And while the pandemic is a major reason for this, it’s not alone. Chris D. Meletis, Naturopathic Physician with Trace Minerals, notes that daily changes can have major impacts: “We are all creatures of habit. Something as simple as watching a scary movie, traveling, or having a change in social activity routinely impacts people’s sleep quality and quantity. In the 2020/2021 COVID Era there have been so many changes in work, finances, news, isolation and separation, and just change in living patterns—the natural circadian rhythm (sleep-wake/light-dark) cycle has changed. Then you add more TV, smart phone and computer time, including Zoom calls, etc. that offer even more blue light activation to our eyes—a vast majority of people have been suffering sleep deprivation at some level.”
People who ended up working from home likely saw this in a major way: “The co-mingling of work and personal life can also disrupt sleep, eating, hygiene, and exercise schedules, which may become less distinct and less effective than before, and affect relationships with family or housemates,” says Neil E. Levin, CCN, DANLA, Senior Nutrition Education Manager, NOW. “It can even create power struggles in the home.”
Outside the home wasn’t much better. Patrick Sullivan Jr., Chief Entertainment Officer at Jigsaw Health LLC, told WholeFoods: “According to a report by American Psychological Association entitled Stress in America 2020, 65% of adults say the current amount of uncertainty in our nation causes them stress.” 31% of Gen Z adults reported disrupted sleep patterns, 28% reported eating more unhealthy foods than usual, and 28% reported weight changes. Sullivan saw the impact on his business: “We saw huge growth of Jigsaw MagSoothe in 2020 that continues into 2021. MagSoothe is a magnesium glycinate powder that’s designed to help relax legs, muscles, and brain for better sleep. Magnesium is ‘mother nature’s original chill pill.’”
Jigsaw wasn’t the only business to see this impact—Lauren Clardy, VP Branded Products, AIDP, cites NBJ, noting that “sleep support supplement sales grew over 35% and mental health/mood/stress sales were up almost 30% in 2020.”
Kartikeya Baldwa, CEO of Ixoreal Biomed, makers of KSM-66 Ashwagandha, points to the importance of science-backed products as people go looking for support. “The biggest change for everyone in every way has been COVID-19. The global pandemic has caused widespread suffering and death around the globe, and people have reported poor sleep and high levels of stress. This has been in the news constantly. Inevitably many turn to herbs for help. In this way, natural agents like ashwagandha that demonstrate efficacy for sleep and stress reduction in human studies are growing in popularity. This not only satisfies people in need, but also has a stimulating effect on the botanical market, boosting companies that conduct rigorous science. With a lot of published human sleep and stress studies, KSM-66 ashwagandha has seen very strong growth, as people get their needs met.”
And this may only be the beginning, according to Douglas MacKay, N.D., SVP Regulatory & Scientific Affairs at CV Sciences. “Not only has COVID-19 impacted all areas of life, but some experts suggest that the pandemic is also fueling an imminent mental health crisis. Recent research—including a study by Columbia University published in March 2021—show an increase in the prevalence of depression and anxiety since the start of the pandemic. Disruption to daily routines and concerns about health, safety, job security, and the economy have led to increased feelings of stress and anxiety. As infection rates decline and pandemic restrictions ease across the country, the pressure of returning to ‘normal’ life can fan the flames of stress even further. This is especially concerning given that stress and anxiety can affect quality of sleep, which impacts overall health and wellness.”
The Stress-Sleep Cycle
“Stress and sleep are unavoidably linked, and unfortunately, the impact of each can be cyclical in nature to the other,” says Bluebonnet Nutrition’s Trisha Sugarek MacDonald. “For instance, significant stress in an individual’s personal or work life causes the brain to send signals to the autonomic nervous system (ANS) to release hormones like cortisol and adrenaline in large quantities. These hormones will engage the flight or fight response in the body, putting the brain and body on full alert, contributing to sleep deprivation. On the other hand, poor quality sleep due to chronic health conditions, like heartburn, respiratory issues (i.e., sleep apnea), or even thyroid disease, may elevate stress levels beyond what is appropriate. This is because, without quality sleep, the brain cannot recollect itself, causing mental tasks, worries, and other cognitive stressors to carry over to the next day. To put this in perspective, the Centers for Disease Control and Prevention (CDC) approximates that 35.2% of adults in the United States are getting less than 7 hours of sleep each night, far below the standard of 7 to 9 hours, daily. This can lead to a sleep deficit that results in lasting physical and mental health problems and can contribute to stress, which roughly affects one out of every six adults in the form of depression and/or anxiety.“By adapting to stress, mindfully,” Sugarek MacDonald continues, “individuals can recover more quickly and this is crucial for preventing chronic stress in the future, which can morph into depression. Consumers can adapt to stress better and manage sleep cycles by using amino acids, adaptogens, and melatonin, but for optimal recovery, we suggest the adjunctive use of healthy sleep, exercise most days, and good nutrition.”Getting a Good Night’s Rest “People are finally beginning to understand why every effort should be made to ensure they get a deep, restful sleep, as we see an ever-increasing emphasis on the importance of sleep and how it primarily affects every aspect of our health,” says Todd Lamb, CEO of PureLife Organics.
