The innate immune system is the body’s first line of defence.  When pathogens like infectious bacteria or viruses get into the respiratory tract or gastrointestinal system, the innate immune system responds by sending cells like neutrophils or macrophages to remove the threat.  These cells try to engulf the invading pathogen or create enzymes to destroy it.

The adaptive immune system specifically targets the pathogen and takes over from the innate immune system.  It is often described as the ‘memory’ of our immune system.  Once exposed to a pathogen, the immune system can remember the identity of that pathogen for the future and quickly mount a defence specific to that pathogen.

The role of Zinc in the immune system includes:

• • helping to maintain the integrity of the skin and muscular membranes, preventing pathogen entry into the body.
  • supporting the growth and differentiation of immune cells.
  • supporting the phagocytic activity of monocytes, and help regulate cytokine release.
  • antibody production, particularly IgG and helping the immune system distinguish between “self” and “non-self” ³.

This role has been recognised in an approved European Union health claim for zinc, stating that it “contributes to the normal function of the immune system” and is available to foods that meet defined criteria within the EU ⁴.

Recommended Intakes

Zinc recommendations range from 5 to 11mg per day for adults, varying by each global region ⁵.  In the US, the Institute of Medicine (IOM) recommendations are 11mg per day for men and 8mg per day for women ⁶.  Similarly, the Chinese Nutrition Society Reference intake (RNI) is 12mg per day for adult men and 8.5 mg per day for women⁸.  In Europe, the European Food Safety Authority has established a Population Reference Intake of 9.4 to 16.3mg per day for men with low to higher intakes of dietary phytate and 7.5 to 12.7mg per day for adults women with low to higher intakes of phytate ⁷.

Most people in developed countries get enough zinc through their diet, meaning their immune system isn’t missing the zinc it needs.  For example, in the US around 18% of people do not meet the Estimated Average Requirement (EAR) of zinc per day.  This means most people are not zinc deficient, but  certain people may still benefit from eating more zinc in their diet.

Dietary Sources

Zinc is mostly found in seafood, beef, poultry, beans, nuts, or fortified cereal.  Phytic acid, found in cereals, legumes, and nuts, is known to decrease zinc bioavailability ¹.  Evidence shows that the biofortification of varieties of staple crops may be useful in improving the zinc status of an individual⁵.

Table 1. Zinc content of common foods in the diet ⁹

Deficiency

Zinc deficiency is a widespread global health issue, particularly prevalent in low- and middle-income countries.  About 17.3% of the world’s population ¹⁰ is at risk of inadequate zinc intake.  When the body doesn’t have enough zinc, it does not develop a strong immune response.  Zinc deficiency affects many different organs and tissues in the body with signs and symptoms varying by age ⁹.  For example, zinc deficiency can delay growth and cause diarrhoea and alopecia in children, and it can alter cognitive and psychological function in older adults.

Most people in developed countries get enough zinc through their diet but it can affect more vulnerable groups.  For example, the percentage of people in the US that do not meet the  Estimated Average Requirement (EAR) of zinc varies from 16% in households with full food security to 27% in those with very low food security ¹¹.  In Europe, the average intake of zinc is above the recommended amount.  However, certain vulnerable populations may benefit from including more zinc rich foods or supplements in their diet e.g. those on plant-based diets with little animal foods, the elderly ⁵.

Excess Intakes

Excessive amounts of zinc can cause nausea, dizziness, headaches, gastric distress, vomiting, and loss of appetite and chronic large doses of 50 mg of zinc or more can inhibit copper absorption and reduce immune function ⁹.  Excessive intakes from food sources are unlikely but may occur with excessive supplementation.  The IOM Tolerable Upper Intake Level for zinc is 40mg per day for adults.  EFSA has set the Tolerable Upper Intake Level (UL) for total daily zinc intake from all sources (diet and supplements) at 25mg per day for adults.  This level is based on the reduction of copper status ¹².   Lower limits are recommended for younger groups.

Zinc Supplementation

A 2024 Cochrane review ¹³ based on 34 randomised controlled trials in children and adults (15 prevention, 19 treatment) showed that compared with placebo, taking zinc preventatively may make little to no difference to whether a person catches a cold or to the duration or severity of the cold.   Taking zinc for treatment of an existing cold may reduce the duration but the authors were not confident of the quality of the result which they describe as low to very low.

The most common negative sides effects were irregularities in taste and stomach upset.  A recent review however supports a preventive role of zinc supplementation in reducing the incidence and burden of respiratory infections, particularly in children with recurrent disease and in zinc-deficient populations ¹⁴.

This article was published in March 2020 and updated on March 31, 2026.

The innate immune system is the body’s first line of defence.  When pathogens like infectious bacteria or viruses get into the respiratory tract or gastrointestinal system, the innate immune system responds by sending cells like neutrophils or macrophages to remove the threat.  These cells try to engulf the invading pathogen or create enzymes to destroy it.

The adaptive immune system specifically targets the pathogen and takes over from the innate immune system. It is often described as the ‘memory’ of the immune system.  Once exposed to a pathogen, the immune system can remember the identity of that pathogen for the future and quickly mount a defence specific to that pathogen.

Vitamin C promotes barrier function, supports the function of neutrophils, monocytes, and macrophages and the activity of NK cells.  It also has a role in the differentiation and function of T cells, especially cytotoxic T cells and in antibody production ¹.  This role has been recognised in an approved European Union health claim for vitamin C, stating that it “contributes to the normal function of the immune system” and is available to foods subject to condition within the EU ³.

Recommended Intakes

Global daily vitamin C intake recommendations range from 40 to 110 milligrams per day, depending on region ⁴.  In the US, the Institute of Medicine’s (IoM) recommendations are 90mg per day for men and 75mg per day for women  ⁵.  In the EU, the European Food Safety Authority has established a Population Reference Intake of 110mg per day for adult men and 95mg per day for adult women ⁶.  Similarly, the Chinese Nutrition Society Reference Nutrient intake is 100mg per day for adult men and women ⁷.

Dietary Sources

Vitamin C can be found in many fruits and vegetables, such as kiwis, oranges, peppers and broccoli.  The table below shows amounts of vitamin C found in commonly consumed foods.

