Immune Support: Playing Good Defense

By Lisa Olivo, Associate Editor | September 1, 2012

Trends show an ounce of prevention is worth a pound of cure.

In today’s fast-paced world, it seems we’re all under constant pressure just to keep up. With continued economic downfalls, growing financial hardships, environmental deterioration and new super viruses lurking in the distance, each of us is bombarded daily by anxiety, toxins, dangerous pathogens and overwhelming personal and professional demands. Given these developments, it’s no wonder immune support has become such an important focus for consumers.
Earlier this year, David Sprinkle, publisher, Packaged Facts, New York, NY, discussed a new report—“Targeted Health & Wellness Foods and Beverages”—in an interview with Nutraceuticals World. During this conversation, he said immune support is poised for significant growth. “Interest in healthy immunity has soared as consumers increasingly recognize its role in everything from reducing risk of illness and chronic disease to staving off the cosmetic signs of aging. Antioxidant powerhouses such as superfruits and tea extracts currently predominate in immune-boosting foods and beverages, but expect more novel formulations and evidence-backed products in the foreseeable future.”
From a lifestyle standpoint, Doug Reyes, North American sales and marketing manager at Embria Health Sciences, Ankeny, IA, says a common denominator in immune support is stress and its impact on our bodies. “It seems we hear about stress more and more in the media, and we are all feeling its effects. Emerging science indicates a very close relationship between external stressors on the body (e.g., physical, emotional, psychological, environmental, microbial) and their effects on our good health.”
Suzanne McNeary, president at NutraGenesis LLC, Brattleboro, VT, offered a similar view. “Consumers have only so much money earmarked for their personal care. Therefore, they are looking for products that can cover more bases,” she said. “We have responded to that by creating new product offerings that provide additional health benefits consumers are looking for on a daily basis, in particular stress reduction, which is directly correlated to healthy immune defenses.” 
The ever-present pressures of our lifestyles often catch up to us, affecting our immune system and overall sense of wellness. But who has time to get sick, let alone deal with a more serious virus like H1N1? Furthermore, with money concerns a priority for most (or for that matter, health insurance), who can handle this kind of medical set back? The overuse of antibiotics, creating drug-resistant viral strains, put us further at risk.
“Consumers are looking for ways to maintain a healthy condition. Many have lost healthcare and are turning to natural products that are less expensive and have far fewer side effects,” commented Bill Pine, vice president, Sales, Improve USA, DeSoto, TX. “Natural products are a viable complement to traditional medicine. Diabetes, gut disorders and other autoimmune conditions are common in our society and can be ameliorated through natural products. A healthy immune system will protect consumers from many of these conditions.”
Consequently, consumers are gaining interest in protecting themselves and their families by cultivating a healthier immune system. From moms looking to protect their kids from colds during back-to-school season, to the large Baby Boomer population looking to maintain good health well into their “golden years,” the market for immune support products is primed for some serious expansion. 
Besides, staying healthy is simple when you have the right products, according Mike Bush, vice president of business development for Ganeden Biotech, Inc., Cleveland, OH. “If your immune system is healthy, you stay healthy,” he said. “If you stay healthy, you’re happier and more productive.”
Understanding Health Obstacles
A healthy diet, exercise and plenty of rest help maintain overall health, but often further measures are needed in order to combat the stresses and health threats that are out of our control. Over-exposure to stress can raise cortisol levels in the body, which can drastically weaken the immune system. Additionally, under-exposure to key vitamins such as vitamins A, C and E as well as certain carotenoids and flavonoids can negatively affect overall health. 

“The human immune system is the body’s defense against all challenges. It is a highly complex network of millions of immune cells and numerous chemical mediators, which protect the body,” explained Rich Mueller, president and CEO, Biothera, Eagan, MN.
These biological networks and processes protect us from disease, pathogens and even tumor cells. Further, distinguishing our own healthy cells from invading agents or unhealthy cells is what protects us from autoimmune disease. Keeping these networks and processes primed for times of crisis represents the main approach supplements and nutraceuticals are taking in the immune support market.
