The digestive health market has experienced an impressive evolution, growing in diversity of the products it offers, as well as scientifically and conceptually.
The digestive health market has experienced an impressive evolution, growing in diversity of the products it offers, as well as scientifically and conceptually, to influence the lifestyles of its users.
“In recent years, the digestive segment has shown growth not only in terms of market size but also in the range of delivery systems and, more importantly, in science,” explains Anurag Pande, PhD, vice president, scientific and regulatory affairs, at Sabinsa Corp. (East Windsor, NJ). “The emerging research on, for example, probiotics has explored the area of gut-brain axis or gut-brain-muscle axis and looked at the influence of digestive health on mood or immunity. New research on turmeric has shown its prebiotic effect and its protective effect against inflammatory conditions associated with the digestive tract, especially the distal part (colon health), as well as benefits related to a healthy microbiome.”
Shoppers are listening. Says Sam Michini, vice president of marketing and strategy, Deerland Probiotics & Enzymes (Kennesaw, GA): “Consumers now know to link their gut status with immune function. This was practically a foreign concept only a few years ago. Simply, when you understand what digestion is—the processing of food to sustain life—then you realize how critical it is. This knowledge is driving consumers to change their diets and take supplements that enhance the entirety of digestion, starting with releasing the proper enzymes in the proper amounts, breaking down foods for assimilation, and supporting that assimilation.”
While herbs have long been used to support acute symptoms of gastrointestinal distress, probiotics, for instance, exposed people to the idea of supporting one’s overall digestive health with bacterial strains. This concept itself emerged from the benefits of fermented foods such as sauerkraut, yogurt, and kombucha, and made its way into a supplement format. Thus, the digestive health space has evolved, embracing everything from enzymes to fiber and prebiotics.
Delivery Systems Expand Appeal
The industry has also come full circle to functional foods and beverages. “We see a lot of innovation in new delivery systems, which have become standard platforms, such as gummies. At one point in time, gummies were limited to multivitamins but now are used for delivering probiotics and fibers,” says Pande. “Kombucha beverages, both in refrigerated or in canned form, are growing in popularity. Functional foods are now focusing on increasing probiotics via prebiotic fibers in products like bread, cookies, cereals, and beverages like tea or herbal teas. Together, innovation in delivery systems and new science have become the driving force for this segment.”
Much like in other supplement categories, consumers buying digestive products are experiencing pill fatigue, especially if they are already taking medications or other dietary supplements. “Some days, consumers just prefer a ‘treat’ instead of another capsule or tablet,” says Michini.
For probiotics, driving innovation in new delivery formats and functional foods means finding probiotic strains that survive not only the manufacturing process but also the digestive system to enable the ingredients to make their way into the large intestine. “Today, probiotics like LactoSpore have made it possible for consumers to have daily probiotic supplementation at low cost, with minimum loss of potency in the manufacturing process, providing more choices to consumers of all ages,” explains Pande. “LactoSpore can be formulated at a dosage of 2 billion spores and up, with structure-function claims and approved health claims in Canada made possible by clinical studies, with the proper endpoint, on LactoSpore at a dosage of 2 billion.”
For example, LactoSpore was found to remain stable for three years after commercial production, without any genetic or phenotypic alterations, as well as remain stable for 36 months at an ambient temperature of 23 +/- 2 °C.1 This makes it suitable for applications such as yogurt and baked goods, with the added benefit of having GRAS status. In terms of efficacy, a recent study demonstrated the gut-brain axis at work. In the study, 40 patients diagnosed with major depressive disorder and irritable bowel syndrome were randomized to receive either placebo or LactoSpore for 90 days.2 Results showed that those in the LactoSpore group had significant changes in primary outcome measures according to the Hamilton Depression Rating Scale (HAM-D), Montgomery-Asberg Depression Rating Scale (MADRS), Center for Epidemiologic Studies Depression Scale (CES-D), and Irritable Bowel Syndrome Quality of Life questionnaire (IBS-QOL). Secondary outcome measures of the following also showed significant changes in the probiotic group: Clinical Global Impression-Improvement Scale (CGI-I), Clinical Global Impression Severity Scale (CGI-S), Gastrointestinal Discomfort Questionnaire (GI-DQ), and Modified Epworth Sleepiness Scale (mESS).
