Consumers are traversing international borders to investigate the numerous health benefits and emerging health applications of medicinal herbs traditionally used by foreign cultures to prevent and treat illness and promote wellness.
Botanicals have been used traditionally for millennia to combat illness and enhance well-being. American consumers are gradually discovering what distant cultures have known for eons: various distinctive, naturally occurring compounds native to the plant kingdom provide effective, natural, gentle treatment for a host of health issues. Herbs can relax or stimulate, improve performance, treat the symptoms of illness and generally promote good health. Commonly gentle in action and inexpensive, botanicals can, in many cases, provide a viable alternative to prescription drugs.
During the last several decades, there has been a proliferation of research into the clinical value of herbs. According to the American Herbal Products Association (AHPA), results of these studies frequently validate centuries-old empirical observations made by traditional cultures.1 For example, ancient man used naturally occurring plant stimulants to achieve altered states of consciousness in religious rites; one of the earliest and mildest of these was strongly brewed herbal tea.2 In 2737 B.C., the Chinese Emperor Shen Nung—tea’s alleged discoverer—wrote in his diary that tea not only “quenches thirst” but also “lessens the desire to sleep.”3 Parallel to the ancient sovereign’s observations, modern clinical research has revealed that green tea contains the stimulant caffeine and exerts an additional thermogenic effect by virtue of its catechin polyphenols.4 Another example of modern research verifying the tenets of traditional herbal medicine lies with the ancient Egyptians, who were the first to mention aloe’s anti-inflammatory and dermal healing properties. Contemporary modern research has verified the Egyptians’ astute observations5 and attributed aloe’s effects to its ability to increase the rate of cell turnover, collagen content and degree of crosslinking in the wound matrix as seen by increased aldehyde content and decreased acid solubility.6,7 And modern science has verified the worth of frankincense against the symptoms of arthritis, as noted by ancient Indian Ayurvedic physicians; the mechanism by which the Southeast Asian botanical provides relief involves its boswellic acids.8
As the popularity of herbal remedies grows, suppliers, manufacturers and end users of herbal products are showing increased interest in botanicals traditionally employed by cultures from distant locales. And, thanks to new research into the health benefits of botanicals native to these areas of the globe and the growing popularity of herbal remedies, such exotic compounds are marketed with growing frequency in the form of teas, tablets, capsules, liquid extracts and other delivery methods for novel as well as traditional wellness applications. Consider these botanical case studies from around the world.
China
“It is a natural expectorant and helps clear the lungs of airborne pollutants,” the company noted. “It is also a natural antitussive. During its hundreds of years of continuous use, LHK’s healthy benefits have largely been defined by the reputation it developed with the people who used it.”
According to clinical research, LHK contains antioxidants that inhibit oxidation of low-density lipoprotein (LDL) cholesterol.10 It may also have anticarcinogenic effects. While searching for cancer chemopreventive agents from natural resources, researchers from Kyoto Pharmaceutical University in Japan found two natural sweeteners isolated from the fruits of LHK exhibited significant inhibitory effects on a two-stage carcinogenesis test of mouse skin tumors.11
LHK is also prized as a nonnutritive sweetener. “LHK contains mogrosides which are some 200 times sweeter than sugar,” Longjiang stated. Chinese scientists tested the influence of LHK extract versus sucrose, glucose, fructose and beet sugar on the growth of Streptococcus mutans bacteria.12 LHK was less conducive to the growth of the organisms than the other sugars, leading the scientists to conclude LHK “possesses many advantages: high sweetness and low adherence; and its anti-cariogenicity is better than beet sugar.”
A company that focuses primarly on LHK’s sweetening properties is City of Industry, Calif.-based Amax Nutrasource, which produces LHK as a liquid additive, a standardized powder 300 times sweeter than sucrose and a low glycemic blend three times sweeter than sucrose. “We have created nutritional decks using LHK in beverages, pastas and sauces and baked goods to lower the caloric content and glycemic properties of these products,” said Larry Martinez, president.
India
Like LHK, ashwagandha has antioxidant properties. Indian researchers found in an animal study 30 days of treatment with ashwagandha root powder produced a significant decrease in lipid peroxidation, and an increase in both superoxide dismutase and catalase.13 The researchers concluded ashwagandha root powder possesses free radical scavenging ability, which may be responsible for its pharmacological effects. Another Indian study showed oral administration of ashwagandha (100 mg/kg) prevented a rise in lipid peroxidation after intravenous administration of different sugars in rabbits and mice.14
Clinical research also backs the value of ashwagandha as an herbal boon to the immune system. A study performed by Hindustan Antibiotics Ltd. in Pune, India, evaluated the efficacy of ashwagandha against an infection of Aspergillosis fumigatus (Aspergillus) in mice and found the herb prolonged the survival period of infected animals.15 According to the researchers, this protective activity was probably attributable to observed increases in phagocytosis and intracellular killing of peritoneal macrophages induced by ashwagandha treatment.