“The skin is the largest of all the organ systems that make up our immune system, serving as a mechanical barrier to infectious problems. The GI tract is another major defense system, often killing off food-and-beverage-borne problems. The lungs are important in their ability to fight off the harmful effects of pollutants and airborne bacteria and viruses” explained Max Motyka, director of sales and marketing at Albion Human Nutrition, Clearfield, UT. “Internally, our various systems, from white blood cells to liver metalloenzymes help to fight off everything from viruses and bacteria to various toxins taken in via drink and food.”
When kept healthy, this network of skin, membranes, cells, enzymes and hormones sends the appropriate signals and messages to protect the body from invading diseases and infections. 
“A healthy functioning immune system is an integral component of the whole. There is increasing evidence that the internal ‘microbiome’ and the immune system are critically linked and work together to maintain a state of total health,” said Connie Falkenstein, RD, MS, MPH, director of marketing, UAS Laboratories, Inc., Eden Prairie, MN. 
Natural Approaches
Vitamins & Minerals. Some of the most popular and commonly recognized nutrients that support immune function lie in the vitamin and mineral categories. Zinc, as well as vitamins A, C and D have been shown to boost sluggish immune systems during times of sickness, and are therefore popular among consumers. 
“An adequate supply of zinc is essential to maintain the integrity of the body’s immune system,” said Patrick Stano, vice president, Sales and Marketing N. America, Dr. Paul Lohmann Inc., Islandia, NY. “While the body’s demand for zinc is higher when the immune system has been activated, even a slight deficiency has been associated with a limited immune response and thus can lead to an increased susceptibility to infections.”  
Albion’s Mr. Motyka offered a similar view. “Zinc is integral to maintaining healthy skin, and plays a key role in cellular immunity, which is needed to fight off infectious invasion (white blood cell functions).”
Minerals such as selenium are also gaining popularity in the immune support market. “Products like Selenium Select also play an important role in supporting a healthy immune system. Their function can be appreciated by the fact that deficiency of selenium in the body can result in immunosuppression, leading to lower resistance against bacterial and viral infection,” explained Dr. Anurag Pande, vice president, Scientific Affairs, Sabinsa, Payson, UT.
Mr. Motyka also singled out magnesium, “a key metallic catalyst in the conversion of essential fatty acids to prostaglandins, which are necessary in a wide variety of inflammatory processes that defend against arthritis and metabolic syndrome.” 
Herbs, Botanicals & Superfruits. Consumers are looking toward herbs, botanicals and superfruits to defend against immune system issues, such as inflammation, allergies and fatigue. Herbs such as echinacea and ginseng have long been popular in the immune health category, but other herbs are making strides in this category too.
“Herbs may be used in two different ways to help the immune system. Tonics strengthen the immune system over time, while strong immune system stimulants have a more immediate action, and are used during an acute infection,” said Ellen Kamhi, PhD RN, author of The Natural Medicine Chest, and professional herbalist/nutritionist for Nature’s Answer and Bio-Botanica, Hauppauge, NY. 
Extracts derived from herbs can provide a significant boost to the immune system. Derived from the Indian spice turmeric, Sabinsa’s Curcumin C3 Complex “is a powerful anti-inflammatory, antioxidant and immunomodulator that helps to reduce inflammation and bring the immune system back to normalcy,” said Dr. Pande. Additionally, Sabinsa produces ashwaganda extract, which “strengthens the body’s defense system to guard itself from the stressors that can affect the immune system.”
Botanicals like aloe also play a role in immunity. “Aloe vera has been widely studied for its ability to support the body’s immune system,” said Improve’s Mr. Pine. The company “produces a unique dehydrated inner fillet of the aloe leaf that retains almost all of the natural components found in the fresh leaf. The major components are polysaccharides…[which have] shown the ability to modulate the immune system to aid in producing a healthy system. Aloe is used topically as well as consumed, and it has been used safely for many decades.”
Medicinal mushrooms are also becoming popular among immune support consumers. Richard Wang, MPH, of NuLiv Science USA Inc., Walnut, CA, said, “Mushroom extracts, ranging from Cordyceps sinensis to Ganoderma lucidum are used by supplement companies for their immune support benefits. Our mushroom extracts play a key role in the maintenance of a healthy immune system through their stimulation and modulation of key immune responses.”
