Immune health is a priority for all consumers, regardless of health status, age, race, gender, lifestyle, or even time of year, as the ability to remain healthy and free from illness all year long is important. Product formulators must understand consumer need and demand, identify the most efficacious ingredients that support year-long immunity, and create novel products that appeal to mass market consumers. Fortunately, there is a rising star in elderberry that meets these criteria and plays well in the worlds of functional foods as well as dietary supplements. 

Immunity: Relevant & Important
There are drugs, treatments, and supplements catering to nearly every possible health condition. However, there is one unifying area of health that affects everyone, and to varying degrees—our natural defense system.

It isn’t just about fighting off a cold; the immune system is integrally tied to other conditions like gut health and inflammation. An improper balance of any of these can lead to a whole host of disease states ranging from an onslaught of free radical oxidative damage, cardiovascular problems, cognitive deterioration, and premature aging just to name a few. Everything is connected, with the immune system at the core.

A Rising Star in the Berry Category
Since keeping the immune system in peak condition is essential to overall health and wellness, it is important to understand which ingredients show promise in this area, and equally as important, whether they are easily marketable and formulation-friendly for product developers. 

Dark berries as an overall category merit strong consideration for immune-supporting products as they not only have a centuries-long history of use in the treatment of ailments, but scientific studies have also corroborated the anti-bacterial, anti-viral, and immune-boosting potential of numerous darkly pigmented berries. It certainly helps that berries have also earned mainstream awareness as “healthy” options due to their antioxidant nature and the association between vibrant colors in foods as being particularly good for the body; and there is a standout: elderberry.

Black elderberry, (Sambucus nigra) also known as European elderberry, is a berry predominantly originating from Europe and is optimally cultivated in the Steiermark region of Austria. The cultivar that has been associated with recent scientific studies is known as Haschberg and it is known for possessing higher naturally-occurring levels of flavonoids.

Not to be confused with the North American variety of red elderberry (Sambucus canadensis), the black elderberry is quickly emerging as “the immune berry,” and for good reason. Originally coined by Hippocrates as “nature’s medicine chest,” elderberry was recognized as a therapeutic agent for warding off diseases ranging from influenza to the pox. The reputation has persisted throughout the years and you would be hard pressed to find modern-day healers or integrative practitioners who didn’t include elderberry with their regimen of elixirs for common ailments.

With the insurgence of functional foods and condition-specific dietary supplements in the natural products industry, there are now more platforms for benefitting from elderberry’s functionality to maintain a healthy immune system through everyday diet and supplementation. Elderberry is well-positioned to be a common immune supporting ingredient in jams/jellies, bars, beverages, tablets, capsules, powder mixes, gummies, teas, and even chocolates, as a natural and healthy way to keep the body in balance. 

The Science on Black Elderberry
There are entire journals and symposia dedicated to sharing the studied and measurable health benefits of berries. As a class, berries share a common property that contributes to these benefits to human health—they are packed with phytochemicals called “flavonoids” that contribute marked antioxidant protection against oxidative damage to cells. Flavonoids are secondary metabolites found in plants under the category of polyphenols that have been tied to controlling pathogens and even allergens.¹

One type of flavonoid called anthocyanins are the compounds responsible for the red-purple-black pigments of berries. These anthocyanins have been the subject of countless scientific research studies over the years and have been closely tied to the immune-supporting (and other) health benefits of berries. For example, Youdim and a team of researchers (2000) demonstrated significant protective effects from black elderberry anthocyanins against oxidative damage to the vascular endothelial cells that line the blood vessels.²

Besides its antioxidant activity, how does elderberry boost the immune system and offer year-round immunity? First, it is important to understand the various ways in which the immune system wards off pathogens and disease. One is serving as a physical barrier (i.e., skin and mucous membranes), another is directly fighting off foreign invaders like bacteria through specialized cells such as macrophages, and yet another is an indirect response of stimulating special messenger compounds in the body called cytokines. The cytokines communicate with other parts of the immune system and influence levels of inflammation in the body.

And now the exciting part—elderberry has been shown to increase and regulate the production of several of these cytokines in the immune system as part of its immunomodulatory activity. For example, Barak et al. (2002) reported elderberry triggered a significant increase in cytokines like IL-1, IL-6, and IL-8, and even TNF-a, which is associated with an increase in macrophage cells, the scavengers of rogue bacteria and viruses.³ This essentially activates or boosts the immune system to be ready for action.