Sleep is not for the weak—it’s for the strong: “Sleep is a critical function for mind and body health,” says Marlena Hidlay, Global Strategic Marketing Manager, Balchem. “It’s the reduced energy demand while we’re asleep that lets us recharge so we can use energy efficiently while we’re awake. It allows the body to repair cellular components that are depleted during the day. Sleep aids in the crucial process of neural reorganization and growth and repair of the brain’s structure and function.”
Simply closing one’s eyes, however, isn’t good enough. “New research indicates the importance of restorative sleep—waking up refreshed, restored, and ready to take on the day’s challenges,” says Dr. Lelah. “Clinicians are seeing a rise in non-restorative sleep. There is also new research into sleep regulation, and it seems there are other processes occurring besides circadian rhythms. There is also new research into the effects of sleep—or lack of sleep—on the body’s metabolic function, hormonal activity, and cardiovascular function.”
Lamb pinpointed some of that research. “Recent science has emphasized the importance of ensuring that people are not missing the most important phase of sleep, known as N3 or Slow Wave sleep. This is the period in which all of the restorative cellular activity takes place, and memory is compiled. However, there are many environmental factors disrupting this most important phase, such as ongoing blue light exposure from phones and laptops, dietary disruptions, depleted nutrients such as magnesium, and a variety of emerging issues.”
As customers come to this understanding, Dr. Lelah says, they’re looking for the science-backed products that may be able to help them. “A new high potency ashwagandha extract has been clinically shown to support restorative sleep and is getting a lot of attention,” he notes. “L-theanine produced by fermentation to mimic the natural enzymatic processes in tea leaves has also been shown to help with stress, anxiety, focus and sleep, without the nightmares and drowsiness typical with pharmaceuticals or hormones.”
Reishi mushrooms are another science-backed option. “Reishi has been shown to improve sleep quality while supporting our nervous system,” says Mark Kaylor, Consultant with Mushroom Wisdom and Founder of the non-profit Radiant Health Project. “Research found that Reishi reduced the time to fall asleep, and increased the total time spent asleep. It is particularly effective for those whose sleep issues revolve around an overactive mind.” And, Kaylor notes, reishi is multifunctional: “Reishi has been shown to reduce stress and protect against its damaging effects; it can support healthy adrenal function and offer neuroprotective activity; and it can help support a healthy inflammatory response and healthy immune functioning.”
Looking at an alternative route, Kaylor suggests lion’s mane: “Lion’s mane works differently than the majority of sleep aids—not as a sedative, but as a Qi tonic that energizes an individual throughout the day, so that come bedtime the body is ready to sleep. Mushroom Wisdom’s proprietary Lion’s Mane Amyloban has been shown in a clinical study to provide relief from obstructive sleep apnea, which is thought to affect nearly 1 billion adults worldwide and 1 in 5 adults in the U.S.; the study showed improvements in oxygen levels, as well as snoring.”
Also pointing to magnesium as vital, Hidlay reports: “Innova Market Insights reports 1,609 new product launches with ‘sleep’ as a health benefit claim since January 2019, and 44% of those products included magnesium. Magnesium is a key nutrient used for relaxation and sleep: It promotes mood and relaxation by reducing cortisol levels, regulates mood by modulating glutamate uptake at the NMDA receptor, and helps muscles relax. And when formulating minerals, the best forms are chelated, which are better tolerated, more bioavailable and taste better.” Albion offers MetaMag, magnesium bisglycinate, wherein the chelation offers dual benefits: the glycine forms a protective shell, allowing the magnesium to be better utilized; and Hidlay tells WholeFoods that supplementation with glycine itself has been shown to significantly improve subjective sleep quality by aiding the body’s temperature reduction, while its action as an excitatory modulator and inhibitory neurotransmitter is useful in mood regulation.