Antioxidant-rich superfruits are also noteworthy in the immune support category for their ability to reduce oxidative stress, and in turn, disease in the body.
“The overall benefits antioxidants provide, particularly in gut health, would be expected to provide indirect support to the immune system. Studies on the effect of anthocyanins on specific immune cell-types suggest that these phenolics could have a more direct effect on immunity as well,” said Dr. Blaik Halling, senior scientist, FMC BioPolymer, Philadephia, PA. “In a study with healthy older patients, the consumption of grape juice showed an increase in … immune cells with both effector and suppressor function located in the epithelial lining of the gut.”
Additionally, studies examining the role of berry extracts in exercise recovery are showing potential. “In an in vitro study with anthocyanin-rich blackcurrant extracts, effects were observed in terms of reductions in oxidative stress, which suggested that the extracts could complement the benefits of exercise to immunity. In a human trial involving runners, blueberry consumption both reduced inflammatory markers while increasing NK [natural killer] cell counts significantly,” said Dr. Halling.
Friendly Bacteria & Dietary Fibers. “Normal intestinal function and colonic integrity are critical to maintaining digestive and immune health. The colon is home to more than three pounds of bacteria that are intimately associated with their host tissues, and are known to exert their influence on the structure and function of these tissues,” stated Patrick Luchsinger, marketing manager, Nutrition, Ingredion Incorporated, Westchester, IL.
Dietary fibers such as Ingredion’s short-chain fructooligosaccharides have been shown to produce short chain fatty acids, and as a result “promote protective effects on the gut and host, such as increased gut integrity, enhanced immunity through pathogen inhibition, reduction of putrefactive substances, improved normal bowel function, and improved nutrient metabolism and absorption,” Mr. Luchsinger added.
As for probiotics, global retail data from Packaged Facts suggests big things for this market, with sales expected to “exceed $22 billion in 2013, representing a compound annual growth rate (CAGR) of 12% between 2004 and 2013.”
Particularly during the last decade, the benefits of fermented food cultures have become better understood by more consumers looking for probiotics and prebiotics to support their digestive health. As a result, the link between a healthy gastrointestinal tract and better overall health is becoming more recognized among consumers. 
“Immune health is the second largest health area after intestinal health,” commented Charlotte Beyerholm, marketing manager at Chr. Hansen A/S, Horsholm, Denmark.
“Several demographic and lifestyle trends are driving consumer attentiveness toward immune and digestive health, such as aging populations and unbalanced diets. With many of these factors likely to become even more important going forward, this will present a widening market for the industry to tap into,” Ms. Beyerholm explained. “As a result, functional foods and dietary supplements with digestive and immune benefits are becoming more and more relevant. The probiotic industry benefits from a growing acknowledgement of probiotics among consumers.”

“Much of our overall health starts in the gut, and that’s our real first line of defense,” said Michael Shahani, director of operations for Nebraska Cultures, Inc., Walnut Creek, CA. Mr. Shahani adds that probiotics are also responsible for “producing B vitamins that your body is absorbing, and they’re producing enzymes that breakdown the other good food that you’re eating.”
Yvonne Kaupmann, technical support manager, FrieslandCampina Domo, Paramus, NJ, also discussed the importance of prebiotics in immune support. “Fermentable prebiotics such as Vivinal GOS are known to aid in stimulation of the growth and activity of beneficial bacteria in the intestine. Colonic bacteria ferments Vivinal GOS to produces short chain fatty acids (SCFA),” she said, adding, “These SCFAs provide energy for the colon cells, increase absorption of some minerals, and trigger important biochemical pathways linked to a wide range of health benefits.”
Fucoidans, Yeast & Beta-Glucans. Looking ahead, natural products with “positioned ingredients associated with ‘healthy whole foods’ such as beta-glucans … [and] fucoidans… will have more success gaining traction,” said Robert Bailey, commercial development manager, Health and Nutrition, FMC BioPolymer, Philadelphia, PA. “Consumers are more confident in the efficacy of natural actives from ‘healthy whole foods’ with a reputation for providing immune support.”
Immune support ingredients such as FMC’s Protasea fucoidan, approaches good health through the use of “a unique polysaccharide from Norwegian kelp that is part of a broader family of fucoidans sold globally in the food supplement market for multiple health benefits, including digestive and immune health,” FMC’s Dr. Halling explained.
