Good normal? Is a return to normalcy for immune health dietary supplement sales cause for worry?

Photo © AdobeStock.com/ kosolovskyy

Is the sky truly the limit? It’s a relevant question when you think about the meteoric rise of the immune health category during the first wave of the pandemic. Consumers treated elderberry and vitamin D as though they were toilet paper—that is, in the sense of hoarding what they could find.

And, quite frankly, there were times when they couldn’t find the immune supplement products they were anxiously trying to grab from virtual shelves and actual shelves. Product over-grabs, disruption in supply chains, and opportunistic adulteration squeezed product availability and left many customers in immune-product limbo.

Then the supply chain issues tamped down, and it was smoother sailing for immune health supplement shoppers and for an industry hoping to balance profits from one category boosted by COVID-19 against losses from other categories shredded by the same virus.

Not too long ago, heading towards 2022, as things were seemingly ready to return to “normal,” the big question executives in the immune health category were pondering was this: Would the health scare have a long-term positive impact on the immune health market, or would consumers forget the lessons they’d learned from the pandemic about the importance of a healthy immune system?

Then this happened. Just before Christmas, the Centers for Disease Control and Prevention (CDC) advised that the Omicron variant had been detected in most states and U.S. territories, with a surge of COVID-19 cases expected.¹

Statistics Show Promise for Immune Health Market

With the health landscape revolving seemingly on a daily basis, industry thought-leaders believe that the immune health category will remain strong—and that’s not even taking into account the impact of Omicron and future variants of the coronavirus.

An August 2021 global survey from Cargill (Minneapolis) of 3,008 consumers on three continents found that interest in immune health support increased since the start of the pandemic and was predicted to continue longer-term. According to 84% of Chinese, 64% of American, and 58% of British consumers surveyed, immune support had become more important to them since the start of the pandemic.²

The latest statistics from the Council for Responsible Nutrition’s (CRN; Washington, DC) annual consumer survey³ in 2021 showed that dietary supplements “reached a new high-water mark for usage by Americans,” according to Brian Wommack, senior vice president, communications, CRN. Specifically, he shared that 80% of Americans used dietary supplements according to the most recent survey, a seven-percentage-point increase from the prior year.

“Overall health and wellness is the top reason users cite for taking dietary supplements, at 44% of respondents,” says Wommack. “Immune health is the second-most-cited reason for taking dietary supplements, at 36%. So, immune health certainly plays a role here, but perhaps not the most prominent role.”

Still, most are optimistic about the immune health supplement category’s fortunes for 2022.

For example, Rachel Baker, RD, CSSD, manager, nutrition content and services, GNC, believes that “Consumers’ focus on immune health is here to stay.” She explains that while the pandemic “has undoubtedly helped the concept take off, products to support immune health or containing immune-supporting ingredients have become more expected.”

Baker has noticed that products that previously featured immune-supporting ingredients, like vitamin C, zinc, elderberry, and others, now actually “call out these [immune] health benefits in their marketing for consumer buy-in.”

She credits the pandemic with having brought to light the importance of good health—whether it’s gut health, mental health, sleep health, and everything in between. “Wellness and being proactive about staying healthy, be it from the common cold, COVID, or long-term, begins with self-care,” says Baker.

Her colleague, Rachel Kreider, MPH, RD, director, nutrition content and services, GNC, agrees. “I believe that immune health will continue to be top of mind and something that we will continue to think about as consumers, year-round, for a very long time.” She advises that in the past, immunity would not have made the cut “as even a tertiary benefit on some sports nutrition products, for example, but now, this is a benefit that we even see relevant in some performance products.”

Alicia Richman, director of brand strategy and innovation, Gaia Herbs, says her company is seeing the numbers that support that immune products are being used as people go back out into the world.

There was large growth in the immune/cold-and-flu category in early 2020 when the pandemic hit and consumers stocked up on those products, advises Richman. “Then as the pandemic wore on and stay-home order[s] continued through 2020 and early 2021,” she says, “we actually saw a steep decline in immune products.”

In fact, says Richman, “The cold-and-flu season for 2020/2021 was the weakest we had seen in years, as people stayed home or wore masks out in public. Summer 2021 saw the first signs of a recovery in the immune/cold-and-flu products.” The recovery, she says, began with children’s products in the summer of 2021 as kids were showing higher levels of cold and flu.

“It’s only been the later part of 2021,” notes Richman, “that we are beginning to see the recovery of the immune segment in retail as we see more variants and people are going back out to more normal patterns.”

Richman remarks that “the pandemic changed the way people think about health and wellness and prevention.” She explains that “as people go back to more normal habits, and the virus continues to circulate, immune [health] will continue to be top of mind for consumers.”

