Digestive health category continues to evolve as we learn more about the microbiome and leaky gut syndrome

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Consumer interest in digestive health is not just limited to dietary supplements; it’s also expanding in food and beverage. Today, consumers have multiple avenues through which to pursue gut health. In fact, the digestive health category is constantly “reinventing itself as new science and products appear,” explains Joana Maricato, market research manager for New Nutrition Business (London). “It’s a space where opportunities flourish, and that’s because [gut health] connects to a strong ‘feel the benefit’ proposition for consumers. Everyone can feel improvements in their digestive health, and that keeps people motivated.”

While digestive health presents businesses with a great deal of opportunity, the sheer variety of products now focusing on the gut may be confusing to consumers. A recent survey from New Nutrition Business shows that consumers are largely confused about what is good for their digestive health. This is particularly true in the case of foods. For example, when New Nutrition Business asked 3,000 people from the UK, Australia, Spain, Brazil, and the U.S. to rank some common foods as good or bad for their gut health, 23.4% of respondents cited sauerkraut and fermented vegetables as bad for their digestive health compared to 15.8% who said those foods were good for them.

According to the survey 76% of respondents found messages about diet and health to be confusing, and when asked where they get information on the subject, 58% said they looked online and read blogs, while only 28% said they consulted a nutritionist. Indeed, changes in official dietary guidelines over the past 15 years have sowed distrust among consumers, says New Nutrition Business, creating a diverse set of ideas about diet and health overall. This survey suggests that there needs to be better and more consistent outreach to consumers in terms of education.

Probiotics

Dietary supplements are not immune to confusion either. For instance, while probiotic is the most recognizable digestive-health supplement term, says New Nutrition Business, with over 80% of surveyed consumers across the markets saying they recognize the term and with 30%-50% of surveyed consumers claiming to use probiotic supplements, there is, nevertheless, a great deal of variation within the probiotic category that can make things a bit hard to understand, including variations in probiotic strains, dosages, and formats.

And the probiotic industry only continues to evolve, with options for consumers expanding further. Continued research in the area of digestive health will both improve our understanding of probiotic strains and also change how products are formulated. For instance, while supplementing with probiotic strains of bacteria such as Lactobacillus and Bifidobacteria has been rather ubiquitous over the years, more supplements and functional foods are beginning to incorporate spore-forming bacteria such as Bacillus coagulans, which may improve not only the types of products on the market-since spore-formers can often be used differently in manufacture-but also improve the diversity of the microbiome.

Kiran Krishnan, chief scientific officer of practitioner-positioned brand Microbiome Labs, talks about the microbiome. “Everyone has a different microbiome, but there are certain universal features within the microbiome that seem to hold true across the board: 1) That diversity is important, and 2) That there are certain keystone strains that hold up the microbiome and provide significant benefit and protection against chronic illness to the host.” When Krishnan talks about diversity, he’s referring to not only the large number of different bacteria, but also the uniformity, or balance, in numbers across the microbiome.

Keystone strains such as Akkermansia muciniphila and Faecalibacterium prausnitzii play an important role in our health, says Krishnan. “There are literally hundreds of studies on Akkermansia, and it is inversely correlated to everything in the cardiometabolic realm,” he explains. “So, if you have high levels of Akkermansia, you are protected against diabetes, obesity, heart disease, all of the things that fall under cardiometabolic syndrome.”

“Faecalibacterium prausnitzii is inversely correlated with all sorts of inflammatory conditions, including Crohn’s disease, ulcerative colitis, and colorectal cancer,” Krishnan continues. “Studies show when you have high levels of that organism, it protects against all of these inflammatory dysfunctions in the gut which lead to inflammatory dysfunctions in the body, like autoimmune disease.”

When it comes to spore-forming bacteria, Microbiome Labs manufactures a product that contains five Bacillus spores that work together to “recondition” the gut. “We just submitted a study for publication showing that in as little as three weeks, the spores can increase diversity of the rest of the microbiome by over 40%,” explains Krishnan. “They are acting as the gut police, reading the microbial environment, and if they find overgrown or problematic bacteria, they will sit next to them, produce up to 25 different antibiotics, bring those bacteria down, and produce a number of other prebiotic and postbiotic compounds to increase the growth of other commensals. So, what we’re seeing is a significant increase in diversity and uniformity in the gut when you add the spores into the system. And then we’re seeing huge increases in these keystone strains.”

