Healthy and Vibrant — At Every Age

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Nearly 8 in 10 women and 7 in 10 men in the U.S. take dietary supplements, says Trisha Sugarek MacDonald, BS, MS, sr. director of R&D/national educator, Bluebonnet Nutrition Corporation. Needs change throughout our lifespan, and while there’s no one-size-fits all approach (making it key that each individual consult a healthcare professional), we asked the experts to give an overview of some main concerns that affect both men and women throughout the years, and the nutritional support that can help keep us feeling forever young.

For women

Taking a broad look at what’s trending for women, Vincent Tricarico, VP, Contract Manufacturing, NutraScience Labs, notes: “With respect to women’s health, we’ve found that brand owners are focusing on creating high-quality sleep support products, stress reduction products, and formulations that address gut health. Additionally, we’ve noticed that beauty from within is a surging category right now—collagen is absolutely huge. We’ve also recently worked with a few high profile brands that have created new products intended to reduce bloating and boost metabolism.” Read on for a closer look at top interests and needs for women’s health.

20s and 30s
“When women are young and in their 20s/30s, they are typically immersed in their education or in the early stages of their careers,” says Sugarek MacDonald. “These women are focused on being healthy, maintaining a healthy weight and some may even be considering starting a family.” In terms of supplements, she adds, these women may gravitate towards a daily multivitamin and mineral formula. Bluebonnet offers Ladies’ ONE Whole Food-Based Multiple, a one-a-day with coenzyme forms of the B vitamins, plus Albion chelated minerals, an organic whole food vegetable blend and a plant-sourced enzyme blend. The multiple also contains extracts from ashwagandha, red raspberry, cranberry, tart cherry, cinnamon and rose hips (to help address menstrual symptoms, support urinary tract health, and help manage blood sugar levels within the normal range), as well as garcinia cambogia (to support healthy weight management when combined with proper diet and exercise).

One issue women deal with throughout their lives: Stress, says David Winston RH(AHG), founder and formulator at Herbalist & Alchemist. “Adaptogens and nervines which help enhance the body’s stress response play a role in many of my formulas. Depending on the underlying issues, different combinations of adaptogens, nervines, anxiolytics, nootropics or restorative tonics are chosen to specifically address common mental and emotional problems.”

For women in their 20s and 30s, Winston continues, there can be a hormonal component. “Herbalists will combine herbs that address conditions from different angles but also work well together. For stress with a hormonal component, I use a formula which we call Women’s Calmpound, the most prominent ingredient is Chaste Tree, along with the nervines Motherwort, Skullcap, Blue Vervain, and a small amount of the powerful herb Pulsatilla. It is specific for PMS-induced anxiety, irritability, nervousness and mild depression.”

In addition to feeling ageless, women want to look ageless. “In their 20s and 30s, having good hair, skin and nails has supported a multi-billion dollar beauty industry for women, but these physical characteristics reflect inner health,” points out Winston. “Osteoherb, our encapsulated formula to support healthy bone structure, also helps strengthen hair and nails.”

Another major player in the beauty-from-within category: collagen. Samantha Ford, director of business development, AIDP, Inc., notes that after age 25 skin begins to lose elasticity. “The youthful qualities of the skin will deteriorate rapidly, unless action is taken to support your skin’s intrinsic defense system. The process of skin aging is both intrinsic and extrinsic. Intrinsic aging is due to genetic and hormonal processes. Extrinsic aging is caused by external factors such as smoking, UV radiation and pollution. Extrinsic and intrinsic aging reduce the number and the quality of collagen fibers. They also reduce the skin’s elasticity and uniformity.”

Collagen I is the most abundant collagen of the human body, Ford adds—but levels fall (they can drop by as much as 30% by the age of 45), resulting in wrinkles, fine lines, and dry skin. AIDP offers Naticol, a natural source of Type I collagen peptides. “Human clinical studies have shown that regular intake of Naticol Fish collagen peptides improves skin moisture and elasticity and reduces wrinkles,” Ford says. “Naticol has clinically demonstrated its role as an ingredient in anti-aging applications.”

