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Jennifer Grebow is editor-in-chief of Nutritional Outlook.
As a supplements category, immune health has come a long way-especially when it comes to consumer awareness and appreciation.
As a supplements category, immune health has come a long way-especially when it comes to consumer awareness and appreciation.
“I think consumer awareness has grown tremendously,” says David Walsh, vice president of communications, Biothera (Eagan, MN), maker of immune-support ingredient Wellmune WGP. “When we started selling our technology five years ago, marketers would ask, ‘How am I going to sell an immune-support product? It’s like selling insurance; it’s boring. Who’s going to want to buy that?’” Many consumers do, it turns out. Walsh says that Biothera doubled its sales last year alone.
To an extent, worldwide scares such as the H1N1 virus may have helped turn the consumer’s mind toward staying well. More likely, however, are economic factors closer to home-loss of jobs and health insurance, increased job stress, rising healthcare costs. These concerns may have shifted consumer focus from, say, treatment of cold and flu symptoms when they occur, to keeping symptoms at bay in the first place-a daily preventive approach.
“No longer synonymous with cold and flu, immune health has evolved into strong sales for products designed to...help cope with everyday stress,” says Cheryl Sturm, director of marketing, Embria Health Sciences (Ankeny, IA).
“I think people realize it is much more pleasant to help maintain a strong immune system through proper diet, exercise, and supplement use than it is to suffer through a cold and the side effects of drugs,” adds Chris Holland, vice president of sales and marketing for BGG North America (Irvine, CA).
Dietary supplements for immune health are now also being marketed as a way to help active people stay active-and, through this, enhance their general sense of well-being and their quality of life. Because when you feel well physically, you feel well overall.
“There appears to be a general community awareness of the connection between having a strong immune system and leading a healthier, happier life with enhanced resilience and reduced illness,” says Marina Linsley, marketing director for NP Nutra (Rancho Dominguez, CA).
Sometimes, the allure of promising immunity may prove irresistible to marketers. This has led to a number of questionable claims. Often, such claims are promoted for products aimed at children, which in turn has led to increased regulatory attention to the category. In July, the Federal Trade Commission (FTC) announced that Nestlé’s Boost Kid Essentials children’s beverage brand would drop what the agency stated were deceptive health claims regarding immune protection and the drink’s probiotics. Last year, Kellogg’s was forced to remove immune-health claims from boxes of Cocoa Krispies and Rice Krispies.
With the immune-health category growing each year, it’s obviously become important for marketers to select ingredients that suppliers’ own clinical tests have shown actually work.
“Borrowed science is junk science,” says Walsh.
On the flip side, says Biothera’s president and CEO Richard Mueller, it’s also crucial for suppliers to ensure that the brands they work with utilize ingredients properly. “We take great care to make sure that any potential customer is making claims consistent with the research that we have to support the claim, but just as important, that they’re using the proper dose that’s consistent with the efficacy we’ve seen in our clinical studies. No fairy dust, so to speak. And that happens-companies will sprinkle an amount of an ingredient in a product that’s not consistent at all with clinical studies and that won’t offer customers any real benefit.”
Below are some ingredients currently gaining attention in this growing market.
A Balanced Approach
When it comes to defending the immune system, some say that simply “boosting” the immune system might not be the best approach.
“A balanced immune system is a healthy immune system,” says Larry Robinson, PhD, vice president of scientific affairs for Embria Health Sciences.
Allergies and autoimmune diseases are thought to be caused by overly active immune systems that are out of balance, he explains. “So, immune boosting is not always good. On the other hand, immune suppression can also cause problems. While beneficial for people with allergies or autoimmune diseases, people taking immune-suppressive drugs are also subject to more infection and problems with wound healing. Therefore, the best supplement for the immune system is one that helps the body maintain immune balance and [doesn’t cause it] to over or underrespond.”
Embria’s EpiCor, a fermented ingredient rich in metabolites and immune-nourishing nutrients-including a proprietary mix of vitamins, minerals, amino acids, and antioxidants-is designed to support the immune system in a balanced way, says Robinson.
