my knees started talking to me at 31

Nobody warns you that your knees start editorialising. Mine began around 31, mostly on stairs, mostly going down, mostly the day after I had done something ambitious in a Pilates class.

It is not an injury. It is a comment. And that specific, unglamorous, activity related joint noise turns out to be exactly where the collagen research is at its strongest.

a joint is largely made of the thing in question

Cartilage, the smooth surface at the ends of your bones, is mostly water held inside a mesh of type two collagen. Tendons and ligaments are mostly type one collagen, packed into dense ropes.

So the tissue doing the complaining is built almost entirely from the protein you are drinking. That is a far more direct starting point than most things in this category can claim.

the study that made me pay attention

In 2008, Clark and colleagues published a 24 week randomised, double blind, placebo controlled trial in Current Medical Research and Opinion. A hundred and forty seven college athletes with joint pain but no diagnosed condition took ten grams of collagen hydrolysate a day or a placebo. The collagen group reported meaningfully less joint pain, with the clearest results at the knee and when walking and standing.

In 2017, Zdzieblik and colleagues published in Applied Physiology, Nutrition, and Metabolism. Young adults with activity related knee discomfort took five grams of specific collagen peptides for twelve weeks. Again, less discomfort than placebo, and the effect was strongest in the people who had the most discomfort to begin with.

Then in 2019, a meta analysis in International Orthopaedics pooled multiple randomised placebo controlled trials in osteoarthritis and found collagen derivatives outperformed placebo on the standard pain and stiffness scales.

Three different populations, three different research groups, same direction of result. That is the pattern you want to see.

how it appears to work

The picture that has emerged is that hydrolysed collagen does not simply get dismantled into loose amino acids. Short peptides survive digestion and enter the bloodstream, and animal studies have shown those peptides concentrating in cartilage after ingestion. Once there, they appear to act as a signal to the cells in that tissue to step up production of new matrix.

Your body reads incoming collagen fragments as evidence that collagen is being broken down somewhere, and responds by building. That is an elegant mechanism, and it explains why the results in these trials build slowly over months rather than appearing in a week.

what i do with all of it

Twenty grams of collagen protein a can, which is above the dose used in every study above. Every day, without having to think about it.

Because that is the part that actually decides whether any of this works for you. The reason I never stuck with powder was never the powder. It was the twenty seconds of admin, every morning, forever. A cold can in the fridge asks nothing of me, and twelve weeks of consistency beats a perfect protocol I abandon in March.

the research i leaned on

• Clark KL, Sebastianelli W, Flechsenhar KR, et al. 24-week study on the use of collagen hydrolysate as a dietary supplement in athletes with activity-related joint pain. Current Medical Research and Opinion. 2008;24(5):1485-1496.
• Zdzieblik D, Oesser S, Gollhofer A, König D. Improvement of activity-related knee joint discomfort following supplementation of specific collagen peptides. Applied Physiology, Nutrition, and Metabolism. 2017;42(6):588-595.
• García-Coronado JM, Martínez-Olvera L, Elizondo-Omaña RE, et al. Effect of collagen supplementation on osteoarthritis symptoms: a meta-analysis of randomized placebo-controlled trials. International Orthopaedics. 2019;43(3):531-538.

LÉS is a beverage, not medicine, and it does not treat or prevent any joint condition. Nothing here is medical advice.