Also of benefit for younger women: Bergstrom Nutrition is pursuing female-specific research based on the results of a yet unpublished study on OptiMSM performed at UC-Davis, shares Tim Hammond, VP of sales and marketing, Bergstrom Nutrition/OptiMSM. ”The surge of estrogen in the period around ovulation decreases the stiffness and cross-linking of collagen, which in turn leads to ligament laxity. Women are 4 to 6 times more likely to rupture an ACL than men participating in the same sport and it is highly likely estrogen and its effects on ligaments may be a contributing factor. The initial research suggests MSM increases collagen cross-linking in engineered human ligaments treated with high estrogen. The results demonstrate OptiMSM might completely reverse the negative effects of estrogen on ligament mechanics. The current follow-up clinical study focuses on determining the effect of OptiMSM on knee laxity changes through the menstrual cycle in young, active women.”

Reproductive health is another central focus. “If I only had one herb to choose for the female reproductive system, it would be Chaste Tree or Shatavari,” says Winston. “But the ability to combine them with other herbs allows one to make a formula more specific for different age groups.” For those in their 20s and 30s, he says, the focus is on balancing a woman’s hormonal system during childbearing years using the nervine Motherwort, uterine tonifier Raspberry leaf, blood builder Processed Rehmannia, Dong Quai, Ginger and Chaste Tree—herbs found in the company’s Women’s Formula. And to provide support for menstrual cramps, Winston suggests a combo of the antispasmodics Black Haw, Roman Chamomile and Wild Yam with the herbal analgesics Cyperus, Corydalis and Jamaica Dogwood, as found in the company’s Full Moon Women’s Anti-Spasmodic.

Choline is another nutrient young women may want to consider: Research conducted at Cornell University (using supplemental choline provided by Balchem, makers of VitaCholine) suggests choline intake during pregnancy, particularly in the last trimester, helps women achieve optimal cognitive benefits for their children.

And after pregnancy: Poor bladder control is relatively common—especially after childbirth and increasing with age, says Dr. Tracey Seipel, N.D., CEO/founder, Seipel Group. “Urinary incontinence affects 25% of reproductive age women.” For up to 70% of American women (the highest prevalence globally, she says), stress urinary incontinence occurs for one to four years after childbirth, with pelvic floor muscle weakening as a result of prolonged excessive strain during pregnancy and childbirth. “These women do not get warning of the bladder accident that occurs with coughing, laughing, jumping and sneezing. Bladder control may improve with time for some women and then recur with increasing frequency with age.”

Dr. Seipel adds that multiple trials have been conducted to confirm the effectiveness of Seipel Group’s Urox ingredient, a patented 3-herbal combination of the Ayurvedic Crateva nurvala, Equisetum arvense and the Japanese/Chinese Lindera aggregata. Results of the latest trial, she shares, showed that over two months of use, total average day frequency returned to normal, urinary urgency was reduced by 60%, there was close to a halving of nocturia (getting up to go at night) and a 60% reduction in urinary incontinence (both stress and urgency). What’s more, 75% of Urox users reduced their pad usage to one or less per day and 23% of participants reported they were fully continent by two months. All Urox users, Dr. Seipel continues, showed improvement in quality of life—and results were seen in as little as two weeks.

One more to consider: “Because women in their 20s and 30s are at a higher risk for urinary tract infections (UTI), it’s smart to be proactive with a targeted blend of probiotics and cranberry like that found in our Kyo-Dophilus Cranberry+ Probiotic,” says Jay Levy, director of sales, Wakunaga of America. “Studies show that cranberries possess anti-adhesion properties that prevent harmful E. coli bacteria from adhering to the cells within a woman’s urinary tract. Adding a probiotic helps protect against the transfer of pathogenic bacteria from the intestine to the urinary tract. Combining a concentrated source of cranberry with probiotics into one convenient supplement is an easy way to sidestep a future UTI.”

40s, 50s and beyond
As women mature, Sugarek MacDonald says, they may start to consider taking products to support specific structure-function applications in the body. “Women, for instance, in their 40s may become interested in products that fit their individual needs and busy lives. Products for managing stress levels, supporting healthy sleep patterns, and possibly helping to turn back the hands of time.” Bluebonnet’s Targeted Choice Stress Relief Vegetable Capsules, she says, are a great adjunct to help keep stress levels in check.