Source: National Institutes of Health Vitamin C Fact Sheet for Health Professionals ⁸

Deficiency

About 53% of the global population have an inadequate intake of vitamin C ⁹, but the exact number varies depending on global region.  Inadequate intakes were more prevalent in men than women and in areas like South Asia.

Scurvy is a nutritional disorder caused by low vitamin C levels which manifests with varied symptoms affecting multiple organ system due to its role in connective tissue synthesis.  Although it is rarely seen, sporadic cases still occur.  In developed countries, it is mainly diagnosed in the elderly and malnourished individuals and is associated with alcoholism and poor dietary habit s¹⁰.

People who smoke or are exposed to second-hand smoke need more vitamin C in their diets because smoke increases the amount of vitamin C that the body needs to repair damage caused by free radicals ⁵.

Excess Intakes

In general, vitamin C has low toxicity, and high intakes of vitamin C do not cause serious adverse effects.  However, high doses of vitamin C can lead to diarrhoea, nausea, abdominal cramps, and other gastrointestinal disturbances ⁵.

There are some concerns surrounding high vitamin C intakes, such as the formation of kidney stones and excess iron absorption, but these are not generally considered a risk in healthy individuals. While EFSA did not establish an upper limit, the IoM Tolerable Upper Intake Level for vitamin C ranges from 400 to 2,000mg per day, depending on age ⁵.

Vitamin C Supplementation

There is some evidence that vitamin C doses exceeding recommended daily values could have potential benefit.  A Cochrane review ¹¹ of clinical trials testing vitamin C’s effect on immune health found that regular supplementation (>200mg per day) did not influence how often participants got common colds but reduced the duration of cold symptoms.  A recent meta-analysis ¹² of trials which used doses of Vitamin C above 1g per day found a greater benefit on more severe measures of the common cold.

Severe Acute Respiratory Syndrome Coronavirus 2 , which is a respiratory condition, is marked by significant oxidative stress and an excessive inflammatory response that results in tissue damage of the respiratory system.  For this reason, there has been interest in combining antioxidants like vitamin C with antiviral and anti-inflammatory treatments to improve patient outcomes.  However, a recent review ¹³ suggests that further trials are necessary to determine optimal doses and conditions of use.

This article was first published in May 2022 and updated on March 24, 2026.

• • maintaining the integrity of skin and mucosal barriers that protect from pathogen invasion.
  • supporting the innate (general) immune system (e.g. regulating Natural Killer (NK) cell production, supporting phagocytic activity of macrophages).
  • supporting the adaptive (specialised) immune system (e.g. development and differentiation of Th1 and Th2 cells which direct the destruction of invading cells, B cell mediated antibody responses to antigen) ^{1, 2}.

There is an approved European Commission health claim for vitamin A, stating that it “contributes to the normal function of the immune system”, and is available to foods that meet defined criteria within the EU ³.

Recommended Intakes

Vitamin A recommendations for adults vary by region:

• • China: the Chinese Nutrition Society Reference Nutrient intake (RNI) is 660mg per day for adult women and 770mg per day for adult men up to 50 years ⁴.
  • Europe: the European Food Safety Authority (EFSA) population reference daily intakes (PRI) are 650 micrograms for women and 750 micrograms for men ⁵.
  • United States: the Institute of Medicine (IOM) recommended dietary allowance (RDA) is 700 micrograms per day for women and 900 micrograms per day for men ⁶.

Dietary Sources

Vitamin A in the diet comes from two sources: preformed vitamin A (retinol and retinyl esters) and provitamin A (carotenoids).  Preformed vitamin A is found in foods from animal sources, while provitamin A  are plant pigments that include beta-carotene, alpha-carotene, and beta-cryptoxanthin.  These provitamin A carotenoids are converted into vitamin A in the body, although conversion efficiency shows considerable variation and is influenced by the food source, an individual’s vitamin A levels, and the amount eaten ⁷.

Preformed Vitamin A or retinol is found in animal products mainly including liver, fish and eggs while provitamin A sources are generally found in colourful vegetables like carrots, sweet potato and peppers (See Table 1).

Some countries such as the US routinely add vitamin A to milk and margarine while some ready-to-eat cereals are also voluntarily fortified with vitamin A.  For this reason, it is important to use local information when calculating dietary intakes.

In Western diets, retinol accounts for nearly 65% of total vitamin A intake with carotenoids making up 35% of the total ⁸ but the contribution of carotenoids is higher in countries such as Southeast Asia and Africa where it can make up to 80% of the vitamin A intake ⁹.  Recent data shows that in China, vegetables are the greatest contributor to total vitamin A intakes ¹⁰.

Table 1. Food sources of Dietary Vitamin A ⁷

Deficiency

Vitamin A deficiency is a public health problem in more than half of all countries especially those in Africa and South-East Asia ¹¹.  The most severe effects of vitamin A deficiency are seen in young children and pregnant women in low-income countries, ranging from preventable blindness to a weakened ability to fight infections.  Vitamin A deficiency is a double‑edged cycle in which illnesses like diarrhoea and measles further deplete vitamin A levels in the body.

In areas of deficiency, routine vitamin A supplementation is recommended in infants and children up to 5 years of age ¹².  Other strategies include dietary based approaches, biofortification, and food fortification.  Even in developed countries, the importance of vitamin A in the very young is recognised, e.g. it is recommended that children in the UK aged 6 months to 5 years take a vitamin supplement containing vitamins A, C and D every day ¹³.

Excess Intakes

As vitamin A is fat-soluble, it can be stored in the body, particularly the liver and excessive intakes can cause harm.  The US IOM set an upper limit of 3,000mg per day of pre-formed vitamin A for adult men and women including pregnant adults ⁴.  The EFSA have set the same upper limit for adults including women of child-bearing age, pregnant and lactating women and post-menopausal women.  Lower limits are recommended for younger groups ¹⁴.

In terms of the provitamin, beta-carotene, there is no indication that intakes from dietary sources are linked to adverse health effects.  However, smokers have been recommended to avoid consuming food supplements containing beta-carotene, and their use by the general population should be limited to the purpose of meeting vitamin A requirements ¹⁴.

Vitamin A Supplementation

Vitamin A deficiency affects not only the growth and development of children but also increases susceptibility to infectious diseases including respiratory and gastrointestinal infections ⁸.

Across Asia, India and Africa, vitamin A supplementation has been associated with a lower incidence of diarrhoea and measles among children (low quality evidence) while all-cause mortality was also reduced with supplementation (high quality evidence) ¹⁵.

