Feature
Great Expectations: Hot Herbs in '99
By Ken Babal, C.N.
Consumer acceptance of natural products sits on something of a three-legged stool, with the first leg constructed of the scientific backing that gives dietary supplements respect. From vitamin C to St. John's wort, science focuses media attention—the second leg—on the benefits of supplements, bringing them to the attention of the public. Notably, as herbs, vitamins and other supplements move into the mainstrean marketplace, mainstream corporations are increasing their presence in the industry. The vast marketing resources these companies bring to bear translate into a more educated general public. Indeed, marketing and advertising efforts represent the third leg that supports industry growth and acceptance. Science, media and marketing meet on the street to help make supplements sell.
While science continues to discover the diverse roles of essential vitamins and minerals, all predictions are that the future of dietary supplements research—and thus consumer acceptance—lies in the area of phytonutrients (phyto means plant). And as research continues to codify and validate traditional plant uses for human health purposes, more and more plant-based components will find mainstream acceptance.
Scientists are finding hundreds of important nonvitamin factors in plant foods with potentially protective and therapeutic value. For example, flavonoids in citrus mediate allergic reactions;1 catechins in green tea and theaflavins in black tea help protect LDL cholesterol from oxidation, thereby reducing the risk of atherosclerosis;2 carotenoids in orange and yellow fruits and vegetables protect DNA from free radical-induced damage;3 proanthocyanidins in grape seeds are potent antioxidants that strengthen blood vessels;4 and sulfur compounds in cruciferous vegetables upregulate detoxifying enzymes that lessen the likelihood of damage caused by exposure to certain toxic compounds.5
Women's Health Products
Women have always represented the bulwark of the natural products demographic. Aging women in particular have opened up the market for natural treatments that address their health concerns. Because of this, phytoestrogen supplements, helpful in menopause, are becoming increasingly popular and will probably become more prominent on store shelves.
Isoflavones, found almost exclusively in legumes—especially soybeans—are among the most common type of phytoestrogen and have the most potent phytoestrogenic activity. Phytoestrogens including isoflavones act like weak estrogens, competing with the body's own steroidal estrogens for the estrogen receptors on cells. This is desirable because estrogen causes cells to reproduce, which can lead to cancer. If, on the other hand, a person's steroidal estrogen levels are low, such as occurs with menopausal women, the plant estrogen acts as a weak estrogen mimic, allowing for some estrogenic effects, which are often useful in decreasing menopausal symptoms.
Isoflavones in soy foods have been credited with slowing osteoporosis and relieving menopausal hot flashes, as well as protecting against kidney disease, diabetes complications and tumor growth, especially hormone-dependent cancers of the breast and the prostate.6-10 Continuing research along with growing public awareness of these benefits has prompted manufacturers to introduce isoflavone-rich soy protein powders and other phytoestrogen supplements.
Red clover (Trifolium pratense) is a concentrated source of estrogenic isoflavones with a level tenfold that of soy. In addition to the soy isoflavones genistein and daidzein, red clover provides two additional estrogenic isoflavones not found in soy—biochanin and formononetin.11 Standardized red clover supplements are now being marketed as postmenopausal supplements.
Black cohosh (Cimicifuga racemosa), traditionally used by Native Americans, contains a phytoestrogen that is now being studied. Isoflavones and other medicinally active constituents have been identified in the herb and have effects similar to that of estriol, one of the milder endogenous estrogens.12 In Germany, a standardized black cohosh extract called RemifeminTM is approved as a nonprescription medicine for premenstrual discomfort as well as menopausal ailments.
Ipriflavone is a semisynthetic compound chemically similar to isoflavones and used for its antiosteoporotic benefits. Research on ipriflavone began in the early 1970s and culminated in the compound's approval in Hungary, Italy and Japan as a treatment for bone loss. The compound enhances the protective effect of estrogens on osteoclast activity and bone density without exerting any other direct estrogenic effects.13 In a study of Japanese women with osteoporosis, patients were given 600 mg a day for one year. The ipriflavone produced a 6 percent increase in bone mineral density, while the control group lost 0.3 percent of bone density.14
Whether this product fits the true definition of phytonutrient is debatable because there is little evidence that ipriflavone occurs in nature. However, about 10 percent of ipriflavone metabolizes in the body to daidzein, one of the soy isoflavones thought to protect against osteoporosis.15 In any event, ipriflavone may become an affordable alternative for women who prefer to take weak estrogens instead of prescription medications to prevent the rapid bone loss that often accompanies postmenopause.
Men's Health Products
While women's products have traditionally outsold men's products, it appears there is more consumer interest in men's health than previously thought. According to the publishers of Men's Health, which includes advice on how to live longer, have a better sex life and other health matters exclusive to men, the magazine is one of today's fastest-growing publications.
Further evidence of a groundswell in the men's health category lies in the Viagra® phenomenon. After much initial fanfare and media attention, advertisements for the drug, used for erectile dysfunction, began to fill magazines. As is often the case with other pharmaceutical "magic bullets," herbal alternatives are now being widely marketed. Traditionally used as aphrodisiacs, these herbs tend to be advertised to help "male vitality," to improve blood circulation and for use as general tonics.