This is a great opportunity to showcase the benefits of natural products—but it’s also a chance to lose a customer. “Sleep, or lack of sleep, is a condition that consumers can ‘feel,’” says Sarah Kunzer, Marketing Manager at NutriScience, “and thus new ingredients for consumers must be supported by high-quality clinical trials with good results, or consumers will not purchase these ingredients. Additionally, consumers often want a quick fix, desperate to get a good night’s sleep. They can often be discouraged by products and ingredients that take a long time to work or if they cannot feel the effects. This makes for a prime opportunity for ingredients that are experiential, like ashwagandha and L-theanine, where consumers can feel the effects within a shorter period of time. This leads to better user satisfaction and more repeat purchases. Consumer brands are relying on their ingredient suppliers for leading research and educational materials they can use at the retail level. This creates opportunities for new effective sleep ingredients without side effects such as nightmares or drowsiness.”
It’s also important to make sure that specific ingredients are studied—for instance, not all L-theanine is the same. Derek Timm, Technical Sales Director of Taiyo International, notes that the company’s Suntheanine has been studied for sleep. “On top of the studies that showed relaxation benefits, a new study published in late 2019 showed a significant improvement in the validated Pittsburgh Sleep Quality Index subcategories sleep latency, sleep disturbances, and less use of sleep medications (Hidese, 2019),” Timm says. “This same study showed some benefits for cognitive function as well. Taken together, Suntheanine may help stressed people relax, work more efficiently, and get a better night of sleep. That said, we are seeing continued growth in the stress and sleep categories, which presents a new opportunity to educate companies and consumers alike. Furthermore, Suntheanine is well positioned to meet the relaxation needs because the effects can literally be felt within 30-60 minutes, which helps new customers immediately become believers.”
Blue Light
Blue light from phones and computers was a problem before the pandemic; now, with students and office workers on computers more than ever, the issue has only gotten worse. “A study published in the Indian Journal of Ophthalmology in November 2020 showed that almost 94% of respondents reported an increase in their screen time since the lockdown was declared, while nearly 63% reported disturbances in sleep,” says Sabrina Di Blasio, Director, Corporate Communication & Branding, OmniActive Health Technologies. “Digital devices emit high-energy blue light, which is believed to play a role in regulating sleep/wake cycles.”OmniActive offers Lutemax 2020, a branded blend of lutein and zeaxanthin, which—besides helping protect eyes against blue light—has been shown to significantly improve sleep quality in subjects exposed to blue light. Di Blasio adds: “Lutemax 2020 has been clinically shown to help reduce stress, promote calm and positive mood, and reduce serum cortisol.” Di Blasio tells WholeFoods that educating retailers and consumers on this matter is a major challenge—and opportunity: “While being a blockbuster ingredient most closely associated with eye health, the benefits of macular carotenoids beyond visual support are also manifold. The macular carotenoids have been clinically shown to support healthy, beautiful skin, cognition, and yes, mood, stress, and sleep! OmniActive works closely with our partners to provide not only sound science to support these health benefits but also content that they can in turn use in their communications—i.e., social media, websites, marketing materials, etc.—to help reach their target consumer audience.”Single Ingredients… There are plenty of ingredients that can be used to support healthy sleep, stress, and relaxation. Levin points out several:
- 5-hydroxytryptophan (5-HTP) is the immediate metabolite between L-tryptophan and serotonin; Levin notes that it can be extracted from the bean of Griffonia simplicifolia.
- GABA, or gamma-aminobutyric acid, functions as a neurotransmitter. “GABA is known as the brain’s own calming agent and is naturally produced in the body,” Levin explains. “By supporting a naturally balanced level of brain stimulation, GABA’s presence within the central nervous system may help promote relaxation and ease nervous tension.”
- L-dopa is a precursor of the neurotransmitter dopamine, which contributes to working memory, attention, and mood regulation. “The legumes of the Mucuna family are known to naturally possess the direct dopamine precursor, L-dopa,” Levin says. “Unlike dopamine, L-Dopa can penetrate the blood-brain barrier and can be used by the brain to produce dopamine.”