A 2024 Cochrane review showed that vitamin A supplementation did not prevent or reduce the duration of acute upper respiratory infections (URTIs) in children up to seven years of age in low to middle income countries ¹⁶.  However, this was based on a limited number of studies and more research is needed.

Anyone with a teenager is no stranger to the wave of curious trends that frequently emerge from social media, many of which revolve around the term ‘maxxing’.  However, the latest term ‘fibremaxxing’ has caught the attention of social media followers and the food and nutrition community alike.

Protein has been such a huge trend that it has been difficult for other nutrients to get attention.  But the world of social media moves quickly and within the last year there has been a wave of ‘fibremaxxing’ clips flooding social platforms, with influencers of all ages sharing their favourite ways to boost daily fibre intake.

As ever, these clips range from the sensible and inspiring through to the more extreme.  Some engage in a type of ‘gamifying’ of fibre to ‘max out’ with the message becoming more about the game than health.  But at its core, the message about fibre is grounded in evidence linking higher intakes to reduced risk of cardiovascular disease and several cancers^1,2, especially colorectal cancer, as well as type 2 diabetes³.

The Good and Not-So-Good of ‘Fibremaxxing’

Table 1 summarises the pros and cons of ‘Fibremaxxing’.  There is a significant gap between fibre recommendations and actual intakes in most western countries so any focus on increasing fibre through cereal-based wholegrain foods, fruit and vegetables, pulses, legumes, nuts, and seeds, is to be welcomed.  However, if fibre intake is low, increasing consumption is best done gradually to avoid issues like bloating, cramping, constipation or diarrhoea.

Table 1.  ‘Fibremaxxing’ Pros and Cons

Many types of insoluble fibre also bind water in the large intestine and an increase in fluid intake is needed for the fibre to do its work properly.  Where dietitians and/or nutritionists have weighed in on this social media trend, these caveats are highlighted.

Counting fibre intake may initially help consumers identify their own fibre gap but this is best used short-term until healthy choices and habits become embedded.  Getting caught up in obsessive tracking of fibre intake rather than enjoying a balanced diet is not the goal.

On the positive side, many ‘fibremaxxing’ posts are useful in calling out the benefits of fibre beyond ‘keeping you regular’.  Previous research has shown that if individuals are regular in their bowel habits, they don’t feel the need to worry about fibre intake⁴, so it is important to clarify that regularity alone shouldn’t be the only goal.  Inspiring social media posts that include tasty high fibre recipes can also help dispel the myth of fibre as ‘bland and boring’.

Some ‘maxxers’ attempt to ‘fix’ their fibre gap with the use of supplements.  While supplements have their place, particularly if constipation is the issue⁵, the benefits observed from prospective cohort studies are based on consuming a diverse range of dietary fibres.

The good news is that ‘Fibremaxxing 2.0’ is on its way in 2026, according to Mintel, with consumers shifting from simply maximising intake to consuming a variety of fibres⁶.  This is a positive progression of the trend, reflecting the science which shows that a diversity of sources is likely to be of most benefit.

How Much Fibre is Enough?

Fibre recommendations vary around the world but in general adults should aim for between 25-30g per day^3,7,8, with fibre intakes for children and younger teens being lower and in proportion to their energy intakes.  The US daily fibre recommendations from the Dietary Guidelines for Americans 2020-2025 are 22–28g for adult women and 28–34g for adult men, varying by age⁷.

Both the World Health Organisation³ and European Food Safety Authority (EFSA)⁸ recommend a minimum of 25g per day for adults based on normal laxation rather than a wider range of health benefits.  In South Africa and India, recommended fibre intake ranges can be as high as 38-40g per day⁹.  But conversations about “optimal” fibre intakes shouldn’t distract from the bigger issue: that most people aren’t getting enough in the first place and this needs to be addressed (Figure 1).

Figure 1.  A fibre gap exists in many countries^7,10-17

Diversity of Dietary Fibres

With its focus on a single fibre target, dietary recommendations may suggest that it is all about quantity, but the term dietary fibre covers a wide range of complex structures with different mechanisms of action.  Fibres that are poorly fermentable, e.g. wheat bran fibre, help to decrease transit time in the gut promoting good bowel function¹⁸.

Fibres that are more fermentable act as a food source for the gut microbiota and produce metabolites which can be beneficial to health, e.g. short-chain fatty acids.  Some fibres exert health benefits even before reaching the large intestine by slowing down the absorption of glucose¹⁹.

Emerging research shows that even small differences in the structure of the same fibre can create very different metabolic “fingerprints” in the gut²⁰, which could one day help target health benefits, with more precise recommendations for different types of fibre.  But for now, the smartest approach is simply to eat a wide variety of fibre containing foods²¹.

Harnessing the ‘Fibremaxxing’ Movement

Fibre Innovation for Food Industry

• • Look at the overall nutritional profile when considering fibre fortification.  With increasing nutrition literacy, consumers are savvy about products that offer a ‘health halo’ and question the levels of other less favourable nutrients including added sugars, saturated fat, and salt.  Manufacturers aiming to make fibre claims should therefore also assess whether reformulation of other nutrients including saturated fat, sugars and/or salt is needed and/or address portion size offerings.
  • Fibre can be leveraged to replace sugar or fat or to improve structure in gluten-free products and at 2 kcal/g (values may vary according to local regulations) it can contribute to a reduced energy value when replacing carbohydrates (4 kcal/g) or fat (9 kcal/g).
  • Consider ‘upcycled’ sources of fibre that help reduce food waste, e.g. brewer’s grain.  Any additional reasons to enrich with fibre, such as an improved environmental footprint or offering technical functions could offer an alternative way to justify any costs associated with fibre enrichment.
  • Consider tolerance and format. Isolated dietary fibres are tolerated differently and have been well described²².  Tolerance can also depend on the food format – whether the fibre is delivered in a drink, a solid food, or within a particular matrix – so consumer trials are often essential.  Manufacturers face a real balancing act: adding a smaller, well-tolerated amount of fibre may only achieve a “source of fibre” claim, while adding enough to reach a “high in fibre” claim may risk digestive discomfort and reduce repeat purchase.  In many cases, combining different fibres may offer a better solution by improving both tolerance and functionality.  Clear communication of recommended serving sizes is also key to managing expectations and supporting a positive consumer experience.
  • Check for any allergen considerations, e.g. wheat derived fibre.

