellbeing as on winning competitions or losing weight. This movement isn’t so much about staying skinny or being first across the finish line; rather, the goal is to feel better, in body and mind.

Notes Nina Hughes-Likins, global marketing director, Prinova USA (Hanover Park, IL), “Women are realizing that working out isn’t just a component of a fleeting fad diet, but actually benefits them mentally and physically. Strength is empowering: it produces visible results and fosters a more consistent fitness regimen.”

Elyse N. Lovett, MBA, MS, marketing manager, Kyowa Hakko USA (New York City), agrees. “We’ve entered the age where ‘strong is the new skinny’-where women all over the world are looking at Olympians and strong, fit influencer moms as role models when it comes to body image.” The upshot: Statista research

 found that, on average, 17.8% of the domestic female population engaged in sports or exercise every day in 2017, compared to 15.6% two years prior.

It should come as no surprise that all those bodies in motion generate growing demand for sports nutrition products designed to fuel their next fitness session-or reward the one just completed. And the fact that this market is entirely female signals a turning point for the entire category.

Carolina Ordonez, senior consumer health analyst, Euromonitor International (Chicago), sees it as a broadening. “Historically, female bodybuilders and athletes were the ones more interested in sports nutrition. But with sports nutrition’s consumer base expanding, more women are following fitness trends and looking for sports nutrition products that can support their fitness goals.”

To Emily Pankow Fritz, PhD, technical services manager, active wellness platform, human nutrition & health division, Kemin (Des Moines, IA), it’s all of a piece with the changes reshaping the category. “Ten to 15 years ago, sports nutrition products were exclusively used by bodybuilders and professional athletes. Now, the category is sold in mass merchandisers, welcomes a wider range of consumers, uses more creative formats, and has broader claims aimed at overall health and wellness. Overall, the definition has expanded to be more inclusive and active, and provides a broader definition for consumers to identify with,” she says.

And female consumers are identifying, in droves. But whether they realize it or not, their identity 

 plays a fundamental role not only in determining which sports nutrition products best suit their needs, but how their bodies respond to sport in the first place.

“Women’s bodies are biologically and physiologically different from males’,” Hughes-Likins says, noting that the former carry 6%-11% more body fat than the latter, “likely due to estrogen, as it suppresses fat oxidation, making it more difficult for women to lose fat.” Women also metabolize some nutrients differently than do men, resulting in higher requirements for iron, calcium, vitamin D, and folate, to name a few.

Adds Sandy Chien, PhD, vice president of innovative products, Horn (La Mirada, CA), “Women also have lower sweating rates than men, mostly due to a lower metabolic rate and smaller body mass. And women have to deal with the rise and fall of estrogen and progesterone, which affects energy and water retention, as well as physical performance.”

Indeed, it’s this ebb and flow of reproductive hormones-including luteinizing hormone and follicle stimulating hormone-that accounts for what Pankow Fritz calls “the most obvious differences” between men’s and women’s metabolic profiles and optimal energy intakes.

Consider pregnancy and lactation, which pose “unique nutritional needs outside the context of activity level,” Pankow Fritz continues. “Increases in recommended energy and micronutrient requirements during pregnancy and lactation are focused on optimizing fetal development and preventing nutrient deficiencies; the demands of physical activity add another layer of complexity, and sports nutrition supplementation adds yet another.”

Of course, not all active women are pregnant or lactating, but even among healthy adult females who aren’t, “the demands of exercise impact energy, micronutrient and mineral needs depending on the exercise volume and intensity, and on dietary intake,” Pankow Fritz reiterates. The catch: “There are currently no official nutrient dietary recommendations based on exercise volume and activity level that are specific to gender.”

“Some of the broader conclusions about the nutritional needs of active females are inferences or culminations of understanding about the physiological differences between males and females, and how the context of exercise might affect nutritional needs,” Pankow Fritz explains. And though these conclusions give us an idea of why men’s and women’s needs differ, “they don’t provide us with evidence of how these differences might affect sports performance, or how they can be addressed with supplementation.” This underscores the need for more research.

 found that among the more than 6 million participants tracked in the 1,382 sports and exercise medicine research papers that the researchers analyzed, only 39% were female.

Sports and exercise nutrition research has historically focused on healthy males aged 18 to 35, perhaps because “some researchers believe that conducting clinical research on females requires extra steps, and that the results could be swayed by the complexity of the menstrual cycle,” Hughes-Likins says. And the need to administer pregnancy tests to potential subjects adds to already weighty research costs. Nevertheless, says Hughes-Likins, “Claims based on clinical research performed on men may not be applicable to women.”

That said, the situation may be headed for a turnaround. Although precious little research has investigated sports nutrition supplements or dietary interventions specific to females, Pankow Fritz says, “this is where ongoing efforts to close the gap are focused: researchers are making attempts to include both women and men in clinical trials so that we can substantiate efficacy in both genders.”

Until they do, sports nutrition marketers don’t have much concrete information to go on when formulating for women’s sports nutrition needs. In the absence of targeted nutritional strategies, they may find themselves leaning more toward targeted concepts. And that requires asking active women not what they 

“Many women are looking for products that enhance their workouts holistically by reducing stress, increasing restful sleep, or providing lean muscle building rather than bulk,” says Brown. “Furthermore, natural and non-GMO ingredients continue to gain momentum.”

Ordonez points to a rough consensus among experts that as go Millennial women, so goes the gender in general. “After discussing this topic with sports nutrition players,” she says, “we all agree that Millennial moms are becoming a very important target in sports nutrition.” Female Millennials spend two times more on self-care than Boomers, she notes, adding, “This female consumer is very educated and looks for sports nutrition products that represent her values: transparency, organic, non-GMO, plant based, few natural ingredients, local sources, vegan or vegetarian, and so on.” Credibility matters, too, and brands that have it include Truvani and Clean Machine, Ordonez says.

