Diligent handwashing, sporting a face covering and keeping a safe distance have become standard best-practices amid the global pandemic. Although most consumers adopted these habits in 2020 to reduce the spread of COVID-19, and even the common cold, many also turned to dietary supplements for additional immune health support, reports Markus Lehtinen, PhD BEng, Principal Scientist, IFF Health

Since the pandemic began, the immune health supplements market has surged globally, growing more than 25% in North America and 53% in Latin America in 2020.¹ What’s more, immunity supporting supplements aren’t just for adults; in 2020, almost half (43%) of US parents provided their children with vitamins or supplements to support immune health.²

Showing no signs of slowing down, the immune health market is projected to reach a value of $31.50 billion by 2028.³ And, with more than 70% of the immune system residing in the digestive tract — and our gut acting as the first line of defence against potentially harmful pathogens — it stands to reason that more consumers are reaching for probiotic supplements to stay healthy.⁴

As market demand for immune-boosting probiotics grows, researchers are diving deeper into the science to identify how, depending on life stage, specific strains can impact certain demographics. For example, recent studies indicate that children’s immune systems may benefit more from certain probiotic strains than those of adults, wheras the elderly may require another strain entirely.

For supplement formulators seeking to develop an effective immune health product, it’s critical to keep in mind that one size does not fit all. The right probiotic strain should be matched to the consumer’s life stage and health benefits for maximum efficacy. By selecing the correct strain, tailored specifically to their target demographic’s age and immune health concerns, formulators can provide personalised and efficacious supplements to further stand out on shelves.

Infants and immunity

Optimal immune health development starts at the very beginning of life. An unborn baby is essentially sterile; thus, bacterial exposure during and shortly after birth is a critical aspect of shaping gut microbiota communities.⁵ The infant gastrointestinal microbiota develops quickly after birth and is strongly linked to immune system development.

Stage of birth (premature or term), delivery method and feeding mode all play a role in an infant’s gut microbiota development, and continue to do so up to 3 years of age. The mother is an infant’s first source of Lactobacillus species, which contribute to forming gut microbiota communities.

Disruption of the bacterial balance during an infant’s critical microbiota development stage is associated with allergy and eczema risk later in life. As such, specific probiotic strains can provide infants with the right lactobacilli types to support microbiota and immune system development.

For example, Lacticaseibacillus rhamnosus HN001, the featured strain in HOWARU Protect EarlyLife, has been shown to support immune health in infants. In a randomised, double-blind clinical study, 316 pregnant mothers and their infants were divided into placebo and HN001 groups.⁶

Mothers received probiotic supplement capsules daily from 5 weeks prenatally to 6 months post-partum, if breastfeeding. Infants received the supplement as a powder diluted in milk or sprinkled on top of food daily, from birth to 2 years of age.

The results revealed HN001’s ability to support infants’ immune balance and development during an extended time period.⁶ Formulators can consider incorporating HN001 into a supplement for pregnant mothers and infants to increase healthy bacteria levels in infants’ intestinal tracts, promote immunity development and support immune health later in life. In doing so, they’ll create a personalised product that supports immune health development for years to come.

Probiotics are for kids

As children grow, they encounter new immune health challenges, such as the common cold. Taking specific probiotic strains can help to support their immune system, so it’s primed to face these new challenges.⁷

Germs and viruses run rampant through day cares, schools and public transportation. On average, children experience 5–6 colds per year — twice as many as adults.⁸ Some dietary supplements have shown benefits by helping children to stay healthy.

Parents seeking options can turn to probiotics to support their children’s immune health and lose fewer school days.^9,10 Probiotics may impact the gut mucosa by balancing the local microbiota, inhibiting pathogen growth and stimulating local and systemic immune responses.¹¹

Specific strains, such as those found in HOWARU Protect Kids, can support children’s immune defences and help children stay healthy.^9,10 HOWARU Protect Kids contains a unique combination of Lactobacillus acidophilus NCFM and Bifidobacterium lactis Bi-07, which help to support children’s immune function and maintain respiratory health.

A double-blind, placebo-controlled clinical study measured NCFM and Bi-07’s effects on cold- and flu-like symptoms — such as cough, runny nose and fever — in healthy children between 3 and 5 years of age.¹⁰ The study took place from November to May, when children are most vulnerable to seasonal illness as a result of inclement weather.

