Functional foods and beverages are growing more adept at addressing the health concerns of today’s consumers. The growing burden of chronic illness, fuelled by global population aging, is emerging as the most important long-term driver in the development of functional products. Global business intelligence provider Euromonitor International looks at three key areas: diabetes; Alzheimer’s disease; and the exploration of the human microbiome, which may soon form the basis for future new product development.

A Dynamic Category 
The global market for functional foods and beverages is sizeable. Euromonitor International health and wellness statistics showed that retail value sales of fortified/functional products amounted to almost $246 billion in 2012, accounting for one third of health and wellness-positioned packaged foods and beverages. Only the naturally healthy category, which comprises products such as bottled water, oat-based cereals, honey, olive oil and whole grain bread, is larger.

As a category, fortified/functional products also demonstrated the most dynamism over the 2007-2012 review period. It mustered a value sales increase of 42%, compared to 29% achieved by organic products and 28% registered by the better-for-you category, which includes reduced-fat and reduced-sugar products.



Chronic Disease Dilemma
According to the World Health Organization (WHO), chronic diseases are the leading cause of mortality in the world, accounting for 63% of all deaths. Chronic conditions are non-infectious, of long duration and slow progression, like cardiovascular disease, dementia, osteoporosis and diabetes. Many of these diseases set in or start to cause symptoms from middle age onward.

The close link between diet and chronic disease is widely recognized, and with the world’s population rapidly aging, it is no surprise that fortified and functional products aimed at mature consumers attempting to stave off and/or manage chronic conditions are an increasingly important focus for food and beverage manufacturers.

The Diabetic Breakfast Challenge
Globally, nearly 350 million people have diabetes, according to the WHO. Selecting the right food to manage the disease adequately is a daily chore for many, particularly when breakfast is concerned.

Mornings are usually the time when blood glucose levels are at their peak. Consuming a sugary breakfast cereal or other bakery products high in refined carbohydrates might just push them through the roof. Excess glucose in the blood, also referred to as hyperglycemia, causes damage to the eyes, nerves and body organs.

Fortunately, the days when diabetics were given the blanket advice to restrict their carbohydrate intake to a bare minimum are long behind us. Today, experts recognize it is important to choose the “right” carbohydrate foods, namely complex ones with plenty of fiber and a low glycemic index (GI), which help diabetes sufferers maintain their blood sugar levels on an even keel.

Whole grain bakery products and cereals have benefited from this insight. Oats, and oat-based porridge in particular, which contain beta-glucan, a type of soluble fiber, also help to lower cholesterol and are often deemed the breakfast of choice for diabetics and people at risk for cardiovascular disease. Diabetes and cardiovascular disease go hand-in-hand; diabetes is considered a major predisposing factor.

However, like most consumers, diabetics want choice as well as convenience, and the offer of ready-to-eat (RTE) breakfast cereals targeted at this growing demographic group is starting to expand. In February 2013, Australian health food company Goodness Superfoods launched a new range of breakfast cereals, Digestive 1st, Heart 1st and Protein 1st, aimed at people concerned about diabetes and heart disease.

The products contain whole grain barley flakes made with BARLEYmax, a grain developed by CSIRO, which possesses a low GI and contains double the dietary fiber of other grains. The company also offers Traditional Barley+Oats 1st and Quick Barley+Oats 1st, which also contain BARLEYmax.

One type of food constantly touted as ideal for diabetics, because of its low GI and high nutritional value, is legumes. The sad reality, however, is that legumes are largely absent from the daily diets of people living in highly industrialized countries, and they certainly do not eat them for breakfast. Except, perhaps, in the U.K., where baked beans constitute part of the “traditional English breakfast.” And even though the concept of eating beans for breakfast may not be totally alien to Brits, it is far from a daily habit. Furthermore, standard baked beans are laden with added sugar, which is not a great choice for diabetics.

Probably the best way to get people to consume legumes for breakfast is if they don’t realize they are eating them, at least from a sensory perspective. To this end, researchers from the University of Nigeria have developed an RTE breakfast cereal that incorporates the African yam bean, a legume lauded as beneficial for diabetics, but onerous to cook with. The researchers found that a flour blend of 60% African yam bean and 40% maize achieved the optimum balance between efficacy and palatability.

According to the International Diabetes Federation, Nigeria is the leading African country in terms of diabetes incidence, with 3.2 million cases. Startlingly, four out of five diabetes sufferers live in developing countries, and the WHO points out that 80% of diabetes deaths occur in low- and middle-income countries. Evidently, there is a rampantly growing need for convenient products, which are both culturally acceptable and economically priced, catering to the burgeoning number of diabetics living in the world’s emerging economies.

Some of these items, and particularly those that might make a suitable breakfast, could quite feasibly make it onto the supermarket shelves in industrialized countries.

Alzheimer’s: Can Functional Products Help?
Alzheimer’s disease is another spiraling global health problem, and one that remains, so far, without a cure. However, dietary intervention may be helping where drugs so far have failed, as long as the condition is detected early.

