Gut Check

Digestive health can be considered an underserved market of the dietary supplement industry with enormous growth opportunity.

According to the 2019 HealthFocus U.S. Trend Study, gastrointestinal/gut health is one of the largest growing health concern categories.

Probiotics are still the market leader in digestive health space when it comes to supplements, with a predicted compound annual growth rate of 7.5 percent from 2019-2024 (Mordor Intelligence). However, consumers are always looking for new, different ways to support their gut health with a growing interest in prebiotics and fermented foods, and ingredients that support the overall gut microbiome.

Consumer understanding of the microbiome is growing, and interest is high, said Dr. Justin Green, director of scientific affairs with Iowa-based Embria Health Sciences. He noted that HealthFocus found more than half of shoppers are “extremely” or “very” interested in the gut microbiome and its relationship to overall health.

Green pointed out that there’s also greater awareness about the relationship between digestive health and overall health and wellness. “The HealthFocus survey found more than 70 percent of consumers believe their digestive health contributes to their overall physical health, with six in 10 shoppers believing gut health may be connected to immunity, energy, weight management, mood, healthy aging and stress.”

Karen Dhanraj, technical marketing and sales manager with Canada-based Lallemand Bio-Ingredients, added, “The current market for digestive health ingredients consists mainly of well-documented probiotics and prebiotic fibers that bring balance to the human microbiome. Probiotics, such as Lactobacillus bacteria and S. boulardii yeast contribute to the population of beneficial bacteria in the large intestine and are in turn supported by prebiotic fiber as a food source,” she said. “These probiotic microorganisms support a variety of health conditions that begin in the human digestive system, such as immune support, brain-gut axis, women’s health, oral health and relief of gastrointestinal conditions.”

“To a lesser extent,” Dhanraj added, “digestive enzymes and herbal ingredients, such as lemon balm and ginger, among others, play a role in digestive health.”

John Quilter, vice president and general manager—ProActive Health with Wisconsin-based Kerry, agreed. “Digestive health markets are thriving across the world, and the probiotics category is performing particularly well, with sales worth $49.4 billion in 2018.”

He stated that there are three principal drivers for growth—interest, awareness and proactivity. “One indicator of consumer interest is online activity: over the past five years, the number of Google searches for ‘Gut Health’ has grown by 669 percent, with the largest leap occurring in early 2019. Over the same period, the number of searches for ‘Microbiome’ and ‘Gut-Brain Axis’ grew by 267 percent and 204 percent, respectively.”

However, GanedenBC30 has carried out research showing that people across the world have not only heard of probiotics, but also understand the benefits they provide. Around eight in 10 (79 percent) of the Americans surveyed perceived probiotics to provide digestive health benefits, while in China, 56 percent of the consumers who were aware of probiotics accurately understood their benefits for good digestive health.

Quilter added, “Finally, the digestive health market is growing because people are adopting an increasingly proactive approach to their health generally. Globally, 42 percent of consumers say they proactively seek out products that can improve their health, and 47 percent say they react to health problems when they arise.”

What’s Next?

Ingredient suppliers say they are anticipating growth in this category.

Jennifer Montgomery, regional probiotics marketing manager with Wisconsin-based DuPont Nutrition & Biosciences, noted, “The digestive health space is still underserved from a dietary supplement perspective, as consumers continue to struggle with rising health care costs and finding effective dietary products.”

She added, “We also see enormous growth opportunity outside of the digestive health category over the next five to 10 years, due to the increasing amount of research into the microbiome and how probiotics can effectively support additional aspects of human health.”

Paul Garrott, CEO and managing director with Marinova Pty Ltd, in Australia, said the company also predicts growth. “The trending interest in gut health is likely [going to] fuel the demand for digestive health products over the next few years. Digestive wellness is set to be propelled by new ingredients and backed by emerging science.”

He added, “Consumer interest in this sector is rapidly rising, and as such, we are seeing increasing demand for gut health ingredients backed by clinical evidence. Consumers are driving the trend toward plant-based ingredients, and novel extracts derived from marine plants in particular are experiencing strong growth.”

As in all health categories, interest is peaking in the ingredient manufacturing process itself and both environmental and social responsibility, Garrott pointed out. “Alongside clear therapeutic benefit backed by science, reputable formulators are seeking ingredients derived from renewable natural resources that are certified organic and non-GMO [genetically modified organism].” “The future of digestive health will continue to focus on natural ingredients that have multifactorial benefits which extend past simple digestive support,” Dhanraj added. “For example, ingredients supporting well-being from a brain-gut axis perspective or ingredients that support immune health via the digestive system. And, the many benefits from traditional, fermented foods such as kombucha, kefir and fermented soy products remain to be fully uncovered.”

