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Elderberry in Ancient and Modern Medicine
A mainstay of herbal medicine since the time of Hippocrates and Pliny, the elderberry and the tree on which it grows have a long history in folk medicine and a growing respect among modern scientists. If you are interested in plant-based cancer treatment and prevention, elderberry may be a useful herbal medicine to consider. Used in traditional medicine as an immune stimulant and tonic, extracts made from elderberries also have cancer-fighting properties. Herbal medicine is not intended to be a replacement for standard medical care, however, so consult your health-care provider before purchasing herbal products. 

Listen to your body. Consume according to body weight and its reaction to your diet and/or medication. If under a doctor's care and taking prescription drugs, consult with him/her in advance. Food and drug interactions are not fully understood by medical professionals, so all advise caution. If other dark, nutrient dense berries are OK with your medical professional, then elderberry is most likely OK, too.

A Comparative Evaluation of the Anticancer Properties of European and American Elderberry Fruits, JOURNAL OF MEDICINAL FOOD. J Med Food 9 (4) 2006, 498–504
© Mary Ann Liebert, Inc. and Korean Society of Food Science and Nutrition

ABSTRACT European elderberry (Sambucus nigra), recognized in Europe for its health-promoting properties for many generations, is known to contain a range of anthocyanins, flavonoids, and other polyphenolics that contribute to the high antioxidant capacity of its berries. American elderberry (Sambucus canadensis), on the other hand, has not been cultivated, bred, and promoted as a medicinal plant like its better-characterized European counterpart. In this study, aqueous acetone extracts of the berries from these two species were fractionated and tested in a range of assays that gauge anticarcinogenic potential. Both cultivated S. nigra and wild S. canadensis fruits demonstrated significant chemopreventive potential through strong induction of quinone reductase and inhibition of cyclooxygenase-2, which is indicative of anti-initiation and antipromotion properties, respectively. In addition, fractions of S. canadensis extract showed inhibition of ornithine decarboxylase, an enzyme marker related to the promotion stage of carcinogenesis. Analysis of active fractions using mass spectrometry and liquid chromatography-mass spectrometry revealed, in addition to flavonoids, the presence of more lipophilic compounds such as sesquiterpenes, iridoid monoterpene glycosides, and phytosterols. [Click here to download a pdf of the entire article.]

Elderberry’s Anti-viral Activity: An Update 
By Maxwell Crispo, ND, and Michael Traub, ND, DHANP, FABNO, 12/04/2019

While elderberry was shown to have inhibitory effect at all stages of influenza infection, it had a significantly stronger effect on the late-stage of infection than at early stage; smaller concentrations (higher dilutions) of elderberry had partial or no inhibitory effect during the early phase but those same concentrations had significant inhibitory effect during the late-phase of infection. Furthermore, the antiviral activity of elderberry on influenza was strongest when used in pre-treatment, during infection and post-infection, rather than when used solely during infection. The study confirmed that elderberry exerts its antiviral activity on influenza through a number of mechanisms of action, including suppressing the entry of the virus into cell, modulating the post-infectious phase, and preventing viral transmission to other cells. Elderberry also upregulates IL-6, IL-8 and TNF, suggesting an indirect effect on viral immune response in the body. Interestingly, elderberry was shown to have this effect but not its major bioactive compound, cyanidin 3-glucoside.

Posted with permission of Dr. Crispo. Read the entire article: herehttps://www.naturalmedicinejournal.com/blog/elderberry%E2%80%99s-anti-viral-activity-update

Variation of Select Flavonols and Chlorogenic Acid Content of Elderberry Collected Throughout the Eastern United States, 
J Food Compost Anal. 2016 Apr 1; 47: 52–59. doi: 10.1016/j.jfca.2015.12.003. Elizabeth Mudge,a Wendy L. Applequist,b Jamie Finley,a Patience Lister,a Andrew K. Townesmith,b Karen M. Walker,b and Paula N. Browna,*

American elderberries are commonly collected from wild plants for use as food and medicinal products. The degree of phytochemical variation amongst wild populations has not been established and might affect the overall quality of elderberry dietary supplements. The three major flavonols identified in elderberries are rutin, quercetin and isoquercetin. Variation in the flavonols and chlorogenic acid was determined for 107 collections of elderberries from throughout the eastern United States using an optimized high performance liquid chromatography with ultraviolet detection method. The mean content was 71.9 mg per 100g fresh weight with variation ranging from 7.0 to 209.7 mg per 100 g fresh weight within the collected population. Elderberries collected from southeastern regions had significantly higher contents in comparison with those in more northern regions. The variability of the individual flavonol and chlorogenic acid profiles of the berries was complex and likely influenced by multiple factors. Several outliers were identified based on unique phytochemical profiles in comparison with average populations. This is the first study to determine the inherent variability of American elderberries from wild collections and can be used to identify potential new cultivars that may produce fruits of unique or high-quality phytochemical content for the food and dietary supplement industries. Read the entire article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750052/

