The End of Collagen for Climbers? (New Evidence & Advice)
Hooper’s Beta Ep. 139
Intro
A new study from May of 2023 took 45 trained athletes (men and women) and measured post-exercise muscle fiber and connective tissue synthesis rates after consuming either 30 grams of whey protein, 30 grams of collagen peptides, or a zero-calorie placebo. That’s right, we finally have well-designed, highly controlled study comparing collagen and whey supplements, *and* they used trained athletes, *and* they measured connective tissue synthesis, *and* they controlled the diet of the participants. It’s like the Pubmed gods heard our prayers and decided to bless us [heavenly light shines down on Jason with an angelic choir in the background].
My name is Jason Hooper, doctor of physical therapy, and that’s Emile behind the camera, and in this video we’re breaking down some new evidence about collagen supplementation and whether or not our opinion on it has changed. We’ve poked fun at collagen supplements in the past and even made a song about it, BUT we need to set those biases aside when we look at the research. [Jason puts on a hat with “unbiased” written on it.] So let’s put on our “unbiased” hats and get into it.
Dave McLeod
Quick shoutout to Dave McLeod for the excellent breakdown of collagen research in his recent video. I highly recommend checking it out, but in this video we’d like to cover a few more pieces of evidence we think climbers should know about.
Collagen Recap
To get a good perspective on where we stand with collagen, here’s a quick recap of the situation: Basically, collagen companies make absurdly bold claims about improving joint and connective tissue health, yet we have not seen particularly strong evidence of that in the literature or in the biological mechanisms thus far.
Some studies do show muscle, connective tissue, and skin benefits from collagen peptides, but they also have some significant limitations in their study design which throws things into question. They usually don’t control for participants’ diets, nor do they provide any information about their diets, nor do they compare collagen supplements to anything other than a placebo. This makes it impossible to see how collagen compares to other protein supplements, like whey. It also makes it impossible to know if the participants are getting enough protein in their diet. If they’re not, maybe collagen is just helping fill in the gaps, and maybe the participants would see far better results if they ate more high-quality protein, rather than collagen.
For example, a 2023 study by Balshaw et al showed huge improvements in muscle growth in the collagen group compared to the placebo over a 15 week period of resistance training. However, the participants were untrained, the researchers didn’t include a whey protein group, and there were potentially large differences in energy intake between groups. There are simply so many flaws in studies like this that I personally hesitate to even count them as valid in the larger body of collagen research.
Furthermore, the way the studies conduct their measurements is often suboptimal. Subjective questionnaires, ultrasound, and other error-prone tools are often used to formulate results. Equally concerning is the fact that many collagen studies are funded by collagen companies. This doesn’t automatically make that research bad -- often the only way research gets funded is from invested companies. However, it does make us read the text with an extra dose of skepticism. Essentially, it just throws more question marks on everything.
Beyond that, the marketing that collagen companies use is often downright predatory. They consistently misrepresent collagen research to make false claims and sell more product. One of the most commonly cited studies by collagen companies was done on engineered ligaments in vitro, which is incredibly far removed from a real person consuming collagen. The researchers themselves acknowledge these limitations in the actual paper, and it really should not be used for marketing purposes, so collagen companies in general leave us with a sour taste in our mouths.
And finally, our current understanding of how collagen is used in our bodies doesn’t seem to support collagen supplementation. The amino acids that make up collagen are non-essential, meaning in theory our bodies can make them as needed provided we have the building blocks from other protein sources. So you should have no need for collagen supplements if you get enough complete protein in your diet. And, if you are lacking dietary protein, you should be far better off using a high-quality protein supplement, like whey, rather than a very low-quality protein like collagen.
As you can see, despite numerous studies there are still a lot of unknowns with collagen supplements. The evidence is quite mixed, confounded by shiesty marketing. Historically, this has led us at Hooper’s Beta to avoid recommending collagen supplements to climbers. We don’t recommend *against them* if you like taking them, but we also can’t in good conscience recommend everyone go buy it. So let’s take a look at some new evidence and see if anything has changed.
