According to a study published by The North American Menopause Society (NAMS), research that discusses the benefits of hormone therapy for women experiencing hearing loss, especially for those experiencing menopause, no longer holds any merit—suggesting that hormone therapy negatively effects hearing.

About 48 million Americans experience hearing loss—a number that will continue to rise as people age. As estrogen and progestogen levels decrease for women as they age, as well as their hearing, many have suggested hormone therapy as a beneficial aid.

After analyzing 80,972 women who claimed to have hearing problems, researchers have noted a higher risk of hearing loss for those using oral hormone therapy.

“The finding from this observational study that women who underwent menopause at a later age and used oral hormone therapy had greater hearing loss was unexpected but should lead to more testing in a randomized, clinical trial,” says executive director Dr. JoAnn Pinkerton.  “Information about the potential effect on hearing is important to include in a discussion regarding the risks and benefits of hormone therapy for symptomatic menopausal women.”

Results from a Six Center, Open Label Clinical Study
Ulrich Danesch1*, Marion Seybold1, Reiner Rittinghausen1, Walter Treibel2 and Norman Bitterlich3

1Weber and Weber GmbH and Co. KG, Biological Medicinal Products, Herrschinger Str. 33, D-82266 Inning/Ammersee, Germany
2Orthopedic Practice, Maxhofstr. 9a, 81475 Munich, Germany

3Medizin and Service GmbH, Boettcherstr. 10, 09117 Chemnitz, Germany

Objective:
NEM® brand eggshell membrane is a novel dietary supplement ingredient that contains naturally occurring glycosaminoglycans and proteins essential for maintaining healthy joints. A six center, open label clinical study was conducted to evaluate the efficacy and safety of NEM® as a treatment for pain and inflexibility associated with osteoarthritis of the knee and/or hip in a European population.

Methods:
Forty-four subjects received oral NEM® 500 mg once daily for eight weeks. The primary outcome measure was to evaluate the mean effectiveness of NEM® in relieving general pain associated with moderate osteoarthritis of the knee and/or hip at 10,30 and 60 days utilizing a 10-question abbreviated questionnaire based on the WOMAC osteoarthritis questionnaire.

Results:
Supplementation with NEM® produced a significant treatment response from baseline at 10 days (Q1-6 and Q9) (8.6% to 18.1% improvement) and at 30 and 60 days for all nine pain-related questions evaluated (22.4% to 35.6% improvement) and at 30 and 60 days for stiffness (Q10) (27.4% to 29.3% improvement). In a Patient’s Global Assessment, greater than 59% of patients rated the efficacy of NEM® as good or very good following 60 days of supplementation. Physicians also rated the treatment effective in subjects, with greater than 75% having moderate or significant improvement from baseline after 60 days. There were no serious adverse events reported during the study and the treatment was reported to be well tolerated.

Conclusions:

Supplementation with NEM® significantly reduced pain, both rapidly (10 days) and continuously (60 days) demonstrating that it is a safe and effective therapeutic option for the treatment of pain associated with osteoarthritis of the knee and/or hip. Results from previous clinical studies on NEM® can likely be extended to the broader European population.

Introduction:

Estimates of the prevalence of osteoarthritis (OA) in European populations vary widely, however a recent study [1] from a region in Spain places the prevalence of knee OA at 12.2% and that of hip OA at 7.4%. The pain associated with these maladies can be quite debilitating and few treatment options exist outside of easing symptoms. This usually involves the use of analgesics (i.e. acetaminophen, oxycodone, propoxyphene) or non-steroidal anti-inflammatory drugs (NSAIDs) (i.e. ibuprofen, diclofenac, celecoxib), alone or in combination. Most of these treatments have shown limited effectiveness in randomized controlled clinical trials (RCTs) [2-5] or are known to have significant and sometimes severe side effects. NEM® brand eggshell membrane has previously demonstrated good efficacy in relieving pain and stiffness associated with OA of the knee in an RCT [6] and has shown similar efficacy in limited trials for other affected joints [7].