Ashwagandha may also exert an immunomodulatory effect. Using hematological and serological tests, Indian researchers studied the immunomodulatory activity of ashwagandha in mice with artificially induced suppression of blood cell and platelet production.16 Significant modulation of immune reactivity was observed and a significant increase in blood components and body weight was observed in Ashwagandha-treated mice in comparison to control mice.
South America
Although maca has been used as a hormone balancer, energy booster, depression fighter and performance enhancer, its most popular traditional use is for improvement of sexual function. Clinical research has verified the herb increases libido,17 elevates sperm count and improves sperm motility.18 Maca has also been shown to elevate and alleviate erectile dysfunction due to its ability to improve penile endothelial L-arginine-nitric oxide activity.19
“Maca diminishes symptoms of sexual dysfunction by regulating the endocrine system,” said Zach Adelman, president of Novato, Calif.- based Navitas Naturals, which supplies maca as bulk powder and vegetarian capsules. “It does this by regulating the endocrine system and specifically the thyroid and pituitary glands.”
A number of studies have indicated maca improves sexual performance. In a rat study from the University of Modena and Reggic nell’Emilia, Italy, subcutaneous administration of various fractions of maca in sexually inexperienced male rats variously improved sexual performance parameters in the animals.20 Another study conducted by researchers at South Hackensack, N.J.-based PureWorld Botanicals examined the effect of oral administration of purified lipidic extracts of maca (as MacaPure M-01 and M-02) on the number of complete intromissions and mating in normal mice, and on the latent period of erection (LPE) in rats with erectile dysfunction.21
The animals were randomly divided into several experimental and control groups and orally administered a 10 percent ethanol suspension of the maca extracts for 22 days. Based upon the results, the researchers concluded the two maca extracts enhanced the sexual function of the mice and rats, as evidenced by an increase in the number of complete intromissions, the number of sperm-positive females in normal mice and a decrease in the LPE in male rats with erectile dysfunction. It was also noted that the study revealed for the first time an “aphrodisiac activity” of maca, for which PureWorld holds U.S. Patent No. 6,267,995.
Pacific Islands
Clinically, noni has been implicated chiefly for its ability to inhibit angiogenesis and prevent cancer. Angiogenesis—the growth of new blood vessels—occurs within in the body both normally and as a byproduct of illnesses such as such as cancer, diabetic retinopathy, age-related macular degeneration, rheumatoid arthritis, psoriasis, and more.23 In laboratory tests, noni has been shown effective as a means of inhibiting new vessel sprouts caused by angiogenesis. For example, in a study conducted at Lousiana State University, noni at concentrations of 5 percent (vol/vol) or greater was highly effective in halting the initiation of vessel sprouts from human placental vein explants, compared with compared with an equivalent amount of saline.24 These concentrations of noni were also found effective in reducing the growth rate and proliferation of newly developing capillary sprouts. The researchers also found 10 percent noni juice in media was an effective inhibitor of capillary initiation in explants from human breast tumors.
Various studies have suggested noni may be an effective anticancer agent. According to a UIC College of Medicine (Rockford, Ill.) study, preliminary data indicated 10 percent Tahitian noni (as a liquid dietary supplement supplied by Provo, Utah-based Morinda Inc.) or Tahitian Noni Juice (TNJ) (also supplied by Morinda Inc.) in drinking water for one week prevented DMBA-DNA adduct formation.25 In female rats, levels of DMBA-DNA adducts were reduced by 30 percent in the heart, 41 percent in the lungs, 42 percent in the liver, and 80 percent in the kidneys. In male mice, more dramatic results were obtained; 10 percent TNJ reduced DMBA-DNA adduct formation by 60 percent in the heart, 50 percent in the lungs, 70 percent in the liver, and 90 percent in the kidneys.
A study performed at the Burns School of Medicine (Honolulu, Hawaii) examined the relationship between a polysaccharide-rich substance in noni and tumor activity and found the substance significantly prolonged the survival of inbred tumor-bearing mice.26 A thorough examination of clinical data obtained during the study led the researchers to conclude the polysacchariderich substance in noni may suppress tumor growth through activation of the host immune system.