Holly E. Johnson, PhD, chief science officer, American Herbal Products Association (AHPA; Silver Spring, MD), agrees that immune health products will continue to be popular with consumers. She also thinks they will be increasingly integrated into daily self-care routines throughout the year, not just during the winter flu season.

“Sales growth for botanical dietary supplements associated with immune support had been increasing for several years before the COVID-19 pandemic began,” Johnson notes. She points to elderberry which, she says, “experienced over 100% growth in both 2018 and 2019, and in 2019, three of the top-four-selling botanicals in the mainstream channel were from the immune health category—elderberry, echinacea, and turmeric.”

Johnson doesn’t discount the impact of the pandemic, though. “Obviously with the public health crisis starting in 2020, those growth trends have continued and rapidly accelerated,” she says.

Cashtyn Lovan, marketing manager for Cargill’s EpiCor brand, says that the events of the last two years have driven home the importance of immune health for many consumers. “We’ve seen a significant uptick in interest both on the supplement side and in foods and beverages with immune health benefits,” she advises.

Audrey Ross, ND, senior national educator, Country Life Vitamins, says that although the growth rates for the immune health category may not mimic the historic levels during the peak of COVID-19, “we as a society have become more aware of our nutritional needs and the importance of supplementation as a whole, including boosting immune health.”

She reminds us that it’s difficult to predict how long consumers will remember the pandemic; however, she adds that “Nutrition Business Journal (NBJ) estimates positive growth rates for the supplement industry year over year through 2024.”

From Unconventional to Mainstream

It’s common wisdom in the supplement industry that the pandemic not only revived interest in veteran immune health ingredients like vitamin C and zinc but also added more scientific gushing over the benefits of vitamin D. However, the pandemic also helped generate buzz around some of the less-conventional ingredients, those not previously considered top of mind in mainstream circles.

AHPA’s Johnson points to a group of botanicals known as adaptogens, which she advises “are defined by the ability to increase resilience and nonspecific resistance to stressors like viral pathogens.” She expects this category “will continue to enjoy sales growth and popularity. Several of these botanicals, including ginseng, eleuthero, rhodiola, schisandra, and ashwagandha, have been shown to have effects on the neuroendocrine-immune system.”

Also, Johnson adds, “there are several species of medicinal fungi, such as lion’s mane, that are increasingly popular with consumers and the subject of ongoing research related to immune function.”

Says Johnson, “As far as other categories, I think botanicals associated with support for stress will continue to grow. Many of the species I have mentioned would fall into both categories.”

Gaia’s Richman is betting on elderberry, an ingredient she thinks “will continue to lead in the more mainstream channels, [as] you’re seeing it added to conventional products as an extra reason to believe and create a natural health halo around conventional products.”

In fact, in July last year, Gaia Herbs announced the extension of its Black Elderberry line with a USDA Certified Organic tonic herbal supplement, an immune blend of a traditional herbal oxymel recipe combined with black elderberries.⁴

EpiCor’s Lovan says that sales prospects remain strong for the immune health category, and that includes the emerging postbiotic segment where her company’s ingredient EpiCor resides. She says that although postbiotics are relative newcomers to the health scene, “our proprietary consumer research suggests one in five shoppers are already familiar with them. This awareness will only grow, propelled by increased media coverage of the newest member of the ‘biotic family.”

Citing statistics from Brandwatch and Lumina Intelligence, respectively, Lovan shares that “We’re already seeing phenomenal growth in online mentions of postbiotics in media, blogs, and more, up almost 1,400% in January 2020 to June 2021, compared to the previous period. Google searches for postbiotics have also increased exponentially—up 1,300% in the last two years. All of this suggests consumers are actively seeking new health-supportive solutions and that the momentum around postbiotics is increasing.”

Lovan suggests that “For product manufacturers, postbiotics like Cargill’s EpiCor offer huge opportunities on the formulation side,” including the ability to deliver immune health benefits across a range of supplement formats and food and beverage applications.

Country Life’s Ross agrees. “Country Life is always searching for quality-tested ingredients to incorporate into revolutionary new products in our immune category,” she says. “Our award-winning Gut Connection Immune Balance contains clinically studied ingredients such as EpiCor, a postbiotic, helping maintain good digestive and immune health.”

Ross says that ingredients that support the immune response, like EpiCor, Wellmune (from Kerry), or astaxanthin, are becoming more popular because of testing and research that indicates those benefits. She adds that Country Life has several products that contain these ingredients, among them its Gut Connection line, Lung Defense, and Astaxanthin.

According to Ross, “Certainly immune products have become what you are calling ‘mainstream,’ and I believe that the immune health category will continue to be popular for years to come.”

GNC’s Baker says that “Besides the usual suspects, consumers are looking for and expecting products to contain immune-supporting ingredients. Products that have always contained micronutrients like vitamins C or D are being marketed in an alternative light—suggesting a protein shake not only helps to support your health goals; it also impacts immune health.”

