It is said, we are what we eat, that is, when we're not busy digging our own grave with a knife and fork. Well, that's never truer for cardiovascular health. The World Health Organisation (WHO) defines cardiovascular disease (CVD) as disorders of the heart and circulatory system, including heart attacks, strokes, high blood pressure and hypertension; and poor diet, among other things, is a major risk factor.
Accounting for 30% of the global death rate, CVD is the top cause of mortality: in 2005, 17.5M people succumbed - 43% with heart attacks and 32% with a stroke. By 2015, an estimated 20M people will die from CVD. It affects men and women alike, and 80% of deaths occur in low- and middle-income countries.
The good news, however, is that 80% of premature heart attacks and strokes are preventable. The WHO recommends a balanced diet with plenty of fruit and vegetables, whole grains, lean meat, fish and pulses, and restricted salt and sugar intake. But there's also considerable opportunity for manufacturers to give the 'balanced diet' a nudge with functional ingredients for which there are proven heart health claims.
Who's launched what?
Geographically, it's Atlantic coast countries that have been busiest with product innovations. By sector, dairy is the most popular - but over the last year there have also been major developments in confectionery and spreads. However, plain numbers need factoring against brand muscle to size-up the opportunity.
In yoghurt shots, Danone's Danaten (Spain) fermented milk has a bioactive peptide to help control blood pressure, as does Emmi's Evolus (Italy). Unilever's European foray into blood pressure control with pro-activ shots - only distinguishable from the standard product by a blue stripe and a subtlely different health claim - has been less successful however, and has been quietly withdrawn.
Julian Mellentin, director at the London-based Centre for Food and Health Studies, says, "Consumers understand cholesterol reduction - but blood pressure control remains ultra-niche, even if the health proposition is sound. It's my guess Unilever simply didn't realise the predicted volume targets of marketing's expectations. But such a proposition works well for smaller brands like Evolus where sales expectations are not so vast and the brand is more closely managed."
But there's also the fad, or bandwagon, angle, he adds: "Even in Japan, the hotbed of functional food innovation, sales of blood pressure lowering products peaked at $80m four years ago, and have declined 20% a year since."
So, even for the most vibrant functional food market this may be a claim too far - a brand equity consumers have invested in, only to desert when the next big idea comes along.
Valio's Benecol shot product extends the plant stanol Benecol brand for cholesterol lowering. A similar effect but with a different ingredient, oat beta-glucan, is found in Kellogg's Optivita cereal. Unilever's Becel/Flora brand takes two approaches; fish derived omega-3 in the spread, whereas its 'pro-activ' shots use plant sterols, and are endorsed by the Dutch Heart Foundation.
Product innovators' great opportunity is to select the right ingredient for their sector - especially if proprietary discovery is beyond their research or academic collaboration budget - and where marketing is about drawing attention rather than education from scratch.
The CVD toolkit: Stanols and Sterols
Elevated blood cholesterol is a CVD major risk factor - and reduction lowers that risk.
Plant stanols and sterols, present naturally in vegetables, fruits, oils (soy, rape) and also in wood pulp, are very similar molecules to cholesterol; and their presence prevents cholesterol absorption, reducing the extraction rate even further, thus promoting excretion from the body.
Health studies affirm that about 2g/day lowers total blood cholesterol typically 6-10% and LDL 'bad' cholesterol by 8-15% - whereas HDL 'good' cholesterol remains unaffected.
Frost & Sullivan estimates compound European market growth in plant sterols of 10% a year until 2012 - and wider regulatory approvals will help drive the market. EU opportunities are presently limited to the dairy sector: milk (soy), yoghurt, cheese, dressings, mayonnaise and spreads and rye bread. The health claim serving is 3g sterols per day.
In the US, sectors also include bakery, beverages, confectionery, snacks, meat analogues and ice cream - but the serving claim is lower at 0.8g.
The recent Food Ingredients Europe (FiE) exhibition saw a couple of new product variants launched addressing the difficulties of formulating regular sterol powders (<10 ?m) with their limited oil solubility, high melting point and poor water dispersion.
Cognis presented its new water-dispersible Vegapure F 90 ME plant sterols with skimmed milk powder, targeting rye bread and cheese. In such low fat applications, fatty-acid rich methyl-esters carry an unacceptably high fat content of around 40%. Cargill, meanwhile, unveiled CoroWise ES101, a high concentration sterol powder with low flavour impact for acid dairy drinks.