Natural bakers yeast and yeast beta-glucan products also boast significant immune benefits. 
Biothera’s Wellmune WGP is a natural yeast beta-glucan derived from the cell walls of a proprietary yeast strain (Saccharomyces cerevisiae), which activates the body’s system of defenses. “Wellmune WGP engages neutrophils, the largest population of immune cells in the body, to more quickly find and kill foreign challenges,” Biothera’s Mr. Mueller explained. “Wellmune naturally helps these innate immune cells do their jobs more effectively without over stimulating the immune system.  Because neutrophils have a short life span of several days, the body is constantly producing new neutrophils that need priming.” 
Embria Health Sciences has also developed a yeast-based ingredient targeted toward immune support. “EpiCor dried fermentate is a complex product containing metabolites, which nourish and should be thought of as a ‘whole food’,” according to Mr. Reyes. “EpiCor balances and educates the body’s immune system to respond appropriately to all the different stressors—thus, maintaining overall wellness—before immune-related issues develop,” he said.
Looking Ahead: Emerging Opportunities
Key demographics are driving trends in the immune support market—a primary area of focus being U.S. Baby Boomers. According to the Population Reference Bureau, “Census 2000 counted 79.6 million U.S. residents born in the years 1946 to 1964” as part of the Boomer population, plus additional members as part of net immigration, bringing the popular estimate for the number of Baby Boomers in the U.S. to an average of 79 million people. 
On a related note, Ms. Kaupmann of FrieslandCampina Domo said “An increasingly significant factor is growing consumer awareness of the importance of prevention and healthy lifestyle in feeling well as you age. According to the U.S. Department of Health and Human Services, the age 65+ population is expected to grow to 19% by 2030. This is approximately a 72 million-person increase. Aging is associated with increased susceptibility to infection resulting in demand by this age group for supplements targeting immune health.” 
The more consumers begin to understand wellness and health as a maintenance process, the more the immune category is likely to become a year-round market, rather than one that only sees significant growth during cold and flu season.
Mr. Reyes of Embria agreed. “The overarching trend is that immune support is becoming a year-round category. Within that trend, we're seeing immune supplements becoming part of the ‘health and wellness’ positioning. We are beginning to see many vitamin stores dividing their aisles into separate ‘Cold and Flu’ and ‘Immune Support’ sets. Look for this trend linking ‘immune support’ and ‘health and wellness’ to continue.”
To meet the growing demands of this market, suppliers and producers of supplements are looking to position their products for the specific needs and desires of their customers, be it through a new, more convenient delivery source, or by providing products targeted toward specific immune support concerns.
An example of this is Biothera positioning its immune support ingredient Wellmune WGP within the sports nutrition and performance sector. Studies have shown that high intensity athletes, such as marathon runners, develop temporarily weakened immune systems as a result of extreme exercise. In a new study, Wellmune was shown to significantly reduce upper respiratory infection symptoms, which commonly affect high performance athletes. As a result, Biothera is gearing its immune health ingredient toward athletes and fitness enthusiasts.
And some companies are taking the opposite approach. Rather than focusing on specific immune concerns, or a specific consumer market, some are looking to cover a broad range of health issues with their products. 
Wherever the market is headed, it will need clinical research to get there, according to Biothera’s Mr. Mueller. “Products that can best respond to these trends will be supported by credible, human clinical research. Multiple peer-reviewed studies demonstrating the safety and efficacy are currently the gold standard for finished products as well as immune health ingredients,” he said. “There will continue to be increased interest in biomarker data that links products to immune health benefits.”
For the future, Ganeden’s Mr. Bush had some words of caution. “It’s tricky,” he said. “Some companies are going after it [the immune market], and some companies are shying away from it. There’s been some hiccups due to the ‘pixy-dusting’ problem we have in food in general, where [companies] put a little bit of vitamin C in something and call it an ‘Immune Formula.’”
Still, Mr. Bush said, “We do see people continuing to have interest. It’s just a matter of companies kicking the tires a little harder on clinical data to make sure that whatever ingredient it is that they’re adding for immune support genuinely provides an immune benefit.” 

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