Between family, career, and social obligations, 40-somethings often find themselves feeling more stressed and spent, adds Levy. “Instead of reaching for that mid-afternoon latte or candy bar to make it through the day, a healthier option is a green drink.” Kyo-Green Greens Blend Energy is rich in barley and wheat grasses, FOS, chlorella, and kelp, he shares, adding that the product provides a nutritious alternative to caffeinated drinks or sugar-laden energy bars, giving women a healthier way to power up.

On the herbal front for stress, Winston says, “In their 40s and later years, as women take on more responsibilities—in their careers, for aging parents and other stressful issues—and the resultant anxiety and emotional lability has become more intense, they need greater support. I mix the nervines Motherwort flowering tops, milky Oat seed, Bacopa, and Blue Vervain with calming Chinese Polygala, hence the name Tension Relief. This formula has anxiolytic, nervine and nootropic effects.”

Women transitioning into their 50s+ often worry about maintaining vitality so they can be active with their kids and grandkids well into their senior years, says Sugarek MacDonald. “Providing the right nutrients to counteract the negative effects of aging is typically their number one goal but women also want the extras to help support menopause, bone health and cardiovascular needs. So, in addition to supplying complete nutritional support for women in their prime, Bluebonnet’s Choice Multiples Ageless Choice For Women 50+ Caplets also incorporates pomegranate, tomato extract and coenzyme Q10 into this innovative multiple for women over 50 to help support her aging heart.” The formula also delivers antioxidants, vitamins C, E and beta-carotene, as well as a special blend of turmeric, elderberry, marigold, green, white and black tea extracts, as well as glucosamine and MSM to help maintain the fluidity of motion and the normal rate of repair of healthy joints, and acetyl-L-carnitine, ginkgo biloba extract and phosphatidylserine to maintain healthy brain function, and extracts from dong quai, black cohosh, red clover and flax lignans to help mediate hormonal health issues.

Once women hit 50, says Levy: “Everyday digestive ailments like dyspepsia, gas, and heartburn can make life uncomfortable and occasionally embarrassing. A daily dose of digestive enzymes plus probiotics can help to prevent these gastrointestinal issues while also fostering good gut health. Kyo-Dophilus Enzyme+ Probiotic combines four key digestive enzymes with three powerful probiotics to support optimal digestion and a healthy microbiome.”

And when menopause strikes: “Because both combined hormone replacement therapy or estrogen alone have been shown to increase the risk of stroke, blood clots, and heart attack, many women are seeking natural alternatives to relieve hot flashes and other menopausal symptoms,” Levy notes. “Studies show that herbs and botanicals rich in isoflavones can support healthy estrogen levels and may help reduce menopausal symptoms. These include black cohosh, soy isoflavones, wild yam, and chasteberry—all of which are found at clinically effective levels in Kyolic Estro-Logic.”

As women’s female reproductive organs mature, adds Winston, impaired circulation and other uterine function irregularities can be supported again with Chaste Tree and adding Dong Quai for increased circulation and liver and bowel excretion, Saw Palmetto (to relieve pelvic fullness), Chinese Peony, and Shepherd’s Purse and Cinnamon to address passive bleeding—the company’s Uterine Tonic delivers these herbs.

Another concern for women that can increase with each passing birthday: Bone loss. “Usually, men and women have the same bone loss speed in mid-life,” says Ford. “However, women can lose up to 20% or more of their bone in the five years after menopause.” And while low bone density is often thought of as a concern for the older population, Ford adds, it can strike at any age. “It is known that, in human bone, calcium builds bone density and collagen builds the framework for calcium to attach. Collagen plays an essential role in improving bone flexibility. Thus, even the strongest bones can crack or break without collagen. Although the body produces collagen naturally, its production diminishes as we age. As a patented collagen and calcium combination, KoACT has been designed to improve bone strength by addressing the bone organic matrix. It provides calcium and collagen through a unique process that models natural bone structure. The result is a synergistic effect of both nutrients into the bones, creating superior bone strength.

Also critical, per Ford: “K2 MK-7 helps to transfer calcium into the bone and is needed to activate a protein that deposits that calcium in the bone. It plays a huge role in bone formation alongside calcium, vitamin D and other minerals. An added benefit, K2 MK-7 has an indirect cardiovascular benefit as it directs free calcium away from the arteries to help maintain a healthy circulation.” AIDP offers a protected, microencapsulated form of K2 MK-7, K2 Vital Delta.