But a product needs more than progressive bona fides to succeed with active women. It also needs to produce a palpable effect. “Females love products that make them feel good-they love to ‘feel’ something,” Lovett says. “While improving their outer image is important, their inner ‘feeling’ is just as important. So, I think products that can enhance their active nutrition performance while making them feel great will be key drivers for the category.”

And do us a favor: make women’s sports nutrition products easy to use, and to behold. As Chien says, “Women prefer delivery systems with easy use, such as sachets and drinks instead of powders. They also prefer vibrant, bright colors with simple, clean packaging and messaging compared to the color black marketed to men.”

So, looks do count. But ingredients count more. And even in the absence of conclusive science on women’s sports nutrition needs, “Companies that offer innovative ingredients backed by clinical research are filling the gap” in products directed toward women, Brown says.

Of course, protein ingredients are as popular with active females as with everyone else, and James Komorowski, chief science officer, Nutrition 21 (Purchase, NY), says that athletic women “increasingly look for quicker ways to incorporate more protein into their diets for sustained energy and satiety and to help them achieve their health goals. This has shifted the protein market over the last decade away from a concentrated focus on sports nutrition consumers toward a wider focus on consumers interested in improving consumption to help improve general health.”

Collagen protein in particular is attracting attention, and as Aouatef Bellamine, PhD, senior scientific manager, consumer health & nutrition, Lonza Nutrition & Health (Basel, Switzerland), points out, it has special relevance for female athletes. “As young women tend to be more prone to ankle injuries,” Bellamine explains, “they may need appropriate joint-support supplementation.” Her company’s UC-II undenatured type II collagen from chicken sternum cartilage offers formulators a “natural, effective option for women’s sports nutrition products” with plenty of science supporting its role in joint health, she says.

Komorowski adds that active women might appreciate his company’s Velositol blend of amylopectin and chromium, which studies show helps the body mobilize the branched-chain amino acids (BCAAs) in dietary protein to accelerate muscle protein synthesis (MPS)-“key to enhanced muscle growth and quicker muscle recovery,” he says. “This is relevant for active and athletic women who want to amplify the effect of protein or BCAAs on muscle growth. And because less protein is needed to boost MPS, it’s also relevant to those who want more impact from their protein with fewer calories.”

Another “focal point” for female active nutrition involves increasing energy, enhancing mental focus, and heightening cognitive function, Komorowski continues. “Nootropic supplements have been on the rise and are geared toward improving focus, mental acuity, and energy. Consumers looking for products with a nootropic effect are growing more interested in ‘naturally’ boosting energy and focus without caffeine, jitters, or a crash.” Nutrition 21’s Nitrosigine ingredient combines the amino acid arginine with silicon, stabilizing the blend with inositol, a carbocyclic sugar sometimes referred to as vitamin B8. Clinical results indicate that it improves processing speed and executive function and increases energy levels without changing heart rate or blood pressure.

Not quite a vitamin and not quite an amino acid, L-carnitine is perennially popular with the gym crowd who prize it for its purported fat-burning and performance-boosting properties. But because Lonza’s Carnipure brand of the ingredient “is flexible and adaptable for the sports nutrition market,” Bellamine says, “it lends itself to the growing requirements of active and athletic women. Studies show it provides significant recovery benefits by reducing tissue damage, muscle soreness, and injury after exercise. It’s also been proven to help improve cardiovascular health by enhancing endothelial function through increase blood flow.”

Also a boon to fitness recovery is curcumin 

“which has a myriad of health benefits including anti-inflammation and delayed-onset muscle soreness prevention,” says Mariko Hill, product developer at Gencor Nutrients Inc. (Anaheim, CA). Gencor and its partner Pharmako Biotechnologies (New South Wales, Australia) offer formulators Hydrocurc, a cold-water-dispersible curcumin ingredient with 90% loading that functions in effervescent, capsule, and powder formats. “Its application in effervescent tablets with its natural orange color and flavor is perfect for the category, as its ability to form stable dispersions in water reflects the ease of use in a sports or on-the-go setting,” Hill says.

The more that formulators turn to ingredients like this and others, the better able they’ll be to create sports nutrition products that “serve female consumers more effectively than they have in the past,” Hill says. “The focus on women’s sports and active nutrition will have a significant impact on the sports nutrition space. As consumer awareness of health and wellness increases, female consumers will soon gravitate toward this trend to incorporate a healthier lifestyle.” 

Women’s Sports Foundation. “Get your game on, girls! Celebrating the 40th anniversary of Title IX.” 

www.womenssportsfoundation.org/media-center/press-releases/press-release-june-23-2011/

Statista. “Percentage of US population engaged in sports and exercise per day from 2010-2017.” 2018.

Costello JT et al. “Where are all the female participants in sports and exercise medicine research?” 

Articles

Are sports supplements meeting women’s needs?

The United States Department of Health and Human Services’ Office on Women reports CDC findings that about 10% of American women of childbearing age have difficulty becoming or staying pregnant. CDC defines infertility as the condition of not being able to achieve pregnancy within one year of trying, or within six months of trying for women older than 35. Nationwide, infertility affects about 6.1 million women between the ages of 15 and 44.

CDC also notes that about one-third of infertility cases are caused by medical problems in women, and another one-third are caused by medical problems in men. The final third are a combination of female and male reproductive issues and unknown causes.

The market for dietary supplements that support reproductive health in women-and also in men-is established and substantial. Additionally, CDC lists poor nutrition as one of a number of factors contributing to fertility problems, making the argument for supplementation that much stronger.

In April of this year, a review of the current body of scientific literature studying the relationship between diet and human fertility was published in 

American Journal of Obstetrics and Gynecology

 by two Harvard professors, Audrey Gaskins, ScD, and Jorge Chavarro.

 The authors identified some clear patterns:

Intake of supplemental folic acid, particularly at doses higher than those recommended for preventing neural-tube defects in babies, has been “consistently related to lower frequency of infertility, lower risk of pregnancy loss, and greater success in infertility treatment.”