[Note: all American, Sambucus canadensis, named elderberry cultivars were collected from the wild at some point.  Some more recently than others. Some with more human breeding efforts involved than others. The same elderberry plant farmed well will have higher nutrition levels than wild collected according to European studies referenced on the Functional Ingredient page found on this website.]

Neutralizing activity of SAMBUCOL® against avian NIBRG-14 (H5N1) influenza virus

S. Balasingam*, R. Lambkin*, D. Safirman**, M. Mumcuoglu** & J.S. Oxford*
* Retroscreen Virology Ltd, St Bartholomew’s & The Royal London School of Medicine & Dentistry, University of London
** Razei Bar Industries (1996) Ltd, Manhat Technology Park, Jerusalem, Israel

Abstract
The spread of avian influenza (H5N1) from the Far East to East European countries raises concerns of a possible flu pandemic and emphasizes the need to search for a preventative and/or cure. The aim of this study was to determine the antiviral activity of Sambucol®, a standardized Black Elder berry extract, against avian influenza NIBRG-14 (H5N1) virus. Antiviral assays were performed in MDCK cells using two Sambucol® dilutions at several incubation times. Results show at least 99% reduction in the titre of avian influenza NIBRG-14 (H5N1), namely 2.0 log10 TCID/ml. Therapeutic index calculations indicated direct influence of Sambucol® on titre reduction. Further studies will be undertaken to assess the effectiveness of Sambucol® against avian influenza (H5N1) virus in animals and humans.

[Potential American elderberry research opportunity: While this research applies specifically to a product delivering concentrations of European S. nigra polyphenols, those same polyphenols are present in differing concentrations among the various cultivars of Sambucus nigra ssp. canadensis, American Elderberry.] 

Polyphenols: food sources and bioavailability
Claudine Manach, Augustin Scalbert, Christine Morand, Christian Rémésy, and Liliana Jiménez
© 2004 American Society for Clinical Nutrition

Abstract
Polyphenols are abundant micronutrients in our diet, and evidence for their role in the prevention of degenerative diseases such as cancer and cardiovascular diseases is emerging. The health effects of polyphenols depend on the amount consumed and on their bioavailability. In this article, the nature and contents of the various polyphenols present in food sources and the influence of agricultural practices and industrial processes are reviewed. Estimates of dietary intakes are given for each class of polyphenols. The bioavailability of polyphenols is also reviewed, with particular focus on intestinal absorption and the influence of chemical structure (eg, glycosylation, esterification, and polymerization), food matrix, and excretion back into the intestinal lumen. Information on the role of microflora in the catabolism of polyphenols and the production of some active metabolites is presented. Mechanisms of intestinal and hepatic conjugation (methylation, glucuronidation, sulfation), plasma transport, and elimination in bile and urine are also described. Pharmacokinetic data for the various polyphenols are compared. Studies on the identification of circulating metabolites, cellular uptake, intracellular metabolism with possible deconjugation, biological properties of the conjugated metabolites, and specific accumulation in some target tissues are discussed. Finally, bioavailability appears to differ greatly between the various polyphenols, and the most abundant polyphenols in our diet are not necessarily those that have the best bioavailability profile. A thorough knowledge of the bioavailability of the hundreds of dietary polyphenols will help us to identify those that are most likely to exert protective health effects.  Read the entire article here: http://ajcn.nutrition.org/content/79/5/727.full

The Phenolic Contents and Antioxidant Activities of Infusions of Sambucus nigra L. Viapiana A, Wesolowski M. (Medical University of Gdansk)