Recommendations for Healthcare Professionals

• • Fibre has been waiting a long time for its moment, and as interest in ‘Fibremaxxing’ grows, the responses from healthcare professionals need to be positive and constructive rather than focused on dismissing influencers – though some of the more extreme claims will inevitably need correction.  When a patient is active on social media and their healthcare provider isn’t, recommending reputable suitably qualified dietitians or nutritionists online becomes especially important.
  • Equally, it is worth bearing in mind that newer patients who are coming through with digestive complaints may well have been overdoing this trend and therefore worth exploring any recent changes in their diet.
  • There is also a need for more effective public health messaging that offers clearer, more actionable guidance on the frequency, quantity, and quality of fibre-rich foods.  For example, Australian researchers²³ found that consumers responded better to specific recommendations – such as “consume legumes once per day” and “eat more than half of your grain foods from whole grain choices” versus more vague statements.  The recent 2026 US Dietary Guidelines for Americans recommends prioritising fibre-rich whole grains (2 – 4 servings per day)²⁴.

In Summary

‘Fibremaxxing’ may have emerged from yet another social media trend, but its value should not be ignored as it represents a long-overdue shift toward recognising the essential role fibre plays in long-term health.

The excitement surrounding high-fibre recipes and inspiring food swaps can be a powerful driver of dietary change, but the trend works best when twinned with evidence-based guidance, gradual increases in intake, and a focus on fibre variety.

For consumers, this moment offers an opportunity to rethink what fibre looks like in everyday eating – not as a bland add-on, but as a naturally rich element of wholegrains, legumes, nuts and seeds, fruits, vegetables, that can support health far beyond regularity.

For industry and healthcare professionals, it is a reminder that meeting people where they are, with clear messaging and products that prioritise both nutrition and enjoyment, will be key to closing the persistent fibre gap.

If the ‘Fibremaxxing’ trend continues to evolve towards a more balanced perspective, rather than extremes and quick wins – it has the potential to do what few nutrition fads achieve: create meaningful, sustainable improvements in public health.

Disclaimer: This article should not be considered as medical advice.  For personalised health guidance, consult a qualified healthcare professional.

In the past number of years, consumer demand for natural, plant-based ingredients to support health has surged, a trend amplified by public health events such as the global COVID-19 pandemic.  During these periods, elderberry became a leading ingredient in the immune-support supplement category, with consumers seeking natural alternatives to support respiratory health ³.

This success in the supplement sector has since resulted in its expansion into the broader functional food and beverage industry ⁴.  Elderberry extracts are now increasingly incorporated into products such as flavoured beverages, snack bars, yogurts, and wines ^5-7, valued not only for their potential health benefits but also for their unique flavour profile and natural colouring capabilities.

Key Varietals

For the food and nutraceutical industries, three subspecies of Sambucus nigra L. are of primary interest:

• • • Sambucus nigra ssp. nigra (European Elderberry): Native to Europe, North Africa, and parts of Asia, this is the most extensively studied and commercially cultivated subspecies.
    • Sambucus nigra ssp. canadensis (American Elderberry): Native to a large portion of North America, this subspecies is gaining significant commercial attention because it may confer greater stability during processing compared with its European counterpart.
    • Sambucus nigra ssp. cerulea (Blue Elderberry): Native to western North America, this subspecies is distinguished by its ecological resilience, including notable drought and fire resistance, making it a sustainable crop option in challenging climates.

The foundational nutritional value of elderberry provides a complex matrix of proteins, lipids, and fibre ².  A thorough understanding of the nutritional and phytochemical composition of elderberry is essential for its effective application as a functional ingredient.  The distribution of these compounds varies significantly across different parts of the plant.

The Phytochemical Matrix

Not only are elderberries good sources of vitamins and minerals, but they also have an extensive and complex phytochemical composition ^4,8.  Phytochemicals form the cornerstone of elderberry bioactivities, responsible for its antioxidant properties, vibrant colour, and many of its health benefits.  The concentration and profile of these compounds vary dramatically depending on the elderberry subspecies, plant part, and growing conditions ^2,4.  The types of phytochemicals found in elderberries include flavonoids, anthocyanins, and carotenoids among others.

Anthocyanins, Flavonols, and Other Flavonoids
Anthocyanins are responsible for the characteristic deep purple-black colour of elderberries and are central to their market identity as an immune-supporting ingredient ^1,2.  Quantitative analysis reveals significant variation among subspecies where the European Elderberry contains the highest levels of anthocyanins, followed by the American Elderberry, whereas Blue Elderberry has the lowest anthocyanin content.  A noteworthy distinction of the American Elderberry is its high concentration of acylated anthocyanins, which can enhance pigment stability against degradation from heat and light, a highly desirable trait for food and beverage applications.

Beyond anthocyanins, elderberry is a rich source of other flavonoids, particularly flavonols, which contribute significantly to its overall antioxidant and anti-inflammatory capacity.  The flowers and leaves are often more concentrated sources of these compounds than the berries.

Carotenoids and Tocopherols
Elderberries are also rich in carotenoids and tocopherols, with a distribution that is highly specific to the plant part.  Berries are an exceptionally potent source of the carotenoids Lutein and Zeaxanthin, which are recognised for their role in eye health.  In contrast, the leaves are the exclusive source of other powerful antioxidant carotenoids, Astaxanthin and Canthaxanthin.  Furthermore, leaves are the primary reservoir of α-tocopherol, the most biologically active form of vitamin E.  Regional variations are also pronounced, with studies showing that samples from southern climates may accumulate higher levels of tocopherols.

Bioactivity and Health Benefits 

The rich and diverse phytochemical profile of the elderberry translates into a broad spectrum of potential bioactivities ^1-5.  Figure 1 outlines the potential benefits of Elderberries and the way in which these are mediated through bioactive compounds have been proposed ⁹.

Figure 1. Proposed Potential Health Benefits of Elderberry ⁹.