Antioxidant supplementation may be beneficial for promoting fertility in the male partner of a woman undergoing infertility treatment.

Long-chain omega-3 fatty acids appear to improve female fertility.

Adherence to a healthy diet “favoring seafood, poultry, whole grains, fruits, and vegetables is related to better fertility in women and better semen quality in men.”

 published a study by Keewan Kim et al. whose findings suggest that low manganese, selenium, and sodium levels increased the risk of sporadic anovulation (no egg release, and therefore, no conception) in women.

 Additionally, low levels of magnesium were found to be associated with lower testosterone levels, while very low levels of potassium were associated with higher testosterone levels. (For the study, 259 women aged 18 to 44 were recruited; the women kept food diaries and had blood drawn and tested by the researchers throughout their menstrual cycles.) Taken all together, the findings of this particular study appear to recommend that women seeking to conceive adhere to the recommended daily allowances of these elements to support regular ovulation.

Successful, competitive supplement brands are staying alert to these recent scientific discoveries, formulating products that provide ample amounts of folic acid/folate in combination with other ingredients, such as minerals, antioxidants, omega-3 fatty acids, and herbs.

One particularly well-known and successful fertility supplement line is Fairhaven Health’s FertilAid, which includes a FertilAid for Women product and a FertilAid for Men. The women’s version is essentially a prenatal supplement containing 600 mcg of folic acid (150% RDA), plus the B vitamins, vitamin D3, vitamin C, vitamin A, vitamin E, minerals, and a blend of herbs intended to both support fertility and maintain a healthy pregnancy. The herbal blend features selections to “stimulate and balance hormones that control ovulation,” according to the company, including chaste tree berry extract and red clover extract. (For more on herbs and botanicals for fertility, see the sidebar on the next page.)

The men’s product contains large concentrations of antioxidants and minerals, and its formulation is supported by clinical trial data presented at the American Society of Andrology’s Annual Proceedings in 2009.

 The randomized, double-blind study was undertaken through 2006 over three months, to determine the effects of FertilAid on men with “abnormal sperm parameters” as defined by the World Health Organization. The researchers noted statistically significant improvements in sperm motility (an indicator of male fertility) for subjects using the dietary supplement, and also suggested that the use of FertilAid for Men may improve sperm count.

In line with findings that omega-3 fatty acid intake is associated with better fertility, Fairhaven’s FH Pro Omega-3 contains “clinical-grade EPA and DHA,” according to company literature. “In women, EPA and DHA are believed to help regulate hormones, reduce inflammation, promote cervical mucus production, and reduce blood clotting, all of which is beneficial for fertility,” the literature reads. “EPA and DHA are also believed to be important for helping to prevent miscarriages and preterm labor and for brain and eye development in the fetus. In men, low intake of omega-3 fats has been associated with poor sperm production and quality.”

Fairhaven also offers a product aimed singularly at improving cervical-mucus quality (another indicator of fertility) and a newer FertileDetox product containing herbs, amino acids, botanicals, and probiotics for the purpose of “promoting the efficient elimination of environmental toxins from the body” by “supporting the body’s own detoxification and cleansing systems”: the liver and the intestines.

Another brand adhering closely to the latest science is Daily Wellness Co., seller of the supplements FertilityBlend for Women and FertilityBlend for Men. The women’s formula contains a blend of folic acid, letter vitamins, magnesium, zinc, selenium, and iron, as well as the amino acid L-arginine plus green tea extract and chaste berry extract. The formula “significantly improves ovulation health and hormonal balance,” says Daily Wellness Co. president Denny Kwock. He cites a double-blind, placebo-controlled study published in 2006 in 

Clinical and Experimental Obstetrics & Gynecology

 that he says showed the FertilityBlend women’s supplement improved the success rate of couples trying to conceive by three times over placebo.

The men’s FertilityBlend formula contains vitamins C, E, B6, and B12, plus folate, zinc, and selenium. The supplement also includes the amino acid L-carnitine, plus green tea extract and dong quai extract, for improved sperm quality.

Folic acid is an established star in the trying-to-conceive and prenatal supplement industry. As reported by 

this summer, a recent small study of 30 couples with histories of infertility or miscarriage found that a full 26 of those 30 were able to conceive after consuming a novel folate ingredient called Quatrefolic (a 5-MTHF glucosamine salt manufactured by Gnosis S.p.A.; Desio, Italy) for four months. The ingredient is a biologically active form of folate (the naturally occurring form of folic acid) “that does not need to be converted by the body via the folate enzymatic pathway that includes the enzyme methylenetetrahydrofolate reductase (MTHFR), which shows common polymorphisms of around 40% in the world population,” according to a number of studies cited by Gnosis. In other words, those persons in whom MTHFR is mutated may not metabolize supplemental folic acid efficiently, in which case, the Quatrefolic ingredient may be a better alternative.

Gnosis also points to studies indicating that folate levels measured in semen have been associated with sperm count and health. “Folate supplementation had a beneficial effect on spermatogenesis, possibly by increasing cellular cohesion within the seminiferous epithelium, thus preventing abnormal release of immature germ cells into the lumen,” Gnosis literature and spokesperson Lorena Carboni assert. “Over the years, a large number of genetic studies focusing on the association between genetic MTHFR polymorphism and male infertility have been carried out with different meta-analyses published. High levels of homocysteine in subjects with MTHFR polymorphism have been associated with low sperm quality,” Gnosis reports. “Notable, different meta-analyses correlated the polymorphism with risk of male infertility,” according to the company, suggesting that men wishing to conceive may also benefit from supplementation with the Quatrefolic ingredient.