Abstract
The aim of this work was to evaluate the antioxidant potential of teas prepared from twenty-four commercially available berries and flowers of Sambucus nigra L. in relation to their phenolic profile, as reflected by the most representative phenolic acids (caffeic, chlorogenic, p-coumaric, ferulic, gallic and syringic acids); flavonols (quercetin, kaempferol, myricetin and rutin); and total phenolic (TPC), phenolic acid (TAC) and flavonoid (TFC) contents. The infusions prepared from elderflowers contained more abundant phenolic compounds than the elderberry infusions. The TPC of these infusions ranged from 19.81 to 23.90 mg of gallic acid equivalents/g dry weight of sample (GAE/g DW) for elderberries and from 15.23 to 35.57 mg GAE/g DW for elderflowers, whereas the TFC ranged from 2.60 to 4.49 mg of rutin equivalents/g dry weight of sample (RUTE/g DW) in elderberry infusions and from 5.27 to 13.19 mg RUTE/g DW in elderflower infusions. Among the phenolic compounds quantified in this study, quercetin (2.07-9.48 mg/g DW) and myricetin (1.17-9.62 mg/g DW) had the highest concentrations in the teas prepared from berries and flowers, respectively. Moreover, the antioxidant potential of elder infusions assessed by 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical and ferric reducing antioxidant power (FRAP) assays revealed that the teas prepared from flowers had higher mean DPPH and FRAP activities than the teas prepared from berries. Therefore, elder beverages could be important dietary sources of natural antioxidants that contribute to the prevention of diseases caused by oxidative stress. [Note: research on European S. nigra flowers/berries.]

Studies drill down to how elderberry ingredient provides immune support via microbial reaction in gut 29-Jan-2018 By Hank Schultz
Developing research in the area of gut health and its connection to immune support has opened a new door for flavonoid-rich ingredients: HTTPS://WWW.NUTRAINGREDIENTS-USA.COM/ARTICLE/2018/01/29/STUDIES-DRILL-DOWN-TO-HOW-ELDERBERRY-INGREDIENT-PROVIDES-IMMUNE-SUPPORT-VIA-MICROBIAL-REACTION-IN-GUT 

The First International Symposium on Elderberry
Columbia, MO USA, June 9-14, 2013
Organized under the auspices of the International Society for Horticultural Science and hosted by the University of Missouri, the First International Symposium on Elderberry attracted a wide variety of papers that will be published in a peer-reviewed, stand-alone volume of Acta Horticulturae. This volume’s anticipated date of distribution depends on a number of factors, but the editors hope to make it available for purchase by the middle of 2014.

As someone who grows elderberry and distributes elderberry juice products, my engagement transcended the scope of the conference fairly well. My immediate purpose is to give you a few general observations about the symposium’s content. My plan is to follow up with brief summaries of a number of the presentations that relate especially to consumers, health and nutrition professionals as well as potential growers. [Click here to download a pdf of the entire article.]

Dietary Sutherlandia and Elderberry Mitigate Cerebral Ischemia-Induced Neuronal Damage and Attenuate p47phox and Phospho-ERK1/2 Expression in Microglial Cells
Dennis Y. Chuang, Jiankun Cui, Agnes Simonyi, Victoria A. Engel, Shanyan Chen, Kevin L. Fritsche, Andrew L. Thomas, Wendy L. Applequist, William R. Folk, Dennis B. Lubahn, Albert Y. Sun, Grace Y. Sun and Zezong Gu, ASN Neuro 2014 6: DOI: 10.1177/1759091414554946

The online version of this article can be found at: http://asn.sagepub.com/content/6/6/1759091414554946. Download a pdf of the original report. Download a pdf of an updated-continued analysis of the original research here.  

Click here to see the Symposium articles on brain research with mice. 

MIND Diet Associated with Reduced Incidence of Alzheimer’s Disease

"The MIND diet score has 15 dietary components including 10 brain healthy food groups (green leafy vegetables, other vegetables, nuts, berries, beans, whole grains, fish, poultry, olive oil and wine) and 5 unhealthy food groups (red meats, butter and stick margarine, cheese, pastries and sweets, and fried/fast food)."

"This prospective study of the MIND diet score provides evidence that greater adherence to the overall dietary pattern may be protective against the development of AD. The estimated effect was a 53% reduction in the rate of AD for persons in the highest tertile of MIND scores and a 35% reduction for the middle tertile of scores compared with the lowest tertile." 

"Unlike the Mediterranean and DASH diet scores, the MIND diet specifies frequent weekly consumption of green leafy vegetables in addition to other types of vegetables. Two large U.S. cohort studies reported significantly slower cognitive decline with consumption of 2 or more daily servings of vegetables, with the strongest associations observed for six or more weekly servings of green leafy vegetables...However, the MIND diet has a separate score component for berry consumption to reflect the positive associations reported between intakes of blueberries and strawberries and slower cognitive decline in the Nurses’ Health Study. This finding is supported by a number of rodent models showing better memory performance and brain neuroprotection from multiple types of berries."