Potential Antioxidant Activity
A foundational mechanism underpinning many of the elderberry health benefits is its potent antioxidant capacity ^1,10.  The antioxidant effects are multifaceted including mechanisms such as direct free-radical scavenging and metal chelation, which position elderberry as a potential effective natural antioxidant ingredient.  Extracts from the flowers, berries, and leaves all demonstrate significant ability to neutralise harmful free radicals and mitigate oxidative stress, which is a key driver of ageing and chronic disease.

Anti-Inflammatory and Immunomodulatory Effects
The most well-known and commercially significant application of elderberry is for immune support, particularly in the context of respiratory health ³.  Its efficacy is rooted in anti-inflammatory and immunomodulatory activities.  Elderberry extracts have been shown to modulate the immune response by inhibiting the production of pro-inflammatory mediators.  This action helps to balance the immune response, preventing excessive inflammation that can cause tissue damage during an infection ^10,11.

Neuroprotective Properties
An emerging area of research is the neuroprotective potential of elderberry.  The bioactive compounds in elderberry can cross the blood-brain barrier and exert protective effects directly within the central nervous system ⁵.  In vitro and in vivo studies have shown that elderberry extracts and their constituent polyphenols can protect neuronal cells from oxidative damage, reduce neuroinflammation, and improve cognitive and motor function in animal models.

Application in Functional Foods and Beverages

The application of elderberry is twofold: as a natural additive for colour and preservation, and as a core functional ingredient to deliver potential health benefits ².

Elderberry as a Natural Additive: Colour and Preservation
In response to strong consumer demand for “clean-label” products, elderberry serves as an excellent natural alternative to synthetic additives.  The final colour is pH-dependent, exhibiting red shades in acidic environments (e.g., yogurts, fruit beverages) and shifting towards blue and purple in more neutral or alkaline conditions ^5,12.

Beyond colour, elderberry’s potential antioxidant properties make it a valuable natural preservative.  By inhibiting lipid and protein oxidation, elderberry extracts may extend the shelf-life and maintain the quality of perishable foods.  This has been demonstrated effectively in meat products, where encapsulated elderberry extract was shown to significantly delay the oxidative processes that lead to rancidity and discolouration in beef burgers ¹³.

Formulation with Elderberry as a Functional Ingredient
The primary driver for incorporating elderberry into food products is its status as a functional ingredient, capable of imparting health benefits beyond basic nutrition ¹⁴.  Its versatility allows for its use in a wide range of food matrices.

In the dairy sector, elderberry has been successfully incorporated into products such as yogurt and kefir ^15,16.  Studies have shown that the addition of elderberry juice, puree, or pomace powder increases the product’s total phenolic and anthocyanin content, thereby boosting its antioxidant capacity.  However, formulation requires careful consideration of texture; direct addition of juice can decrease viscosity, while using restructured or encapsulated forms can maintain or even improve consistency and has been shown to lead to higher consumer acceptance.  The stability of the bioactive compounds is also a key factor, with evidence showing that elderberry anthocyanins can remain stable during the shelf-life of yogurt ¹⁵, particularly when protected within a restructured matrix.

In bakery applications, elderberry adds both functional and nutritional value ¹⁷.  The incorporation of elderberry powder into gluten-free wafers has been shown to increase the final product’s flavonoid and mineral content while also improving batter properties by reducing delamination ¹⁸.  Similarly, adding elderberry juice to croissants or fermented elderberry to bread enhances their antioxidant capacity and bioactive compound content without negatively impacting nutritional quality.  Fermentation has been shown to enhance the bioactivity of the elderberry before its incorporation, leading to a final product with a higher phenolic content and an extended shelf-life.

The meat industry represents a significant opportunity for elderberry application.  Due to the high susceptibility of meat to oxidative degradation, the antioxidant properties of elderberry are particularly valuable.  A study on beef burgers demonstrated that an encapsulated elderberry extract acted as a highly effective “meat extender,” significantly delaying both lipid and protein oxidation more effectively than synthetic antioxidants during refrigerated storage ¹³.  This not only extends shelf-life but also adds a health-promoting, clean-label ingredient to the product.

Another novel application is the use of elderberry vinegar as a marinade or spray for grilled meats, which has been shown to inhibit the formation of harmful polycyclic aromatic hydrocarbons by over 80% ¹⁹.

A central challenge in utilising elderberry is the need for thermal treatment to ensure safety conflicts with the desire to preserve heat-sensitive bioactive compounds.  Raw elderberries should not be consumed because certain parts contain cyanogenic glycosides (CNGs) ², which must be degraded through heating to render the product safe for consumption.  Therefore, it is critical that elderberry products intended for consumption must undergo a heating step.

Considerations
As consumer interest in more natural, proactive health products continues to grow, science-backed, botanical ingredients, such as elderberry, have an opportunity to take a further foothold in the health and wellbeing market.  While future studies are needed to further confirm the efficacy of elderberries and how they mediate immune benefits, the research has shown that, at a minimum, elderberry is a safe option with the botanical showing no evidence of over stimulating the immune system.

The functional potential of an elderberry ingredient is not uniform. Factors such as climate, soil type, and genotype directly influence the concentration of key bioactive compounds.  Therefore, sourcing elderberry cannot be a simple commodity-based decision. It requires a strategic approach that aligns the specific phytochemical profile of a given source with the desired health benefit and final product application, moving beyond a generic “elderberry extract” to a precisely characterised, high-performance functional ingredient.

Vitamin B12 is a water-soluble vitamin, also known as cobalamin, this cannot be made in the body and needs to be ingested through food, supplements, or medication. It is essential for red blood cell formulation, keeping your nerve and brain function healthy, production of DNA, and maintaining cell metabolism.

Vitamin B12 is absorbed by the stomach with the help of a protein named intrinsic factor which is a glycoprotein, this protein substance binds to the B12 molecule and aids in the red blood cells absorbing it. Excess B12 can be stored in the liver for future use or excreted through urine.

With more consumers choosing plant based diets or veganism, meeting essential B12 requirements can sometimes be challenging. Unlike many essential vitamins that can be readily sourced from plants, Vitamin B12 is primarily found in animal products, making it difficult for vegans and vegetarians to obtain adequate amounts of through their diet alone. Understanding the role of Vitamin B12 in the body is crucial for maintaining optimal health and wellness.

How much Vitamin B12 do we need and where do we find it?