According to Alzheimer’s Disease International, there were approximately 35.6 million people suffering from dementia in 2010, of which Alzheimer’s disease is the most common form. The organization estimated that the economic costs (in 2010) amounted to $604 billion, and predicted the number of people affected will double every two decades.

A decline in cognitive performance is inherent in the aging process. The brain is an organ like any other, and all human body parts deteriorate as the body ages. Alzheimer’s, though, is a disease rather than a normal part of aging. Plaques consisting of starch-like (amyloid) protein build up in the brain, causing nerve cells to malfunction and die off. This leads to a drastic reduction of memory capacity and cognitive functioning.

Nestlé has been investing heavily in the area of medical nutrition for several years now, and nutrition-based solutions designed to tackle neurodegenerative diseases like Alzheimer’s is one of the company’s focus points. In July 2012, Nestlé acquired a stake in U.S.-based Accera, maker of Axona, a medical food available by prescription for people suffering from mild to moderate Alzheimer’s disease.

The product is designed to provide the brain with medium-chain triglycerides (MCTs) to use as an alternative source of energy, because, according to the company, brain cells affected by Alzheimer’s grow progressively less efficient at using their habitual and primary source of energy, namely glucose.

In February 2013, Nestlé announced the latest jewel to be added to its brain health crown: Pamlab LLC, a U.S. company specializing in “natural personalized medicine.” CerefolinNAC is a prescription product aimed at people with mild cognitive impairment (MCI), half of which usually go on to develop Alzheimer’s disease. The product contains Methylcobalamin, L-Methylfolate and N-acetylcysteine (NAC), and seeks to address metabolic and genetic imbalances that trigger and worsen MCI.

In January 2013, Nutricia (acquired by Danone in 2007) launched Souvenaid in the U.K. market. Souvenaid is a medical nutrition drink, aimed at people in the early stages of Alzheimer’s disease, that is available over-the-counter in pharmacies. It contains a cocktail of nutrients, including choline, EPA and DHA omega 3s, vitamins E, C, D, B12, B6, folic acid, selenium and UMP (uridine monophosphate, a nucleotide found in cellular RNA).

An institution as prestigious as the Massachusetts Institute of Technology (MIT) was in charge of Souvenaid’s development and clinical testing. In a study published last July in the Journal of Alzheimer’s Disease, MIT researchers reported that Souvenaid had a significant biological impact on the brain, and that this was achieved by the nutrient combination contained in the drink stimulating the formation of new synapses, as well as improving the functioning of existing ones. Within six months, the study population consuming Souvenaid once a day saw EEG brain patterns shift back to readings within the parameters of normal activity.

A Turning Point for Coconuts & Caffeine
As dementia becomes an ever more momentous public health problem, food and beverages naturally rich in some of the substances featured in products like Souvenaid and Axona, and those fortified with these ingredients, will grow in popularity.

For instance, a study published a year ago in the Journal of Alzheimer’s Disease suggested that DHA omega 3 and vitamin D3 helped to optimize the immune system’s amyloid plaque clearance rate. Omega 3 and vitamin D fortified food products are already popular, and a strengthening of the brain health connection will only add traction.

Another study, carried out by Oxford University, showed that the oil contained in coconuts seems to have at least a temporary effect on restoring the memories of people affected by Alzheimer’s disease.

Coconuts and products made from coconut are finally gaining in popularity, after having long been avoided by health-conscious people due to their naturally high saturated fat content. In recent years, however, research has come to the conclusion that not all saturated fatty acids are created equal, and that some types are actually conducive to health, offering benefits to the cardiovascular system, and, as it now transpires, cognitive functioning.

And then there is caffeine, a substance not universally regarded as health promoting. In June 2012, a study came to light, again courtesy of the Journal of Alzheimer’s Disease, in which researchers at the University of South Florida and the University of Miami had concluded that three daily cups of coffee consumed by people showing mild memory impairment had the power to prevent, or at least significantly delay, the onset of Alzheimer’s disease.

There are other studies suggesting that caffeine may be a useful tool in the battle against Alzheimer’s. The Journal of Neuroscience, for instance, featured a piece of animal research in October 2012 in which caffeine appeared to block the brain-based inflammation associated with neurodegenerative disorders like Alzheimer’s disease.

Manipulating the Microbiome
It is highly likely that the functional foods of the future will be designed either to optimize or to manipulate the vast ecosystem of microbes that form an integral part of the human body in order to achieve specific health outcomes, particularly with regard to chronic conditions.

The human body is inhabited by more than 100 trillion microbes, vastly outnumbering the cell count of their host. They amount to a combined weight of around 2 kg, and are predominantly found in the nose, the mouth and on the skin, as well as in the urogenital and gastrointestinal tracts.

