Immune health isn’t merely of interest to consumers; it is one of the top five reasons why they take dietary supplements today, period. According to the Council for Responsible Nutrition’s latest Consumer Survey on Dietary Supplements, published last fall, immune health is one of the top reasons consumers surveyed said they take supplements, alongside reasons like energy, healthy aging, filling nutrient gaps, and staying well overall. In the survey conducted on more than 2000 U.S. adults in 2019, 27% of those who use dietary supplements cited immune health as a reason they take supplements.
Market numbers also reflect this interest. According to market researcher IRI (Chicago), dollar sales in the immune health supplement category grew 12% in 2019 over the previous year.
Another consumer survey conducted by Kerry International (Beloit, WA) also saw high interest in immune health. “We asked consumers to choose five options from a list of 13 health areas and rank them in order of importance. Nearly two-thirds (63%) chose immune system support, ahead of healthy bones and joints, good digestive health, energy levels, and heart health support,” says John Quilter, vice president and general manager, ProActive Health, for Kerry International. Demand for immune support products is particularly high in Asia—specifically China, where 50% of survey respondents said they had used an immune health product in the previous six months, while 29% said they would consider doing so in the future.
So what does this mean if you’re an immune health product company? “This means that immune health markets are increasingly competitive,” Quilter says. “The best way to stand out is to use scientifically substantiated, well-recognized ingredients that can complement and enhance your brand.”
A number of brands are hard at work doing just that, choosing suppliers investing in research and helping manufacturers develop products that are not only efficacious but also encourage use and enticement through innovative delivery formats beyond traditional dietary supplements. Not only that, but ingredient suppliers and researchers are exploring the various pathways by which ingredients can support immune health—particularly, the way ingredients interact with the gut to impart immune benefits.
Some of the best-performing herbs on the market are popular ingredients for immune health products, perhaps an indication of the immune health category’s overall strength. For example, according to figures from SPINS reported by the American Botanical Council’s HerbalGram journal in its annual Herb Market Report in September 2019, the bestselling herbs in the U.S. mainstream multioutlet channel in 2018 were horehound and echinacea.1 Total 2018 sales of horehound, the #1 bestselling herb in the U.S. mainstream multioutlet channel per the HerbalGram report, hit nearly $147 million that year. Echinacea, meanwhile, ranked as the #2 bestselling mainstream herb, growing to $110 million in sales in 2018.
Aside from those two market giants, perhaps the most impressive sales growth among herbs in the immune health space in 2018 went to elderberry. According to the HerbalGram report, in 2018 elderberry grew 138.4% in sales to nearly $51 million in the mainstream channel, and grew 93.9% to $25 million in the natural channel, making elderberry the #4 top-selling herb in the mainstream channel and the #3 top-selling herb in the natural channel in 2018. Pretty impressive.
Elderberry’s star continued to rise in 2019, too. In recent numbers provided to Nutritional Outlook by SPINS, cross-channel sales (mainstream, natural, and specialty retailers) of elderberry grew 83.4% in the 52 weeks ending October 6, 2019, to total sales of $113 million. In the mainstream multioutlet channel alone during that period, elderberry grew in sales by 116% to nearly $63 million.
Elderberry, which has a long history of traditional usage, experienced a surge of popularity after a particularly intense flu season in 2018 that saw a shortage of over-the-counter flu medicines, leaving natural remedies like elderberry to fill the void.2 Consequently, more consumers became aware of the ingredient and learned more about its benefits.
While a number of factors led to elderberry’s rise in popularity, Devon Bennett, CEO of North American elderberry supplier INS Farms (Purdy, MO), believes that elderberry is more than a trend and is here to stay. “Elderberry will become a lifestyle ingredient, with more research and science to follow,” Bennett predicts.
Elderberry already has some research under its belt, which gave the ingredient more clout during the severe 2017-2018 flu season. For example, the most significant study to date, using a branded elderberry extract from Artemis International (Fort Wayne, IN) called ElderCraft, was conducted in travelers over a 21-month period in 2013-2014 by the School of Pharmacy at Griffith University (Queensland, Australia).3
“This has become the highly reviewed and cited ‘Tiralongo long-haul flight study,’ a randomized, double-blind, placebo-controlled human clinical trial involving 312 healthy adults (economy-class passengers),” explains Chris Tower, vice president of sales and business development for Artemis. “Results of the study revealed ElderCraft demonstrated a significant reduction in cold duration and symptoms in air-travelers, resulting in 50% fewer cold episodes, 33% shorter illness duration, 50% fewer symptoms, and 33% less severe symptoms.”
He adds: “Notably, the 2016 Tiralongo study on ElderCraft was published one year in advance of what later proved to be a particularly severe and long flu season (2017-2018), with ER doctors and general practitioners on record supporting the use of elderberry, and social media further drawing increased attention to elderberry as a supplemental frontline treatment for flu and colds.”
The benefits of elderberry are attributed to the anthocyanins found in the berries. Anthocyanins are the black pigments that give the black elderberry its color. “Studies have indicated that European black elderberry can effectively boost the body’s natural immune response by way of cytokine stimulation to ‘ready the soldiers’ for fighting off pathogens,” explains Melanie Bush, director of berry science for Artemis.
Bush adds that the polysaccharides present in the fruit—but which are often stripped away during extraction—may also provide antiviral benefits. “Artemis International’s ElderCraft extract is uniquely produced without the use of harsh chemical solvents, thus retaining the polysaccharides along with concentrating the important flavonoid actives, making a truly superior and efficacious immune supporting ingredient,” she says.
Being a fruit, elderberry lends itself to a variety of applications. “We see the greatest opportunity for elderberry in both traditional supplements and food and beverage—both growing markets with consumers seeking a way to preempt sick days and/or a visit to the doctor,” says Leslie Gallo, president of Artemis.
Alternative delivery formats, previously reserved for children, now apply to the larger population of adults experiencing pill fatigue, and elderberry fits in nicely with many of these.
“Traditional supplements are not so ‘traditional’—not your grandmother’s pills and tablets—as gummy delivery continues to lead the pack, with liquid supplements close behind,” Gallo says. “Confection delivery (i.e., lozenges, lollipops), infusions, as well as shots, powder sticks, and chewables are growing in popularity.”