"This suggests that the MIND diet is not specific to the underlying pathology of AD but perhaps better overall functioning and protection of the brain.” [See also: Elderberry & Brain Health]

"Results of the study suggest that even modest adjustments to the diet may help to reduce one’s risk of developing AD. For example, the MIND diet score specifies just two vegetable servings per day, two berry servings per week, and one fish meal per week.”

Berries Boost Kids’ Cognition
While this article reports on studies conducted with wild blueberries, elderberries are also very high in flavonoids. All dark berries usually have some of the same nutrients in common, but in different proportions as well as varying in total composition, vitamins, etc. Studies on one dark berry may be and indicator of benefits also enjoyed by consuming others, so eat a variety of berries. 

Optimized elderberry, green tea and cinnamon extracts rich in certain flavonoids compounds were shown to block HIV-1 entry and infection of GHOST cells. [Download and read the entire article.]

Elderberries, elder flowers and elder leaves all have medicinal properties, though they have different uses. Germany's Commission E, a government agency responsible for approving herbal remedies, approves elderflowers to treat coughs, colds and other respiratory problems. Both the berries and the flowers appear to have antioxidant properties, according to a report on black elder from the University of Texas, El Paso.

A standardized extract of elderberry leaves has proved effective in treating flu symptoms. In a double-blind study conducted during a 1993 flu outbreak at an Israeli kibbutz, 93 percent of patients taking the elderberry extract reported significant improvement in flu symptoms four days sooner than those taking a placebo. Elderberry juice and extract may reduce stress, according to an article published in Better Nutrition magazine in October 2000, as well as limit the damage done by LDL bad cholesterol. The author cites studies conducted in Italy and Austria that seem to show the purple berry's antioxidant properties. (Click here to download a pdf of this article.)

River Hills Harvest Elderberry Juice sets good processing standards for MEC members: After careful picking/screening for consistency of ripeness, de-stemming and cleaning, River Hills Harvest freezes its berries within 24-48 hours of picking. At the time of processing, the frozen berries are thawed, and the juice is mechanically separated from the skins and seeds. Then, the elderberry juice is cool processed at 180° F in small batches. 

[Note: Although elderberry has been used by many cultures for thousands of years, some confusion exists over the specifics of safe use. Some of that is likely due to the fact that different species of elderberry exhibit different biological properties. More than a few sources warn against eating raw elderberries. Others eat the dark, black elderberry regularly and point out that the problem lies in eating unripe berries, red or white berries, and in not removing all of the small twigs and leaves. We linked to an article on observing and collecting wild elderberry that communicates common sense in this regard. You will find more information about this in the general articles about elderberry.]

Effects of polyphenolic antioxidants on exercise-induced oxidative stress
J.M. Morillas-Ruiza·*, J.A.  Villegas Garciab, F.J. L6pezb, M.L.  Vidal-Guevarac, P. Zafrillaa

aE.U. Human and Dietetic  Nutrition, San Antonio Catholic University, Campus Los Jer6nimos, sin. 30107, Murcia bU.C. Physiology of the Exercise. San Antonio Catholic University, Murcia, cResearch and Development Department,  Hero Spain, Murcia. Received 1 August 2005; accepted 4 November 2005.

Elderberry = Available Antioxidants

Elderberry is one of the most concentrated sources of antioxidants. The next article indicates that high in antioxidant beverages (like elderberry juice) transfer the antioxidant capacity to human body fluids.

"Polyphenols are of increasing interest to consumers and food manufacturers for several reasons. Commonly referred to as antioxidants (they are the most abundant antioxidants in our diets), they may prevent various oxidative stress-related diseases, such as cancer, cardiovascular disease, inflammation and others.  Physical activity is known to induce oxidative stress in individuals after intensive exercise…This may indicate that the antioxidant supplement offered protection against exercise-induced oxidative stress…indicate that poly­phenol-rich beverages are able to transfer their antioxidant capacity to body fluids. The aim of the present study is to follow through the effects of the ingestion of a drink of polyphenolic antioxidants (flavonoids) on lipid and protein oxidation and the TAC of plasma in cyclists under oxidative stress.”

[If you exercise, this research indicates that antioxidants seem to provide relief for the oxidative stress on your body that comes from musclular exertion. Click here to read the entire research article.]

Iprona AG: Human Trial Results Published in "Nutrients" / Unique Elderberry Formula Protects Air Travelers from Colds
Elderberry extract gives air travelers extra protection against colds and flu, according to landmark new study. 