Eggshell membrane is primarily composed of fibrous proteins such as Collagen Type I [8]. However, eggshell membranes have also been shown to contain other bioactive components, namely glycosaminoglycans (i.e. dermatan sulfate, chondroitin sulfate and hyaluronic acid and keratan sulfate) [9-11]. A number of these constituents have been shown previously to be beneficial in the treatment of OA [12,13]. Eggshell membrane itself has been shown both in vitro [14] and in vivo [15] to reduce various pro-inflammatory cytokines, including interleukin-1 beta (IL-1β) and tumor necrosis factor alpha (TNF-a), two primary mediators of inflammation. A U.S. company, ESM Technologies, LLC (Carthage, MO USA), has developed methods to efficiently and effectively separate eggshell membrane from eggshells on a commercial metric-ton scale. The isolated membrane is then partially hydrolyzed using a proprietary process and dry-blended to produce NEM® brand eggshell membrane. Compositional analysis of NEM® conducted by the manufacturer has identified a high content of protein and moderate quantities of glucosamine (up to 1% by dry weight), chondroitin sulfate (up to 1%), hyaluronic acid (up to 2%), and collagen (Type I, up to 5%).

The multi-center trial reported herein was designed to evaluate the acceptability of this natural arthritis treatment with European orthopedic surgeons and patients. Success of this trial would also validate the extension of the body of clinical evidence for NEM® from the United States to a European population. Therefore, a 2-month open-label study was conducted at six different clinical sites throughout Germany to evaluate the efficacy and tolerability of NEM® for the relief of the pain and discomfort associated with osteoarthritis of the knee and/or hip.

Materials and Methods Study Design

The study was conducted according to a prospective, multi-center, open label design and was conducted in Germany in accordance with the International Conference on Harmonization guideline for the principles of Good Clinical Practice (ICH E6) and the Declaration of Helsinki to ensure protection of human subjects. Patients provided their written informed consent to participate. Neither the clinical investigators nor the patients were blinded to treatment (open label design). Treatment consisted once daily orally of Atrosia® (Weber and Weber, GmbH and Co. KG, Germany) providing 500mg of NEM® in vegetarian capsules that were stored in closed containers at ambient temperature. Clinic visits were scheduled for subjects at study initiation and at 60 days following the onset of treatment. Treatment compliance was checked at clinic visits by patient interview and by counting the number of unused doses of the study medications. Analgesics (i.e. acetaminophen) were allowed for rescue pain relief. However, subjects recorded the time and amount of analgesic taken in patient diaries so that overall analgesic use could be evaluated as part of the study.

Patients

All subjects 18 years of age or older who were seeking relief of mild to moderate pain due to osteoarthritis of the knee and/or hip were considered for enrollment in the study. In order to be eligible, subjects must have had moderate persistent pain in the knee and/or hip associated with osteoarthritis and must have had baseline scores within the range of 4-7 on the first three questions dealing with joint pain. Subjects that were currently taking analgesic medications or NSAIDs every day, currently taking glucosamine, chondroitin sulfate, MSM, or collagen were ineligible to participate in the study. Patients were excluded if they were currently receiving remission-inducing drugs such as methotrexate or immunosuppressive medications or had received them within the past 3 months. Other exclusionary criteria were: a known allergy to eggs or egg products, or pregnant or breastfeeding women. Subjects participating in any other research study involving an investigational product (drug, device, or biologic) or a new application of an approved product, within 30 days of screening were also excluded from participating in the trials.

Treatment response

The primary outcome measure of this study was to evaluate the mean effectiveness of NEM® in relieving general pain associated with moderate osteoarthritis of the knee and/or hip (Questions 1-9). Additional outcome measures were to evaluate general stiffness (Question 10) and analgesic use during the study. e primary treatment response endpoints were the 10-, 30-, and 60-day patient assessments utilizing a 10-question ‘Short Form’ questionnaire derived from the Western Ontario and McMasters Universities Osteoarthritis Index questionnaire (WOMAC), which has some precedence [16,17]. Each question included a zero to 10 analog Likert-scale, with zero equating to no pain (or no stiffness) and 10 equating to most severe pain (or most severe stiffness). Patients were asked to mark a number corresponding to the perceived pain (or stiffness) from the affected treatment joint(s). Endpoints were then compared to pretreatment assessments. At the conclusion of the study, subjects were asked to provide a Patient’s Global Assessment of treatment efficacy (4 categories-very good/good/moderate/poor) and tolerability (same 4 categories). Clinical investigators were also asked to provide a Physician’s Global Assessment of treatment efficacy (5 categories- symptom-free/significant improvement/moderate improvement/ unchanged/impaired).