She expects this trend “will likely continue in products not previously considered to be ‘immune supporting.’” Plus, Baker cites another trend, one that packs a gut punch in a good way, or, as she puts it, “harnesses the idea that good bacteria influences overall health and wellness.”

Mushrooms and greens are another area of interest, notes Baker. “We also expect increased research efforts surrounding vitamin D to further understand its impact in supporting immune health.”

Education Key in Sustaining Growth in Immune Health Category

Tyler McGlasson, MK, CISSN, senior manager, GNC Product Design, says that while COVID may have been a very specific driver for products not previously viewed as mainstream becoming so during the pandemic, the results were much broader. According to McGlasson, “Some of the most significant swings in trends have been proven to be the simplest.”

He uses vitamin D as an example. “Public awareness of vitamin D’s impact on overall health has grown tremendously.” He explains that since the benefits of this nutrient extend far beyond the reach of COVID, it’s likely that interest in vitamin D supplementation and other vitamins is here to stay. He adds, “Customers just needed to get over that hill of education that needs to take place before they feel the confidence to make a purchase.”

The CRN Foundation is one of those vitamin D educators. Launched in May 2021, “Vitamin D and Me!” is a science-rich consumer education website⁵ created to share the scientific evidence that links vitamin D, or lack of vitamin D, with COVID-19 outcomes.

In a press release accompanying the launch of the “Vitamin D and Me!” initiative, Steve Mister, CEO of CRN and president of the CRN Foundation, advised that “most people don’t have time to keep up with research, but that’s what we do. We have been fascinated over the past year at the amount of research being conducted examining the potential relationship between vitamin D and COVID-19. The CRN Foundation is delivering unbiased education on the latest science, which helps people make smarter decisions to maintain their health.”⁶

The International Alliance of Dietary/Food Supplement Associations (IADSA) created an information resource center—“Mind the Gap”—on its website⁷ where it shares positive information about the benefits of nutrition in a series of easily digestible and visually appealing snapshot stories.

Its latest story, “Fighting Fit: Building Resilience Through Nutrition,” connects the need for resilience and the importance of adequate nutrition with supporting immune health.⁸

According to a press release, Simon Pettman, executive director, IADSA, said, “With inadequate nutrient intakes so widespread, we need to find ways to help people maintain normal immune health and achieve greater resilience. Better nutrition education is key. Acting now could transform the lives of millions of people.”⁹

Companies, too, are seeking to do their part. “As a leader in the postbiotic category,” says EpiCor’s Lovan, “we are investing in consumer education to help build greater awareness and understanding for the category, and we’ve seen a lot of interest from both customers and consumers.”

As Lovan notes, there are tremendous growth opportunities with postbiotics for immune health.

EpiCor’s consumer website features information from registered dietitian and influencer Keri Gans who serves as a nutritional advisor for the company. In an educational website post about postbiotics, Gans wrote, “Your immune system is an important factor in maintaining health at any age. Fermentation is getting a lot of attention for its ability to support the gut and the immune system.”¹⁰

GNC’s McGlasson says that consumers are aware of the sheer volume of resources at their disposal when it comes to learning about dietary supplements and their role in human health. “And to a degree,” he says, “that kind of research can be empowering.”

His GNC colleague, Kreider, shares how the company helps with that empowerment. She says, “In terms of keeping the category relevant, we continue to scan the ingredient market daily for anything up and coming in the immune health space. Aside from new and unique ingredients, we also continue to monitor other ways consumers can improve their body’s response to illness, such as improving their vitamin D status or adding exercise to their daily routine.”

“We want to provide helpful products and information to our customers to be a solution-center to them as we all walk through this challenging time in the world,” she says.

Adds McGlasson, “It’s true that having the specter of an international pandemic is an incredible motivator for education. We hope that GNC can be a part of that educational journey and give customers the confidence and the knowledge they need to live and also thrive long after the pandemic is past us.”

Will Supply Chain Disruptions Cause More Problems?

While the outlook for the future of the immune health market for supplement and food ingredients is hopeful, the industry is not discounting potential bumps in the road.

Lovan remarks that “heading into 2022, we believe that the immune market will continue to grow—however, not at the unusually high rate that it did in the last two years. As seen with other markets, some of that slower growth is due to supply chain issues with our customers having longer lead times for capsules, bottles, and more.”

Gaia’s Richman notes that there are still broad supply chain issues across the industry due to the pandemic, but, she says, “not the elderberry issues that were seen at the beginning of COVID.”

And there are solutions.

CRN’s Mister recognizes that “whenever there are supply chain disruptions, there will be a temptation for manufacturers to cut corners, but the vast majority of the industry is firmly committed to delivering safe and high-quality supplements to their consumers.”