Savvy supplement brands aren’t just following the science of nutrition and fertility; they’re creating whole trying-to-conceive programs that combine technology with supplemental nutrition. One of these is Fruitful Way, a company that offers an app to help users “optimize [their] chances of getting pregnant” via a fertility assessment, an ovulation cycle tracker, a menstrual period calendar, personalized health and lifestyle recommendations, and a nutritional-supplement dosage reminder and tracker. The company’s related supplements include Fruitful Couple (for women and men), featuring omega-3 fatty acids; Fruitful for Her, with folic acid, the B vitamins, and vitamins E, A, and D; and Fruitful for Him, made with the antioxidants L-carnitine, vitamin E, and selenium.

Udi Alroy, Fruitful Way’s CEO and co-founder, tells 

 that his company’s app is “focused on a personalized solution based on the proprietary fertility algorithm developed by Fruitful Way to accommodate [users’] lifestyles and relationship management, reduce stress, and formulate the best nutrition solution on the new-family level.”

He adds, “Our technology enables us to connect the couples on a daily basis, assisting in the trying-to-conceive process, synchronizing the fertility window for both, and optimizing his and her physical condition. The Fruitful Way personalized supplements are science-based with the intention to improve… conditions toward conceiving.”

Another brand combining fertility supplements with tech is Thorne Research, which sells a direct-to-consumer fertility test for just under $400 and provides results and recommendations to the user’s desktop computer or mobile device. The test kit includes materials for at-home blood and saliva collection, and samples are subsequently mailed back by the user. Those samples are tested, and Thorne research sends a digital summary of results and recommendations within three to five days. Biomarkers tested include hormone levels (estradiol, progesterone, testosterone, follicle-stimulating hormone, luteinizing hormone, thyroid-stimulating hormone, triiodothyronine, free T4, cortisol), levels of the sex-hormone-binding globulin protein, levels of thyroid peroxidase antibodies, and levels of DHEA. The personalized plan provided by Thorne is based on test results and includes supplement recommendations; Thorne’s fertility-related supplements include its Basic Prenatal, recommended for women trying to conceive in addition to those who are already pregnant or lactating. It features L-5-MTHF (glucosamine salt), vitamin B12, antioxidants, and minerals. The company also sells a Super EPA omega-3 fatty acid supplement.

Herbal ingredients for a complementary approach to infertility

Brien Quirk, director of R&D at Draco Natural Products (San Jose, CA), points to a handful of herbs and botanicals used in traditional Chinese medicine to combat infertility. “We have some great recommendations for both female and male infertility,” he says. “For women, in traditional Chinese medicine, dodder seed 

 is the most commonly recommended single herb by clinical practitioners, while the multiherbal formula most recommended is dang-gui-sha-yao-san. That formula consists mainly of blood-moving herbs, such as dong quai, lovage root, white peony root, poria, atractylodis macrocephala root, and alisma rhizome. These address blood stasis, a major cause of female infertility.”

Another formula Quirk cites is Rehmannia 8, which he says “can address polycystic ovarian disease [PCOS], a major cause of female infertility due to excess body weight and metabolic syndrome.”

In men, celery and red ginseng are backed by some studies showing they improve sperm quantity and quality, Quirk says. Herbs that increase sperm production or enhance their health and motility, he adds, include 

 seed, goji berries, fupenzi or Chinese raspberry fruit, schisandra berry, plantaginis seed, Chinese yam, Chinese foxglove root or prepared radix rehmanniae, 

Quirk cites a number of scientific papers in support of traditional Chinese herbs and botanicals marketed for fertility, including one from the journal 

 in which the authors write, “Our review suggests that management of female infertility with Chinese Herbal Medicine can improve pregnancy rates 2-fold within a 4-month period compared with Western Medical fertility drug therapy or IVF.”

Gaskins AJ et al. “Diet and fertility: a review.” 

American Journal of Obstetrics & Gynecology, 

Keewan K et al. “Dietary minerals, reproductive hormone levels and sporadic anovulation: associations in healthy women with regular menstrual cycles.” 

Clifton GD et al. “Prospective study of FertilAid vitamin in men with low sperm quality.” Poster 25. Presented at American Society of Andrology Annual Proceedings, April 2009.

Ried K et al. “Efficacy of Traditional Chinese Herbal Medicine in the management of female infertility: a systematic review.” 

Westphal LM et al. “A clinically proven natural fertility remedy.” 

Clinical and Experimental Obstetrics & Gynecology, 

Nutritional ingredients to help couples trying to conceive

Can fertility dietary supplements help?

Magnesium is a mineral that is a crucial cofactor for over 300 enzymes, playing a core role in the structure and function of the human body. Magnesium’s broad-reaching importance extends to areas including energy production, the synthesis of DNA and proteins, structural roles in bone and cells, facilitating cellular signaling, and nerve function.

 With its breadth of reach and influence over human physiology, it’s not surprising that magnesium is a critical mineral for muscle function.

Magnesium influences muscle performance by participating in energy metabolism and maintenance of muscle contraction and relaxation. Research further shows that magnesium deficiency can lead to a disruption of neuromuscular function-and that high levels of physical activity increase the body’s demand for magnesium. Further studies in individuals on a strength training program have found that suboptimal magnesium status leads to decreased endurance, while higher magnesium intake in aerobic exercise is associated with a requirement for less oxygen and improved cardiorespiratory fitness.

Although maintaining optimal levels of magnesium is essential for all, athletes and others who are physically active may have increased requirements for magnesium. Similarly, those with sarcopenia as well as those experiencing other muscular issues related to the aging process may also need higher intakes of magnesium. However, according to USDA data, almost half of all individuals have magnesium intake levels below the Estimated Average Requirements (EAR) for this nutrient. Strikingly, for adults aged 71 and over, this percentage rises to two-thirds of the population.

 The Recommended Dietary Allowance (RDA) for magnesium ranges from 400 to 420 mg per day for males aged 14 to over 70. For women, the RDA for those aged 14 to over 70 ranges between 310 and 320 mg per day.

In addition to nearly 60% of adults falling short of these guidelines, reviews suggest that magnesium consumption in most athletes falls well below amounts that are considered adequate.