Brain health is top of mind for many. “Shrinking brain volume begins after age 25 when brain growth peaks,” says Ford. “Research suggests this shrinkage equates to roughly 5% per decade after 40 years of age, which accelerates to an even greater degree after age 70. As the brain ages, it loses efficiency due to loss of neurons and reduced synaptic density and plasticity. The result is declining cognitive function over time. Cognitive health covers a range of conditions including memory loss, stress or anxiety management, phobias, sleep issues and other degenerative conditions.” All of these, she says, are controlled by the health of the brain.

Magnesium plays a role in many brain and nervous system functions; Ford notes that AIDP’s Magtein (Magnesium l-threonate) has been shown to effectively raise the brain’s magnesium levels, which leads to enhanced learning abilities, working memory and short and long-term memory. “Magtein supplementation led to significant improvements in a composite score of a series of cognitive tests that assessed: Executive Function, Working Memory, Episodic Memory & Attention. Magtein intake led to 10% improvement in a clinical assessment of executive function. This improvement is equivalent to a 9 year reduction in ‘brain age’ after 12 weeks of supplementation.”

“As women continue to age,” Winston says, “nootropics or tonics for mind and memory that increase cerebral circulation help with calm focus. Clarity Compound blends nootropics Gotu Kola and Bacopa with the circulatory support of Gingko, and adds in the adaptogenic Schisandra with the uplifting nervine Lemon Balm.”

Bladder issues also impact 50% of post-menopausal women, and 50%-75% of women in nursing homes, says Dr. Seipel. She notes that bladder issues are associated with shame and remain underreported with most sufferers having to modify their lifestyle and manage with adult diapers and padded underwear, significantly reducing self-esteem and quality of life. And while it is already a large category, with 400 million people globally and more than 60 million Americans, Dr. Seipel points out that it will increase in relevance with our aging population. (See above for details on the science from Seipel Group that can help.)

For Men

Taking a broad look at what’s trending, Tricarico says, “On the men’s health side of things, pre- and post-workout products remain popular, but brands are starting to get really creative as it relates to the flavors they’re coming out with. We’re also starting to see nerve support products that contain B vitamins grow in popularity.” Another surging category, according to Tricarico: Eye health; he notes that products with lutein and bilberry are really popular with consumers (go here for more on eye health). “Last, but not least,” Tricarico adds, “brands are contacting us about formulating cognitive support and cellular energy products.” Read on for more insights on men’s health.

20s and 30s
“Practicing healthy habits while a man is in his 20s and 30s can help reduce the risk of major diseases later in life,” Levy says. “Along with adopting a whole foods diet, including a daily multi-strain probiotic can support a healthy microbiome. Choosing a probiotic that offers a diverse community of beneficial bacteria, including L. gasseri, B. bifidum, B. longum, B. infantis, B. breve, and L.rhamnosus, promotes both strong digestive and immune health. These strains can be found in Kyo-Dophilus Multi 9.”

Men in their 20s and 30s tend to focus on their physical activity and performance needs, says Sugarek MacDonald. “These younger men tend to gravitate towards a daily multivitamin and mineral formula, like Bluebonnet’s Men’s ONE Whole Food-Based Multiple that is a one-a-day, male multiple formulated with coenzyme forms of the B vitamins, plus Albion chelated minerals—in addition to an organic whole food vegetable blend, a plant-sourced enzyme blend, as well as extracts like ashwagandha, saw palmetto, pumpkin seed, broccoli, stinging nettle, rhodiola and American/panax ginseng extracts to help support male stamina and prostate health.”

40s, 50s and beyond
As men transition into their 40s, they start to require additional support for structure-function related issues, such as those associated with bone/joints and heart health, says Sugarek MacDonald. A top seller for Bluebonnet: Targeted Choice Joint Support & Targeted Choice Pain & Inflammation, each of which deliver wholesome ingredients that are necessary for healthy ligaments, connective tissues and joints, and also provide temporary relief from pain caused by physical overexertion, she says. “By employing the right nutrients, the body will be able to repair and maintain cells and tissues for optimal joint health and collagen synthesis that is also required for bone support.”

For an aging population, loss of muscle strength and lean mass is another concern. Enter protein. “Plant proteins appeal to those interested in reducing animal protein consumption but also to special diets of vegans and vegetarians,” Ford says. “There are a wide variety of plant proteins that can be grown in numerous types of conditions. AIDP offers RisaPro, PeasiPro, pumpkin-seed, hemp and many other plant proteins, some of which are available in organic forms.”