A better understanding of the microbiome and how specific bacteria can influence our health is crucial for moving the category forward, says Lauren S. Clardy, president, NutriMarketing Business Group (Santa Rosa, CA). “Certainly, the media bringing the microbiome to the forefront, elucidating gut health as playing a key role in chronic disease, has helped the market innovate and accelerate,” she explains. “Conditions associated with gut dysbiosis have been correlated to obvious links like Crohn’s disease and irritable bowel syndrome to Parkinson’s disease, various spectrum disorders, chronic fatigue syndrome (CFS), and allergies. The state of our nutrition and food intake and the influence it has on us, based on our microbiota, is fascinating, and we are still in the early stages.”

One health condition to keep an eye on is “leaky gut syndrome,” which Clardy says will gain traction in the media. “This term, recognized as increased ‘intestinal permeability,’ is a disorder in which gaps in your intestinal walls start to slacken,” she explains. “This allows bigger proteins, molecules, and substances, such as undigested food particles, to pass through the intestinal walls into your bloodstream. Studies have shown that increased intestinal permeability or leaky gut may be linked to several chronic and autoimmune diseases, including diabetes and irritable bowel syndrome.”

Krishnan agrees. “Leaky gut is quickly becoming an accepted condition. The term leaky gut has been mentioned in numerous large-scale studies published over the last few years. And as researchers use the term more in papers, it becomes more understood-and, of course, more accepted as a condition,” he explains. “Consumer awareness has certainly increased…There are a lot of well-penetrated web personalities that are using the term leaky gut, and, as you know, if things are drawing attention on social media, it’s really pushing the awareness.”

Prebiotics

While probiotics have dominated the conversation around gut health for years, prebiotics are now moving their way into the spotlight. Interest among health practitioners and consumers is certainly high, says Krishnan, whose company recently released a prebiotic product of its own. “Even before we launched our product, we were getting lots of requests from both doctors and consumers I end up coming in contact with for advice on prebiotics,” he states. “It is becoming clear that prebiotics are going to play a very significant role in the overall health of the microbiome.”

Microbiome Labs’ prebiotic product focuses on oligosaccharides, which Krishnan says provide more precise and targeted support of the growth of keystone bacteria. “The first prebiotics your microbiome encounters from mother’s milk are oligosaccharides,” he explains. “Our ancestors got a significant intake of oligosaccharides. They ate roots and tubers and foraged for fruits and nuts and so on, all of which contained high levels of fructo-oligosaccharides and xylo-oligosaccharides.”

Oligosaccharides are highly complex carbohydrates that survive digestion long enough to get to the large intestine, where they can be consumed by healthy bacteria such as Akkermansia and Bifidobacteria. Other types of prebiotics that have less complexity may feed bad bacteria in addition to good bacteria, in the small intestine, potentially exacerbating problems, Krishnan says. This where having personalized knowledge of one’s microbiome may come in handy.

Fact is, consumers are motivated to learn more about their health, and now the resources exist for them to do so privately. Services like 23andMe are not just giving consumers ancestry results; they help consumers learn which diseases they are genetically predisposed to be at risk of, and motivate consumers to adjust their lifestyles accordingly. Similar services exist for the microbiome as well. One such service is the Swedish-based firm Carbiotix, which provides affordable monthly microbiome testing and gives subscribers a personalized soluble fiber recommendation as well as a tier that provides a customized soluble fiber supplement.

This is not only a resource for consumers, however; Carbiotix is a way to accumulate longitudinal data about changes in the microbiome with soluble fiber as an intervention tool. The company will continue to offer the affordable as well as higher-cost comprehensive tests as an engine of information generation as it moves into therapeutics development, making licensing deals with pharmaceutical and nutraceutical companies.

“This engine of information generation can be there to leverage and amplify the efficacy of those therapeutics that have been developed because if you could utilize fiber more efficiently, then obviously fiber consumption can lead to even more benefits,” says Kristofer Cook, CEO of Carbiotix.

This all points to a promising future for microbiome research and digestive health supplements, which will be able to better address underlying causes of digestive health problems.