These herbs include Chinese or Korean ginseng (Panax ginseng), an adaptogen traditionally used in Asia; ginkgo (Ginkgo biloba), for increasing circulation to the extremities; damiana (Turnera diffusa), a Mexican tonic herb traditionally used for enhancing libido; yohimbe (Pausinystalia yohimbe), an African herb from which the impotency drug yohimbine hydrochloride is manufactured; wild oat (Avena sativa), a tonic traditionally used as a sexual stimulant for humans and animals; and ashwagandha (Withania somnifera), the Ayurvedic answer to ginseng for the male libido.
In addition, aging baby boomers—a cornerstone of the natural products marketplace—are becoming concerned with male prostate health. Prostate cancer is an increasingly common male cancer. Its incidence increases with age, and most men eventually develop it if they live long enough. However, the National Cancer Institute reports that less than one-quarter of cases lead to death. In Europe, plant-based medicines, particularly saw palmetto (Serenoa repens), are de rigueur for men with benign prostatic hypertrophy, or BPH, a nonmalignant enlargement of the prostate gland.
German Commission E-Approved Herbs
Before they were promoted in the United States and became top sellers, certain herbs were approved as medicines by the German government. Herbal medicines in Germany are reviewed by Commission E, a group of experts and authorities responsible for the creation of monographs similar to the official summaries used to regulate drugs in the United States. Commission E monographs describe each herb, its applications, the appropriate dosage and contraindications. St. John's wort (Hypericum perforatum) and ginkgo came to be widely prescribed in Europe and ultimately in the United States by way of Commission E recognition.
If the German marketplace is a reliable predictor of herbs that will gain recognition in the United States, we can expect several other preparations to increase in sales in the near future. Among the most frequently prescribed herbal monopreparations in Germany and now being promoted in the United States are ivy leaf extract (Hedera helix), hawthorn (Crataegus laevigata), stinging nettle (Urtica dioica) and horse chestnut (Alasculus hippocastanum).
Dried ivy leaf extracts have been used in Europe for nearly 50 years to soothe respiratory irritations. Numerous randomized, double-blind, crossover studies have been performed with adults and children and show the extract to be beneficial and well-tolerated.16
Hawthorn leaf and flower extract is approved by Commission E as a cardiotonic agent. It is recognized not only as a therapeutic agent but more and more as a prophylactic or tonic for the heart. A compelling body of scientific research exists, most notably in the German Commission E monographs, on which a structure/function claim might be made in the future. These claims are due largely to the nutritional role of flavonoids. In Eat Right for Your Type (Putnam Pub Group, 1997), Peter D'Adamo writes, "If I had my way, extracts of hawthorn would be used to fortify breakfast cereals, just as vitamins are." Mark Blumenthal, executive director of the American Botanical Council in Austin, Texas, says considering how significant a problem cardiovascular disease is in America, the market position of hawthorn is likely destined to go nowhere but up.
In Europe, stinging nettle root (Urticae radix) is categorized as a urologic agent indicated along with saw palmetto as a treatment for benign prostatic hypertrophy.17 Horse chestnut seed extracts are widely used in Germany to support veinal circulation. The herb may offer a natural solution to varicose veins.17
Fortifying Factors
The German Commission E deals with Europe's science-based phytotherapy, which evolved from Western folk medicine. Retailers can also expect to see other traditional herbal systems gain a larger share of the market. These include traditional Chinese and Ayurvedic medicines as well as South American rain forest and Native American systems.
In the United States, many factors can contribute to making a supplement a big seller. Who knew at the start of 1997 that St. John's wort would become a household name by year's end? Marketing aside, positive, timely studies generally come into play to help a supplement along. The great market force of baby boomers, who continue to come to terms with their aging, should mean antiaging and weight-loss supplements continue to sell well.
Finally, it's important to remember that there are many nutrients in the store that we know to be helpful, but it can take a long time for these supplements to catch on in the mainstream. All we can do is educate consumers from the retail side.
Sidebars:
Botanicals Not The Only Growth Category
Ken Babal, C.N., is a consulting nutritionist and a member of the Society of Certified Nutritionists. He is staff nutritionist for Erewhon Natural Foods Market in Los Angeles.
References
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2. Ishikawa T, et al. Effect of tea flavonoid supplementation on the susceptibility of low-density lipoprotein to oxidative modification. Am J Clin Nutr 1997 Aug;66(2):261.
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5. Zhang Y, et al. A major inducer of anti-carcinogenic protective enzymes from broccoli. Proc Natl Acad Sci 1992;89:2399-403.
6. Erdman JW, et al. Short-term effects of soybean isoflavones on bone in postmenopausal women. 2nd International Symposium on the Role of Soy in Preventing and Treating Chronic Disease; 1996 Sep 15-18.
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12. Duker EM, et al. Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal women and ovariectomized rats. Planta Medica 1991;57:420-4.
13. Brandi ML. New treatment strategies: ipriflavone, strontium, vitamin D metabolites and analogs. Am J Med 1993 Nov 30;95(5A Suppl):69-74.
14. Passeri M, et al. Effect of ipriflavone on bone mass in elderly osteoporotic women. Bone Miner 1992;19(1 Suppl):S57-62.
15. Brandi ML. Flavonoids: biochemical effects and therapeutic applications. Bone Miner 1992;19(Suppl):S3-14.
16. Lassig W, et al. Efficacy and tolerance of ivy-containing cough medications. TW Pediatric 1996; 9:489-91.
17. Blumenthal M, et al. The complete German Commission E monographs. Austin (TX): American Botanical Council; 1998. p 148-9, 217.