Deerland, for its part, recently studied the efficacy of its spore-forming probiotic on children, an important segment to capture. Immune health is already cited as a category of major opportunity for brands that want to target families with small children. According to a report from Kerry International (Beloit, WI), only 2% of children’s food and drink products launched globally between 2012 and 2017 carried immune health claims.3 As more research emerges linking digestive health with immune health, children’s health products offer a great deal of potential. In the randomized, parallel, double-blind, placebo-controlled study that is pending publication, children ages 2-6 were given Deerland’s B. subtilis DE111 strain, or placebo, for eight weeks to observe the changes to the children’s microbiome profile and subsequent digestive health.
“After eight weeks of daily probiotic consumption, the researchers observed an increase in alpha-diversity at the phylum level, suggesting an expanded functional diversity of the microbiome compared to that of the children in the placebo group,” explains Michini. “Specifically, there were nine differentially abundant taxa at the genus level found in the probiotic group. Six (of the phylum Bacteroidetes) grew in abundance, while three (of the phylum Firmicutes) were reduced. The six taxa of Bacteroidetes that flourished are involved in immune regulation and the reduction of inflammation.”
The modulation of the Firmicutes/Bacteroidetes ratio in the microbiome of children taking the probiotic is a positive indication of improved gut function. The study also found that supplementation supported resilience to gastrointestinal infection, reducing incidence and duration in subjects who were supplementing with the probiotic. Specifically, children taking DE111 had 18 days of gastrointestinal discomfort while the placebo group had 48 days. DE111 is viable for use in gummies and stick packs and, with this research demonstrating efficacy in children, is ideal for products designed for kids.
While probiotics are important to digestive health, they are not necessarily the best solution for everyone, nor do they offer the best results in isolation. Prebiotics are therefore becoming more recognized for their digestive health benefits, both as a complement to probiotics, given the nature of prebiotic fiber to feed gut bacteria, and as an alternative to probiotics.
“Though probiotics have gained a bulk of the attention in the digestive category for individuals seeking gastrointestinal relief, consumers are becoming increasingly aware of the importance of prebiotics as part of their diet and lifestyle regimen,” explains Samantha Ford, MS, director of business development for AIDP (City of Industry, CA). “There is compelling evidence for the use of prebiotics to selectively target the growth of specific probiotics in the gut. Similarly, synbiotic formulas are on the rise, as prebiotics can act as a fertilizer to support the proliferation of probiotics within a supplement. As prebiotics have been on a hockey stick trajectory in terms of growth, we are already seeing these concepts disrupt the market.”
“For example, ‘probiotic-free’ digestive health formulas are becoming more and more popular. Also, the concept of food-derived ingredients that can selectively alter the microbiome, as would happen with the consumption of more whole, plant-based foods, is appealing to the consumer in the era of clean-label, functional ingredients,” adds Ford.
AIDP supplies a variety of ingredients that offer unique benefits, with or without probiotics. Livaux, made from the Zespri SunGold brand of kiwifruit, is associated with an increase of Faecalibacterium prausnitzii bacteria. This is important because F. prausnitzii is the most abundant anaerobic bacteria in the colon, and it has been observed that individuals with irritable bowel disorder have significantly less of the bacteria than healthy individuals. Unfortunately, because F. prausnitzii is anaerobic, it cannot survive in oxygen and therefore cannot be replenished as a probiotic supplement.
Another prebiotic ingredient called PreticX, which is a non-digestible xylooligoscacharide, can support the levels of beneficial Bifidobacteria, reconditioning the gut by only feeding beneficial bacteria. A common complaint users have of prebiotics is that they cause gastrointestinal side effects such as bloating. This happens because some types of prebiotics do not selectively feed beneficial bacteria but rather feed both good and bad bacterial strains present in the gut. This is where PreticX offers an advantage. “Due to the small dosage required, PreticX may have reduced gastrointestinal side effects, as compared to other prebiotics,” says Ford.