It’s an approach that research has shown to work. Embria’s latest clinical trial, published this year in the Journal of Alternative and Complementary Medicine (Moyad MA et al., vol. 16, no. 2 (February 2010): 213-218), demonstrated that EpiCor reduced incidence of cold- and flu-like symptoms in at-risk subjects. Moreover, a recent clinical trial published in Advances in Therapy (Moyad MA et al., vol. 26, no. 8 (August 2009): 795-804) found that EpiCor reduced seasonal allergy symptoms, especially nasal congestion.
Biothera’s Walsh agrees with a balanced approach. “Immune boosters or stimulators may be harmful.” He says that unlike other immune-health ingredients, Wellmune WGP enhances immune function, without stimulating the entire immune system.
Biothera says that Wellmune WGP targets neutrophils, the most abundant (up to 70%) immune cells in the body. “Specifically, Wellmune WGP binds with complement receptor 3 (CR3) on neutrophils, which initiates an immune response,” says Walsh. Simply stated, he says, Wellmune WGP, once bound to neutrophils, enhances them so that they can more effectively circulate in the body and attack foreign challengers.
Another immune-support ingredient, Lonza’s (Allendale, NJ) ResistAid, also targets specific functions of the immune system, without affecting others. The ingredient is derived from the wood and bark of larch trees and contains soluble polysaccharide arabinogalactan and bioactive flavonoids for antioxidant support.
The company recently presented the results of a randomized, double-blind, placebo-controlled, parallel-group study that showed ResistAid not only increased the antibody response to a vaccine in healthy adults compared to placebo, but that the ingredient responds to specific antigens. Specifically, the company says, the study showed that ResistAid had an immunomodulatory effect, “meaning that it enhanced the appropriate response to the antigen, without indiscriminately enhancing other arms of the immune system that would not be expected to respond,” says Bryan Rodriguez, technical marketing and scientific affairs manager.
Be More Specific
Consumers educating themselves about immune-health nutraceuticals are also learning that it’s necessary to get down to specifics when understanding which ingredients can actually pose real benefits.
For instance, probiotics suppliers and marketers have been generating more awareness among consumers that it’s not just probiotics in general that can aid their immune health-it’s specific bacterial strains.
Probiotics help keep a balance between good and bad bacteria in the digestive tract, where 70% of the immune system is based. Namely, they keep bad bacteria and yeast from growing, keeping the immune system healthy, says Michael Shahani, director of operations at Nebraska Cultures Inc. (Walnut Creek, CA).
“Probiotics’ mechanisms of activity in our bodies are varied,” says Tim Gamble, senior vice president of sales and marketing for Nutraceutix Inc. (Redmond, WA), which markets its Immunobiotix probiotic dietary supplement. “Studies have shown that a viable population of good organisms in the gut can preclude the overgrowth of pathogenic bacteria by competing with harmful bacteria for colonization sites and food sources, can produce compounds that inhibit the growth of pathogenic organisms, and can, by colonizing and interacting with the walls of the intestinal tract, stimulate important components of a healthy adult immune system.”
“The latter mechanism, it’s important to point out, is systemic in nature,” he adds.
Immunobiotix capsules contain one strain of Bifidobacteriumand three Lactobacillusstrains. The capsules also incorporate Nutraceutix’s Bio-tract controlled-release feature that helps protect probiotics from digestive acid until they safely reach the digestive tract, for optimum benefits.
A study on Immunobiotix published in Nutritional Research (“Daily ingestion of a nutritional probiotic supplement enhances innate immune function in healthy adults,” vol. 26, no. 9 (September 2006): 454-459) showed a statistically significant increase in the percentage of phagocytic monocytes and neutrophils over an eight-week treatment period.
Another ingredient popular with consumers for immune health is Echinacea. It may be obvious, but bears repeating, that not all Echinacea is the same. With at least nine known species, Echinacea can have differing immune-health effects, depending on the species and the part of the plant used.
“The various species of Echinacea and their different plant parts (roots, leaves, flowers) have a different phytochemical profile,” says Christian Artaria, marketing director and head of functional food development, for Indena S.p.A. (Milan, Italy). “This includes isobutylamides (different types) and polyphenolic markers like caffeoyl conjugates (echinacoside and cicoric acid, etc.). None of these, while commonly used as phytochemical markers to characterize Echinacea extracts in the market, have an immunomodulator activity.” Artaria says that because bacterial lipopolysaccharides are common contaminants of hydrophilic plant extracts and have been detected in both Echinacea roots and Echinacea preparations, the presence of these compounds can interfere with the study of immune-stimulating activity.