Adverse events

A secondary objective of this study was to evaluate tolerability and any adverse reactions associated with supplementation with NEM®. The subject’s self-assessment diaries were reviewed and any discomfort or other adverse events were recorded and reported in accordance with applicable ICH Guidelines. Adverse events and serious adverse events were assessed by the clinical investigator at each study visit and followed until resolution, as necessary. Serious adverse events were required to be reported to the clinical monitor immediately.

Statistical analysis

As this was an open-label study, a simple single group sample size estimate [18] was performed for statistical power determination for a continuous variable. In previous trials with NEM® [6,7], the standard deviation for the study subjects for pain (within the inclusion range of this study) averaged 34.6%. We hoped to be able to detect a 1.5 point difference from baseline within the 10-point Likert scale. us a minimum of 43 subjects would need to be enrolled to have a 95% likelihood of detecting the expected improvement with a statistical power of 80%. Comparisons of demographic data from the six clinical sites were made with a Kruskal-Wallis test for multiple independent samples at baseline. Statistical significance was accepted at p<0.05. Post-baseline statistical analyses were done as repeated measures Analysis of Variance (rm-ANOVA) with a Greenhouse-Geisser correction. Items found to have statistical significance with rm-ANOVA were then compared using a Wilcoxon test for dependent samples. Statistical significance was accepted at p<0.05. Analysis of the primary outcome measure (the change from baseline in general pain levels) was conducted in the per protocol population. SPSS Statistics V19.0 was used for all statistical analyses [19].

Results

Patient recruitment began in March 2012 at six clinical sites in Germany and the final follow-up was conducted in July 2012. A total of forty-four subjects between the ages of 32 and 95 were enrolled with osteoarthritis of the knee and/or hip. Of these subjects, twenty-seven (61%) were female and seventeen (39%) were male. e treated joints consisted of knee (39), hip (14), ankle (3), both either knee and hip (10), or both knee and ankle (2). Of the thirty-nine subjects with knee OA, sixteen (40.0%) had bilateral incidence. Of the fourteen subjects with hip OA, seven (50.0%) had bilateral incidence. Patient demographics are reported in Table 1. All forty-four subjects completed baseline evaluations. Thirty-seven (84%) of the forty-four subjects completed the two-month study per the protocol. Compliance with the study treatment regimen was good.

Patient data was initially evaluated between sites to exclude site bias (not shown). As there were no abnormalities in these evaluations, the data were pooled for all subsequent analyses. A clinical comparison of valid subjects was carried out to obtain a mean baseline score for each of the ten questions from the patient questionnaire (Table 2). Statistical analysis of the primary outcome measure revealed that supplementation with NEM® produced a significant treatment response from baseline at 10 days (Q1-6 and Q9) (8.6% to 18.1% improvement) and at 30 and 60 days for all nine pain-related questions evaluated (22.4% to 35.6% improvement) (Table 3). Treatment response fell just shy of statistical significance at 10 days for Questions 7 and 8 (p=0.056 and p=0.064, respectively). Supplementation with NEM® produced a significant treatment response from baseline at 30 and 60 days for stiffness (Q10) (27.4% to 29.3% improvement). Greater than 59% of patients rated the efficacy of NEM® as good or very good (Table 4) following 60 days of supplementation. Physicians also rated the treatment effective in subjects, with greater than 75% having moderate or significant improvement from baseline after 60 days (Table 5). For the 30 days prior to study commencement, patients consumed on average 7.0 ± 6.0 doses of acetaminophen. Analgesic use had dropped considerably to 2.43 ± 2.69 doses (per 30 days) at 30 days of supplementation with NEM®. Analgesic use rebounded slightly to 3.59 ± 3.86 doses (per 30 days) by the end of the study at day 60. There were two adverse events reported during the study. One was a scratchy throat and was believed to be related to antibiotic use. e other was stomach discomfort which was believed to be related to the study material. ere were no serious adverse events reported during the study. The treatment was reported to be well tolerated by study participants with greater than 86% of patients rating NEM® tolerability as good or very good.