Currently, a major research interest involves uncovering the connection between the microbiome and chronic disease. This was the focus, for example, of MetaHIT, a 4-year, €22 million, EU-funded study, which wound up in summer 2012. The U.S. National Institutes of Health runs its Human Microbiome Project to the same end.

One of the many interesting findings of the MetaHIT study was that the make-up of the human gut microflora may have a significant impact on the development of type 2 diabetes. The gut flora of healthy people was markedly different from that of diabetics, which harbored a much greater proportion of harmful bacteria.

As new insights are gleaned, our understanding about the relationship between these numerous bacterial strains and health continues to evolve. Modern science is starting to regard the large collective of bacterial cells, also referred to as the microbiome, as something like another “organ” of the human body.

In terms of dietary implications, what we might see in the future is an “eat right for your microbiome” trend, akin to Peter D’Adamo’s blood type diet “Eat Right 4 Your Type,” which gained popularity in the late 1990s, and still enjoys a sizeable following. The make-up of the microbiome is susceptible to diet, and probiotics, in particular, can alter its composition.

MetaboGen, a Swedish biotech company founded in 2011, has made its primary objective to examine the role of the microbiome in the development of metabolic diseases, with a special emphasis on obesity, diabetes and atherosclerosis. The company envisages itself as aiding the industry in developing the next generation of pharmaceuticals and functional foods.

Diabetes (and by implication, cardiovascular disease) and progressive cognitive impairment caused by conditions like Alzheimer’s disease are but two examples of chronic health issues that require sustained management over a significant duration of an affected person’s lifetime.

Chronic illness is such a vast area of concern that it provides virtually limitless scope for new functional product development and applications. Drugs, sadly, have little hope of ever fully eradicating even one of the many branches of chronic disease, and there will always be consumer demand as well as space for functional foods and beverages to co-exist with medication and other types of treatments.    

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Simone Baroke is health and wellness research analyst with Euromonitor International. For more information contact Ewa Hudson at ewa.hudson@euromonitor.com



Are Breakfast Cereals On Life Support?

Analysts indicate the U.S. breakfast experience is evolving.

A new report from Rabobank examined factors contributing to a decline in breakfast cereal consumption in favor of other breakfast options. The report, titled “Cereal Killers: Five Trends Revolutionizing the American Breakfast,” also explored various strategies by breakfast cereal companies to inject new growth into the category.

Nicholas Fereday, global senior analyst with Rabobank’s Food & Agribusiness Research and Advisory group, said in the report, “Flat sales and declining volumes over the past decade indicate consumers are tiring of boxed cereals, lured away by more contemporary, aspirational and convenient morning eating options in other grocery aisles or restaurants.”

Rabobank identified five trends—“cereal killers”—that are changing U.S. consumers’ breakfast habits:

1) “I’ll take that to go.” Breakfast is the new eating-out occasion.

2) “Snackfast.” Consistent with trends across all eating occasions, the rising culture of snacking is transforming breakfast into “snackfast” as consumers seek convenience and portability.

3) Beware of Greeks bearing yogurt! Protein is the latest superfood promising satiety and weight management.

4) The nutrition challenge. As politicians and pundits weigh in on what to eat, the cereal industry struggles to find the balance between regulation and self-regulation without alienating consumers. Consumers today are more interested in the nutritional profile of food than in past eras, and the cereal category has two hot-button issues that attract critics: added sugars and marketing to children.

5) Boomers or bust? With declining birth rates, the growth of a key cereal-eating demographic, children, is slowing. Who will be left to munch on cereal in the future? If millennials are a lost cause, is it a case of Boomers or bust?

Among the possible strategies cereal companies have to lure in breakfast skippers are innovation and targeted marketing that emphasizes the importance of breakfast as the most important meal. Rabobank suggested renewing the focus on innovation to generate new brand platforms, such as Kraft has done with Mio, Oscar Mayer Selects and Velveeta Skillets. In addition, companies should spend more on food ingredients relative to advertising budgets, learning from the success of fast growing companies such as Clif Bar & Company, Chipotle Mexican Grill, Inc., and Whole Foods Markets, Inc., that food does not have to be a least-cost formulation.

The breakfast cereal category pioneered marketing in the age of mass media, but Rabobank said it is struggling to find its voice and target customers in today’s age of multimedia and fragmented retail channels. Equally, many current consumer food trends do not necessarily play well to cereal’s core strengths, as consumers move away from highly processed foods. Nevertheless, Rabobank believes breakfast cereals remain a highly relevant platform for delivering many health and wellness positives, but that manufacturers need to reboot their message to consumers regarding the relevance of their product.

Mr. Fereday concluded, “Despite the numerous health positives associated with breakfast cereal, some companies already appear to be exiting through the snack aisle. We are not predicting the end of this $10 billion market, rather, we believe that breakfast cereals can aspire to more than single-digit growth and erosion of market share. To turn the tide, we suggest a renewed focus on innovation, a rebooting of the message to consumers, and, for children’s cereal, an embrace of what you are, even if that means new positioning in a different grocery aisle.”