And old adage proclaims, “We are what we eat.” But many in the nutraceuticals industry would probably like to alter that for a bit more accuracy—“We are what we digest.”
 
This holds truth in many ways both visible and invisible. Digesting nutritionally bankrupt food as well as too much of it shows in large body size, poor skin tone and lack of hair luster. Inside, years of poor diet can impair a system designed solely to extract macro- and micronutrients and evacuate the wastes expediently. As the digestive system can virtually impact all others—too much salt absorbed can spike up blood pressure, which can lead to such events as strokes; too much trans fats ingested will lead to clogged arteries, and so on—promoting digestive support becomes more imperative.
 
Thus, as brand marketers, it may make powerful and profitable sense to build a line of health-promoting products with the very foundation of life: the digestive system.
 
Digestive Issues & Their Causes: The List Continues to Grow
 
As the modern industrial world continues to evolve rapidly, and the population grows, gastrointestinal conditions seem also to be on the rise. No longer is this category of “plop, plop, fizz, fizz, oh what a relief it is” geared toward men in gray flannel suits.
 
“Traditionally, we have portrayed the digestive system as a passive system whose primary role has been the extraction of nutrients,” said Rhonda Witwer, senior business development manager, Nutrition, National Starch Food Innovation, Bridgewater, NJ.
 
However, today she feels research continues to demonstrate that the digestive system plays many roles and contributes significantly to overall health. When the digestive system is not functioning optimally, the results of impaired digestion manifest in multiple organs and symptoms within the body and are therefore not limited to disorders of the digestive system. “It is not possible for an individual to be healthy without also having digestive health,” she stated.
 
Ms. Witwer correlated the same knowledge process with fiber. Many consumers still believe dietary fiber is “one homogenous type of ingredient,” yet research has been groundbreaking in showing that different types of dietary fibers provide different physiological benefits. A more accelerated specificity appears to be the way the industry is moving, seemingly in tandem with continued medical research.
 
For example, according to Bérengère Feuz, international product manager—Human Nutrition, Institut Rosell-Lallemand, irritable bowel syndrome (IBS) appears to be one of the most common digestive troubles and certainly the most debilitating, greatly affecting patients’ quality of life. “IBS is the most common functional disorder of the gastrointestinal tract, characterized by abdominal pain, bloating and irregular bowel function,” he explained. “Depending on the dominant symptom, there are now three known different sub-types of IBS: IBS-C (constipation), IBS-D (diarrhea) or IBS-A (alternating diarrhea and constipation episodes).
 
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), which is part of the National Institutes of Health (NIH), “As much as 20% of the adult population, or one in five Americans, has symptoms of IBS, making it one of the most common disorders diagnosed by doctors. It occurs more often in women than in men, and it begins before the age of 35 in about 50% of people.”
 
Dr. Stephen Collins, associate dean of research, Faculty of Health Sciences at McMaster University, a gastroenterologist for Hamilton Health Sciences, and a Distinguished University Professor of the Michael G. DeGroote School of Medicine, relates that alternative medicine is popular with IBS patients, simply because of the disappointment and the lack of drugs with proven efficacy in IBS. “I use probiotics from reputable sources. For IBS-D (diarrhea dominant), I usually use Saccharomyces boulardii yeast, while for constipation–dominant and mixed symptoms IBS (diarrhea and constipation), I recommend taking Lactobacillus plantarum 299v.”
 
Gastroenterologist Theodore Hersh, MD, chief science officer, Deerland Enzymes/Thione International, Kennesaw, GA, is particularly keen on research showing a typical presence of small intestinal bacterial overgrowth in patients with IBS. “In the past decade clinical investigators have revealed that more than 50% of the individuals with the functional diagnosis of IBS are afflicted by an overgrowth of bacteria in the proximal small intestine, thereby causing alterations in the structure and function of the absorptive small intestine.”
 
Along with IBS, Evelyn Murillo (R&D), Ecuadorian Rainforest, LLC, Belleville, NJ, said consumers also seek medical intervention for ulcers, gallstones and lactose intolerance, causes of which are most often linked to dietary habits of the individual over the course of many years. Ironically, she points out, modern medicine is often a major cause for a lot of digestive issues. Numerous drugs advertised come with unwanted side effects, such as diarrhea, nausea, irritable bowel and constipation.
 