Discussion:

Joint and connective tissue disorders are quite common in Westernized countries [1,20] and result in significant costs, both financial [21] and quality-of-life [22], for those that suffer from the debilitating diseases. This open-label clinical trial was designed to evaluate the acceptability of this natural arthritis treatment with European orthopedic surgeons and patients and to validate the extension of the body of clinical evidence for NEM® from the United States to a European population through the evaluation of the efficacy, safety, and tolerability of NEM® brand eggshell membrane as a treatment option for osteoarthritis of the knee and/or hip. Results of the study indeed suggest that NEM® is both effective and safe for treating pain associated with osteoarthritis of the knee and/or hip in a European population.

Patients experienced relatively rapid (10 days) responses for pain- related questions with a mean response of approximately 14%. By the end of the follow-up period (60 days) the mean response for pain- related questions had more than doubled to approximately 33%. A brief responder analysis of the data provides a number of clinically relevant highlights. On average, nearly one-fourth of the subjects experienced a 30% improvement in pain-related questions within 10 days (Figure 1). And almost 20% of the study population experienced a 50% improvement in pain-related questions by the end of the study (60 days) (not shown). These results align well with results from previous clinical studies of NEM® that were conducted in the U.S. [6,7].

The safety pro le for NEM® is also of significance as this is the h clinical trial to date in which there have been no reports of serious adverse events associated with treatment. No side effects from consuming NEM® have thus far been identified, excluding the obvious egg allergy concern. This is of obvious importance in a condition such as osteoarthritis that requires long-term treatment.

e trial had a limited initial enrollment (44 subjects), however there was a relatively low drop-out rate (16%) and good treatment compliance. As the trial was also open label, there is the obvious issue of the placebo effect. The inclusion of a placebo control would have provided greater clinical meaning; however, it would have required a significantly larger study population.

Conclusions:

With so many people suffering from osteoarthritis of the knee and hip in Western populations, it is important for patients to have treatment options that are both safe and effective. The reporting of the results from this six center, open label German clinical study demonstrates that NEM® brand eggshell membrane may be a viable treatment option for the management of osteoarthritis of the knee and/or hip in the broader European population. In this clinical study, NEM®, 500mg taken once daily, significantly reduced pain, both rapidly (10 days) and continuously (60 days). It also showed clinically meaningful results from a brief responder analysis, demonstrating that a significant proportion of treated patients will bene t from NEM® supplementation.

Acknowledgement:

The study sponsor was Weber and Weber GmbH and Co. KG. UD, MS and RR are employed by the sponsor. WT and NB have no competing interests. The authors would like to acknowledge ESM Technologies, LLC for providing the powdered NEM® ingredient used to produce the study capsules for this trial.

