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Nutraceuticals for immune support: Growing standards, room for improvement

Immune health supplements must be backed by quality clinical trials that demonstrate safety and efficacy to win over discerning consumers.

From traditional herbal infusions to today’s sophisticated formulations, nutraceuticals for immune support have come a long way. Owing to the pull of scientific progress and push of demanding consumers, we are entering an era where certain products are delivering the promised value with guaranteed safety and clinical proof. But this is far from the standard. 

Astragalus, elderberry and Echinacea infusions are among the earliest immunity-boosting additions to diet. With their successful track record and word-of-mouth popularization, it is understandable they are still regularly used, yet in most cases, they have not advanced in decades or have even dropped in quality. A large portion of immunity nutraceuticals are still simple herbal extracts, commodities that rely solely on historic use and bibliographical data for proof of efficacy. Additionally, ingredients included in a product don’t necessarily have a connection to assumed benefits apart from the name. Questionable origin, interchangeable use of different plant parts and adulterants are producing ineffective, unsafe supplements that contribute to consumers’ decreasing trust. For a credible product, herbal extract inclusions need to be traceable, have direct research and an established safe dosage, especially when formulating for children.

With increased understanding of biochemical processes in the human body came the next big players of the immunity market: vitamins and minerals. Starting as simple chemical compounds such as ascorbic acid, vitamins and minerals have made an immense leap to what we see today. Branded, patented, clinically supported ingredients with advanced delivery technology are widely available and boast increased stability, controlled release, enhanced absorption or bioavailable chemical states. More importantly, consumer awareness of the range of quality and consequence of lower price is most present for these ingredients. We see partners on markets worldwide increasingly interested in formulations containing vitamins with improved characteristics, seeking to satisfy the growing demand of educated users and to differentiate in a noisy category.

Differentiation can also be achieved by more biologically complex ingredients that later entered the global spotlight. Colostrum, propolis and fungal extracts have brought a new dimension to the industry, correlating with the natural alternatives trend and sparking substantial investment into clinical research. The relatively new concept of immunostimulation is showing undeniable results (Diets, Immunity and Inflammation. 2013;416-434), but keeping the immune system in an excited state should be approached with caution. The benefit of long-term use of activating ingredients such as beta-glucans is questionable. Harmful over-boosting is a new topic, not yet widespread in the industry, and will likely be an influence in future product development trends.

The realization of the complexity of the immune system and its connection to the gut has sparked an exciting new era of research and a completely different angle. Investments into consumer education have made a remarkable shift in gut health. Probiotic product launches with immunity positioning are steadily rising yet may come with some drawbacks: the discrepancy between claim and effect due to personal microbiome differences, and stability issues. The latter are solved with convenient and booming prebiotics.

No matter the composition, the importance of clinical trials is growing for all nutraceuticals. With access to information and digitalized packaging, consumer trust and first purchase will increasingly depend on solid scientific support. Consumers won’t choose just any product off the shelf. Ingredient manufacturers are paving the way in quantity of clinical trials, yet the trials are still often lacking in quality. Double-blind, randomized, placebo-controlled trials are becoming the standard, but the importance of encompassing several seasons, several testing centers and healthy subjects is understated. Questionable inclusion criteria, quality of data and analysis additionally often compromise results. Finished product brands lag even further behind and consequently have a greater opportunity for differentiation through clinical trials on their products. From our experience, companies with established brands have built up a loyal consumer base with strong rebuy rates by focusing on products that are proven to bring actual value to end-users.

Simply delivering all the promised benefits of a product will, however, not be enough to excel in a market. Demand for convenience and user-friendliness is becoming an equally important consideration, if not a prerequisite. While we see certain geographically specific preferences, overall popularity of non-pill product forms is applicable to immunity nutraceuticals globally. Liquids, gels and single-serve formats are booming. Great taste is key for immune support supplements aimed at children and prevention, where there is no acute motivation for compliance. 

Consumer demand has steadily driven the evolution of immunity supplements. With the desire to support several aspects of the immune system, companies are including several complex ingredients into new products. To satisfy users, convenient product forms are chosen. These two factors culminate in what is one of the largest flaws of the nutraceutical industry in general: product stability. With lack of regulatory enforcement and insignificant awareness of the public, nothing is pushing companies into guaranteeing the promised amounts of main ingredients are still present and active at the end of the shelf-life. Especially with immunity products that contain vitamins, minerals and complex extracts, possibly in liquid form, chances for ingredient interactions are high, making ingredient stability an art. Stability is important for finished product companies because it dramatically affects the value that end-users receive. Raising standards and awareness among consumers is a future responsibility of the industry. Ultimately, it is also an opportunity for differentiation.

The ideal nutraceutical immune support product of the future will combine scientifically supported safe ingredients in a stable way, support several aspects of the immune system, have clinically proven benefits and deliver it in a tasty, user-friendly form.

Maja Orešnik is the science and research director at PharmaLinea Ltd.

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