This is where relationships and trust come into play. Says Mister, “In times like this, though, consumers should know with whom they are dealing when they buy supplements, and look for trusted brands and retailers. Not all companies play by the rules—and, unfortunately, some are more inclined to break the rules when faced with supply chain disruptions.”

AHPA’s Johnson, too, acknowledges that “consumer demand for herbal products for immune support during the pandemic has left some companies challenged to find ingredient suppliers for new product formulations, which has the potential to drive up the price of high-quality raw materials.”

She firmly believes that “the key to success for companies in the dietary supplement and natural products industry is building long-term committed relationships with their suppliers and maintaining strong supplier and ingredient qualification programs when expanding sourcing partnerships and onboarding new ingredients.”

These companies agree and are keen to share examples of the kinds of things they do to help ensure confidence for their customers and for consumers.

Gaia Herbs, for example, addresses adulteration concerns by working with a long-time stable of trusted growers and suppliers with ingredients they trust. In a previous interview with Nutritional Outlook, a Gaia executive explained that “the company’s trusted partners are asked to follow organic and sustainable cultivation methods, which are validated through site visits and analytical testing of the raw materials themselves. Gaia Herbs also has a rigorous testing process for its ingredients to ensure quality and authenticity.”¹¹

And then there is the longstanding Gaia traceability program, MeetYourHerbs.com, an initiative that focuses on transparency by providing unique ID numbers for each product that allows purchasers, or shoppers, to learn more about how the herbs in the product were grown, harvested, and extracted as well as about the tests taken to validate the product’s purity, integrity, and potency.^11,12,13

Lovan, too, agrees that the best way for suppliers and manufacturers to ensure the safety of their ingredients is to “work with reputable brands and companies they can trust.”

She explains that “food safety and product efficacy are always our priority. Backed by more than 75 years of fermentation expertise, EpiCor postbiotic is produced in the U.S. using a natural, proprietary process that creates a unique ‘fingerprint’ of metabolites. Further, we go the extra mile to validate the composition of every lot using FT-NIR (Fourier-transform near infrared) spectroscopy.”

And Country Life’s Ross allows that there are still issues in the supply chain shortages that will take some time to return to some semblance of order. However, she says, “We stand by each and every product that leaves our door at Country Life. We stand by our Pledge of Integrity, proudly printed on the front label of every Country Life product.” It’s a pledge, she advises, that focuses on “authenticity, cleanliness, freshness, consistency, and accuracy.”

So, while the world waits for the pandemic to be over, the dietary supplement and functional food industry hopes to contribute to immune health in a positive way.

Lovan summarizes what many in the industry believe. “The last two years helped amplify the importance of a healthy immune system in dramatic fashion. Given the growing body of knowledge supporting the connection between immune health and overall wellbeing, we believe this is only the beginning.”

And then, Lovan summarizes what many in the industry believe to be at the core of the immune health market. “Consumers are looking for proactive steps they can take to have more healthy days,” she says. “Supplements, foods, and beverages that deliver immune-supportive benefits can help them realize that goal.”

References

1. Centers for Disease Control and Prevention website, COVID-19. “Omicron Variant: What You Need to Know.” Updated December 20, 2021.
2. Press release. “New Study Finds Consumer Interest, Demand for Products that Support the Immune System Increased Since Pandemic Began.” Cargill Inc. Posted September 29, 2021.
3. Council for Responsible Nutrition news release. “CRN Reveals Initial Data from 2021 Consumer Survey on Dietary Supplements.” Posted October 21, 2021.
4. Press release. “Gaia Herbs Expands Line of Best-Selling Black Elderberry Products with New Black Elderberry Tonic.” Gaia Herbs. Posted July 1, 2021.
5. Vitamin D & Me! website
6. Council for Responsible Nutrition news release. “CRN Foundation Announces Launch of Vitamin D & Me! Consumer Education Website on Vitamin D and COVID-19.” Posted May 11, 2021.
7. International Alliance of Dietary/Food Supplement Associations website
8. International Alliance of Dietary/Food Supplement Associations webpage. “Fighting Fit: Building Resilience Through Nutrition.”
9. Marrapodi A. “IADSA Focuses on Immune Health, Resilience in New ‘Mind the Gap’ Resource.” Nutritional Outlook. Published November 9, 2021.
10. EpiCor website. “Postbiotics for Epic Immune & Gut Support.”
11. Blatman J. “What Does the Natural Products Business Look Like Now in the COVID-19 Pandemic?” Nutritional Outlook. Published December 21, 2020.
12. Grebow J. “Marketing: Getting to Know You.” Nutritional Outlook. Published September 9, 2010.
13. Gaia Herbs website, Meet Your Herbs webpage