Unique Effects of Dried Apple Peel Powder (DAPP) on Inflammation and Joint Pain

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1 Unique Effects of Dried Apple Peel Powder (DAPP) on Inflammation and Joint Pain Boning up on the problem The human body contains more than 300 joints, working together with muscles and bones to allow movement and accomplishment of everyday activities. As one ages, chondrocyte cell death contributes to loss of cartilage matrix tensile strength, causing increased stiffness, restricted joint movement and loss of mobility. 1 Factors like malnutrition, heredity, injuries, illness and infection also contribute to cartilage degeneration. Whether cartilage degeneration is age-related or caused by other factors, it leads to inflammation, reduced flexibility and pain. The cost of deteriorating joint health is on the rise. Hospitalization, joint replacement surgeries, and rehabilitation are costly not only for individuals and families, but also create a financial burden shared by the entire health care system. The most common costly procedures are knee replacements, hip replacements, and spinal fusions. 2 Through nutritional support, joint function can be improved, inflammation can be managed, degradation slowed and natural repair processes enhanced. Nutrition-focused prevention and intervention offers enormous cost-savings compared to hospitalization, joint replacement and rehabilitation. 3-4 The inflammation cycle Many joint problems are not isolated in the joint. Chronic, low-grade inflammation throughout the body is common. This disturbs many of the body s normal reparative functions. Inflammatory conditions can lead to reduced muscular function, so that the ability to use the joint is further reduced. Inflammation often accelerates joint degeneration, creating a vicious cycle. Joint degradation can prompt bone and tissue destruction, causing pain, damage and worsening health. Implementation of nutritional support for a healthy inflammatory response can improve joint comfort and mobility, by intervening in the inflammation/degradation cycle. Non-steroidal anti-inflammatory drugs (NSAIDs), like acetaminophen, aspirin and ibuprofen are frequently used for joint pain. Too often, NSAIDS come with unwanted side effects including gastrointestinal and cardiovascular health issues leading many consumers to natural products. Fruits are taking center stage as an option for nutritional support of joint health. That is because researchers, health care practitioners and consumers are seeing promise in the polyphenolic flavonoids content of fruits. Research into polyphenolic flavonoids is revealing the potential of fruit to reduce inflammation, improve mobility and reduce pain sensation.

2 Apples the original super-fruit Nearly everyone knows the name of the fruit that promises to keep the doctor away. Apples have a long association with health, and are widely considered to be the original super-fruit. Apples have been shown to inhibit tumor cell growth and protect cells from oxidative damage. 5 Epidemiological studies show that apple consumption may help reduce the risk of chronic diseases such as cancer, type II diabetes, cardiovascular disease, pulmonary disease, bone demineralization and asthma. 6, 9 One polyphenolic flavonoid, quercetin, found in apples, is especially promising. Research in animal and human models has found that quercetin has significant anti-inflammatory effects, suggesting benefits for support of disease related to ongoing inflammatory response including joint health. 8 The appeal is in the peel While apples are universally coveted as healthy, less well known is the fact that the most beneficial part may be the peel. Although apples contain many healthful compounds, the distribution of polyphenols found in the peel is different from the apple flesh. Both apple flesh and peel contain compounds like phloretin glycosides, phloridzin, and chlorogenic acid. However, other flavonoids are found exclusively in the apple peel. 7 A study that compared antioxidant activities and tumor cell growth inhibition found that apple peel was significantly more beneficial than apple flesh. 7 Gentle drying retains valuable nutrients Processing of apples for juice or other products can significantly reduce the concentration of phenolics and total antioxidant activity. 6 However, gentle drying of apple peels acts to lock in the fruit s natural antioxidant power. 7 Clinical research Intrigued by the power of the peel, researchers at NIS Labs, an independent contract research laboratory specializing in natural products research, performed a 12-week study to explore the effects of organic dried apple peel powder (DAPP). Healthy people with moderate complaints of reduced joint range of motion (ROM) in well-defined areas, and associated chronic discomfort were selected for the study. The subjects consumed 4.5 grams DAPP daily for 12 weeks, with evaluations at baseline, 2, 4, 8, and 12 weeks. Each evaluation included measurements of: Cellular Antioxidant Protection capacity (CAP-e bioassay) 17 distinct ROM measurements Joint discomfort evaluated through Visual Analogue Scales (VAS)

3 The results were: Improved antioxidant protection. Subjects demonstrated a statistically significant improvement in serum antioxidant protective status. This improvement was measured by the CAP-e bioassay, including several inflammation markers. Improved joint mobility (range of motion). Subjects exhibited improved ROM, with some areas improving in as little as two weeks and all areas showing improvement by 12 weeks. Reduced joint discomfort. Reductions in joint discomfort were statistically significant after 4 weeks (p<0.05) and were highly significant by the end of the 12-week period. Participants on DAPP experienced a statistically significant reduction in joint pain after 4 weeks, and highly significant results after 12 weeks Baseline Week 2 Week 4 Week 8 Week 12 Primary pain center Secondary pain center Charted score is the mean Visual Analogue Scale (VAS) value of all subjects.

4 Conclusions Loss of cartilage matrix tensile strength and increased stiffness can be caused by a myriad of factors. No matter the cause, the results are restricted ROM, inflammation and pain. Declining joint health is a significant public health problem, and conventional treatments come with enormous financial costs as well as unwanted side effects. Nutritional support for joint health, such as available through consumption of DAPP, may offer an effective, cost-efficient solution. Clinical study reference: GS Jensen, et al., 2013, Consumption of dried apple peel powder increases joint function and range of motion. (Manuscript pending publication.) DAPP is commercially available as AppleActiv, from AppleActives, Quebec, Canada. For more information or a copy of the complete study, including ROM measurements for all areas of motion (including hips, shoulders, lumbar region, thoracic and cervical regions) contact Lorraine Leahy, President, AppleActives, , lorraine@appleactiv.com.

5 References 1. Martin JA, Buckwalter JA. Aging, articular cartilage chondrocyte senescence and osteoarthritis. Biogerontology 2002;3: Merrill C, Elixhauser A. Hospital Stays Involving Musculoskeletal Procedures, : Statistical Brief #34. Healthcare Cost and Utilization Project (HCUP) Statistical Briefs [Internet]. Rockville (MD): Agency for Health Care Policy and Research (US); Jensen GS, Ager DM, Redman KA, Mitzner MA, Benson KF, Schauss AG. Pain reduction and improvement in range of motion after daily consumption of an açai (Euterpe oleracea Mart.) pulp-fortified polyphenolic-rich fruit and berry juice blend. J Med Food. 2011, 14: Benson KF, Ager DM, Landes B, Aruoma OI, Jensen GS. Improvement of joint range of motion (ROM) and reduction of chronic pain after consumption of an ergothioneine-containing nutritional supplement. Prev Med. 2012, 54, Suppl:S83-5. Hyson, DA. A comprehensive review of apples and apple components and their relationship to human health. Adv Nutr 2011;2(5): Boyer J, Liu RH. Apple phytochemicals and their health benefits. Nutrition Journal 2004;3(1): Wolfe K, Wu X, Liu RH. Antioxidant activity of apple peels. J Agric Food Chem 2003;51(3): Heeba GH, Mahmoud ME, El Hanafy AA. Anti-inflammatory potential of curcumin and quercetin in rats: Role of oxidative stress, heme oxygenase-1 and TNF-α. Toxicol Ind Health 2012; doi: / Shen CL, von Bergen V, Chyu MC, Jenkins MR, Mo H, Chen CH, Kwun IS. Fruits and dietary phytochemicals in bone protection. Nutr Res 2012;32(12):