The Recommended Daily Intake (RDI) of Vitamin B12 is 2.4 micrograms daily for adults and children over the age of 4 years old. Those who are vegetarians, vegans, pregnant and breastfeeding may need to increase their intake slightly or could run the risk of deficiency. Older adults, those with intestinal issues, those who are Pregnant and Breastfeeding, Infants of Vegan and Vegetarian mother’s, Vegetarians and Vegans are all at higher risk for developing a deficiency in B12. It was also reported that 1 in 10 adults over 75 years, and 1 in 20 adults aged between 65-74 years had a deficiency of Vitamin B12.

B12 can naturally be found in foods of animal origin such as meat, fish, eggs and dairy products, specific examples include animal liver and kidneys, beef, tuna, salmon, broccoli, peas, and brussels sprouts. It can also be added to fortified nutritional yeasts and fortified breakfast cereals. In cases of Vitamin B12 deficiency, it can also administered in the form of supplements and injections.

What happens if we do not have enough Vitamin B12 in our diets?

Insufficient intake of Vitamin B12 can lead to deficiency. This can occur when Vitamin B12 levels in the blood drop, resulting in metabolic abnormalities. These abnormalities lead to the onset of physical and psychological symptoms, such as as nausea, constipation, diarrhoea, metal health issues, low red and white blood cell count, deterioration in walking, vision impairment, and fatigue. The long-term symptoms of include, pernicious or macrocytic anemia, heart conditions, temporary infertility, and issues with the nervous system. If untreated, this can then result in the development of pernicious or macrocytic anemia.

Pernicious anemia is when the immune system attacks the healthy cells within the stomach which results in a lack of absorption of Vitamin B12 in the body. Macrocytic anemia is when the body produces abnormally large blood cells that lack the required nutrients and do not function as they should. Vitamin B12 deficiencies are treated by taking supplements or Vitamin B12 injections (hydroxocobalamin) depending on GP advice and the severity of your deficiency. Supplements/injections may be required long-term if symptoms persist. However, a beneficial start to improving Vitamin B12 levels in the body is to consume a high about of Vitamin B12 rich foods.

The preventative steps we can take to avoid a Vitamin B12 deficiency is to consume foods rich in B12, as listed above. Additionally, a deficiency in Vitamin B12 may not always be due to an inadequate dietary consumption of foods containing B12, it is possibly due to the lack of the intrinsic factor, this is most common among older adults which is associated with an autoimmune disease called pernicious anemia.

How Does Vitamin B12 interact with other Vitamins?

It should be noted that taking Vitamin C in close proximity to Vitamin B12 foods/supplements should be taken with caution as Vitamin C can reduce the amount of B12 in the body, therefore spacing out the consumption of both vitamins is recommended.

Vitamin B12 and Folate (B9) work together to produce a compound that aids in immune functionality, and red blood cell formulation. Therefore, consuming a balanced amount of foods containing B12 and Folate is beneficial for the overall health. It should also be noted that consuming over 1mg of folic acid daily can mask the symptoms of a Vitamin B12 deficiency.

Vitamin B12 Production Process and Sustainability:

For those who can’t get enough Vitamin B12 through their diet, supplementing B12 may be necessary. Supplemental Vitamin B12 is produced commercially through a bacterial fermentation process, taking up to two weeks from beginning to final product. It is one of the most complex vitamins to produce beginning with bacteria growing in large vats holding over 100,000 liters, this amount still only produces a small yield of final product. It is not a sustainable process and can be harmful to the environment as it traditionally uses cobalt and cyanide, and the harmful and hazardous surplus is expensive to be disposed of to ensure environmental health measures are not affected.

Research from the University of Kent took place in 2023 to develop a sustainable manufacturing process for Vitamin B12. The team manufactured a strain of E-coli that contains a smaller amount of cobalt that is then absorbed during the production process and there is no surplus cobalt left to be disposed of, therefore it is not a high health or environmental risk and is less of an expense. This is a step in the right direction and is a template that other bacterial processes could benefit from and become more sustainable in the future.

Vitamin B12 plays a vital role in the functionality of a healthy body. Ensuring a holistic diet to include certain meats, dairy products, fish, and certain vegetables will help reduce the risks that come with its deficiency. Increasing the availability of knowledge surrounding the importance of Vitamin B12 and its sources would advocate for a better understanding among individuals. This in turn will reduce the risks associated with lower consumption of this vital vitamin. Additionally, looking towards the future of supplemental B12 production, a long-term plan to formulate a universal sustainable production process of Vitamin B12 would reduce the harmful environmental impact and costs all while benefitting those with a deficiency.

What is Mindful Drinking?

A perspective by Derek Brown; author, wellness coach, bartender and founder of Positive Damage.

The holidays can be joyful and connect us with loved ones. But it’s also a time where the alcohol flows freely, from feasting with family to toasting the year’s end. In fact, it’s hard to imagine the holiday season without a glass of eggnog or Champagne. But what is tradition––and part of our celebrations––can lead to drinking out of habit, conformity, and peer pressure. And, sometimes, it can lead to drinking much more than you intended.

However, more and more, the scientific consensus is that little to no alcohol is the best approach to health and that previous studies suggesting alcohol could have a positive effect on health––especially the French Paradox that suggested wine had protective factors against cardiovascular disease––were biased or neglected to consider certain factors such as “sick quitters,” which are participants that quit alcohol for health reasons. Some governments, such as Canada, have gone so far as saying there is no amount of alcohol that is healthy.

Whether you drink or not, there remains a need to be social and have complex adult-sophisticated beverages. It can feel isolating and frustrating if you don’t drink or are drinking less than everyone else. And social wellness is an important aspect of our health––we should spend time with our friends and family. On top of that, alcohol is often a part of our cultural foodways. It doesn’t just connect us to our family and friends, it connects us to where we’re from and our past.

With alcohol playing such an important role in our lives and culture, it’s hard to ignore it. But also with all of the health implications, it’s important to be deliberate in the way that we drink (or don’t drink) alcohol.

The solution to this is mindful drinking.

Mindful drinking is a self-led strategy to drink (or not drink) in a way that supports your goals, health or otherwise. This self-directed approach is really just drinking with intention. With mindful drinking, you can choose not to drink alcohol, to drink some alcohol, or even substitute alcohol with delicious no- and low-alcohol beers, wines, and cocktails. It’s about making choices that support your goals. And those choices are getting better all the time.

Where does Mindful Drinking Come From?

