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The Immune Boom


Once thought of as a “winter category,” consumers are learning the importance of maintaining their immune systems year-round.

In the United States, “cold and flu season” typically begins in the fall and peaks in the winter months of January or February. According to Flu.gov, five to 20 percent of U.S. residents get the flu each year, while more than 200,000 people are hospitalized for flu-related conditions. Further, the Centers for Disease Control and Prevention (CDC) reported that annually, almost 22 million school days are lost due to the common cold, and that the number of people who die from flu-related causes in the U.S. ranges anywhere from 3,000 to 49,000.

Maintaining a healthy immune system can help prevent a person from catching a cold or the flu. A balanced network of cells, organs and tissues that work together to protect the body, it is the immune system’s mission to find and destroy any pathogens that try to invade the body. And while many consumers believe that they only need to be concerned about immune health during the winter months, the immune system goes far beyond just protecting the body from catching a cold. It also works to shield the body from a number of other issues including allergies and autoimmune diseases.

“The immune system, as you know, is the foundation of health,” said Stacy Wick, co-owner of Living Green Natural Food and Apothecary in Langley, WA. “It seems that there are more colds to catch in the winter and that is when people want a boost. Yet, spring and summer are good times, too, due to seasonal allergies.”

A Year-Round Concern

While it is ideal to keep the immune system in tip-top shape year-round, for many Americans, this is easier said than done. Today, the standard American diet is full of processed foods that lack the nutrients that are required to fuel the body. Further, many are not getting enough exercise or sleep, while stress is affecting a large number of the population. According to the Anxiety and Depression Association of America (ADAA), seven out of 10 adults in the U.S. say they experience stress or anxiety daily. These factors can greatly affect the immune system’s function. “As the population continues to age, the demand for immune support supplements should strengthen even more. But the aging population is not the only factor contributing to an increased demand,” said Nena Dockery, technical services manager for Missouri-based Membrell, exclusive distributor of Allera Health Products, Inc., in Florida. “We live stressful lives, board crowded flights to travel around the world for work or pleasure, we spend too much time indoors and not enough time outside in the fresh air, we eat too many overly processed foods and overuse medications such as antacids and antibiotics. These factors can deplete the immune system, so most of us, regardless of age, are interested in ways to restore immune system health.”

According to Ramona Billingslea, marketing manager for Betsy’s Health Foods in Houston, TX, in the past, customer interest in immune health was predominantly seasonal, but consumer interest in immune health as a yearround concern is widening as it is garnering more attention from the media. “Most recently, with shows like Dr. Oz and commercials about probiotics in the mainstream that talk more specifically about immunity in the body, customers are beginning to show more interest in this aspect of their health,” she said.

And while it is positive that this information is reaching a larger number of people, some natural products retailers have developed a love-hate relationship with Dr. Oz types because, although they are educating the masses and introducing them to preventative and alternative care options, their recommendations can be unexpected. “Our biggest challenge is keeping up with the recommendations of Dr. Oz! He seems to recommend a lot of the odd products and sometimes they are hard to find,” said Trent Hurley, owner of No Name Nutrition Market West, with two locations in Omaha, NE. “The immune category seems to change constantly. New combinations come out every day claiming to be the latest and greatest. We try to keep abreast of them, but sometimes we fail.”

As consumers are learning that maintaining a healthy immune system should be a daily concern, the market for immune health products is booming. The category appeals to everyone and with health care costs rising, Americans are looking for effective alternatives. Additionally, they are searching for natural options for their families, according to Angela Butler, director of New York-based Erba Vita USA. “Erba Vita recently entered the U. S. market as consumers here are starting to think more like Europeans in terms of health and wellness,” she said. “More U.S. consumers are seeking natural, preventative medicines for health ailments, similar to how Europeans visit the apothecary for suggestions on chemical-free supplements.”