Rich Troyer, CEO of Comet Bio, in Illinois, said the company expects the future of the digestive health market will expand drastically based off of recent reports and its trajectory to date. “The gut microbiome continues to position itself as a key to health and wellness, and as research strengthens this link, the category will only continue to expand. Prebiotics will play a role in the development of this category due to their ability to help fuel both probiotics and the good bacteria in the gut.”

What Consumers Want

Right now, gastroesophageal reflux disease (GERD) is the most common GI (gastrointestinal) complaint seen around the globe with a prevalence of 10-20 percent, Dhanraj said. “Symptoms of GERD include heartburn, chest pain, difficulty swallowing, regurgitation or nausea. Increased stress levels are likely to exacerbate this condition. In the past, symptoms were more likely to be seen in those aged 50 and older; however in recent years, the population of those aged 30-39 with GERD is increasing. Smoking, pregnancy and obesity may also cause the occurrence of symptoms.” He added, “There are few remedies which bring relief to these symptoms, and most are synthetic options meant to be short-term treatments. These bring only temporary relief and have unwelcome side effects.”

At Embria Health Sciences, consumers are looking for new, different ways to support their gut health and microbiome. “We are seeing interest from customers and consumers alike for novel, non-probiotic, gut-supporting ingredients,” Green said.

“Postbiotics have the potential to disrupt the digestive health category,” he added. “Made through fermentation, postbiotics contain bioactive compounds and metabolites that can convey a health benefit. Our ingredient EpiCor, a whole food fermentate, is a postbiotic ingredient with clinical studies showing that it may support immune health. It also has emerging science that suggests it may positively modulate gut microbiota. With a clinically tested dosage of 500 mg, EpiCor can easily be formulated into capsules and tablets for gut microbiota support formulations.” New and Improved

The top ingredients for digestive support include natural ingredients such as probiotics and prebiotics, as well as synthetic options such as antacids, proton pump inhibitors and H2-blockers, according to Dhanraj. “More natural ingredients and remedies are being sought after by consumers who are savvier than ever and give careful consideration to what they are consuming.”

Lallemand Bio-Ingredient’s Gastro-AD is a natural vegan food supplement based on non-GMO soy fermented by Lactobacillus strain L. delbrueckii R-187 (Rosell-187). It has an excellent track record of safe and effective use for management of symptoms such as heartburn, gastric pain, vomiting and nausea, and has been backed by several published studies since the 1950s, Dhanraj said. Gastro-AD represents a safe and proven alternative to over-the-counter (OTC) remedies with the extra nutritional benefits of fermented soy, and it is suitable for all populations. Troyer added, “There is an abundance of probiotic products available for the consumer in both the supplement and food and beverage industries. This could be due to the fact that more consumers are purchasing digestive health products than in the past, or because the consumer continues to demand innovative delivery formats—perhaps it’s a combination of both. The benefits of probiotics have spurred a whole industry of other products, and one rising category is prebiotics.”

Prebiotics can be found in grains, fruits and vegetables, but there is a new class of prebiotics which are healthier, upcycled and sustainable, Troyer pointed out. “Our Arabinoxylan Plant Fiber Extract, or Arrabina, is a prebiotic dietary fiber shown to support the growth of beneficial bacteria in the gut and help maintain healthy blood sugar levels. Due to the ingredient’s solubility and functionality, it can easily be added to beverages, baked goods, bars, supplements and more for consumer convenience.

Ingredient and Formulation Trends

The HealthFocus research suggests that consumers most often consider fiber (78 percent), whole grains (72 percent), probiotics (60 percent) and prebiotics (51 percent) as key ingredients for digestive health. “We also believe consumers are looking for new, better ways to support their health,” said Green.

“Postbiotics like EpiCor whole food fermentate have the potential to disrupt the digestive health category. Emerging science suggests that consuming EpiCor may support a healthy gut ecology and positively modulate gut microbiota. The latest published human clinical on EpiCor shows it may shift the gut microbiota at a low daily dose of 500 mg without side effects like bloating. Further, EpiCor is not a live organism, making it easier to formulate with other ingredients and in different delivery forms. EpiCor is heat stable, can handle varying pH levels, has lower moisture content and has a long shelf life.”

Dhanraj added, “At Lallemand Bio-Ingredients, we are completing our latest clinical trial with Gastro-AD. We are taking a closer look at how this unique ingredient may bring relief to and increase the quality of life of those suffering from a range of digestive problems.” He noted that Gastro-AD fits closely with the trend of improving health with natural whole foods, rather than synthetic medications.