References

1. Quintana JM, Arostegui I, Escobar A, Azkarate J, Geonaga I, et al (2008) Prevalence of Knee and Hip Osteoarthritis and the Appropriateness of Joint Replacement in an Older Population. Arch Intern Med 168(14): 1576-1584.
2. Altman RD (1999) Ibuprofen, acetaminophen and placebo in osteoarthritis of the knee: a six-day double-blind study. Arthritis Rheum 42(S403).
3. Case JP, Baliunas AJ, Block JA (2003) Lack of Efficacy of Acetaminophen in Treating Symptomatic Knee Osteoarthritis. Arch Intern Med 163: 169-178.
4. Geba GP, Weaver AL, Polis AB, Dixon ME, Schnitzer TJ (2002) Efficacy of Rofecoxib, Celecoxib, and Acetaminophen in Osteoarthritis of the Knee. J Am Med Assoc 287: 64-71.
5. Towheed TE, Maxwell L, Judd MG, Catton M, Hochberg MC, Wells G (2006) Acetaminophen for osteoarthritis. Cochrane Database of Systematic Reviews 1: CD004257.
6. Ruff KJ, Winkler A, Jackson RW, DeVore DP, Ritz BW (2009) Eggshell membrane in the treatment of pain and stiffness from osteoarthritis of the knee: a randomized, multicenter, double-blind, placebo-controlled clinical study. Clin Rheumatol 28: 907-914.
7. Ruff KJ, DeVore DP, Leu MD, Robinson MA (2009) Eggshell membrane: A possible new natural therapeutic for joint and connective tissue disorders. Results from two open-label human clinical studies. ClinInterv Aging 4: 235-240.
8. Wong M, Hendrix MJC, von der Mark K, Little C, Stern R (1984) Collagen in the egg shell membranes of the hen. Dev Biol 104: 28-36.
9. Baker JR, Balch DA (1962) A study of the organic material of hen’s-egg shell. Biochem J 82: 352-361.
10. Long FD, Adams RG, DeVore DP (2005) Inventors. Preparation of hyaluronic acid from eggshell membrane. U.S. Patent No. 6,946,551.
11. Ha YW, Son MJ, Yun KS, Kim YS (2007) Relationship between eggshell strength and keratan sulfate of eggshell membranes. Comp BiochemPhysiol A MolIntegr Physiol 147: 1109-1115.
12. Richy F, Bruyere O, Ethgen O, Cucherat M, Henrotin Y, Reginster JY (2003) Structural and Symptomatic Efficacy of Glucosamine and Chondroitin in Knee Osteoarthritis: A Comprehensive Meta-analysis. Arch Intern Med 163: 1514- 1522.
13. Moreland LW (2003) Intra-articular hyaluronan (hyaluronic acid) and hylans for the treatment of osteoarthritis: mechanisms of action. Arthritis Res Ther 5: 54-67.
14. Benson KF, Ruff KJ, Jensen GS (2012) Effects of Natural Eggshell Membrane (NEM) on Cytokine Production in Cultures of Peripheral Blood Mononuclear Cells: Increased Suppression of Tumor Necrosis Factor-α Levels After In Vitro Digestion. J Med Food 15: 360-368.
15. Ruff KJ, DeVore DP (2014) Reduction of pro-inflammatory cytokines in rats following 7-day oral supplementation with a proprietary eggshell membrane- derived product. Mod Res Inflamm 3: 19-25.
16. Baron G, Tubach F, Ravaud P, Logeart I, Dougados M (2007) Validation of a Short Form of the Western Ontario and McMasters Universities Osteoarthritis Index Function Subscale in Hip and Knee Osteoarthritis. Arthritis Rheum 57(4): 633-638.
17. Bilbao A, Quintana JM, Escobar A, Las Hayas C, Orive M (2011) Validation of a proposed WOMAC short form for patients with hip osteoarthritis. Health Qual Life Outcome 9: 75.
18. National Research Council (2003)Guidelines for the Care and Use of Mammals in Neuroscience and Behavioral Research. The National Academies Press Washington, DC.
19. IBM Corporation. SPSS Statistics.
20. Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, et al (2008) Estimates of the Prevalence of Arthritis and Other Rheumatic Conditions in the United States. Part I. Arthritis Rheum 58: 15-25.

21.U.S. Centers for Disease Control (2007) National and state medical expenditures and lost earnings attributable to arthritis and other rheumatic conditions -United States, 2003. Morbidity and Mortality Weekly Report 56: 4-7.

22. Cook C, Pietrobon R, Hegedus E (2007) Osteoarthritis and the impact on quality of life health indicators. Rheumatol Int 27: 315-321.

This year’s CHFA East trade show was nothing short of informative with over 850 exhibitors showcasing the latest in the natural health and organic food industry. From beauty products and natural supplements to innovative grocery items, the show was filled with industry experts, retailers, manufacturers, and distributers from every niche.