“The number of colds in the U.S. is estimated to be more than one billion annually. According to a 2009 Gallup Study, 72 percent of American adults took a supplement to help fight infection,” added Ron Antriasian, vice president of sales and business development for Florida-based Life Extension. “Given the annual U.S. market for supplements is estimated to be about $30 billion and growing at an eight to 10 percent annual clip, the market for immune health supplements will continue to grow accordingly, and perhaps exponentially given demand for such products is no longer just a winter seasonal event.”

The Crowded Shelf

Because maintaining a healthy immune system is fundamental to living a healthy life, there is a laundry list of vitamins and minerals that are utilized singularly or in combination formulas to aid in that task. Some, such as echinacea, omega-3s and zinc, as well as vitamins A, C, D and E, are among the long-standing ingredients that have been used for years and are trusted by a number of consumers.

Illinois-based Carlson Laboratories offers a number of products that can help improve the immune system, including ACES, a multiple antioxidant that also provides levels of betacarotene, vitamin C, vitamin E and selenium—the building blocks needed for the natural production of glutathione peroxidase, which supports immune function, according to the company. “Ahead of its time, the nutrients ACES provides are now known to protect individuals who have asthma as these dietary antioxidants not only ameliorate airway inflammatory antioxidant stress, but also (probably more importantly in the immunopathogenesis of asthma) may play a more fundamental role by influencing T helper cell differentiation,” said Jolie Root, the company’s nutritionist and educator.

And while these long-standing ingredients are staples in the category, research has afforded opportunities for “newer” ingredients to display what benefits they can offer to the immune system. For instance, probiotics, which are mainstays in the digestive health market, are becoming more popular in the immune health category as consumers are learning that 70 percent of the immune system is located in the digestive tract. Reishi mushrooms are also garnering attention for their immune health benefits. “Reishi mushroom has been traditionally used to boost immune system vitality,” explained Jeff Taylor, executive director of product development for Life Extension. “Its broad-spectrum benefits have been demonstrated in thousands of studies.1 An advanced extraction technology has resulted in a new reishi extract that make its active compounds even more bioavailable.”

Additionally, Life Extension now offers Immune Modulator with Tinofend, a botanical extract that has been shown to support a normal, modulated immune response.2-11 According to the company, Tinospora cordifolia is a plant that has a long tradition of use in ayurvedic medicine.12,13 Tinofend is a standardized extract of active compounds that work synergistically5,11 to provide immune-modulatory support.2-11 “Immune Modulator with Tinofend provides the versatile Tinospora compounds shown to help maintain the balanced cellular responsiveness, sensitivity and strength of an optimized and properly-modulated immune response2-11,” explained Antriasian.

Another up-and-coming ingredient in regard to immune health is propolis, a resin-like material that is collected by honeybees from tree buds, sap flowers and other plants. “Propolis has been used for hundreds of years in natural medicine and is just starting to catch on in the U.S.,” explained Butler. “A resinous material collected by honeybees from tree buds and other plant sources, propolis is used to protect the beehive from disease and infection.” Erba Vita uses a patented extraction process to collect the propolis from the hive, which improves the quality and efficacy of its propolis products, Butler explained.

Erba Vita’s Propolis does not break down in the stomach, which allows it to reach the digestive tract. Studies have shown that it inhibits the growth of H. Pylori bacteria and helps aid in digestive health, an important part of a healthy immune system, according to the company.

Erba Vita also offers Immun Act, a unique formulation of ingredients known to be immunostimulants and with antioxidant properties among other active principals to maintain immune health, including cat’s claw, pau d’arco, echinacea angustifolia, andrographis, grapefruit extract and papaya.

The Greeks first documented the health benefits of pinecone extract in 500 A.D. Today, the extract is used in Japan where it has been associated with an increase in health and longevity. Allera’s Immune Extra contains Proligna pinecone extract, which originated in Japan, but is now produced in the U.S. Immune Extra can help provide longterm health and wellness benefits, according to Frank Tufaro, CEO of Allera, in Florida. “In fact, many people don’t feel different after taking it, except they note that they stay healthy. Some people actually do feel better almost immediately because of the immune-balancing effect of the product,” he said, noting that scientists have learned that the immune system can be unbalanced, or not optimized for disease fighting, and many new drugs attempt to alter this immune balance. “We believe that the pinecone extract in Immune Extra is a gentle and natural compound that can help to keep the immune system optimized.”