"According to the U.S. Centers for Disease Control and Prevention (CDC), up to 20% of all travelers experience respiratory infections that require them to seek medical care. For those traveling long distance, upper respiratory infections are among the most prevalent problems they’ll face — along with jet lag and fatigue. The new study showed that taking an elderberry formula could help.”

Hippocrates called the elder his “medicine chest.” 
The fruit from this native North American and European shrub is used to relieve stress, various stomach ailments, high cholesterol, congestion and to fight the flu - all strains. Elderberry also promotes a healthy complexion and generally strengthens the body’s immune system.

A 1995 study published by the Journal of Alternative and Complementary Medicine found that nearly 90% of flu patients given elderberry extract were completely free of symptoms within two to three days, as compared to at least six days with a placebo.

The results of a clinical trial published in the International Journal of Medical Research in 2004, showed flu patients given one tablespoon of elderberry extract four times per day recovered in an average of 3.1 days compared to 7.1 days for those given a placebo.

From the Dr. Oz web site: “Elderberry juice has been used for centuries. Elderberry will boost the immunity and works well for colds...elderberry juice is probably one of the biggest cold secrets known around. Works very well to get rid of that cold and flu.” 

Antioxidants in Periodontal Disease - A Review 
by S Lakshmi Shree, R Mythili. Retrieved 10/1/2013: http://www.ijmdent.com/Articles/volume1-issue3/review-article-antioxidants.pdf

"Whilst a myriad of possible mechanisms leading to the destruction of periodontal tissues exist, ROS would appear to play a significant role in the pathology of periodontal diseases. Oxidative stress observed in a diseased periodontium could result directly from excess ROS activity or antioxidant deficiency or indirectly by creating a pro-inflammatory state. Novel adjunctive antioxidant and anti-inflammatory strategies to the traditional periodontal therapy can help us in achieving good clinical results."

[Click here to ownload pdf of the entire article. Note how iron, Vitamin A and Vitamin C, which elderberry is very high in, play vital roles in how the antioxidants work to preserve healthy gums and bone mass. Click for a supporting article in the Journal of the American Dental Association. A Michigan dentist’s web site explains how it all works in layman’s terms here: http://www.thegentledentist.com/antioxidants-for-periodontal-disease-treatment/.]

Quercetin
The highest concentrations of quercetin are found in berries and onions. Elderberries, of all the berries, are very rich in quercetin, but blueberries—and all other berries—also contain substantial amounts of quercetin. So, while the average American consumes only 20 milligrams of quercetin per day, vegetarians who eat a lot of apples, onions, berries and that sort of thing have been found to get 100 to 200 milligrams daily. People with high quercetin intake have a 60 percent reduction in lung-cancer death rates. They have a third less incidence of heart disease, and research shows that they have less pancreatic and colon cancer as well. If people increase their intake of apples, onions and berries, over the long term they should experience lower rates for various types of cancer and heart disease. (Dole Nutrition Institute)

• Quercetin news, articles and information from naturalnews.com
• Elderberry—A Clinical Perspective, March 9, 2009 by Dimitri Papadimitriou, Ph.D.
  
  

Quercetin Overview: 

Quercetin belongs to a group of plant pigments called flavonoids that give many fruits, flowers, and vegetables their color. 

Flavonoids, such as quercetin, are antioxidants -- they scavenge damaging particles in the body known as free radicals, which damage cell membranes, tamper with DNA, and even cause cell death. Antioxidants can neutralize free radicals and may reduce or even help prevent some of the damage they cause. They also help keep LDL ("bad") cholesterol from being damaged, which scientists think may contribute to heart disease. In test tubes, quercetin has strong antioxidant properties, but researchers aren't sure whether taking quercetin (and many other antioxidants) has the same effects inside the body. 

Quercetin acts like an antihistamine and an anti-inflammatory, and may help protect against heart disease and cancer. Quercetin can also help stabilize the cells that release histamine in the body and thereby have an anti-inflammatory effect. [Click here to continue reading.]

Elderberry is touted as a powerful antioxidant. Research shows that it may offer immune boosting properties. By stimulating the production of side of kinds proteins that help the body fight off disease. One study found the people who took elderberry extract while having the flu so -- symptoms subside for days earlier than those who did. But getting the immune system of – is not the only thing elderberry may be good for. We checked in with the medicine hunter to find out more.

• Link to a full pdf of the transcript