According to Peggy Steele, global business director for Danisco USA Inc., Madison, WI, 60 to 70 million people are affected by digestive disorders in the U.S. today. Other statistics are somewhat startling:
 
• Almost half of households are currently managing some type of digestive health problem;
• Nearly 40% of older adults have one or more digestive disorder;
• 18% of adults suffer from constipation;
• 10-14% of adults, particularly women, suffer from IBS; and
• It’s estimated that 375 million episodes of acute diarrhea are diagnosed each year (an average of 1.4 episodes per person per year).
 
Age-related decline in enzymes needed to extract essential nutrients from food along with an imbalance of healthy gut flora and pathogenic bacteria in the lower GI are significant causes for a host of GI problems, according to Shaheen Majeed, director of marketing, Sabinsa, East Windsor, NJ. “The result of enzyme deficiency is poor nutritional status, which can contribute to numerous disease conditions,” he said. “Digestive health can be further impaired by a bacterial imbalance in the gastrointestinal tract, which can contribute to symptoms of gas and bloating as well as poor utilization of nutrients. Fortunately, advanced enzyme supplements, along with specially encased probiotics can help restore balance to the digestive system, allowing for the optimal utilization of precious nutrients. The benefits of a healthy gastrointestinal system include digestive comfort, improved immune health and decreased inflammation.”
 
More recently, Helicobacter pylori has become a common suspect for digestive discomfort, according to Dan Murray, vice president of business development for Morristown, NJ-based Xsto Solutions. He is “often surprised” how many people in the U.S. are just now discovering they have Helicobacter pylori, harmful bacteria present in the stomach.
 
H. pylori can be present for decades, waiting for stress or a metabolic imbalance to encourage proliferation, and thus, instigate an ulcer. “I think the isolation and identification of H. pylori in the 1980s was an enormous achievement,” he opined. “This Nobel Prize-winning research provided the opportunity for a true clinical diagnosis of previously unidentified issues.”
 
“On the not-so-positive side,” he added, “I think the discovery of proton pump inhibitors and acid-suppressing agents, while impressive, has led to an arguably much over-prescribed use of these drugs. Nutrition not only provides fuel for the engine of our digestive system, it provides for the maintenance of the engine itself. We can’t over emphasize the importance of good nutrition in digestive health.”
 
Dr. Hersh has also observed an increased incidence of Celiac disease, which is generally characterized by a toxic reaction in the body upon the introduction of the gluten moiety found in wheat, rye, barley and oats. As a result, he said, “A major emphasis has been directed toward digestive enzymes that could digest the gluten and render it non-toxic to individuals with Celiac disease.”
 
Deerland Enzymes has been working on specific enzyme systems consisting of pepsin and trypsin, which impact the toxic molecule in gluten even after digestion. “This formulation may also benefit patients with autism since approximately 60% of autistic children are also gluten intolerant,” he said. “Both Celiac and autistic patients show low levels of endogenous antioxidants and thus these specific digestive enzymes plus the antioxidant defenses could help ameliorate the oxidative stress in these individuals.”
 
That correlation may have profound impact upon how those two patient populations may be treated in the future. And there’s more. According to Ms. Steele, a doubling of digestive cases in 20 years is rather alarming: CDC statistics show that in 1989, nearly 30 million Americans were reported to have digestive ailments; 20 years later that number has swollen to about 60 to 70 million.
 
However, Ms. Steele warned, it’s not fully understood why there has been such an increase in digestive health issues in the past two decades, but there are several contributing factors recognized by experts.
 
First, the typical diet contains far less fiber than diets consumed by previous generations—i.e., today’s diet contains only 10-15 grams of fiber per day, which is only 50% of the recommended daily allowance (RDA) for fiber (25 grams). Second, diet and lifestyle have been shown to contribute to significant changes in GI microbiota, an extremely important component of our digestive system. “Specifically,” Ms. Steele elaborated, “some examples shown to impact GI microbiota and GI wellness include: antibiotics, aging, pathogen-induced diarrhea, stress, alcohol consumption and numerous over-the-counter (OTC) medications. Additionally, OTC medications such as non-steroidal anti-inflammatory drugs, or NSAIDS (some common pain relievers) are believed to contribute to deterioration of the GI lining. Finally, the relatively limited amount of exercise associated with our increasingly sedentary lifestyles is clearly a contributing factor.”
 