 As magnesium is an electrolyte, strenuous exercise causes a significant amount to be lost through urine and sweat. This can increase magnesium requirements by 10%-20%.

A recent review coauthored by Mario Barbagallo and Ligia Dominguez from the University of Palermo (Palermo, Italy) outlines several important ways in which magnesium impacts muscle function and performance.

 As physical exertion depletes magnesium and leads to increased oxidative stress, higher levels of reactive oxygen species, or free radicals, are generated. These free radicals may contribute to the development of muscle fatigue. Magnesium has antioxidant effects that can confer protection to muscle tissue.

Additionally, magnesium plays a fundamental role in mitochondrial energy production. Over one-third of total cellular magnesium is found in the mitochondria and is present complexed together with adenosine triphosphate (ATP) and as a component of membranes. Magnesium is, therefore, critical for basic mitochondrial functions, including the production of ATP, and confers a protective role to skeletal muscle mitochondria.

Furthermore, inflammation is a critical factor in reduced muscle performance. Poor magnesium status is known to exacerbate the inflammatory state and leads to increased circulating levels of pro-inflammatory markers. Magnesium intake, on the other hand, has repeatedly been found to reduce systemic inflammation, including significant reductions in the cytokine IL-6 and C-reactive protein (CRP) levels, two markers of inflammation.

Magnesium may also influence muscle function and exercise performance in another important way. Hsuan-Ying Chen and colleagues from Providence University in Taichung, Taiwan, found that administering magnesium to animals prior to a treadmill exercise led to increased glucose availability in muscle and brain tissue while increasing the clearance of lactate from muscle.

 This central role of magnesium in glucose utilization and metabolism is critical for shuttling glucose to where it’s needed in the body during exertion.

Benefits of Optimal Intake across Demographics

Alisa Welch and colleagues from the University of East Anglia (Norwich, UK) recently conducted two relevant studies evaluating the significance of magnesium intake for muscle health across broad spectrums of the population.

In one study, the researchers analyzed data from a cohort of 156,575 men and women aged 39-72 to assess the impact of dietary levels of magnesium on skeletal muscle and bone health parameters.

 They found that higher dietary intakes of magnesium were positively associated with greater grip strength, skeletal muscle mass, and bone mineral density in both men and women. In men over the age of 60, the relevance of higher magnesium intake as it relates to grip strength was even more exaggerated compared with younger men, emphasizing the importance of ensuring optimal magnesium consumption in this group. Furthermore, when the researchers analyzed the benefits of greater magnesium intake across this population versus the annual losses of bone mineral density and skeletal muscle with age, they concluded that the findings were of clinical significance in terms of higher magnesium intake stemming these decreases over time. Dietary levels of magnesium may, therefore, have relevance for prevention of sarcopenia, frailty, falls, and fractures.

In a second study, Welch and colleagues analyzed cross-sectional data from 2,570 women aged 18 to 79 years to determine the effect that dietary magnesium intake has on age-related skeletal muscle loss, power, and chronic low-grade inflammation.

 They found that higher dietary magnesium intake was significantly positively associated with skeletal muscle mass (fat-free mass as a percentage of body weight), leg explosive power (a measure of the force and velocity of muscle contraction of the quadriceps), and circulating levels of the inflammation marker CRP. Quite remarkably, the difference in leg explosive power was shown to be more than 24% greater in those women with the highest versus lowest magnesium intake. In terms of inflammation, the differences in CRP concentrations is significant as magnesium may play a greater role in skeletal muscle conservation in older women via attenuating the production and effect of inflammatory cytokines.

Moreover, an analysis from the Maastricht Sarcopenia Study in the Netherlands compared nutrient intakes in 227 older adults (aged 65 or older) and found that individuals with sarcopenia had significant nutritional differences in five nutrients compared to those without sarcopenia.

 Sarcopenic individuals had a 10%-18% lower intake of omega-3 fatty acids, vitamin B6, folic acid, vitamin E, and magnesium, with the difference in magnesium intake approaching 12% between the groups.

These data taken together substantiate the critical importance of ensuring optimal magnesium intake for skeletal muscle health through the lifespan.

Magnesium Supplementation and Physical Performance

Clinical trials involving magnesium supplementation for improving athletic performance and muscle function have yielded mixed results; however, some recent studies point to positive benefits in professional and recreational athletes, as well as the elderly.

In one recent study conducted by CÃ³rdova MartÃ­nez Alfredo and colleagues from the University of Valladolid (Soria, Spain), researchers investigated the effects of magnesium supplementation on muscle damage in male professional basketball players.

 Twelve elite basketball players who were members of a team were asked to supplement with 400 mg magnesium daily in the form of magnesium lactate during the entire basketball season (approximately 32 weeks). Blood samples assessing parameters of muscle damage were taken throughout the season at eight-week intervals. As a comparison, twelve college age students who played recreational basketball and competed in minor university leagues were used as a control group to assess baseline parameters. This group was not supplemented with magnesium.

Serum magnesium levels did not differ significantly at baseline between the professional players and the recreational players serving as controls. Over the course of the study, serum magnesium levels registered a decrease at the third timepoint with respect to the first and second timepoints; however, these levels recovered and were significantly higher at the fourth timepoint versus the third. Additionally, there was no significant increase in the parameters of muscle damage versus baseline levels in the professional athletes, indicating a protective effect on muscle tissue associated with magnesium supplementation.

In general, with exertion levels seen in these athletes, a rise in these markers of muscle damage is expected. The parameters assessed included myoglobin, lactate dehydrogenase, aldolase, serum urea, and total proteins, along with the liver enzymes ALT and AST. Overall, this small study supported the use of magnesium supplementation in elite athletes for preventing the normal drop seen in serum magnesium with intense physical activity as well as mitigating an increase in biochemical markers of muscle damage during the basketball season.