Researchers evaluated the children’s symptoms according to frequency, duration and severity. Upon completion, the study revealed a significant reduction in fever, cough and runny nose for the probiotic group.

The number of sick days taken was nearly cut in half and reported antibiotic usage was 80% lower for children taking the NCFM and Bi-07 combination.

Such strong clinical results speak to the strain-specific impact that NCFM and Bi-07 can have on children’s immune health. Formulators seeking to develop children’s immune health supplements can consider incorporating strains such as those found in HOWARU Protect Kids to support children’s immune systems and keep them healthy through preschool years and possibly beyond.

Adult immune defence

Immune health concerns for infants and children vary greatly from those of adults and seniors. For adults younger than 55, pollution, allergies and respiratory infections are primary immune health concerns. The probiotic strain Bifidobacterium lactis BI-04 was the subject of a recent clinical study in healthy adults; results showed that those taking BI-04 for a 5-month period had a 27% lower risk of recurring upper respiratory tract illness (URTI) episodes compared with a placebo group.¹²

Athletes require a more tailored approach. Research suggests that active sport performers can suffer from a higher incidence of infections owing to altered immune functions from increased exercise levels. During this temporary alteration of immune defences, viruses and bacteria may gain a foothold, increasing an athlete’s risk of infection — particularly URTIs, which are associated with impaired sports performance.

Strains Bifidobacterium lactis Bi-07 and Lactobacillus acidophilus NCFM — a combination found in HOWARU Protect Sport — have been shown to promote greater physical activity levels in active adults during seasons with inclement weather.¹² This strain-specific benefit can help brand owners to stand out on shelves when formulating immune-health supplements that target the trending sports nutrition market.

Immune health with age

As people age, changes in gut microbiota composition occur, including a loss of beneficial bifidobacteria. This loss and concomitant changes in microbiota are associated with seniors’ declining immune function and vaccine response, as well as increased susceptibility to infection.

For those aged 55 and older, formulators can incorporate different strains than those used for children or adults to help the elderly shift their microbial balance and reap maximum immune health benefits. Specific probiotic strains, such as Bifidobacterium lactis HN019, may help to prevent age-associated decline in immune functions and microbiota dysbiosis.

A clinical study has shown that consumption of HN019 increases beneficial Lactobacillus and Bifidobacterium levels in the gut of elderly consumers.¹³

Researchers conducted a systematic review and meta-analysis to determine HN019’s effects on seniors’ cellular immunity. The meta-analysis, including four clinical studies, showed improved phagocytic capacity of monocytic cells and increased natural killer (NK) cell activity in those consuming HN019 daily.¹⁴

Phagocytosis, the process of immune cells eating harmful bacteria, is an important immune function to maintain intestinal homeostasis and defend against pathogens, wheras NK-cells kill virus-infected cells to combat viral infections. Overall, HN019 clinical studies show solid results on senior’s cellular immune markers and microbiota composition.

Globally, the elderly population continues to increase — and demand for supplements tailored to senior citizens’ needs isn’t likely to slow anytime soon. To meet growing market demand, formulators can consider incorporating strains, such as Bifidobacterium lactis HN019, into products tailored to senior needs to provide a safe, efficacious way for ageing populations to stay healthy.

Potential in probiotics

It’s no secret that immune health has been a trending topic during the past year. As consumers continue to seek immune-boosting supplements, formulators can meet market demand by incorporating high-quality strains, tailored to specific life stages and immune health concerns, into their end products.

But, to stand out in a crowded immune health market, product personalisation is key. Savvy formulators can consider adding trending botanicals to increase brand awareness and maximise end-product benefits. Well-known natural ingredients, such as echinacea and thyme, may reveal synergistic effects with certain probiotic strains to further bolster immune health.

In the future, though, it’s likely that probiotics will become even more tailored to consumers’ immune health needs.

In coming years, they may be able to undergo microbiome diagnostic testing or immunoprofiling to selec probiotic supplements that specifically target their individual immune health concerns.

For now, to meet current consumer demand and stay ahead of ever-evolving immune health trends and technology, formulators and manufacturers should partner with a trusted supplier who can help them to develop innovative products both today and tomorrow. For probiotics, immune health innovation is just beginning.