In their 50s, Sugarek MacDonald says, “They may prefer a daily multiple with higher levels of certain nutrients like those found in Bluebonnet’s Choice Multiples Age-Less Choice for Men 50+ Caplets.” It contains pomegranate, tomato extract and coenzyme Q10 to support heart health, as well as antioxidants, vitamins C, E and beta-carotene and extracts from turmeric, elderberry, marigold, green, white and black teas to combat the ravaging effects of free radicals caused by a lifetime of stress, pollution, smoking, drinking and processed fast foods. “Additionally, scientifically researched ingredients like saw palmetto, rhodiola, stinging nettle and quercetin have been integrated into the formula to help them maintain the health of their prostate, a growing concern for maturing men,” she explains. “In an effort to help men in their prime stay physically active, mobile and mentally healthy and alert, glucosamine and MSM were included to support joint health, as well as acetyl-L-carnitine, ginkgo biloba extract and phosphatidylserine, which not only increases oxygen to the brain but also facilitates communication between the brain cells for enhanced focus and memory.”

Prostate problems typically become more prevalent, too, Levy notes, adding that research shows the risk of benign prostatic hyperplasia (BPH) increases during a man’s 40s. “When the prostate is enlarged, extra pressure is put on the urethra—the tube that carries urine from the bladder and out of the body—causing a small amount of urine to remain in the bladder. Because of this, those affected may often feel the need to urinate more frequently or more urgently, especially at night. Several key herbs and nutrients, found in our Kyolic Prosta-Logic product, have been shown to reduce the risk of an enlarged prostate and support overall prostate health. These include aged garlic extract, saw palmetto, pygeum, and pumpkin seed oil extract, as well as zinc and lycopene.”

Sexual problems and a loss of vitality can be triggered by prostate issues, reduced testosterone levels, and other factors, Levy adds. “Certain nutrients known as secretagogues have been found to act as testosterone precursors and improve sexual function and vitality. These ingredients include zinc, selenium, codonopsis lanceolata root, l-citruline, maca, tribulus terrestris, and longjack, which can all be found in our Lucky 7 supplement.”

Herbs can help maintain vitality as men mature into their 40s and 50s, agrees Winston. “Herbs are not a replacement for Viagra; they don’t work the same way, but they do strengthen the underlying system, which is a healthier way for men to address sexual health,” says Winston, who has been working as a clinical herbalist for 43 years. “That is the context in which we market this category. Many issues men face including stress, drug side effects, and lifestyle choices impact allover health, including reproductive function. Today more men want to maintain an active lifestyle as they age. If they get the right kind of support, they can.”

What is the right support? According to Winston: “As a general tonic for the male reproductive system, in my Men’s Adapt formula I combine adaptogens Ashwagandha and Red Ginseng to normalize the endocrine, nervous and immune functions. Both herbs have reputations for strengthening male reproductive function, especially in tired, overworked and stressed-out men. I add Cynomorium and Epimedium to help with lack of libido and increase sexual functioning. And Maca is a nutritive tonic that supports healthy male sexual functioning.”

Addressing urinary concerns, Dr. Seipel says, “Since around 2000, there has been a significant paradigm shift in the approach to male lower urinary tract symptoms (LUTS) as our knowledge of LUTS has expanded. In 2001, the International Continence Society categorized the term overactive bladder (OAB) to describe the increasingly more prevalent symptom picture of urinary urgency, with or without day frequency, night frequency and incontinence due to urgency, or not reaching the toilet in time.”

Men often attribute their LUTS to the prostate, Dr. Seipel says, but this is only half the story: “Male urinary symptoms of difficulty emptying/voiding—such as hesitancy, intermittency, weak stream, dribbling and feeling that the bladder hasn’t fully emptied—are likely symptoms due to prostate enlargement.” She adds that the symptom of nocturia (getting out of bed at night for the toilet) is the most bothersome symptom, and may be due to the prostate but may equally be due to a bladder storage problem of overactive bladder (OAB). Symptoms of OAB also include increased urinary urgency, frequency and accidents if the toilet isn’t reached in time, she says.