Another study aimed to assess the effect of magnesium on muscle fatigue. Conducted by researchers at the University of Mazandaran (Babolsar, Iran), the randomized controlled trial looked at the benefits of magnesium supplementation on muscular fatigue following intense anaerobic exercise.

In this pilot study, 16 physically active male college-aged volunteers who exercised regularly for at least 30 minutes four days per week for the prior three months were randomly divided into a placebo groulp or a supplementation group. The subjects were asked to supplement with 350 mg of magnesium sulfate or placebo nightly before dinner for fourteen days. They underwent the Wingate test at the beginning of the trial period and again at the end. The Wingate test is a stationary bicycle test of exhausting physical anaerobic activity. It involves 30 seconds of maximal exertion (pedaling as fast as possible) following a five-minute warmup session.

Blood was drawn both prior to and after the test. The muscular activity of the right leg (three main muscle groups) was assessed by an electromyography (EMG) device. While in the placebo group a decline was noted in mean power frequency (an indicator of muscular motor unit fatigue) between pre-test and post-test numbers, magnesium supplementation led to significant increases in these values post-test, suggesting an increase in the ability of muscle fibers of the leg to continue to fire. Magnesium supplementation led to reduced muscular fatigue and enhanced performance on the Wingate test, while no significant changes were noted with placebo. The results of the study suggest that magnesium supplementation benefits muscle function during anaerobic exercise performance.

Earlier, Nicola Veronese from the University of Padova (Padova, Italy) led a study looking at the ability of magnesium to impact physical performance in healthy elderly individuals involved in a weekly exercise program.

In the 12-week randomized controlled study, 139 women (average age of 71) were allocated to either a magnesium group (300 mg/day as magnesium oxide) or a control group (no intervention). The primary outcome assessed during the study at baseline and week 12 was a change in the Short Physical Performance Battery (SPPB), which consists of three objective physical function tests: 4-meter gait speed, repeated chair stands, and standing balance in increasingly challenging positions. Secondary outcomes included changes in peak torque isometric and isokinetic strength of the lower limbs and handgrip strength.

Baseline SPPB scores were similar between the supplement group and control group; however, at 12 weeks, magnesium supplementation led to significant improvements in total SPPB scores, chair stand times and 4-meter walking speeds. No significant changes were seen in the secondary measures of muscle strength. Overall, the authors concluded that 12 weeks of supplementation with magnesium improved physical performance in healthy elderly women and noted that those with magnesium intake lower than the recommended daily allowance saw the greatest benefits.

Magnesium’s importance in muscle health and physical performance in individuals of all ages can’t be overemphasized. Its necessity for skeletal muscle function is indispensable.

As the majority of the adult population in the U.S. fails to meet basic RDA levels, improving magnesium intake is essential. In athletes, the influence of magnesium in improving athletic performance combined with the potential increased needs in those who are physically active necessitates a second look to ensure adequate intake in this group of individuals. After taking a closer look at improving dietary intake, a simple cost-effective approach would be to supplement with this mineral in at-risk populations. This could lead to better performance in athletes, better physical fitness with age, and better overall musculoskeletal health throughout life.

Is magnesium awareness growing in active nutrition?

Evidence continues to build showing magnesium is crucial for muscle function, but are supplement shoppers getting the message? 

 interviewed one industry expert, Stephen Ashmead, MS, MBA, senior fellow for Balham Corp., Albion Minerals (Layton, UT), about how well consumers understand the link between magnesium and active nutrition and sports nutrition.

How aware are today’s sports nutrition customers about the role of magnesium in muscle function and performance?

Ashmead: While scientific evidence continually emphasizes the importance of proper magnesium intake, and despite the fact that consumers have access to more information about magnesium than ever before, research consistently shows that people aren’t getting the recommended amounts in their diet. According to the National Health and Nutrition Examination Survey (NHANES) 1999-2000, researchers found 68% of Americans consumed less than the recommended minimum daily intake (400 mg) of magnesium.

However, there is greater and growing awareness within the sports nutrition market of the many roles of magnesium. The lines between athletes and “lifestyle users” have blurred, and active nutrition is an important segment of the sports nutrition market. With growing interest in leading active lifestyles and increased participation in sports and fitness activities, the demands within this market are evolving. Both athletes and active-lifestyle consumers want supplements that help support specific goals for energy, endurance, performance, weight loss, muscle comfort, and overall wellness.

We are seeing tremendous growth for magnesium in this sector. Magnesium sales will continue to grow as more consumers recognize the benefit of adequate magnesium in their diets and lifestyles. They will use it to prevent deficiencies due to diets or other issues, and to support physiological function and their active lifestyles.

Can you highlight the importance of magnesium to athletic performance?

Magnesium is the catalyst or cofactor in many of the oxidative phosphorylation reactions, converting sugars into glycogen and ultimately ATP (adenosine triphosphate) needed for refueling in preparation for future exercise or athletic performance. Sports performance and exercise require a high supply of the energy produced by magnesium-sparked reactions.

As we exercise, the body burns through our glycogen stores. The longer and the more intense the exercise, the more glycogen we burn. Fast glycogen recovery or refueling is most important in athletes who train multiple times per day or participate in back-to-back events. In these individuals, a proper refueling strategy is essential, otherwise they put themselves at risk for poor performance and even injury.

Minerals play important roles in counteracting the impact that exercise performance can have on the body. Magnesium and zinc play important roles in fighting against oxidative stress and reducing inflammation, thereby reducing muscle damage. Magnesium is involved in a multitude of processes that impact muscle function, including oxygen uptake, electrolyte balance, and energy production. Proper magnesium intake can enhance exercise performance.

What kind of inroad has magnesium made in the sports nutrition market? Can you comment on the volume of sports nutrition products you see now incorporating magnesium?

magnesium supplements had almost 9% in sales growth in 2017. In fact, it is predicted that by next year, magnesium sales will overtake calcium as the single largest mineral sold in the market. Some of this growth can certainly be attributed to growing interest from the sports nutrition market, which is also growing steadily. Euromonitor reports that sports nutrition sales grew from US $7.3 billion in 2011 to $13.6 billion in 2017, and is expected to continue growing at nearly 8% CAGR by 2021.

