I was asked this question at least three times this week, so I think there must be something going around. It doesn’t help that a Kardashian with 140 million Instagram followers recently signed a deal to become an equity partner and global spokeswoman for a company selling collagen supplements. The global market for collagen-containing products was estimated at $300 million last year, and is projected to climb to $6.5 billion by 2025. So no wonder I’ve been getting more questions lately. The buzz is building. Is it hype?
My quick answer is that collagen supplements probably help skin, bones, and joints a little. There are plenty of small studies but nothing very authoritative. Producing collagen supplements sounds pretty industrial. I would rather get my collagen from good food.
Deep dive answer
Collagen is the structural protein found in our skin, cartilage, bone, tendons, and ligaments. Collagen supplements are usually produced by breaking down connective tissues and bones primarily from cows, chickens, or pigs. It can also be derived from fish bones and scales. All these tissues are made into gelatin, which is then further broken down into collagen hydrosylates, which are small protein building blocks. In theory, if the body has more connective tissue building blocks, repair might be stimulated and facilitated.
There is conflicting evidence about whether collagen protein hydrosylates are absorbed better than just eating animal protein. Some experts think our digestive systems achieve the same results. But at least one study claims that processed collagen hydrosylates are more directly absorbed, and delivered in higher concentrations, than through normal digestion.
I performed my own literature search on PubMed, and found thousands of journal articles and trials under the search term “collagen supplement.” Sorting through the quality of each study, conflicts of interest, and results is too large a task for any individual. Most of the studies were small and often industry-funded. Fortunately, other researchers help us out by selecting the best quality studies and then combining the results into meta-analyses. Some of these larger, pooled studies do show some benefit from taking collagen supplements in terms of reducing wrinkles, increasing skin hydration and elasticity, and relieving some degree of joint pain.
One meta-analysis found some modest short-term benefit for patients with arthritis pain, but the long-term benefits were less convincing. It was hard to find enough high-quality studies to give a definitive answer beyond sort of effective for joints. Most studies were paid for by the companies selling the supplements, which is less than ideal.
Another study showed a modest benefit for women’s bone density.
Many manufacturers claim collagen will help gut health. Evidence-based proof was hard to find, with most experts stating there has been little study of GI benefits one way or another. Anecdotally, I’ve tried drinking my own homemade chicken bone broth for a month, and didn’t notice much difference.
A study of 89 nursing home patients with pressure ulcers who took collagen supplements three times a day for eight weeks saw healing rates that were twice as fast. This makes sense to me, as these sorts of people might not be getting as much collagen from dietary sources, and stand to benefit the most from a temporary boost.
Many collagen supplements are formulated with additional ingredients like biotin, whey protein, lactose, sugar, and hyaluronic acid which make it harder to know what is helping or causing side effects. Collagen derived from marine sources, instead of the usual pig or cow, might rarely trigger shellfish allergies.
There is also a theoretical risk that as animal bones are ground up and processed, prions that cause diseases like mad cow disease (BSE) might slip through. The FDA in 2016 prohibited the use of certain cow parts in supplements because of this possible risk. Taking a collagen supplement derived through mass production means you are ingesting traces of thousands of animals. But if you make your own collagen source like bone broth, you are reducing that exposure to just the one animal (chicken, cow, fish, etc.). There is no definite proof that gelatin can contain infectious prions, as long as it is manufactured according to industry standards. At least that I could find.
Rarely, heavy metals have been detected in collagen supplements by consumerlab.com (a testing company).
The quality and purity of each collagen brand is hard to assess. As you probably know, the multi-billion dollar supplement industry is subject to very little scrutiny when compared to the prescription pharmaceutical industry. Love or hate the FDA, at least they try to fulfill their safety assurance mandate. Supplements like collagen get more of a free pass.
It should be mentioned that the environmental costs of raising cows, processing them, hydrolyzing their bones and tissues, packaging the goo into supplements, shipping in plastic bottles, etc., adds up. Eating whole, sustainable sources of protein, lower down on the food chain like fish, eggs, beans, and some dairy is less energy-intensive. The body also needs adequate vitamin C, plentiful in foods like citrus, peppers, and tomatoes, to help with collagen metabolism.
It seems better to me to eat good food, so we get the structural benefits of enough collagen building blocks, as well as the pleasure of eating tasty chicken, fish, green leafy vegetables, and foods high in vitamin C. Whole foods also have lots of other micronutrients and vitamins, and make a reductionist goal of simply “getting more collagen” seem too easy. Plant protein also provides most of the building blocks we need for collagen production, and is found in beans, nuts, seeds, and whole grains.
As it gets colder outside, we often start roasting chicken for dinner. I collect the bones and drop them in an Instant Pot pressure cooker with onion, carrots, celery, and some salt and water to make an amazingly good bone broth. A cup of broth so made has about 6 grams of collagen, similar to supplement dosages studied in trials.
We can also try to get more rest and sleep for collagen repair, and to avoid too much sun exposure, which can break down collagen in the skin. Staying well hydrated helps the collagen matrix in our cells.
Maybe this post will save you a couple hundred dollars, a portion of which can be invested in healthy, real, less processed foods. Or maybe you have already tried a collagen supplement. Or perhaps you have been holding on to a secret family broth recipe, the one that kept your grandmother dancing in heels until her mid-90s? If so, please do share.
But if you do personally invest in collagen supplements, that’s probably fine, and maybe it will help a bit.
Ryan McCormick is a family physician and writes a medical newsletter at McCormickMD.
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