How COVID-19 revitalized interest in familiar letter vitamins

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It’s amazing what a little hindsight can do. Roughly a year into the COVID-19 pandemic, you can almost make out—if you squint hard enough—the glimmers of silver lining that this horribly disruptive episode in global health may have left behind.

Perhaps most relevant to the dietary supplement industry is the sales boost the sector enjoyed when consumers—either newly awakened to, or simply reminded of, the importance of baseline wellness—turned to nutritional products as a backstop against illness. And, as Saumil Maheshvari, CMO, Orgenetics (Brea, CA), points out, they turned in particular to a class of products that was due for a boost.

“While scientists and doctors rushed to learn more about the new virus and how the body responds, a few things became clear,” he recalls. “First, a strong immune system and healthy lifestyle provided the best fighting chance against the disease, should one contract it. And vitamins—plain and simple—are known, and proven, to help bolster the immune response.”

As a result, back-to-basics As, Bs, and Cs (and Ds, and Ks, and Es) are basking in a kind of cool that they haven’t had in…forever, maybe. And if the research keeps mounting, they may hold onto that cachet long after the reason for their rediscovery is over.

From Panic to Purchase

Consumer concern about COVID-19 clearly “drove many to single-vitamin options early on,” Maheshvari says. And while surprising at first, this panicked purchasing of vitamin products has become a familiar pandemic-era theme.

“It’s similar to the story we’ve seen with Clorox wipes and Purell hand sanitizer since spring of last year: demand racing as consumers rushed to stock up while new consumers entering the market sought to boost their own health according to available guidance,” he notes.

But while the stockpiling of sanitizer eventually abated, demand for supplements in general and vitamins in particular continues.

Sales Still Strong

“Since the pandemic’s start, nutritional supplement sales have exploded,” observes Dominik Mattern, vice president, marketing, Kappa Bioscience (Oslo, Norway). More specifically, domestic sales of multivitamins grew by 105% in 2020, according to Nutrition Business Journal, he says, with vitamin D in particular projected to rank among the “top growth” ingredients for 2021.

Similarly, the Council for Responsible Nutrition (CRN; Washington, DC) found in its COVID-19 survey on dietary supplements last year that multivitamin, vitamin C, and vitamin D formulations received the biggest pandemic-driven boosts among supplement ingredients considered, with intake by current supplement users rising 59%, 44%, and 37%, respectively. This put the three formulations ahead of not only zinc, calcium, and iron, but protein, as well.

All About Immunity

Tara Thompson, senior vice president, business development and sales, Morre-Tec Industries (Union, NJ), notes that Morre-Tec’s Vitacyclix division saw an increase last year in inquiries for basic letter vitamins generally, and for immune-associated vitamins like D3 and K2 in particular. In fact, Thompson points out that while Vitacyclix’s business “grew significantly” in the past 12 months overall, “vitamin D sales grew by 60% during the same period.”

The subtext: Immunity is where it’s at.

“Preventive healthcare products addressing concerns like immunity are trending higher than symptomatic products,” Mattern declares. “In this context, products with vitamins C and D come to mind and benefit from decades of research and hundreds, if not thousands, of scientific publications backing their associated health claims.”

Maheshvari agrees. “Vitamin C has been scientifically proven as vital for immunity,” he notes. “Strong published research also suggests that vitamin E is pivotal as an antioxidant in the immune response. It would appear from later research, too, that vitamin D and K levels are also important factors in how some respond to COVID, and how severely.”

Jia Zhang Lee, executive director, Davos Life Science (Singapore), notes that his company has seen a steady increase in demand for vitamin E tocotrienols in particular. “Research studies have shown that tocotrienols have positive health benefits in the management of hypertension, heart disease, and diabetes,” Lee notes. “These chronic conditions predispose individuals to the more severe form of COVID-19, and therefore there’s been growing interest in tocotrienol supplementation to help promote the prevention of these chronic diseases.”

But plenty of botanicals, antioxidants, probiotics, and other more “exotic” nutritional ingredients have immune associations, too, so why have humble vitamins gotten so much glow?

For one, those “exotic” upstarts, Mattern argues, are “less understood by the wider population.” What’s more, he continues, “Insufficient standards and adulteration create confusion and frustration for the industry and consumers. There can be a lot of heterogeneity in product quality, for botanicals especially. In comparison, vitamins are better known and understood, and their health applications are clearer.”

D Marks the Spot

These health applications are growing clearer still for vitamin D, which has been a fixture of pandemic-related discussion among both nutrition professionals and civilians.

Thompson points to results of a recent poll on Facebook finding that if consumers had to choose between supplementing with vitamin C or D, 52% would choose the latter. And with good reason: “Continuing studies are focusing on vitamin D’s benefits for immune support—especially its role in preventing the risk and severity of respiratory infections,” Thompson says.