What kind of synergistic benefits does magnesium have with other commonly used sports nutrition ingredients? Are you seeing those combinations featured in the end-product market today?

When formulating sports nutrition products, it is also important to consider the cognitive aspects, along with the physical benefits of the ingredients. Nootropics are gaining substantial interest in sports nutrition. Minerals such as iron, zinc, and magnesium play important roles in achieving optimal physical and cognitive sports performance, and are considered to have nootropic characteristics.

For example, magnesium is crucial in ATP synthesis. ATP is the primary energy source for mitochondria in every cell, including those in the brain. ATP must be bound to magnesium in order to be activated. Magnesium combined with B vitamins can help maximize the energy potential. Magnesium joined to creatine has shown to increase work output over individual components and is present in many powder formulations in the market today.* As cognition and active lifestyles gain more awareness, magnesium and beneficial combinations with other nutrients will become more important.

How well does magnesium formulate into the many types of sports nutrition products on the market?

Magnesium has traditionally been supplemented as tablets and capsules, and can still be used in that way. However, magnesium lends itself well in the many sports nutrition applications, including sports drinks, powders, bars, “shots,” and gummies. Selecting the right form of magnesium for the application is important based upon delivery mechanism, other ingredients, and organoleptic properties.

* Editor’s note: Balchem/Albion supplies a magnesium creatine chelate ingredient called Creatine MagnaPower.

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Magnesium influences muscle performance by participating in energy metabolism and maintenance of muscle contraction and relaxation.

Magnesium for muscle function and performance

Though SPINS reports that sales of supplements targeted for joint health were down about 10% overall during the 52 weeks ending June 17, 2018, the news isn’t all bad. In fact, in the natural channel, sales are up, to the tune of 6.6%. And if you ask Jaume Reguant, director of Spain-based Bioiberica Health Care Business Unit, increased growth is on the horizon as the population continues to age and, simultaneously, up the amount of physical activity in their daily lives.

“The joint health market is thriving as an increasingly aging as well as active population looks towards natural solutions to support their range of motion, fluidity, and flexibility,” agrees Samantha Ford, business development director at AIDP (City of Industry, CA). “People are simply living longer and recognize the importance of taking care of their bones and joints for the sake of quality of life into their later years.”

Also driving sales is the fact that younger consumers are taking joint health supplements, says Deanne Dolnick, science director at TR Nutritionals (Alpharetta, GA). Younger consumers are doing so not only because they’re generally a group that’s open to taking supplements, but also because they’ve gravitated towards group workouts like CrossFit and Spartan challenges, the intensity of which can put stress on the joints.

One ingredient on many supplement consumers’ minds is collagen. New research coming out of Lonza Health & Nutrition (Basel, Switzerland) and recently published in 

 supports the use of Lonza’s UC-II undenatured type II collagen in supporting joint health across different age groups.

The aim of the study was to determine the ability of the ingredient to prevent excessive articular cartilage deterioration in a rat model with osteoarthritis. The results found that immediate treatment with UC-II preserved the weight-bearing capacity of the limb with deteriorated articular cartilage. Taking a small daily dose also helped preserve the integrity of the cancellous bone at tibial metaphysis, and limited further damage to the articular cartilage. “As such, the study demonstrates that a clinically relevant daily dose of the UC-II brand, when applied immediately after injury, can improve the mechanical function of the injured knee-preventing excessive deterioration of the articular cartilage,” says senior marketing manager Juliana Erickson.

But collagen isn’t the only game in town. “Virtually everybody suffers from some sort of joint discomfort and it’s not the type of ailment where the consumer runs to the doctor,” Dolnick explains. “And because joint problems are either ongoing or intermittent, most people do not want to take NSAIDs for an unspecified period of time or even for a week or two, so they turn to supplements.”

A number of trends are driving sales across the joint health market.

First is an increased interest in alternative delivery formats. “Consumers don’t want to take yet another pill or capsule, but rather a convenient supplement-in a food, drink, or powder format-that can easily be part of their daily routine,” says Ford.

If you ask Erickson, younger consumers with busier schedules look for alternative formats like shots, bars, ready-to-drink beverages, and gummies, which help “pave the way for increased supplement usage in the joint health category.”

The challenge, according to TR Nutritionals’ Dolnick, is that many manufacturers need extracts that are water soluble, which aren’t always easy to find. And, even if they do find it, it’s usually “not too tasty,” she says, especially in the case of turmeric, a hot joint health ingredient for which Dolnick says her company receives quote requests daily.

Another trend is consumer demand for transparency, which is driving sales and interest in vegan and vegetarian joint health ingredients and supplements. “In the information age, with so much false information and hype, consumers are increasingly becoming more skeptical about the ingredients in the products they consume and are demanding more transparency from manufacturers,” explains Suhail Ishaq, president of BioCell Technology LLC (Irvine, CA), supplier of branded ingredient BioCell Collagen. “Everything from the source, quality, purity, non-GMO, and clinical substantiation are all factors that consumers consider in their purchasing behavior.”

And, according to Silvia Pisoni, marketing manager at Gnosis S.p.A. (Desio, Italy), this desire for transparency and quality is translating into demands for ethical and non-animal-based ingredients. The company’s vegetarian chondroitin sulfate, Mythocondro, gained U.S. GRAS status in the U.S. and Novel Food Approval in the beginning of 2018. “Non-animal origin claims are recognized as added value,” Pisoni says.