Researchers from the Hormel Institute at the University of Minnesota also found noni to be useful against cancer.27 Upon extracting two glycosides from noni and applying them to mouse epidermal cells, they were able to show that the glycosides inhibited transactivation and transformation in these cells.
Retailing Botanicals
Increasingly, botanicals are being marketed for novel uses, often sold in isolated form and frequently in higher concentrations than used traditionally. Whether these preparations can affect the safety profile of an herb poses a legitimate question in contemporary retailing.
“The safety of these items cannot be assumed,” said Steve Dentali, AHPA’s vice president, scientific and technical affairs. “The further you depart from a traditional use, the more evidence is needed to demonstrate the safety. The closer you stay to the traditional use, the less likely you are to have a new dietary ingredient.”
An example of the potential harm in isolating, concentrating and marketing an herb for an unconventional use is found in ephedra. The herb, which was banned for use in dietary supplements by the Food and Drug Administration (FDA) in April 2004, was marketed for weight loss and energy in an isolated and concentrated form that generated many adverse events. “Critics of ephedra, including many from the traditional herb community, have charged that the modern Western uses of ephedra—increased athletic performance and increased metabolism for weight loss—are not consistent with the herb’s traditional use,” said Mark Blumenthal, founder and executive director of the American Botanical Council (ABC). “Ephedra was or is traditionally used for its pulmonary effects, for conditions like those of asthma, plus congested conditions related to colds. Ephedra is still used for these disorders, usually in combinations with other herbs not used as concentrated extracts, as was formerly found in many dietary supplement products.”
According to AHPA, ensuring the safety of products like ephedra is not something to be taken lightly. “[T]here are any number of plants that are highly toxic, even deadly,” states AHPA’s Web site. “Every 10-year-old hiker knows to stay away from poison ivy (Toxicodendron spp.) when walking in the woods. The death sentence imposed on Socrates by an Athenian jury 2,400 years ago was carried out with a fatal dose of hemlock (Conium maculatum). The poison curare, a blend of several equatorial rain forest plants (e.g., species of Chondrodendron, Curarea and Strychnos) is used by some South American hunter cultures to make their arrows more deadly. And in the ‘concrete jungle’ of Los Angeles, two young boys died in 2000 from ingesting a few leaves of the ever-present oleander (Nerium oleander).”
Gary Troxel, executive vice president of Benicia, Calif.-based InterHealth Nutraceuticals Inc., concurs with AHPA’s sentiments on the issue of herbal product safety. According to Troxel, ensuring herbal products possess an adequate safety profile is a consideration of supreme importance for retailers prior to putting such compounds on store shelves.
“The safety of any product, botanical or other, is paramount and the industry is coming under increasing regulatory scrutiny to ensure those safety parameters are met,” Troxel said. “The only way that can be done is through solid, scientific research.” InterHealth’s Super CitriMax® product (extracted from the South Asian fruit Garcinia cambogia) underwent rigorous clinical testing and was affirmed GRAS (generally recognized as safe) by an independent third party prior to becoming commercially available.
Dentali agreed the safety and efficacy of a botanical must be backed by clinical trials in order to ensure suitability for retailing. “Manufacturers can’t rely on traditional data if the material they manufacture isn’t what is traditionally used,” he said. “If they’re inventing new indications that lack evidence provided by thousands of years’ worth of cultural information, it’s important that these new indications be backed by something other than short-term anecdotal evidence.”
According to AHPA, “There are so few credible reports of unexpected side effects due to herbal products that most experts consider problems with herbal products to be of only minor or occasional concern.”28 However, as safe as botanicals are sometimes touted to be, FDA regulates the manufacture, labeling and advertising of herbal supplements in order to ensure user safety. Manufacturers of these products must adhere to mandated good manufacturing practices— basic guidelines designed to assure sanitary conditions, thwart contamination or adulteration, and ensure safety for consumption. In addition, supplement labels must provide consumers with nutritional information, including the type and quantity of each ingredient or ingredient blend. According to AHPA, all herbal products are required to identify the parts used of each of the plant ingredients, and to label them with their commonly accepted names; and marketers of herbal supplements may not use statements suggesting prevention, cure, mitigation or treatment of diseases. Obviously, retailers should regard products that fail to adhere to these guidelines as potentially problematic.
The consensus among suppliers, manufacturers, regulatory bodies and end users seems to be that education is the best way for retailers to prepare themselves to sell botanicals.