At Maritech, organic fucoidan is a trending ingredient in the gut and digestive health category, said Garrott. “These fucoidan extracts are the only high purity, certified organic fucoidan extracts with demonstrated potential in gut and digestive health applications. Comprehensive research demonstrates a range of gastrointestinal benefits including protecting gut flora from antibiotics, maintaining the balance of good and bad bacteria, reducing gut inflammation, reducing the growth of yeast and fungus, inhibiting viruses and bacteria, and protecting against liver disease.” Another important development in the digestive health category has been the emergence of Bacillus coagulans probiotic strains, such as GanedenBC30, Quilter said. “These are hardy, spore-forming bacteria with a structure that is much more resistant to extremes of pH, heat, cold, and pressure, making them an excellent fit for the fortification of everyday foods and beverages.

They can be used in products that are hot, cold, frozen, shelf-stable or subject to extreme manufacturing processes. As a result, spore-forming probiotics can be incorporated into products in an increasingly wide range of categories.”

Digestive Health News

Recently, the FDA (U.S. Food and Drug Administration) announced that ranitidine, a common ingredient used in OTC heartburn medications, contains a probable human carcinogen. Ranitidine is an H2-blocker widely advertised and used by the general public. Prescription strengths are also used to treat and prevent more serious conditions, such as ulcers in the stomach and intestines. Multiple companies sell generic versions of both OTC and prescription ranitidine products. In October 2019, Novartis, Apotex GlaxoSmithKline, Sanofi, Teva, Dr. Reddy’s Laboratories and others recalled their generic versions of this drug. Regulatory agencies in Canada and Europe also supported the recall. This news has not gone unnoticed by the natural ingredients industry.

“Gastro-AD contains no ranitidine and no other synthetic ingredients,” said Dhanraj. “Being a fermented soy food product, and an old dietary ingredient available on the market since the early 1990s, it is considered a safe food ingredient suitable for all populations. It is a better alternative for those who need relief from heartburn and other symptoms and desire an all-natural, safe option.” Another current trend, according to Monica Mitchell, vice president of strategic sales & marketing with California-based Stauber, is the growing demand for probiotics beyond the traditional categories. “As part of our research, we asked consumers whether they would be interested in purchasing products in specific categories if they featured ingredients that promoted digestive health. It’s probably unsurprising that yogurt and yogurt-based drinks emerged as the most popular option at 48 percent. Yet significant numbers also expressed an interest in less traditional categories. Fruit and vegetable juices were of interest to 39 percent of respondents, followed by cereal, granola and breakfast bars (35 percent) and snacks (33 percent).”

Mitchell added, “There has been recent scientific interest in the intestinal microbiota metabolism and the impact of gut bacteria on human health and disease. Dysbiosis, or imbalanced microbiota, can negatively affect health in many areas such as cardiovascular, inflammatory responses, metabolism, nervous system and brain health. Polyphenols, and specifically pomegranate polyphenols from authentic juice or extract, such as Pomma+, have been shown to enhance the growth of bifidobacteria and lactobacilli, while inhibiting the growth of the B. fragilis group, clostridia and enterobacteriaceae, in vitro. Additional published literature suggested the ellagitannins of pomegranate may be useful in the management of C. difficile.”

In addition, according to Garrott, “The growth of the functional beverage market over recent years is worth noting. Versatile ingredients that can be readily incorporated into a range of products, whilst maintaining their safety and efficacy, are of increasing interest to manufacturers. The delivery of digestive products in a drink or gel format expands the consumer market considerably.” Customers are not only seeking products that follow through on their promises, but also those that are light on their wallets and offer multiple delivery options.

“Symptomatic consumers are increasingly demanding effective, clinically proven products, Montgomery pointed out. They are looking to dietary supplements to help ease their health care cost burdens. Wellness consumers desire more value—multifunctional combo products. They also want more format choices to improve the consumption experience.

And consumers want to be assured their product purchase is trustworthy.

“The benefits of GanedenBC30 are substantiated by more than 25 peer-reviewed, published papers, with the research showing that it supports digestive health when consumed daily,” Quilter concluded. “Savvy manufacturers understand the huge importance of scientific substantiation in a market where consumers are increasingly skeptical. (It’s worth keeping in mind that only 15 percent of people believe that nutrition and performance drinks deliver on their promised claims.) The digestive health products that succeed are those containing well-studied, branded probiotics, that easily convey a benefit-driven story that consumers can understand and trust.” NIE