There have been a number of different phrases to express reducing or eliminating alcohol in the past decade such as “sober curious” and “sober-ish.” Books like “Mindful Drinking: How Cutting Down Can Change Your Life” by Rosamund Dean and “Sober Curious: The Blissful Sleep, Greater Focus, Limitless Presence, and Deep Connection Awaiting Us All on the Other Side of Alcohol” by Ruby Warrington have inaugurated a movement to drink more mindfully. There are also newly emerging terms such as “tempo drinking” and “flex drinking,” which indicate when someone is switching back and forth between no- and low-alcohol drinks based on the occasion. All of these fall under the category of mindful drinking.

Mindful drinking may be a trend but it also has roots in traditional wisdom and foundational religious texts. In the 19th century, there was a movement to reduce the way we drink called Temperance that found a stronghold in the United States and was eventually hijacked by zealots, leading to the Prohibition of the sale and transportation of alcohol in the United States between the years 1919 and 1933. However, mindful drinking in its more contemporary form is more about individual consumption and less about governmental policy, culture, or religion. Anyone can adopt mindful drinking and set the rules for themselves.

Try Dry January

January is a great time to start drinking mindfully. During Dry January, people generally take a break from alcohol for the entire month. Although some may choose to practice “Damp” or “Dryish January,” drinking less alcohol than they normally might. Either approach can help you explore your own drinking habits during a time when other people are doing the same. There are even some studies that suggest the effects of Dry January can be seen for months after.

The important thing to remember is that you set the rules. Therefore, drinking in a way that meets your goal is a higher priority than purity or perfection. You can break the rules for one night if a friend is in town or decide you’re going to only reduce alcohol on the weekends. This is not to say you shouldn’t give it a sincere try, but that black or white thinking may even be a hindrance to achieving the month’s goal.

Incorporating Non-Alcoholic Beverages

One of the best ways to achieve your goals around mindful drinking is by substituting delicious no- and low-alcohol drinks, including non-alcoholic beers, wines, spirits, and cocktails. This has even been shown to reduce the amount of alcohol people drink in a recent Japanese study. Instead of concentrating on what you aren’t drinking, focus instead on trying new things. And no- and low-alcohol products are not just growing but also getting better.

At one point in time, non-alcoholic beverages were relegated to syrupy sweet mocktails and bad tasting non-alcoholic brews. However, over the past few years we’ve seen a tremendous growth in both the number and quality of non-alcoholic beverages. Perhaps one of the largest growth areas has been non-alcoholic beer. However, non-alcoholic wine and spirits are also growing, too. Then there are the cocktails, which range from ready-to-drink cocktails to cocktails made on the spot using fresh ingredients.

Making Non-Alcoholic Cocktails

In my book, “Mindful Mixology: A Comprehensive Guide to No- and Low-Alcohol Cocktails,” I outlined four sensory characteristics that make great non-alcoholic cocktails. Really, these characteristics are what distinguish a non-alcoholic cocktail from other non-alcoholic beverages like ice tea.

I came up with the sensory characteristics after thinking about cocktails like the Tom Collins. The only thing that distinguishes a Tom Collins from lemonade is the gin. What characteristics does the gin add besides gin’s unique flavors?

Intensity of Flavor

Alcohol has an intense flavor itself but it’s also a great solvent. Therefore alcoholic drinks from flavored vodka to Bourbon include strong flavors from additives such as extracts or barrel aging. Using strong flavors in non-alcoholic drinks can help to mimic this sensory characteristic. This might include over-steeping tea or packing in more spices and herbs.

Piquancy

Piquancy is that burn you get from the alcohol itself. Another way to say this is stopping power––cocktails contain some element we don’t usually enjoy drinking by itself. And, though it may seem counterintuitive, this is what makes cocktails so delightful. Ideally, it slows us down and makes us sip the drink slower and more thoughtfully. For non-alcoholic cocktails that element can include bitter, sour, or spice. Think gentian (a bitter root used in bitters) or capsicum (spicy peppers).

Texture

Cocktails are also richer than juice or tea. They carry more weight and mouthfeel. This is partly from syrups and juice but also from the alcohol. To get a similar mouthfeel with non-alcoholic cocktails, you might use salt tincture or aquafaba (chickpea water). You can also use fresh juices that are high in pectin.

Length 

Lastly, there is length or volume, which is the amount of liquid that is not from juice or sugar. In a cocktail with alcohol, this is usually the spirit. There are a number of things to use in place but also non-alcoholic spirits are a great way to replicate the flavor profiles of classic spirits such as Gin, Bourbon, and Tequila.

Ultimately it’s not just the taste but the ritual, too. It’s fun to make non-alcoholic cocktails and you can substitute them on occasion whether it’s Dry January or just because you have a big meeting the next day.

No matter how we choose to drink, mindful drinking can be there to help make your choices more intentional. We can’t always, and likely shouldn’t, avoid our friends and family when alcohol is present. And we can’t always avoid the pressure to drink alcohol. But we can be deliberate and choose to substitute non-alcoholic beverages when the occasion calls for it.

The importance of hydration lies in its role in allowing the body to perform our internal processes effectively and efficiently. Water is involved in a number of essential functions in the body. For example, it helps maintain our body temperature and acts as a primary material for our cells (the building blocks of our bodies). This means that staying hydrated is essential for our bodies to do their job to ensure that we can keep ourselves going. ⁽¹⁾

The function of water in the human body

As mentioned, water plays an important role in the body. It maintains our body temperature, helps transport signals to our brain, flushes out waste and helps deliver vital oxygen around the body. This, along with many other actions, is why water plays such a big part in our everyday lives.

Up to 60% of the human body is composed of water. This water is shared between our different organs (most organs contain up to 70% water). The brain and kidneys contain the highest percentage of water compared to other organs within the body. By ensuring that we are hydrated we can assist with the function of these vital organs. ⁽²⁾

The composition of water in our bodies changes with age. Research shows that the bodies of older people consist of approximately 55% water, whereas the water composition of infants lies at about 75%. ⁽³⁾ As we age, the decrease in fluid composition of our bodies can cause issues such as urinary tract infections and constipation. Older people may be less aware that they aren’t getting enough fluids, and this can exacerbate issues with hypohydration, which we will explain in the following section.