Trygve Bergeland, PhD, vice president of science at Kappa Bioscience, points out that several meta-analyses already demonstrate vitamin D’s benefits against respiratory-tract infections, with low levels of the vitamin associated with a higher risk both for infection and symptom severity. “Similar findings have been published regarding an association between low vitamin D levels and a higher risk for SARS-CoV-2 infection,” he adds.

Knowing that consumers will continue vitamin D supplementation only as long as it fits their lives, Thompson notes that Morre-Tec developed Good Rāz, a brand of liquid-soluble vitamin D set to launch on Amazon this spring. Colorless, odorless, and tasteless, the product “especially appeals to anyone with an aversion to swallowing tablets or capsules,” Thompson says. “It doesn’t contain the sugar often found in gummies,” Thompson adds, and it slips right into coffee, tea, water—“any food or beverage desired.”

K and D: Better Together

Yet, while Thompson predicts that continued research into vitamin D’s heart, bone, and immune benefits “will certainly fuel continued growth in its consumption,” vitamin K2 may also benefit from that research.

As Mattern says, “An increasing number of studies show that some benefits attributed to vitamin D—on bone and vascular health, for example—actually require vitamin K2 for activation. Because of their common connection to calcium, vitamins D and K2 actually work in synergy.”

Namely, vitamin K2 acts on an amino acid in the calcium-regulating matrix Gla protein; absent sufficient levels of the menaquinone-7 trans isomer of the vitamin, the protein doesn’t undergo carboxylation and thus can’t direct calcium to where we want it—think bone—and instead moves it into the bloodstream for deposition into soft tissues in arteries and the lung’s elastic fibers where we don’t.

Alas, vitamin K tends to fly under the radar for all but the most informed of consumers, who even so tend to think of it in terms of its effect on blood clotting. But while that’s a valid association for vitamin K1, vitamin K2’s claim to fame are its “broader benefits to bone, cardiovascular, and immune health,” Bergeland says.

This is especially important during the pandemic. Bergeland points to two recent publications^1,2 showing that low levels of vitamin K correlated with worse cases of COVID-19—and death—in hospitalized patients. “This indicates that vitamin K might be playing a protective role,” he says. “In fact,” he continues, “a review³ suggested that vitamin K deficiency is the ‘missing link’ between lung damage and thrombosis in COVID-19.”

Bergeland notes that Kappa Bioscience is establishing a research program in conjunction with hospitals in the United States, the Netherlands, and Denmark “to help the scientific community better understand the many roles that vitamin K plays in our bodies and whether supplementation with vitamin K2—the circulating form—may help COVID-19 patients.”

Meanwhile, savvy supplement shoppers are already cluing in. Sales of Vesta Nutra’s (Indianapolis, IN) proprietary NattoMK-7 vitamin K2 supplement rose about 10% year over year, says company president Sam Kwon, who attributes the vitamin’s rising profile to the difficulty of consuming it via conventional Western diets and to consumer awareness. “Educated consumers understand the need to supplement their diets with this important vitamin,” he says.

Staying Power

Moreover, he believes, they’ll continue doing so even after COVID-related concerns abate. And their newfound fondness for letter vitamins more generally may persist, too.

“We definitely believe that consumer demand for high-quality natural vitamins will continue,” Kwon says. “As standards in the supplement industry rise, and with more education about vitamins’ benefits, we see this sector growing steadily.”

Mattern is of like mind, pointing to a survey from Nutrition Business Journal and New Hope Network projecting strong supplement use “even in a scenario where vaccination is available and widely distributed,” he says. “This supports the assumption that interest in immunity and vitamins is about broader prevention.”

All of which bodes well for the category’s future. Because this won’t be the last time that a virus puts immune support—or vitamins—center-stage.

“The pandemic has created both temporary and permanent shifts in consumer behavior and thinking,” Maheshvari concludes. Even new adherents to the category, he says, “are looking at our industry long-term as part of a more permanent commitment to a healthier lifestyle. One step in that direction is the permanent inclusion of organic and plant-based vitamins to their routines.”

References

1. Dofferhoff AS et al. “Reduced vitamin K status as a potentially modifiable risk factor of severe COVID-19.” Clinical Infectious Diseases. Published online ahead of print August 27, 2020.
2. Linneberg A et al. “Low vitamin K status predicts mortality in a cohort of 138 hospitalized patients with COVID-19.” MedRxiv. Published online ahead of print December 23, 2020.
3. Janssen R et al. “Vitamin K metabolism as the potential missing link between lung damage and thromboembolism in coronavirus disease 2019.” The British Journal of Nutrition. Published online ahead of print October 7, 2020.