How Consumers Digest Digestive Issues
 
A significant majority of digestive issues discussed by experts in this article point to a clear link between lifestyle and diet—and to aging, an inescapable inevitability. The industry as a whole knows this. But what about consumers? It appears that consumers don’t think about their digestive system until it wakes them up and screams at them—through bouts of embarrassing gas emissions, cramping, nausea, searing pain of acid reflux or a developing ulcer.
 
Most consumers, observed National Starch’s Ms. Witwer, have little idea of the extent to which their diet impacts digestion and health. Sadly, she commented, “Maintaining digestive health is not a top priority for consumers today, according to proprietary research. Fewer people are reporting that they are personally affected by gastrointestinal/digestive problems than two years ago.”
 
Further, a report by HealthFocus International states that 21% of primary grocery shoppers say they have gastrointestinal and digestive problems. Individuals between the ages of 40 and 49 are more likely to report they are personally affected (27%) compared to individuals within other age ranges.
 
Contrarily, Steve Siegel, vice president, Ecuadorian Rainforest, LLC, Belleville, NJ, said consumer awareness about digestive issues is on the rise. Specifically, he referenced the rapid proliferation of digestive aid products in supermarket and drug store aisles as a case in point. “I believe digestive health is a huge priority for consumers. But it’s not just what is inside that matters when it comes to digestive health; consumers now are realizing that their overall appearance is affected. [In other words,] they will look slimmer and feel better if they maintain good digestive health.”
 
Beyond individuals who are already experiencing bouts of digestive unrest, Danisco’s Ms. Steele believes those consumers, of any age, who fully understand prevention and the desire to reduce the number of doctors’ visits for themselves and their families, are likely highly interested in trying newer digestive support formulas. She also points to the Baby Boomers, many of whom are focused on maintaining active, thriving lives, as being “increasingly receptive to the digestive health message.”
 
On the other hand, Xsto’s Mr. Murray said, “Young consumers may have a better idea about how lifestyle impacts overall health, but I think consumers over 35 or 40 [Generation X] are heading into the ‘age of retribution’ with regard to digestive health. Sometime in our middle age we start paying for poor lifestyle decisions in a number of ways. How often do we hear ‘that food doesn’t agree with me’ or ‘I love that but I just can’t eat it anymore?’”
 
Digestive Health: A Pharmaceutical-Only Future?
 
Blame it on uncouth TV shows and films featuring people belching and farting for the laugh tracks, but people today are more comfy talking about their solid, liquid and gaseous emission issues as well as ulcers and acid reflux. As legions of consumers continue to share the intimate details of their bowel health, there should be plenty of fertile ground for new marketing messages and product opportunities in the digestive health market for years to come.
 
But that brings a challenge: Nutraceutical ingredient science is on par, quality wise, with Big Pharma. However, how, as brand marketers, can you compete against Big Pharma for a share of sales in one of its most lucrative categories?
 
Perhaps one such way is to grow the digestive food category and build supplements around that, said Sabinsa’s Mr. Majeed. Since a growing number of food products primarily cater to consumers with specific health requirements or challenges, such as gluten or lactose intolerance, consumers who are concerned about the link between diet and health also find these foods attractive. “Consequently,” Mr. Majeed said, “an increasing number of consumers are relying on nutritional supplements and digestive foods as an alternative means to evade the high-priced pharmaceutical medical paradigm.”
 
Nutraceutical ingredient suppliers, notably in the probiotic/prebiotic playing field, have made great strides in providing quality and efficacy; and it is well known that the big players have stridently plowed onto the field with mass-market infusion of foods featuring beneficial bacteria that have achieved outstanding consumer acceptance.
 
Still, Danisco’s Ms. Steele reminded brand marketers to stick with legal claims. “While Big Pharma wasn’t traditionally a competitor in the dietary supplement space, this has changed with Merck, Bayer and J&J all operating in the probiotic arena. Our products are not drugs; rather, they are ingredients with clinical documentation strong enough to support structure/function claims, such as: ‘shown to improve transit time’ or ‘improves digestive function,’ versus a drug claim that focuses on treating or mitigating disease.”
 
Further, Xsto’s Mr. Murray said, while the supplement and functional food industry does not have the mammoth marketing budgets of Big Pharma, “We do have a swiftly growing population who reads labels because they question conventional treatments due to a bevy of side effects.”
 
Mr. Majeed of Sabinsa offered a similar view. “Consumers continue to be interested in learning more about digestive supplements and foods. In fact, the majority is aware of foods and beverages that can provide a host of benefits. So the saying ‘you are what you eat’ makes sense again.”