Elders & betters: Elderberry research is validating the hype

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Elderberry (Sambucus nigra) product sales are on a tear. According to a November 2021 market report by Technavio (London), the elderberry market will grow by a 6.52% CAGR through 2025, driven primarily by sales in Europe and e-commerce.¹

But the sailing ahead won’t necessarily be smooth. While the elderberry product market presents significant opportunities for reputable brands, the rise of inferior copycat products threatens category growth and longevity. In addition, the science around elderberry is nuanced. Finally, consumers rushing into store aisles for elderberry products likely don’t grasp market challenges like adulteration, supply chain transparency, and poor-quality research. But these factors remain a threat to elderberry’s reputation.

Here are some of the studies that do back the elderberry hype, as well as the ways in which suppliers and brands are cracking down on adulteration.

Clinical Trial Shows Elderberry Reduces Respiratory Symptoms After Flight

“Airplane colds” are so ubiquitous that they often provide fodder for stand-up comedy routines. But now, research demonstrates that elderberry’s immune support properties could help tame this scourge of the skies.

A landmark study² on European black elderberry extract—a randomized, double-blind, placebo-controlled clinical trial—sought to determine whether elderberry supplementation could reduce cold symptoms and shorten cold duration in travelers aboard a long-haul flight. In this trial, 283 healthy Australian adults who were traveling in economy class on an overseas seven-hour flight were randomly assigned to receive Iprona’s (Lana, Italy) BerryPharma-brand elderberry capsules containing 300 mg of elderberry extract (n=144), or a placebo (n=139). Iprona funded the study.

All participants were assessed on the Wisconsin Upper Respiratory Symptom Survey (WURSS-21) and 12-Item Short Form Health Survey (SF-12) at baseline, before travel, and after travel. Subjects also kept a daily diary that included a Jackson symptom score, a subjective assessment, a log of any prescription medications they were taking, and a compliance report.

The subjects in the experimental group took two BerryPharma capsules per day for 10 days prior to travel, three capsules per day during travel, and three capsules per day for five days after arriving at their destination. The control group received a matching regimen of placebo pills.

Seventeen subjects in the placebo group developed a cold during the study compared to 12 in the elderberry group. This difference was found to be statistically insignificant. However, the placebo group’s collective symptom duration was 117 days compared to the elderberry group’s collective symptom duration of 57 days. The placebo group’s collective symptom score of 583 was also substantially higher than the elderberry group’s score of 247. Both of these differences were found to be statistically significant (p = 0.05 and p = 0.02, respectively). The study authors concluded that elderberry shortened cold duration and reduced cold symptoms.

Melanie Bush, vice president of science and research for elderberry supplier Artemis International Inc. (Fort Wayne, IN), says elderberry products have rapidly become one of the most sought-after immune health ingredients. While the uptick in mainstream awareness has prompted a sales surge, Bush says that consumers are now experiencing “immune fatigue” that demands a new approach to immune health products—and emerging research could provide the answer.

“Product innovators are starting to capitalize on multifunctional benefits and blends as a way to differentiate and capitalize on consumers’ interest in proactively prioritizing their health,” Bush explains. For instance, she says, “A new trend that is unfolding is an increased understanding of the prebiotic benefits of polyphenols. Preliminary studies have indicated that polyphenols from high-flavonoid berries like elderberry can influence the balance of microbes in the gut.”

Meta-Analysis Backs Elderberry’s Efficacy Against Symptoms

More recent and comprehensive research further validated elderberry’s immune health benefits. One 2019 meta-analysis³ of four clinical trials involving a total of 180 subjects found that elderberry supplementation reduced the severity and duration of upper respiratory symptoms in cold and flu patients.

Bush says that meta-analyses of clinical trials can help add a level of credibility and confirmation to elderberry studies. Meta-analyses, she explains, can cut through the noise of improperly structured studies or biases to arrive at conclusions with true clinical relevance and consistency. She says the future of elderberry research involves examining the ingredient’s effects in more depth using larger trials.

“There are opportunities for targeted randomized controlled trials that seek to answer questions related to moderating effects, minimum optimal dosages, and delivery forms. [Other avenues of future research could include] variations in effects between men and women, pediatric applications, and the impact of gut microflora composition.”

Metabolite Fingerprinting Ensures Supply Chain Transparency

While elderberry research shows favorable results, ensuring that consumers benefit from the finished products they consume is more complex than just adding elderberry to an immune health formulation. Devon Bennett, CEO of elderberry supplier INS Farms (Purdy, MO), says the problem with elderberry products is that many suppliers don’t understand which parts of the elderberry plant provide its trademark immune health benefits. Problems like adulteration and an opaque supply chain led INS Farms to implement an elderberry identification process in partnership with TRU-ID (Guelph, ON, Canada).

“If we were to test the whole berry, we could compare that to a juice powder versus a whole-fruit powder,” Bennett says. “In a few years from now, people will be able to come back and figure out which parts of the elderberry deliver the full benefits. This won’t stop all adulteration, but it’ll take a pretty big bite out of it.”

Steven Newmaster, PhD, is a professor of botany and genomics at the University of Guelph, the Director of Botanical Genomics and Metabolomics at the NHP Research Alliance, and a co-founder of TRU-ID. Newmaster says that metabolite fingerprinting has a long history of use in the coffee and wine industries, and now, TRU-ID is bringing this technology to the elderberry market.

“I have a large database now of elderberry that has come from a variety of industry members, plus samples we collect,” Newmaster says. “We create fingerprints that can be compared to products, so if something is adulterated, you’ll see it. Or if it’s been processed so much that it doesn’t match the natural metabolite fingerprint of elderberry, you’ll see it. When there’s high demand for a product, people are going to cheat.”

Less-reputable suppliers may use a variety of adulterants in elderberry raw material, including coloring agents like black rice or black bean, and fillers like grape juice extract or peanut skins. Bennett says combining metabolite fingerprinting with bioavailability studies can enable a more granular, supplier-specific level of supply chain transparency.

“A lot of companies have their own specific blends,” he says. “When you can show that your proprietary product had a certain effect, that makes it possible for your brand to claim things that other brands can’t.”

Bennett says the next step for INS Farms will involve a new study in spring 2022. The company plans to test the bioavailability of its elderberry ingredients using a combination of urine and plasma tests.

Elderberry Studies Validate the Hype

The elderberry market is undergoing aggressive growth due to consumers’ prioritization of immune health. While some elderberry products have received validation through clinical trials, meta-analyses, and metabolite fingerprinting, other products provided by less-reputable suppliers may use subpar formulations containing fillers and adulterants.

Finished-product brands can ensure product efficacy by working with reputable suppliers, using validation processes like metabolite fingerprinting to verify ingredient origins, and conducting or sourcing research on dosages and delivery formats. Not all elderberry ingredients are created equal, but the best ones will live up to the hype.

References

1. Technavio report. “Elderberry Market to Grow at a CAGR of 6.52% by 2025 | Health Benefits of Elderberry to Boost Growth | 17000+ Technavio Reports.” Published online November 17, 2021.
2. Tiralongo E et al. “Elderberry supplementation reduces cold duration and symptoms in air-travellers: A randomized, double-blind placebo-controlled clinical trial.” Nutrients, vol. 8, no. 4 (March 24, 2016): 182
3. Hawkins J et al. “Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials.” Complementary Therapies in Medicine, vol. 42 (February 2019): 361-365