- L-tryptophan, an essential amino acid that’s a precursor of serotonin and melatonin. Serotonin regulates positive mood and the stress repsonse, and melatonin regulates the circadian rhythm.
- Melatonin itself is involved in regulation of the normal sleep/wake cycle, regulation of the immune system, and maintenance of a healthy gastrointestinal lining—and while the GI tract may not seem particularly related to sleep, Levin points out that sleep and relaxation can be disturbed by GI distress.
- Saffron can help support a positive mood, a relaxed attitude, and may promote restful sleep; it seems to influence neurotransmitters such as serotonin and GABA. “Other studies suggest that saffron may also help to support a balanced immune response and is a powerful free radical neutralizer,” Levin adds.
- Taurine is an amino acid that has a relaxing effect on mood and nerves.
And some contend that the best way to use those actives is by blending them. “In all systems of traditional medicine, herbs are used in complex formulas,” says David Winston, RH(AHG), Founder and President, Herbalist & Alchemist. “Many Americans use herbs as ‘simples,’ one herb at a time. While this approach can work, it is not how herbs are the most effective. However, simply throwing a bunch of herbs together is not always a good idea, and is sometimes a terrible idea. Over many millennia, traditional practitioners have come to understand the concept of synergy. The skillful combining of herbs can create something that is more than the sum of its parts—1 + 1 = 3—and poorly designed combinations can create anti-synergy, or antagonism, where 1 + 1 = 1.”
A blend of ingredients—offering synergistic benefits and effects—may be well worth the money, for some customers. There are plenty of blends available. One from Trace Minerals: “The Sleep formula, which provides the body with a foundational array of trace minerals combined with a proprietary blend of naturally occurring substances,” suggests Dr. Meletis. “For instance, it contains GABA, a naturally occurring brain chemical in the human body that helps provide a calming to the nervous system. Also, the formula contains a special amino acid from green tea called L-theanine that has been shown in studies to help individuals relax and feel calmer. These are combined with a synergistic blend of traditionally used botanicals called nervines.”
A blend from Bluebonnet: Targeted Choice Sleep Support, which contains valerian root, L-theanine, tart cherry extract, passion flower extract, 5-HTP, and chamomile flower powder. “We only use sustainably harvested or wildcrafted herbal extracts,” says Trisha Sugarek MacDonald, BS, MS, Sr. Director of R&D/National Educator, Bluebonnet Nutrition. “Our Stress Relief and Sleep Support products contain scientifically relevant/meaningful quantities of each complementary ingredient supported by science to help the body cope with and/or revitalize from emotional and physical stress; improve cognitive performance and memory; encourage overall balance in the body as it relates to managing stress; support an overall sense of relaxation; and minimize occasional sleeplessness.”
And, of course, Herbalist & Alchemist offers several. “My Calm Adapt formula is designed for high-strung people who cannot relax,” Winston says. “I combined calming adaptogens ashwagandha, reishi, and schisandra with nervines oat and linden flower; it helps provide a serene, calm mindset, reducing anxiety, agitation, irritability, and nervousness. I developed Serenity Compound to help reduce an excessive stress response and relieve stress-induced headaches, stress-induced GI symptoms, or mild anxiety; it contains the nervines fresh milky oat and skullcap, chamomile, linden flower, and the adaptogen eleuthero. One of our biggest sellers is our Stress Support Kit, which contains Serenity Compound as well as Tension Relief, which supports a calm mind; Daily Adapt, which promotes energy and balances stress; and Phytocalm, which promotes restful sleep.”
Phytocannabinoids “More and more people are turning to CBD/hemp extract for sleep aids, as it has even more benefits than just helping you fall asleep,” says Rachel Stewart, Marketing Manager, American BioSciences. “It can also help soothe anxiety, bodily discomfort, and more.”
But the CBD/hemp market faces more challenges than most in the sleep/stress arena. “The CBD market was hit hard by the pandemic, due in part to retail stores closing and household spending being diverted to essential goods,” MacKay says. “At the same time, the CBD industry itself remains hamstrung due to the lack of federal regulation that is allowing bad actors to stay in the game and keeping major retailers from carrying CBD ingestibles. In addition, DSHEA limits our ability to speak directly to consumers with insomnia or anxiety.”