Check out some of this year’s booths that shared their inspiring brand philosophies and new products at the Metro Toronto Convention Centre, from September 16-17.

According to research conducted by The Ohio State University, researchers discovered that mice modelled with a strain of lupus showed signs of improvement after walking every day for 45 minutes on a treadmill. Compared to 88 per cent of the mice who didn’t exercise who had severe inflammatory damage the kidneys, 45 per cent of the mice who exercised showed less signs of kidney damage.

Researchers found that biomarkers that serve to increase inflammation, decreased immensely for the mice who partook in regular exercise.

In addition to analyzing the exercise experiments, the research team wanted to track the implications of psychological stress that triggers lupus symptoms by placing a mouse with a “stronger” mouse. Results showed that inducing stress increased inflammation and caused more kidney damage in the mice.

These observations are of importance as they can be of use in regulating the symptoms of lupus in humans.

“If we observe similar results in human studies, this could mean that stress reduction and a daily regimen of physical therapy should be considered as interventional strategies to be used alongside current medical treatment,” says Nicholas Young, a senior author and research scientist in rheumatology and immunology at Ohio State’s Wexner Medical Center. “We may have started to characterize an effective way to reduce inflammation and help people with lupus aside from conventional drug therapy.”

While regular exercise is often recommended by health professionals to their patients with lupus, there lacks the scientific evidence to prove why exercise is effective.

“What you hear a lot from patients is that they’re hurting and they don’t want to get out of bed in the morning and don’t feel like exercising,” Young said.”One of the largest hurdles to get over is that it may not seem intuitive that movement will make you feel better, but it does.”

To see whether the results from the mice research could work for human patients, the research team conducted a pilot study where they enrolled a group of lupus patients into a tai chi program that focused on reducing stress and exercise. In the same way that the mice showed a decrease in inflammatory biomarkers, humans also showed positive results.

To elaborate on their findings, Young is seeking more funding to gather more research and potential evidence.

“We’ve shown on a molecular level that both exercise and stress can impact inflammation by regulation of the immune system, which may provide a unique opportunity to help people suffering from the chronic inflammation associated with autoimmune diseases like lupus,” says Young. “If we find consistent benefits in a large group of people with lupus and can standardize a specific regimen, you could almost imagine a prescription for exercise and stress reduction.”

Daniel Staackmann, owner and president of Upton’s Naturals, spoke candidly with Jenna Blumenfeld from Supermarket News about veganism and the future of the plant-based meat alternatives.

“I’m a vegan of over 25 years, and seitan was always a favourite food of mine. When I started the company in 2006 there was just one national seitan brand and no one doing it locally. It seemed like a good opportunity that there was room for in the market. I chose not to do tempeh and tofu because they are way more complicated to make, and there are so many regional producers of those protein alternatives,” says Staackmann about the inspiration for starting his company.

While Staackmann’s meat alternatives appeal to himself and vegans alike, all types consumers are enjoying Upton’s alternative meat products to simply reduce their meat intake for dietary purposes. “Less than half are vegan,” says Staackmann. “That’s based off social media posts, consumer events and in-store demos that we have done. It doesn’t seem like we’re 70 percent die-hard vegans and then just 30 part-time vegetarians. It really seems like there are just more and more people trying to reduce the amount of meat in their diets. We think a lot of our customers eat vegan most of the time, and then once in a while they have a steak.”

When asked about food-tech versus old-school ingredients like tofu and seitan, Staackmann favors the old-school approach to the industry but sees how high-tech methods can benefit the industry and be of interest to consumers. “As consumers are drawn to a more vegan diet, they’ll start to explore other alternatives such as seitan. All those big investments and food-tech companies are certainly helping the entire vegan category,” says Staackmann.