While the antioxidant and cytokine modulation properties of elderberry significantly contribute to its functionality in keeping the immune system and related body systems in a state of balance, perhaps most interesting are the direct anti-viral and anti-bacterial findings. A 2011 study by Krawitz et al. showed that treatment with an anthocyanin-standardized elderberry extract exhibited a dose-dependent reduction in bacterial growth of Streptococcus species and Branhamella catarrhalis, which often causes infections of the upper respiratory tract.⁴

In addition, the researchers demonstrated that a low concentration of elderberry extract that was shown to be safe to normal cells significantly inhibited the growth of both a highly pathogenic avian type A influenza virus and a slower mutating type B influenza virus. The infectivity of the viruses was reduced, as evidenced by the diminished levels of virus production by about 30% and 25% for the type A and B influenza virus, respectively. These results suggest the extract may be blocking cell factors which allow the viruses to propagate.

For the times when a cold or flu hits, preliminary human studies by Zakay-Rones showed a reduction in duration and symptoms of influenza by elderberry.⁵ Tiralongo et al. (2016) set out to take it to the next level with a randomized, double-blind, placebo-controlled clinical trial.⁶ The researchers investigated the effects of an anthocyanin-standardized elderberry extract on long-haul international flight passengers who are especially prone to illness. The elderberry treatment resulted in less than 35% infections, a third-shorter duration of the cold occurrences, a reduction in severity of cold symptoms, and three times better overall health reported by all passengers taking elderberry. 

A word of caution: not all elderberry products are created equal. Harsh processing through the use of solvents or excessive heat can deteriorate the anthocyanin actives that are crucial to the observed benefits. Care should be taken to obtain an extract that is standardized to consistent levels of actives and gentle processing techniques to preserve as much of the natural matrix of the fruit as possible. 

Formulating with Flavonoid-Rich Berries
Marketing efforts for immune support products are often flooded with language like “it’s that time of year again,” implying late fall/winter is when immune health becomes a key concern. Yes, some germs tend to spread more in certain times of the year, but other times of the year can bring their own set of offenders to the body. Seasonal allergies that strain the immune system, and everyday stressors like lack of sleep or a big deadline at work can impact the strength of the immune system. Immune health is an all-year-long issue and berries, with elderberry leading the pack, have the multifaceted functionality along with being “friendly” and “familiar” enough to be an effective natural solution.

Due to the increased understanding about the mechanisms of action of certain immune supporting compounds, expect to see growth in the market toward combination products that focus on synergies and complements among ingredients. Formerly, popping a single isolated supplement like vitamin C may have provided a level of consumer confidence, but cumulative benefits of multiple, complementary ingredients offer an extra layer of protection and allow for creative and innovative products. 

Berries blend well with other berries (e.g., cranberry) as well as other ingredients (e.g., echinacea or probiotics). Formulators are encouraged to be creative when formulating new functional foods and beverages as well as supplement deliveries to appeal to mass consumers—children, the elderly, health fanatics, and the health-challenged alike.

Beverages continue to be a strong force in the functional food category and since berries are already a common flavor and ingredient in juices and drinks, it’s a natural extension to have elderberry-fueled immune beverages. No color additives are needed thanks to purple pigments, which contribute to clean ingredient panels; and with all of the flavoring and natural sweetener options available today, it is easier than ever to formulate around taste barriers. Also, keep in mind that lower dosages of anthocyanins can be used in products that spend some time in the mouth (e.g., liquids, chewables, dissolvable tablets, etc.) because of superior absorption and bioavailability through the mouth/tongue versus traveling through the digestive tract first.

And to the up-and-coming generation of food scientists, formulators and practitioners alike, remember, always respect your elderberries.

Melanie Bush is chief science officer at Artemis International, a leader in science-driven berry-based nutraceutical ingredients for dietary supplements, functional foods/beverages and cosmeceuticals. Artemis International launched the Berryceuticals brand to categorize and create a clear market position for its wide range of berry-based extracts, including elderberries, aroniaberries, cranberries, blueberries, and black currant. Ms. Bush has been at the helm of driving ongoing research and innovation into the area of nutritional benefits of dark berries, and has been instrumental in helping the company break ground in immune health research as it relates to its ingredient portfolio.

References

1. Tanaka, T., Curr Pharm Des. 2014; 20(6):879-85.
2. Youdim, K.A., et al., Free Radic Biol Med. 2000 Jul 1;29(1):51-60.
3. Barak, V., et al., Isr Med Assoc J. 2002 Nov;4(11 Suppl):919-22.
4. Krawitz, C., et al., BMC Complement Altern Med. 2011 Feb 25;11:16.
5. Zakay-Rones, Z., et al. J Int Med Res. 2004 Mar-Apr;32(2):132-40.
6. Tiralongo, E., et al., Nutrients. 2016 Mar 24;8(4):182