Dehydration vs. Hypohydration

Simply put, dehydration is the process of losing water, whilst hypohydration is the end result, when we are in a water deficit. ⁽⁴⁾ This means that our bodies are losing more fluids than we are taking in. The signs of hypohydration are more noticeable than the signs of other nutrient deficiencies. Hypohydration is the uncompensated loss of water from our bodies, and this is when we begin to notice signs that we need to replenish our fluids by drinking liquids. For example, many of us have noticed a dry mouth, the feeling of thirst, the change in the colour of urine. These are signs of hypohydration and these are clear signals our body is giving us to rehydrate ourselves. We should listen to these messages carefully.

Hypohydration’s impact on focus, mood, and memory

Even mildly hypohydrated individuals (1-2% fluid loss) have shown impairments in cognitive performance. This means not being fully hydrated can affect our short-term memory, ability to focus on tasks, or our mood. ⁽⁵⁾ For example, a study conducted in school-age children found that children with better habitual hydration showed better cognitive flexibility than children who were less hydrated and providing a water intervention led to improved task-switching capabilities. ⁽⁶⁾⁽⁷⁾

Hydration and our bowels

Our Hydration status can also impact our bowel movements. When we have bowel issues such as diarrhoea, this can cause our body to lose water via loose stools. Patients that suffer from chronic diarrhoea can also lose important electrolytes in the process. When we are re-hydrating post diarrhoea, we also have to consider the electrolytes that have been lost. The WHO have created an Oral rehydration formula containing different substances such as glucose and sodium to help with this. This is often used when children have diarrhoea. When we lose water, it is important that we replenish both the water and the electrolytes that were lost. ⁽⁸⁾

How the body hydrates itself

The body always wants to be a constant state of physiological balance. This is known as homeostasis. When the body senses that the fluid balance is off, a deficit for example, it moves water stored on our cells outside of the cells to regain an equilibrium. Similarly, if the body feels that it is overhydrated, the opposite occurs and the kidneys help excrete the excess water. The kidneys play an important role in maintaining the fluid balance of the body by producing concentrated urine when we are dehydrated to conserve water (that is why we have dark urine when we are dehydrated). The body also tries to re-hydrate itself by sending signals to the brain to indicate that we feel thirsty.

How hydration changes as we age

Dehydration is the most common fluid complication amongst the elderly. This is a result of a diminished thirst sensation, decreased muscle mass (therefore giving a decreased body fluid composition), and older adults have less of an ability to produce more concentrated urine to preserve low fluid levels in the body. Along with have a reduced thirst sensation some older people have trouble swallowing, therefore thicker fluids may be required to hydrate themselves. Many older adults with swallowing issues do not enjoy the texture of thickened liquids and this could contribute to a reduction in fluid consumption for these groups. ^(9-11)

Fluid consumption typically decreases beginning at age 50, largely due to water intake decreases. Drewnowski A, Rehm CD, Constant F. Water and beverage consumption among adults in the United States: cross-sectional study using data from NHANES 2005-2010. BMC Public Health. 2013 Nov 12;13:1068. doi: 10.1186/1471-2458-13-1068. PMID: 24219567; PMCID: PMC3840570.

Role of the electrolyte in hydration

Electrolytes are substances that break down into positive or negative charges when dissolved in water. Some examples of electrolytes include sodium, potassium and chloride. These electrolytes work together to create channels of communication within our bodies to conduct actions such as nerve impulses and muscle contraction. ^(12)(13)

Electrolytes also play an important role in hydration. Electrolytes can be found in foods that we eat, so our nutrition can play a role in our hydration status as well! The kidneys help regulate the amount of electrolytes present in the body so that we don’t have too much or too little of them in our system.

As mentioned before, electrolytes carry charges. Sodium and potassium have a positive charge whilst chloride has a negative charge. Sodium and chloride are found in the fluid outside of our cells and potassium is found in the fluid within our cells. Chloride works hand in hand with sodium to transport substances in and out of cells. As sodium is positive and chloride is negative, the charges cancel each other out to ensure that a neutral charge is maintained, this is known as charge neutrality. ⁽¹⁴⁾

Both Sodium and chloride can often be found in savoury foods containing salt. The chemical name for salt is sodium chloride. Sodium and chloride help to maintain the fluid outside of our cells. Often excess salt consumption is discouraged as it plays a role in high blood pressure, but sodium and chloride play crucial roles in fluid balance. This is because the regulation of salt and water balance in the body is highly inter-connected. Water is known to follow salt; this can contribute to the regulation of blood pressure and thus fluid balance. ⁽¹⁵⁾

Another nutrient that plays a role in fluid balance is potassium. Potassium is often found in fruits and leafy green vegetables. It maintains the fluid inside the cells. Potassium and sodium work together to help us transport fluid where it is needed the most. ⁽¹⁶⁾

Good beverages to help us hydrate

Instantly when we think of beverages to help us hydrate, we think of water. We are encouraged to take approximately 6-8 glasses of water per day to maintain good hydration. Water is a solid choice to maintain hydration, but we should also remember that all beverage consumption can contribute to good hydration. We should avoid sugar sweetened beverages to hydrate ourselves as they can help us hydrate, but over consumption of beverages such as these could put us at risk of issues with our dentition. Teas and coffees can also help with hydration. Although previously thought to exacerbate dehydration because of the diuretic effect of caffeine, these alternative options have been shown to ultimately push us toward a more hydrated state. ⁽¹⁷⁾ Fortified milk can be useful as a hydrating solution as it contains vitamins and minerals such as Vitamin D and calcium.

Hydration and activity

Also, to note that depending on the activity, you may need to consume more or less fluid, this can be dependent on timings for breaks for example. Those that play soccer or rugby might have a higher risk of hypohydration as the alternate pauses can sometimes interfere with our opportunity to rehydrate.

If we are expected to sweat a lot during activity, sports drinks may be a more suitable choice to rehydrate as the electrolytes within them can help the body retain fluid and give us energy. Post activity, milk can also be a good rehydration choice as along with the hydration properties, the protein found in milk can contribute to building and retaining muscle. It is always important to continue to rehydrate yourself when carrying out physical activity. ⁽¹⁸⁾

Conclusion:

Staying hydrated is very important for our overall health and well-being. We need water to survive, it is one of the primary nutrients required to sustain us. Hydration is key to maintain all of the bodies process and we must not take it for granted.