Omega-3
Frost & Sullivan forecasts 32% market growth for omega-3s up to 2010. At FiE, Cognis subsidiary Napro Pharma showcased omega-3 Omevital 18/12 T G Gold, a well refined marine oil with an extremely clean sensory profile and stability, ideal for dairy and spread applications. However it may be too costly for use in commodity products.
Conversely, a bespoke offering for bakery and morning goods is Bakels' Nutr?mega, which also debuted at FIE. Incorporation at just 2% permits the UK joint health claims initiative heart health claim in just two slices of bread, claims md Paul Morrow. "While there are several products on the market, Nutr?mega offers a cost effective advantage. Since it's designed specifically for bakers, there are no other carriers or additives such as fish gelatin or milk protein, which means we can claim clean-label status, currently the only product on the market to do so."
This last point is significant: many omega-3 encapsulated ingredients are a 'one-size fits-all' across all product sectors: spray dried with protein carriers adds unwanted allergens and also unpredictable interactions when formulating - whereas the Bakels proposition is bespoke to its core sector.
Addressing multiple risk factors
Meanwhile, the largest food ingredient companies are looking at ways to combine a range of ingredient functionalities to add value through an optimised 'health and wellness' proposition - for example addressing a range of CVD risk factors.
DSM Food Specialties covers a few bases: in peptides it offers TensGuard, which directly helps to control blood pressure; for type 2 diabetics it has Insuvital to manage blood glucose peaks after meals. A less direct approach is Pep2Balance, an innovation still being worked on which helps improve mental acuity and manage stress - another CVD risk factor.
Larger ingredient trading companies may also offer a co-ordinated health approach based on their product range, says Joy Thomas, industry manager, health and food at Cornelius Group. "Most people seem to understand omega-3, but the market is becoming saturated. Customers are looking for the next new big thing.
"There are a few other materials with claims for heart health submitted for article 13 of the Nutrition and Health Claims Regulation such as lycopene, folic acid and coenzyme Q10. Out of these, CoQ10 could be a new functional ingredient in western Europe. It is already big in countries such as Slovenia, Croatia and Poland, where milks, yoghurts and juices contain it - with water soluble versions such as Valens QVital."
Not just for the big boys
Beyond the largest companies, there's a burgeoning underbelly of innovative opportunities which don't yet have the critical mass or scale to hit the big time - or regulatory approvals yet! The trick is to spot the next healthy market happening - and execution is key.
Take an example from the Mediterranean diet with its lower incidence of CVD: besides being found in olive fruits oleuropein antioxidant also occurs in olive leaves in high levels. Thus Frutarom's water soluble Benolea in animal studies has been proven to improve heart health and reduce blood pressure.
Coressence, a UK firm developing bioactive ingredients from ancient apple varieties boasting "higher concentrations of polyphenols than green tea and cocoa", is also looking for a slice of the action in cardiovascular health products.
Chief executive Richard Wood makes mention of the Kuna Indians, "With an almost total absence of CVD, epidemiology shows they habitually consume large quantities of epichatechin [an antioxidant] in raw cocoa drinks. We have completed a similar study on epichatechin from apples."
His contention is that in the past we would have consumed more flavonols with a lower incidence of degenerative disease, due to a relaxed vascular system. Richard continues, "Vascular age is a concept consumers can understand; if stressed or damaged by modern lifestyle it can exceed your chronological age."
Whether his confidence in consumers' ability to grasp the concept of 'vascular age' is well placed remains to be seen, however. There is also the minor detail of convincing the category buyer or 'gatekeeper' to list such products.
Getting the marketing right
Which reminds me: whatever happened to Sirco? You remember: Provexis' chilled juices with heart health and circulation claims based on its 'Fruitflow' tomato extract, which maintains blood flow?
Some 18 months ago Provexis volunteered product withdrawal to focus on ingredient co-development with manufacturers - an approach which appears to have paid off following recent announcements with Coke and Unilever (see p13).
But what will the consumer benefit be? My suspicion is that further discreet segmentation of the CVD market will need substantial and targeted consumer campaigns to succeed. Those diagnosed will already know - and, be looking beyond optimised diet for medicines: thus it may be a tough job convincing consumers early enough about dietary risk prevention, well before it's too late.
Paul Hart is application technology manager with the Solanic Institute. He has over 25 years' experience of working of Food R&D, IPR and Nutrition. Contact him at [mailto: paul.m.hart@btopenworld.com]