“Undoubtedly, education is the key to helping customers purchase the products that best suit their needs,” Troxel said. “Manufacturer literature can be very helpful in that respect, but must be viewed with a critical eye. Is there solid scientific research to support the product that addresses both safety and efficacy? Has that research been published in peer-reviewed journals? Also, keep up to date on the latest information and research through trade magazines.”
Roy Upton, executive director of the American Herbal Pharmacopeia, stressed the importance of investigating manufacturers and their quality control practices before retailing their products. “Retailers need to educate themselves not only about the products they are carrying and who checks the raw materials, but about the companies making these products,” Upton said. “What are their quality control criteria? Who checks their raw materials? Do they employ botanists, herbalists, pharmacognosists or chemists?”
To ensure a thorough educational experience, Dentali recommended retailers visit the areas where the herbs they sell or plan to sell grow natively and are used traditionally. “Herbal use is a human cultural activity,” he said. “The closer you get to the people who are growing, collecting and harvesting it, the more you know about it. I don’t think you can really know an herb unless you have traced it back to the source. For example, valerian is traditionally grown in villages in Poland. I think going there would really help a retailer learn about it. And nothing compares to growing the material yourself. When you see motherwort growing in your garden, you know something about it.”
According to Shailinder Sodhi, ND, B.A.M.S., president of Bellevue, Wash.-based Ayush Herbs Inc., retailers are not alone in the need for education. “The best way to attract customers is to educate them,” Sodhi said. This holds true for the retailing of botanicals in general, but especially for Ayurveda. Many American consumers are unaware of Ayurvedic herbs and their beneficial properties. This, in turn, reflects their purchasing behavior.”
Chuck Wurzbacher of Gilbert, Ariz.-based Herbally Yours Inc., agreed that education of consumers is of great importance in the retailing of herbs. “As much as we can all do to educate the public will in the long run benefit everyone,” he said. “Because this is a relatively new industry, there is a level of ‘fear of the unknown,’ hindering peoples’ willingness to try a preventative alternative. An educated buyer is a loyal buyer.”
Comprehensive retailer and customer education is not the only factor in the successful retailing of botanicals. Another approach consider for retailers who wish to add herbal products to their product repertoire is an individually tailored marketing plan crafted from the existing surfeit of promising marketing methods.
In addition to becoming knowledgeable about botanicals and their traditional uses, Dentali recommended retailers attend the annual conference of the American Herbalists Guild, take classes, and look into correspondence courses and books. “One book I reviewed recently was Botanical Medicines: A Desk Reference for Major Herbal Supplements [publisher: Haworth Press Inc.]. It discusses both clinical trials and traditional uses behind herbs,” Dentali said.
Sodhi recommended brochures, product sheets and articles. He also suggested an Ayurvedic physician make an in-store appearance to deliver a lecture about different products, including their ingredients, dosages and possible toxicity levels.
A file containing herbal solutions to the most common ailments mentioned by customers was suggested by Upton. “Ideally, the customer should be able to get copies of supporting research articles or papers, obtain information from a kiosk or in-store database, or read a section of a customer reference copy of a book,” he said. “Make sure the information is unbiased and reliable.” Upton also suggested quarterly herb lectures with local herbalists, holistic physicians and acupuncturists; and annual herbal events to highlight the benefits of herbs, including herbal cooking classes, lectures, herb walks and book signings.
“In-store displays can draw attention to the product and provide information, while seminars are excellent because they offer an interactive forum where customers can ask questions about information they may not understand,” Troxel said. “All of these contribute to a customer’s knowledge base, which can motivate purchase and build trust in the retailer and his products. Once a retailer makes the leap from salesperson to trusted advisor, the result is repeat business and customer loyalty.”
There are many possible motivations for American consumers to investigate botanicals as a pathway to wellness. The best reason, however, may be the fact that herbs and herbal products, with their incredibly wide use throughout time and place, continue to provide real health benefits while maintaining a remarkable safety profile.29
“ABC feels the awareness of herbs is expanding. For example, in 2003 we published the ABC Clinical Guide to Herbs. This book has received quite a lot of attention; sales have been good. Also, ABC’s membership base has been expanding,” said Wayne Silverman, Ph.D., chief administrative officer with ABC.
Whatever the reasons, the market for botanicals appears to be expanding, and American consumers may be the wiser for jumping on the botanicals bandwagon.
“In general, only the United States is behind on using botanicals,” Wurzbacher said. “All of Europe, Asia, Africa and India place an emphasis on botanicals, and are raised in cultures where botanicals are as common as soft drinks in the United States. The industry is definitely on the rise, but we need trusted formulations that show results and do not promise miracles.”
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