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The New Study
The researchers took a highly controlled approach to this study, which is a godsend for us nerds. Unlike previous collagen studies, they even controlled the participants' diet. Using measurements from things like blood serum and even muscle biopsies, they found some interesting results when it came to both muscle protein and connective tissue synthesis in the 45 participants.
For muscle protein synthesis, they found that the whey protein group showed a significant increase post-exercise compared to the collagen and placebo groups. Neat! Though, this is not really surprising, seeing as whey is a complete protein with a high concentration of leucine, which are crucial attributes for muscle protein synthesis. Collagen supplements, on the other hand, have a very *limited* amino acid profile and relatively *little* leucine. So, this appears to be one more pebble on the mountain of evidence showing that adequate doses of *high-quality* protein are critical for muscle repair and growth. Collagen is simply not a replacement for that. Translation? All climbers need to be getting ample amounts of high-quality protein.
Of course, climbers are generally more concerned about connective tissue in relation to collagen supplements, and luckily the researchers looked at that too. The study showed increases in connective tissue synthesis rates after exercise in all three groups, with no significant differences between groups. Statistically speaking, they were all the same! What does that mean? It’s not what the participants *ate*, it’s what they *did*. *Exercise* is what increased connective tissue synthesis, not the supplements.
So, if you want to strengthen your connective tissue, of course you need to get good sleep and eat well, but you also need to *train*. No amount of collagen -- or any supplement for that matter -- can make up for a lack of exercise. And according to this study, collagen peptides do not appear to improve connective tissue growth even with exercise.
Case closed, right? Collagen officially doesn’t do anything and we can all finally move on, right? I’ve seen several YouTubers using this study as the nail in the coffin for collagen, but… much as it pains me to say, I don’t think that’s the right approach. While this study did an admirable job of controlling for variables and collecting data, it still has some key limitations.
One potential issue is that the connective tissue they studied was intramuscular connective tissue, meaning it was from inside the muscle rather than from a tendon or ligament. Could this kind of connective tissue respond differently than something like our pulleys? Possibly. But at least one study shows that connective tissue synthesis rates are similar between all types of connective tissue surrounding the knee, so I don’t think it’s unreasonable to apply this collagen study’s findings to tendons and ligaments. [2]
However, there is a much bigger issue at play: the study’s duration. Participants only completed *one bout* of a single exercise (barbell squats) on a single day. The measurements were all taken five hours after this single bout of exercise and that is what all the study’s conclusions are based on. In other words, this is a *very* limited set of data, with no medium- or long-term measurements. Now, I can’t really fault the researchers for this. When it comes to human studies, basically the more control you exert in human trials the less willing they’ll be to participate, so if you want a highly controlled human experiment it’s going to be a short one. It’s an unfortunate reality, and it means I’m not willing to call this study definitive, though I certainly find it more useful than most.
The Unbiased Perspective
In my opinion, most discussions of collagen stop short of the full picture. If we’re actually interested in an unbiased perspective, we have to acknowledge that we simply don’t know everything there is to know about collagen synthesis, so it’s possible collagen supplements affect us in a way that hasn’t been described by science.
In fact, there are some research papers arguing glycine, a key collagen amino, may in fact be “conditionally essential.” In other words, our bodies can make enough for us to function, but perhaps not enough to be ideal at all times, so a collagen supplement could be beneficial in that case. Now, these papers involve a lot of assumptions without enough hard evidence to convince me personally, but they should still be considered.
Beyond that, we have to consider the cost-benefit analysis of collagen peptide supplements.
While far from proven, there is a general trend of benefits to soft tissues in the studies. Numerous experiments show positive outcomes for things like muscle growth, patellar tendon stiffness, skin growth, skin elasticity, skin hydration, and more. However, these studies are too flawed to truly argue in favor of collagen in my opinion. On the other hand, none of the studies show adverse effects from collagen supplementation (unless of course you’re trying to replace high-quality protein with collagen, which is a bad idea).
Essentially, collagen supplements present little to no cost other than monetary. I would absolutely like to see stronger evidence, but I feel that way about most other supplements too (aside from well-supported ones like high-quality protein and creatine, of course). I would include caffeine in that list, but I don’t consider coffee to be a supplement -- coffee is life.