Pending publication is new research that supports the effects of Mythocondro at 600 mg per day, Pisoni says. The randomized, double-blind, placebo-controlled study was carried out in 60 individuals over the course of 12 weeks. Researchers evaluated pain intensity at motion and rest using the Visual Analog Scale; knee function as assessed by the WOMAC Index; and knee pain, health-related quality of life, and inflammation markers in plasma at baseline, four weeks, and 12 weeks. “All endpoint results show a statistically significant modification of the parameters with impressive results related to the decrease in the WOMAC Index and the Tegner Lysholm Knee Scoring,” says Lorena Carboni, product support specialist, Gnosis. Mythocondro can be used at a daily dosage of 600 mg, and offers a once-a-day alternative to larger chondroitin sulfate pills that need to be taken twice a day, the company says.

Pycnogenol, a French maritime pine bark extract from Switzerland-based Horphag Research, was the subject of a recent study published 2017 in the journal 

, which showed that the polyphenols from Pycnogenol are distributed directly into the synovial fluid of patients with osteoarthritis.

The double-blind study examined 33 individuals diagnosed with severe osteoarthritis, and who were scheduled for knee replacements. Participants were supplemented with 200 mg of Pycnogenol daily over the course of three weeks leading up to their surgeries. Synovial fluid samples were collected during surgery to detect and measure the presence of polyphenols.

Results from the synovial fluid samples show that the polyphenols found in Pycnogenol, including taxifolin, ferulic acid, and catechin, were distributed throughout the synovial fluid in the Pycnogenol-tested group. Taxifolin and ferulic acid were not detected in control group serum samples. “This research further supports previous studies examining Pycnogenol’s benefits for joint health, including the ability to reduce inflammatory mediators COX-2 and 5-LOX which helps alleviate discomfort,” says Sebastien Bornet, vice president of global sales and marketing, Horphag Research.

Because many ingredients in the bone and joint health market are animal-derived, finding ethical and equally effective alternatives to appeal to clean label and vegan consumers has been an ongoing challenge and category driver. AIDP recently launched Phytodroitin, a 100% plant-origin alternative to chondroitin. According to Ford, the ingredient mimics the structure and function of animal-based chondroitin and is Vegan Society registered.

Finally, combination supplements are resonating with consumers in the joint health space. “Any of the popular combinations of nutrients designed for the bone or joint categories usually have a synergistic effect on each other,” says Steve Holtby, president and CEO of Soft Gel Technologies Inc. (Los Angeles), “or often target the functionality of that category through different pathways to support the overall health of that system.”

Some suppliers and formulators are meeting this trend by targeting systemic inflammation with ingredients like turmeric. Others are creating proprietary blends, as in the case of Valensa (Eustis, FL). “Formulations that attack joint issues from multiple pathways provide a better product overall and better differentiation for our brand partners,” says Valensa senior vice president of global sales and marketing Doug Lynch. “In short, one physiological mechanism equals a better claim; multiple mechanisms equal a better consumer response.”

Valensa’s flagship joint formulation, FlexPro MD, received its 18

 patent in 2018. Its FlexPro ES formulations capitalize on the synergy trend by offering egg membrane alongside astaxanthin. “Our FlexPro line works on synergies of multiple mechanisms to support your joints,” Lynch adds. “Ultimately, FlexPro brings anti-inflammatory benefits to the joints themselves, and our use of phospholipids in the formulation-coming from krill oil or vegetarian sources-unlocks the antioxidant benefits of astaxanthin.”

In support of synergistic formulas, Bergstrom Nutrition (Vancouver, WA) points to a study demonstrating that adding 500 mg of MSM to glucosamine and chondroitin doubles the benefits of the latter ingredients

. “While Bergstrom’s OptiMSM ingredient is beneficial as a standalone ingredient, this study makes the case that MSM also delivers synergistic effects when formulated with other ingredients”, says vice president of sales and marketing Tim Hammond.

Bioiberica plans to launch a new combination ingredient for joint and mobility in 2019, called Mobilee, the company says. It will blend hyaluronic acid with polysaccharides and collagen for joint function and muscle strength. According to Bioiberica’s Reguant, this ingredient responds to the market trend that has evolved the joint health market to encompass bone and muscle health for overall mobility support.

At Lonza Consumer Health & Nutrition, DuoCap capsule-in-capsule technology can help “overcome complex formulation challenges by allowing manufacturers to incorporate traditionally incompatible ingredients together in one single dosage form,” says Erickson, which addresses “diverse health needs from bone and joint health to cardiovascular and weight management.”

Going forward, supplements that target athletic consumers will find favor, too, says Valensa’s Lynch, as will those that step outside the box on delivery and offer vegetarian or vegan labels. Reguant agrees: “Convenient dosage and intake, effective and safe ingredients from natural origin, a reliable producer-that’s what consumers are asking for.”

C Bagi et al. “Oral administration of undenatured native chicken type II collagen (UC-II) diminished deterioration of articular cartilage in a rat model of osteoarthritis (OA).” 

vol. 25, no. 12 (December 2017): 2080-2090

Mulek M et al. “Distribution of constituents and metabolites of maritime pine bark extract (Pycnogenol

) into serum, blood cells, and synovial fluid of patients with severe osteoarthritis: A randomized controlled trial.” 

Lubis AMT et al. ”Comparison of glucosamine-chondroitin sulfate with and without methylsulfonylmethane in grade I-II knee osteoarthritis: A double-blind randomized controlled trial.” 

Innovative formulations and a widening consumer base are redefining the joint-health category.

Nutritional Outlook Vol. 21 No. 7

Are sports supplements meeting women’s needs?

Can fertility dietary supplements help?

Magnesium for muscle function and performance

Joint-health market trends: Synergy sells

Recall ready: How nutraceutical manufacturers should prepare

How a Quality by Design model can benefit the dietary supplements industry

Digestive enzyme opportunities: high protein, plant sources, pet health, and more

Fermented products are invigorating the probiotics market

Which dietary supplements ingredients are on FDA’s radar?

Why is it so hard to color a natural drink blue?

What Does High-Quality Ingredient Testing Look Like?