In terms of merchandising meat alternatives, Staackmann is aware of the controversy of placing vegan products in the meat aisle—a ongoing industry discussion that’s difficult to ascertain. “There’s been a lot of debate in the industry—is integration better than having the subset somewhere else like in dairy or produce? You would think, yes, if they are in the meat case, maybe you’re going to find that eaters of meat can make decisions to choose vegan protein easier. But consumers of meat alternatives have been pushed into those dairy and produce areas for so long to find vegan products, I wonder if you’re going to lose out on those people. As a longtime vegan, I don’t enjoy going into the meat department to find things. I’m very curious to see what’s going to happen in that regard,” admits Staackmann.

As meat alternative products continue to expand, Staackmann believes that plant-based eating is a decision that more people are likely to turn to. “I just don’t see any reason for anyone in 2017 to say “veganism is ridiculous, why would I do that?” How many studies do there need to be that prove a vegan diet is healthier and better for the environment? Even setting aside the animal rights issues, do you not care about the environment and your own health?” says Staackmann. “There are so many alternatives right now that make it easy to make the transition.”

While Upton’s Naturals is based in Chicago, a selection of their meat alternative products are available to purchase in Canada at vegansupply.ca.

Back to school shopping doesn’t just mean a jump in office supplies sales—sports drinks also saw a 35 per cent increase from last year during August 13 – September 10. According to the Nielsen Insights report, the back to school shopping rush is a popular, and successful time for beverage companies.

“While there is definitely seasonality to sports drinks, there is a spike in the weeks heading back to school,” says director of health and wellness strategic insights at Nielsen Andrew Mandzy. “In addition, households may perceive sports drinks as a healthier alternative to soda or juice boxes that would typically go into lunches.”
  
According to the Nielson Insights report that sought after research concerning back to school lunchtime and snaking needs, consumers are spending more one sports drinks without artificial sweeteners, as well as 19 per cent more on beverages that are sugar free during the back to school period. The report also showed that low-sodium drink options also sell well during this time, including those with antioxidant properties.

In terms of back to school lunches, mangos saw a 75 per cent increase when compared to two years ago. In addition, apples were on the top of the produce list in 2016, showing that healthy snacks are of a priority.

Steve Reuter, a third-generation farmer, is transitioning into organics at his dairy farm in Minnesota—a transition that hasn’t come without its costs. Aside from adapting to the needs of the animals, transitioning into organics means buying organic seeds, maintaining a pesticide-free pasture, and hiring a company for proper certification—all of which comes with higher labor costs and an increase in prices.

As more companies decide to produce organics like Reuter’s dairy farm, the industry is placing a close microscope on companies that are utilizing organic labelling, especially for marketing.

According to Mark Kastel, co-founder of an organic industry monitoring company called the Cornucopia Institute, about half of the organic milk sold in the U.S. comes from dairy farms with a large supply of cows that can be difficult to monitor accordingly. “We have livestock factories with as many as 15,000 cows on an ‘organic operation,’” explains Kastel. As a result, it’s not unusual for large farms to push what it means to be considered as “organic.”

“Now that corporations have invested in organics, they would like to use that label for marketing purposes, with as little encumbrance as possible, in terms of their bottom line,” says Kastel.

For this reason, organic farms like Reuter’s must also provide detailed documents of the products they are buying to the certification company in order to meet industry standards.

Likewise, organic imports are also questionable, not only for the American market but for international markets like Canada’s organic industry. With a growing Canadian market that’s worth an estimated $3.7 billion, tightening the standards on the industry in the states will help to maintain the reputability of the Canada’s industry. Recently, the USDA discovered that soybean shipments from Turkey were fraudulently labeled as organic. As a result, the USDA removed the Turkish company’s organic certificate.

“There are some certification agencies we think are absolutely at fault for either turning a blind eye or being negligent about the grain that’s coming in from foreign countries,” explains John Bobbe, executive director of Organic Farmers Agency, a marketing group for U.S. organic producers. For this reason, Bobbe claims that the USDA should hire more inspectors when it comes to importing organics.

In the meantime, strategically—and carefully—transitioning into the organic industry by taking part in the necessary steps is a must as the industry continues to grow and expand—a process that Reuter’s farm is taking seriously in order to maintain the integrity of organics.