Seconding that: “Everyone in the CBD and hemp space deals with a certain degree of uncertainty due to FDA’s stance on CBD,” says Laura Fuentes, CEO of Green Roads. “The institution still forbids companies to make any claims about the medical benefits of hemp and CBD. Only time, more research, and greater awareness is likely to change this.”
That said, MacKay points to the 2021 Mid-Year US CBD Report from Brightfield Group, which indicates that we can expect to see a lift in the CBD market as the pandemic ends. “Given this expected resurgence in CBD sales and growing interest in plant-based products for health and wellness, CBD brands have the opportunity to capture new consumers—especially those looking to manage stress and improve sleep without the use of pharmaceutical drugs. Meet consumers where they are—many brands are doing this by introducing new products that combine CBD with other ingredients. Take, for example, our PlusCBD Calm and Sleep Gummies that we launched this year. These condition-specific products combine CBD with meaningful amounts of other plant compounds—such as magnolia and lemon bark—that work synergistically to support the endocannabinoid system and overall health.”
Other cannabinoids show benefits as well. “We’re excited by the possibility of CBN and other cannabinoids in connection with sleep support,” says Fuentes. “Calming down before bed is a huge part of being able to drift off to sleep. CBD is great at helping people manage daily stressors. When you start with melatonin, which is part of your natural sleep cycle, and then add supportive cannabinoids as we do in our sleep products, you have a great addition to your evening routine.”
Combining multiple cannabinoids can help products achieve the “entourage effect”—the principle that a full- or broad-spectrum hemp will have more effects than just one isolated cannabinoid. Along those lines, AIDP offers Certified European Panoramic Entourage hemp oil from Verdant Oasis: “Panoramic Entourage hemp is a food and complete botanical extract with a long history of safety and human consumption,” Clardy explains. “Only EU Commission Certified strains and seeds of agricultural hemp that have not been modified are used. Verdant’s full spectrum hemp is harvested through vertically integrated operations from seed to shelf. These strains are EU approved and are compliant with US regulatory policy with undetectable THC (<0.02%).”
All this being said, PureLife’s Lamb offers a word of warning about the use of cannabinoids to improve sleep. “While it may promote a sleep state, the wrong amounts can completely deprive a user of entering N3 or Slow Wave sleep, thus never giving the user the benefits of sleep.” Be sure to stock products with a dosage that has specifically been studied for sleep.
Nutritional Psychiatry
In February, Naturally Informed hosted the event Mental Wellness: Mastering the Market. One of the keynote speakers was Uma Naidoo, M.D., a Harvard psychiatrist, professional chef, and the author of This Is Your Brain on Food. Her main practice: nutritional psychiatry.Nutritional psychiatry offers clinical guidelines based on nutrition science and evidence-based research for the use of whole foods and nutrients to improve well-being, Dr. Naidoo told attendees. “Not all medical schools educate properly on nutrition,” Dr. Naidoo pointed out. “We are not talking about how our body may be impacted by how we eat.”
Part of how it is impacted is via the vagus nerve, which literally connects the gut and the brain. When food is digested, it impacts the gut environment—and, therefore, the end of the vagus nerve in the gut, which is constantly sending messages to the brain. Dr. Naidoo shared a story of a patient who had always been both healthy and happy, until she got a promotion—and began suffering from severe anxiety. Dr. Naidoo discovered that this patient had stopped homemaking her food, and had started eating less healthily. A diet switch set the patient on the path to recovery.
View Dr. Naidoo’s presentation here. And to see the whole conference, go to www.NaturallyInformed.net and register to view it on demand.2 Challenges 1. Education. Education—and the lack thereof—was cited by nearly every expert, in some form or another. And while it’s always been tough to educate, it’s been even harder this past year, given an inability to educate in-person. “The topic can be very complex,” Lamb notes, making short-form education like that which can take place on Instagram or Twitter difficult. That said, he concludes: “In these challenges lies an opportunity to continue to direct people’s attention to the value sleep has and its role and function in their lives.”
