{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:15:21Z","timestamp":1790082921788,"version":"4.0.1"},"reference-count":44,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Joint and bone diseases are major causes of morbidity worldwide. While glucosamine sulfate (GS) and chondroitin sulfate (CS) have demonstrated benefits in severe degenerative joint conditions, real-world evidence on the use patterns and reported outcomes of their combination with calcium (GCC) among individuals with mild-to-moderate joint discomfort remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This real-world study enrolled 9,090 adults who used GCC for \u22651 month and completed an online questionnaire; pre- and post-use symptom scores were analyzed among participants reporting joint symptoms or back pain. Linear mixed-effects models adjusted for demographics, lifestyle, comorbidities, medications, and other dietary supplement use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After GCC use, joint pain, stiffness, swelling, inflexibility and back pain scores were significantly lower than pre-use scores, with mean changes of \u22121.74 (95% CI: \u22121.81 to \u22121.68) for joint pain and \u22121.37 (95% CI: \u22121.45 to \u22121.28) for back pain (all\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), although none of the mean changes reached the pre-specified primary two-point minimal clinically important difference. Notably, intake at or above the recommended dosage was associated with more favorable changes in pain, stiffness, and back pain scores. Longer intake duration, better adherence, and physical activity were also associated with more favorable changes in some symptom scores. Self-reported adverse events were rare (5.61%), predominantly gastrointestinal.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although the mean changes did not reach the pre-specified primary two-point minimal clinically important difference, GCC use was associated with lower joint discomfort and back pain scores, and self-reported adverse events were rare.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1888176","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:56:26Z","timestamp":1790081786000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Real world evidence for glucosamine-chondroitin-calcium supplementation on joint pain"],"prefix":"10.3389","volume":"13","author":[{"given":"Jingmeng","family":"Ju","sequence":"first","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition, School of Public Health, Sun Yat-sen University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongxia","family":"Li","sequence":"additional","affiliation":[{"name":"BYHEALTH Institute of Nutrition & Health","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jialu","family":"Yang","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition, School of Public Health, Sun Yat-sen University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaoming","family":"Deng","sequence":"additional","affiliation":[{"name":"BYHEALTH Institute of Nutrition & Health","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Xia","sequence":"additional","affiliation":[{"name":"Guangdong Provincial Key Laboratory of Food, Nutrition and Health, and Department of Nutrition, School of Public Health, Sun Yat-sen University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1745","DOI":"10.1016\/S0140-6736(19)30417-9","article-title":"Osteoarthritis.","volume":"393","author":"Hunter","year":"2019","journal-title":"Lancet"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e508","DOI":"10.1016\/S2665-9913(23)00163-7","article-title":"Global, regional, and national burden of osteoarthritis, 1990\u20132020 and projections to 2050: a systematic analysis for the global burden of disease study 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