Support System

While consumers may have garnered some knowledge through their own research and television experts, they will often look to their local natural products retailer for advice to help them sort out fact from fiction. And it is imperative that retailers take advantage of the literature, training opportunities and other promotional/ educational materials that manufacturers offer.

While Erba Vita provides its retail partners literature, sample packets, staff trainings and in-store demos, Ron Roybal, West regional manager with Missouri-based Membrell, noted that highlighting the immune health section and making it stand out is important in garnering customer attention.“Adding signage that highlights its immune modulating qualities is one way to generate attention,” said Roybal. “Our floor displays are also a great way to bring awareness and encourage self education of the product.”

And Billingslea said that manufacturers are also assisting retailers by simply updating their labels. “In the past year or so, manufacturers across the board are redesigning product labels that offer more information about the actual product. These labels help us tremendously as we try to explain products to customers.”

Retailers may also consider offering seminars and other events to keep their customers “in the know” as well. No Name Nutrition’s Hurley explained that the store brings in expert speakers such as Jordan Rubin, Terry Lemerond and Dr. Michael Murray in addition to offering customers an educated staff. “We have an excellent staff that is very knowledgeable. We have more than 300 combined years of experience working between our two stores,” said Hurley. “We also have a vast library and access to the internet.”

Offering information and suggesting an appropriate supplement may be part of what retailers do to help keep their shoppers’ healthy, but encouraging shoppers to eat balanced meals, exercise and get enough sleep in conjunction with taking an immune health supplement gives them the best shot at keeping the immune system in “fighting” shape.

“One challenge with immune health is to convince the customer that any supplement is just that—an additional support to an overall lifestyle plan of better eating, rest, exercise and healthy habits that may help improve a person’s overall health,” concluded Billingslea. “We would all love that ‘magic bullet’ pill that would let us eat fried food and sugar, be couch potatoes and never have a health problem, but that pill just doesn’t exist. Customers buying an immune health product need to understand that the supplement is not a license to eat more greasy fries!”


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Vitamin D Levels are Highest in August, Lowest in February

University of California, Irvine (UC Irvine) and Mayo Clinic researchers have found that vitamin D levels in the U.S. population peak in August and bottom out in February.

Low levels of vitamin D are believed to impair “innate immunity” (i.e. the body’s first line of defense against pathogens).

To further study this link, good estimates of the cyclicality of the vitamin are necessary. Solar exposure—a timely topic since June 21 marks the first day of summer—is the most important way people acquire vitamin D. But certain foods, including egg yolks and oil-rich fish like mackerel, salmon, sardines and herring contain the nutrient. In addition, milk and cereal are often enriched with vitamin D.

“Even with food fortification, vitamin D levels in the population show a high level of seasonality due to the influence of sunlight,” said Amy Kasahara, a UC Irvine graduate student in public health and first author on the paper, which was published in the journal PLOS ONE. “The exact biochemical pathways from UVB rays to vitamin D were discovered in the 1970s. In this study, we have shown that vitamin D levels lag the solar cycle, peaking in August and troughing in February.”

Researchers measured the level of 25-hydroxyvitamin D in 3.4 million blood samples collected weekly in the U.S. between July 2006 and December 2011. The study looked at population averages, so people shouldn’t make assumptions about their own levels of vitamin D based on the calendar. Health care providers can perform individual blood tests to measure vitamin D directly, and supplements are available for those who cannot or do not receive enough exposure to sunlight.

“What we have been able to do is put a lot more precision on the estimates of vitamin D seasonality,” said Andrew Noymer, associate professor of public health and senior author of the article. “Our analysis, combined with other data, will help contribute to understanding the role of vitamin D in all seasonal diseases, where the simple winter/spring/summer/fall categories are not sufficient.”

For more information, visit www.uci.edu or www.mayoclinic.com.

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