And social media-based education has been the only option available for many businesses, this past year. “We were forced to improve our digital marketing strategy,” says Steve Myers, President of Bio Nutrition. “Since the shutdown, traditional face-to-face meetings and social gatherings became nonexistent, and reaching out to customers became difficult. In addition, we usually host product education sessions at trade shows throughout the year, which have gone virtual. We have had to incorporate more modern ways of connecting, by utilizing our social media platform. These challenges have provided insight into areas we can improve and afford us the opportunity to become better prepared for future interruptions to the normal scheme of business.” And in spite of all that, Myers notes, the company’s sleep and stress sales have soared—largely due to its California Poppy Seed product, with its Sleep Wellness product coming in second place.
Bio Nutrition is not the only brand revamping its education strategy. “The biggest challenge is educating people that were not routinely going into their neighborhood health food store,” says Dr. Meletis. “Trace Minerals Research has partnered with their retail partners and online to offer increased access to electronic educational material.”
Baldwa points out that this is also an issue of protecting consumers and industry from low-quality or adulterated products, noting that combating useless products isn’t so much a regulatory issue as it is an industry one. “Many companies fail in education. This is a never-ending effort. People do not necessarily know to look for the right brands and products, so educating the botanical/supplement industry is critical to the success of high-quality products. Many poorly made or low potency botanical supplements float around in the market. People try them and get disappointed, and this damages the whole scene. We don’t need more regulations. As it is, there is inadequate enforcement of existing regulations. We need companies to rise to the challenge of today’s market by conducting hard-core research and studies to verify product efficacy. Companies like Ixoreal, the makers of KSM-66 ashwagandha, have put such efforts. This boosts confidence in good products, and reinforces the great value of botanical remedies.”
A major part of this challenge, according to Lamb, “is always navigating what one is permitted to discuss with respect to specific ingredients in products and the impact they have to support healthy sleep. The FDA and FTC have very rigorous guidelines regarding structure/function claims which can make promoting natural sleep remedies very challenging.”
Levin agrees. “Research to back claims is complicated by the need to have had them studied on healthy individuals to avoid making illegal disease claims, or implied claims, versus the allowable ‘structure-function claims’ discussing maintaining and supporting already healthy body structures and functions. The wording on labels and websites is often strange and somewhat opaque to consumers due to the mental gymnastics and verbal challenges required to make claims without using terms that suggest improving the body, avoiding illness, or correcting problems other than nutrient deficiencies. The law (DSHEA) prohibiting such claims is ripe for revisiting, and this is one area that could be improved to avoid such consumer confusion.”
2. Supply Chain. “During the pandemic, the supply chain was hit by shutdowns and quarantines that disrupted the availability of many ingredients needed by manufacturers,” recalls Levin. “That problem persists today, as areas of the world where certain ingredients are sourced remain in lockdown. When we add in labor shortages caused by illness, quarantines, physical distancing requirements, and facility closures for additional sanitation, it becomes difficult to meet the increased demand even if additional supplies of necessary ingredients are available. Adulteration of ingredients, such as andrographis, was an ongoing concern that expanded as new suppliers were qualified to replace or augment existing vendors. Even the required qualification of new ingredient vendors to replace or add to current ones was disrupted by an inability to send auditors to facilities due to travel bans; so increased demand has been often unmet by increased production. That means supplement manufacturers are still grappling with lack of inventory and inability to fully supply their customers. We’ve seen both stores and consumers stocking up when supplies are available to avoid interruptions in their nutritional regimens, but that magnifies the supply shortage problem.” And of course, Levin adds, that impacts customers: “If you are afraid that any essential commodity won’t be available next time you shop, it’s only natural that you’d try to stockpile some whenever you can find it. That fuels the fear of potentially running out of needed supplies. The more important an item is to your well-being, the scarier the thought of not being able to get it for a prolonged period of time. Our stress levels hit a peak and stayed there for months.”
A few brands managed to turn these issues into an opportunity. “Due to the pandemic, it was tough for us to source certain ingredients,” says Stewart. “We had to tweak the formula for our popular sleep supplement SLEEPSolve 24/7, but we believe our product has improved because of it. We were able to add two new ingredients that, when combined, will work symbiotically with the others to help customers fall asleep more quickly.”
At the end of the day, there are two points to keep in mind: “Although the pandemic appears to be coming to an end,” MacKay says, “its impact on stress and sleep will persist long after.”
But in the face of that, Dr. Meletis says: “We are all in this together, and together we will rally and grow as a wellness community.” WF