Indena believes that the activation of T-cells is the main mechanism of Echinacea’s immune-enhancing action. The company has linked this action to a specific compound present in Echinacea angustifolia root. Indena’s Polinacea ingredient is an Echinacea angustifolia root extract standardized in a unique and patented plant polysaccharide (as well as in echinacoside and for its lack of alkamides). The company says the presence of this polysaccharide is critical for Polinacea’s action on T-cells.
“Indena believes that the main active responsible for boosting the immune system is a specific polysaccharide that can only be found in Echinacea augustifoliaroots,” says Artaria. He says that this species is also what has a solid history of use in the traditional Indian folk medicine as well as among North American Plains Indians.
Indena offers another Echinacea ingredient, ImmunoSelect, which is also extracted from the dried roots of Echinacea augustifolia. As with Polinacea, ImmunoSelect guarantees that the correct species and part of the plant are used.
Polinacea and ImmunoSelect are each standardized to different constituents of Echinacea augustifolia-and therefore target different mechanisms of immune support. Each should be used at different stages of the flu.
Polinacea is standardized to contain a higher-molecular-weight polysaccharide (IDN 5405) of over 20,000 Daltons, which stimulates T-cells. It can therefore be used for helping prevent the flu, says Indena. (Because isobutylamides can exhibit CB2-mediated immunosuppressive activity, Polinacea doesn’t contain isobutylamides.)
ImmunoSelect, on the other hand, is standardized to contain at least 4% echinacoside and does contain isobutylamides, which research shows have anti-inflammatory and pain-relief benefits. Therefore, ImmunoSelect is useful in treating symptoms once a person already has the flu.
Consumers should be wary when distinguishing between different Echinacea products, says Artaria. He says that because it can be quite difficult to identify a single species of Echinacea when it is dried-and especially in root form-it’s easy for adulteration to happen. “This is a very well-known issue,” he says. “A specific paragraph in the American Herbal Pharmacopoeia has addressed this issue for years.”
As ingredient suppliers, marketers, and consumers become better aware of the need to scrutinize Echinacea ingredients, it may also help advance education surrounding this long-known immune remedy. “Echinacea is a classic, but far from being old,” says Artaria. “Consumers who have taken Echinacea understand its potential immune-enhancing benefits, and there are numerous cold and flu products that rely on it as a key ingredient.”
“As industry stewards, it is important to discuss the varying forms of Echinacea and how these forms deliver a biological effect in the body,” he continues.
Vitamin C is also considered a classic ingredient consumers turn to when they feel the need for immune support. Like Echinacea, when it comes to vitamin C, it behooves consumers to ensure they’re using one that works.
Last year, Scientific Food Solutions LLC (SFS; Fairfield, CA) introduced Fast-C, a vitamin C ingredient touted for its faster absorption time and retention in the human body.
Last October, the company released its second clinical study, a double-blind, randomized, crossover trial on 10 male subjects that confirmed a faster rise of vitamin C in the blood following supplementation with Fast-C, yet no greater urinary excretion of ingredient traces than a leading vitamin C formulation would cause. (Results were presented at the American College of Nutrition conference last October.)
Fast-C is distributed by E.T. Horn (La Mirada, CA). It incorporates Alkemy, a patent-pending blend of Generally Recognized as Safe alkalizing minerals that results in a buffered, acid-neutralized vitamin C formulation. The company calls it “a step ahead of buffered forms of vitamin C.”
“Buffered does not necessarily mean better, in relation to the acid load a person may experience when an ascorbic acid-containing product enters the gut,” says Anthony Almada, MSc, chief scientific and intellectual property officer for SFS. “A more definitive assessment would be a resulting neutral pH when added to water. When ascorbic ‘acid’ is used, this is key to neutralizing the acid load.”
Fast-C also includes BioPerine, a multipatented standardized extract of Piper longum from Sabinsa Corp. (East Windsor, NJ), which helps increase the bioavailability of nutritional compounds. Earlier this year, the companies extended their licensing agreement to continue including BioPerine in Fast-C.