“A male LUTS approach that focuses only on the prostate, neglecting the bladder, is inadequate with the current knowledge of bladder involvement,” Dr. Seipel maintains. “This also explains why many men find their prostate formula does not provide the complete array of results they were expecting.” To that end, Seipel Group developed Prorox herbal formula specifically to target the bladder and prostate for a comprehensive approach to male LUTS, she explains. “Prorox combines the bladder-supportive benefits of the clinically researched Urox formula with a premium quality saw palmetto for the 5-alpha reductase enzyme benefits in blocking excessive androgen production and the resultant prostate enlargement. Prorox further supports the prostate with additional prostate-specific nutrients of Tomato with lycopene, zinc, selenium and vitamin D3.”

For later in life: “I’ve worked clinically with many men facing life changes, such as retirement and aging issues, who often find themselves feeling isolated, anxious, angry, impatient or disillusioned,” says Winston. “The working title for the formula I developed for this was ‘Grumpy Old Man’ formula, but my staff talked me into the name Men’s Midlife Tonic.” The formula combines Milky Oat seed (Winston says this is a great nerve trophorestorative), Ashwagandha (a calming adaptogen that Winston says helps enhances testosterone production, plus helps elevate mood and offers a mild anxiolytic activity), Mimosa Bark (another mood elevator) and Black Cohosh and Pulsatilla root (both used for hormonal depression). Of course the formula also features saw palmetto. Winston explains that this herb helps inhibit conversion of testosterone to dihydrotestosterone (DHT), which contributes to symptoms.

Strategies to increase sales

1. Go condition-specific: “Highlighting products specific to men’s and women’s health issues at shelf level can help customers sort through the multitude of generalized condition-specific supplements on store shelves,” says Levy. Winston and Ford agree that this is the way to go with supplements. Winston adds, “Condition specific sections are helpful for people seeking new products. Because many herbal formulas can address several conditions and genders, don’t hesitate to have them in more than one place.”
2. Cross merchandise. Sugarek MacDonald advises renovating the women’s and men’s department, making them attractive, interactive and informative for the consumer. Using the men’s section as an example, she suggests: “Cross merchandise, ‘men’s health’ products on an end cap combining dietary supplements, packaged foods, books and possibly fitness cookbooks for men’s health.” And add signage relating to a men’s health– Sugarek MacDonald suggests the Men’s Health Network (MHN) Flyer, noting that MHN is a national non-profit organization whose mission is to reach men and their families where they live, work, play, and pray with health prevention messages and tools, screening programs, educational materials, advocacy opportunities, and patient navigation.
3. Sub-categorize: Sugarek MacDonald recommends selecting wide-ranging and appropriate targeted supplements for each category (mens and womens) and then dividing the product sections into subcategories. Using men as an example,create subcategories formulas for: maintaining prostate health (e.g., saw palmetto, zinc, vitamin C); maintaining muscle health (e.g., whey protein isolates, BCAAs, and nucleotides); maintaining healthy cholesterol levels (e.g., CholesteRice, red yeast rice, policosanol, pantethine and plant sterols); providing general heart health and antioxidant support (e.g., CoQ10 – Ubiquinol or Ubiquinone, vitamin D₃, Omega-3 fish oil, flax oil, vitamin E, magnesium and arginine); maintaining a healthy weight (e.g., CLA, chromium etc.)
4. Seek out “white space” areas: “It is important for brand managers to identify and capture the opportunity in ‘white space’ areas,” says Dr. Seipel. “Bladder control, for men and women, is the current white space.” That said, she adds, “Those affected by LUTS and poor bladder control are often reluctant to start the conversation and may search for discreet online or direct mail purchasing methods. However, store owners can offer an invaluable service by starting the conversation and making their customers aware of the natural bladder control products they offer.”
5. Beware product redundancy. “Focus on one particular men’s health subcategory or pick 3 popular items across the men’s health categories for an overall male health approach and then rotate on a monthly basis,” Sugarek MacDonald suggests.
6. Offer support materials: “A well-informed staff and targeted educational material available to customers at the checkout counter, as well as during health fairs and other in-store promotional events, can enhance both customer education and successful merchandising,” says Levy. “Wakunaga provides retailers with a wealth of information, both on our web site and via in-depth fact sheets. We also reach out to consumers directly through educational articles and booklets. These materials are available to retailers free of charge as part of our customer education efforts.” WF

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