So what am I getting at here? I’m definitely not willing to say collagen peptides are effective at this time, but I’d also place them higher up on the list of “worth a shot” than most other supplements. If you're interested in the potential small gains you could get from safe supplements and you have the funds to support that, I see little reason to hold out. For everyone else, you can rest easy knowing that if you already eat a healthy diet, you won’t benefit much or at all from most supplements -- though that won’t stop many of us from trying them anyway.
Just remember there are far more effective methods for improving your health than taking supplements. Want stronger muscles? Work out! Want strong connective tissue? Work out! Want to slow skin aging? Use UV protection! Want more energy? Eat and sleep better!
Conclusion
Be sure to check out those affiliate links if you feel like it and until next time: train, climb, send, repeat!
CITATIONS
Aussieker T, Hilkens L, Holwerda AM, et al. Collagen Protein Ingestion during Recovery from Exercise Does Not Increase Muscle Connective Protein Synthesis Rates [published online ahead of print, 2023 May 19]. Med Sci Sports Exerc. 2023;10.1249/MSS.0000000000003214. doi:10.1249/MSS.0000000000003214
Smeets JSJ, Horstman AMH, Vles GF, et al. Protein synthesis rates of muscle, tendon, ligament, cartilage, and bone tissue in vivo in humans. PLoS One. 2019;14(11):e0224745. Published 2019 Nov 7. doi:10.1371/journal.pone.0224745 [2]
Kim J, Lee SG, Lee J, et al. Oral Supplementation of Low-Molecular-Weight Collagen Peptides Reduces Skin Wrinkles and Improves Biophysical Properties of Skin: A Randomized, Double-Blinded, Placebo-Controlled Study. J Med Food. 2022;25(12):1146-1154. doi:10.1089/jmf.2022.K.0097 [3]
Asserin J, Lati E, Shioya T, Prawitt J. The effect of oral collagen peptide supplementation on skin moisture and the dermal collagen network: evidence from an ex vivo model and randomized, placebo-controlled clinical trials. J Cosmet Dermatol. 2015;14(4):291-301. doi:10.1111/jocd.12174 [4]
Meléndez-Hevia E, De Paz-Lugo P, Cornish-Bowden A, Cárdenas ML. A weak link in metabolism: the metabolic capacity for glycine biosynthesis does not satisfy the need for collagen synthesis. J Biosci. 2009;34(6):853-872. doi:10.1007/s12038-009-0100-9 [5]
de Paz-Lugo P, Lupiáñez JA, Meléndez-Hevia E. High glycine concentration increases collagen synthesis by articular chondrocytes in vitro: acute glycine deficiency could be an important cause of osteoarthritis. Amino Acids. 2018;50(10):1357-1365. doi:10.1007/s00726-018-2611-x [6]
Liu J, Klebach M, Visser M, Hofman Z. Amino Acid Availability of a Dairy and Vegetable Protein Blend Compared to Single Casein, Whey, Soy, and Pea Proteins: A Double-Blind, Cross-Over Trial. Nutrients. 2019;11(11):2613. Published 2019 Nov 1. doi:10.3390/nu11112613 [7]
Barati M, Jabbari M, Navekar R, et al. Collagen supplementation for skin health: A mechanistic systematic review. J Cosmet Dermatol. 2020;19(11):2820-2829. doi:10.1111/jocd.13435 [8]
Bagheri Miyab K, Alipoor E, Vaghardoost R, et al. The effect of a hydrolyzed collagen-based supplement on wound healing in patients with burn: A randomized double-blind pilot clinical trial. Burns. 2020;46(1):156-163. doi:10.1016/j.burns.2019.02.015 [9]
DISCLAIMER
As always, exercises are to be performed assuming your own risk and should not be done if you feel you are at risk for injury. See a medical professional if you have concerns before starting new exercises.
Written and Presented by Jason Hooper, PT, DPT, OCS, SCS, CAFS
IG: @hoopersbetaofficial
Filming and Editing by Emile Modesitt
www.emilemodesitt.com
IG: @emile166