Herbal Gut Support
And don’t count out the popularity of herbal ingredients in the digestive health space. “While prebiotics have experienced significant growth, we also see a strong uptick in herbal sales for digestive health,” explains Ford. “Herbals have seen strong growth for immunity and cold/flu symptoms. As this has grown, consumer acceptance and knowledge of herbals has increased. Ayurvedic practices focusing on bringing the body in balance have also contributed to herbals being used for digestive health.”
As Pande explained earlier, emerging research shows that turmeric may have prebiotic benefits in addition to its well-known ability to support inflammation. A recent pilot study found that the combination of curcumin with piperine—Sabinsa’s flagship Curcumin C3 Complex ingredient coupled with its BioPerine ingredient—increased bacterial species in subjects by 69%, on average, compared to supplementation with a conventional turmeric extract and piperine (these subjects saw a 7% increase in bacterial species) and compared to placebo (whose subjects saw a 15% decrease in bacterial species).4
While responses to the treatment were highly personalized, those who did have a positive response experienced increases in most Clostridium spp., Bacteroides spp., Citrobacter spp., Cronobacter spp., Enterobacter spp., Enterococcus spp., Klebsiella spp., Parabacteroides spp., and Pseudomonas spp. These subjects also saw reduced relative abundance of several Blautia spp. and most Ruminococcus spp.
“Often the science of curcumin gets more focus on the area of bioavailability as we see an increasing number of brands claiming bioavailability as the main factor. However, the above study shows that the interaction of curcumin and the microbiome cannot be neglected when evaluating and discussing the health benefits of curcumin,” says Pande. “In fact, curcumin is metabolized into its reductive metabolite form (tetrahydrocurcuminoids) by a commensal strain of E. coli residing in the gut.”
Another ingredient, derived from Glycyrrhiza glabra (licorice), that supports digestive health is GutGard. “It is entirely different from standard deglycyrrhized licorice (DGL) with respect to chemistry and composition, manufacturing process, mechanisms of action, and physicochemical properties,” explains Ford. “GutGard itself has been clinically tested and is effective for addressing digestive complaints related to the upper GI tract. Because of the concentrated nature of the flavonoids, GutGard is effective at a much lower dose than that needed for standard DGL, at 150 mg/day versus 1500 mg/day.”
The ingredient has been studied for functional dyspepsia, heartburn, and H. pylori infection, and can support occasional indigestion and heartburn.
What is clear is that the digestive health space is becoming more diverse, and with this growth will come more knowledgeable consumers who will look for digestive support that fits their needs. This presents an opportunity for ingredient suppliers and product manufacturers alike.
“What’s interesting is that today, when a consumer hears his/her gut ‘growl,’ more than ever the thought that arises is ‘Is my digestive function okay?’ Thanks to the consumer media and ads, people generally are ‘listening to their gut’ a lot more, which is good,” says Michini. “Industry is now accelerating brand—and consumer—education about the link between optimal digestive function and immune health status. In tandem is the increased knowledge and dispensing of that knowledge about the microbiome and how it impacts health. Consumers are coming to understand the connection between digestion and the microbiome and how they also influence immune function and other areas of health such as cardiovascular, sleep, mood, and more.”
The link between digestive health and our overall health will be an important factor as the ongoing COVID-19 pandemic makes consumers more aware of their health, particularly immune health. Offering a product with multiple benefits is a welcome convenience, and providing multiple delivery formats to choose from is even more ideal. So, while ingredient suppliers are developing innovative products that offer higher stability, solubility, and/or bioavailability, product manufacturers will be finding ways to incorporate these digestive health ingredients into added-value propositions. Some ingredient suppliers are already thinking ahead.
“Beyond digestion, probiotics are increasingly found to pair up synergistically with other functional ingredients to support other health areas. As such, we recently created a turnkey supplement portfolio of several condition-specific product concepts,” says Michini. “For example, Beauty from Within combines probiotics with antioxidant vitamins D3, E, and B3 as well as Solarplast, a spinach extract that provides superlative amounts of antioxidants. There’s also Mood Support, Immune Support, Cardio Support, Sleep Support, and Women’s Health Probiotic, as well as SBO Probiotic and Multi-Strain Probiotic, both for digestive health.”