Digestive Health Report 2021
Understanding the tailored needs of women and identifying whitespace opportunities to support these needs through nutritional intervention.
The star of lockdown
As consumers connect the dots between gut, immune and cognitive health, industry is primed to deliver products to fit their wants and needs
The global pandemic has incrementally accelerated
interest in gut health, as consumers have become
more aware of the interlinkage of their digestive health,
immune function and general wellbeing. As awareness
levels increase, consumers are also demanding
more science-backed products without
compromising on accessibility or flavour.
This report discusses how the
COVID-19 pandemic has impacted
the digestive health market, diving into
market growth, consumer demands and
unique ingredients. We explore
market opportunities for synbiotics
and psychobiotics, and
innovative delivery formats.
Natalia Franca Rocha reports.
Digestive health market growth overview
Industry stakeholders have seen exponential growth in this category, especially in 2020, when consumers started turning to gut health products to boost immunity. Mike Hughes, head of research and insight at FMCG Gurus, highlights that approximately 6 in 10 consumers have bought at least one probiotic product over the last twelve months. Further, Kevin Krail, business development manager at Marinova, noted that “recent market research1 indicates nearly half of all consumers now believe that a healthy gut is key for overall wellbeing.”
The results of a consumer study—conducted May 2020 in the United States, China, and Italy by IFF Health—showed that consumers’ usage and compliance towards probiotic supplements increased during the early days of the pandemic. Jennifer Montgomery, probiotics and marketing manager at IFF Health summarised: "From six months prior, to the time of the study, consumers in Italy reported the greatest increase in usage (188%) and weekly compliance (83%) while China saw a 108% increase in total users, and the U.S. an increase of 66%.
Consumers’ usage and compliance towards probiotic supplements increased during the early days of the pandemic
IFF Health research conducted May 2020
Projecting forward past the current spikes, and in comparison to the baseline, the data indicates that in both Italy and the U.S., usage and compliance will continue to grow. In China, though usage will fall back to the baseline level, compliance among those users is expected to increase. As usage and compliance increase worldwide, the dietary supplement industry can expect the global probiotic supplement market to grow. Valued at $5.97 billion in 2019, the global probiotic supplement market is projected to reach $7.21 billion by 2024, with a compound annual growth rate of 3.9%.2”
Even as probiotics consumption has increased during the pandemic, consumers are becoming more aware of how gut health can influence overall health. Sophie Medlin, a well-recognised consultant dietitian and chair for the British Dietetic Association in London, sees that consumers are more interested in the link between gut health and immunity, encouraging brand owners to update messaging to take advantage. For example, Medlin observes manufacturers adding vitamin C, zinc or vitamin D to gut health products in order to include an immune health claim.
1 2020 gut health report by FONA International
2 © Euromonitor International, Consumer Health Industry Database
Positioning digestive health products
As consumers transform their approach to digestive health and become more knowledgeable, it’s pivotal that the industry can meet consumers’ wishes and demands. Krail shared that Marinova identified an “increase in demand for natural ingredients that deliver on three primary fronts—high purity, certified organic and backed by science. Brand marketers will do well to consider the trifecta of properties when selecting key ingredients for digestive support products.”
Hannah Ackermann, a registered dietitian at Comet Bio, shared "more consumers are reaching for prebiotic and probiotic supplements rather than the traditional standbys, like vitamin C or zinc, to boost their immune system." She added, “research suggests that over 70 percent of our body's immune system resides in the gastrointestinal tract, and prebiotic dietary fibres fuel good bacteria growth in our gut, especially bifidobacteria and lactobacilli probiotic strains.”
Interestingly, Medlin feels that the messaging around prebiotic fibres from plant-based products is a market opportunity. As she comments, “The highest levels of diversity in the microbiome are found in people who eat the greatest variety of plants.” According to the review, gut microbiota diversity according to dietary habits and geographical provenance—published in the Human Microbiome Journal—dietary habits and geolocations highly influence the microbiota diversity. In one of the ‘largest’ microbiome studies, the American Gut Project found a positive correlation between the number of unique plants consumed and the microbiota’s diversity. Such whitespace offers category specialists, especially manufacturers and product developers looking to expand their products portfolio, further potential to tap into the plant-based trend.
Digestive health market opportunities in APAC – podcast
Additionally, consumers are seeking nutritional products with preventive positioning rather than cure. Montgomery says consumers are “taking a daily probiotic to boost immune health, rather than only focusing on immune health acutely—like reaching for medicine once they already have the flu.”
Krail adds, "consumers are increasingly recognising that digestive health is a key factor influencing all manner of biological functions—from inflammation and immune function right through to brain and heart health.”
Radhika Bongoni, head of business development at BaseClear BV, notes, “there is a still a big gap in the level of knowledge between industry and researchers to the consumer and end-users.” Consumer education seems pivotal in pushing the digestive health market to further progress; thus, companies could take advantage of market presence by educating consumers on their products.
Ingredients must be deemed safe and natural, and consumers are fully educated about the related benefits
Mike Hughes, FMCG Gurus
The industry agrees that physicians, dietitians, and nutritionists are at the forefront of educating consumers with the latest research developments and health claim communication. Ackermann encourages “any brand making a health claim to lead with the science behind what makes their ingredients unique within the supplement market.”
Hughes called out additional issues: “Ingredient-led claims are becoming more influential on purchasing habits because consumers are researching different ingredients as they take a proactive approach to health maintenance. Consumers are more accepting of ingredients they know and trust; they are open to trying new ingredients—especially if they are associated with increased efficacy. There is an opportunity to launch new ingredients that aid digestive health. Still, these ingredients must be deemed safe and natural, and consumers are fully educated about the related benefits."
Immunity, cognition, synbiotics in focus
Gut health and immunity
Although the connection between gut health and immunity has attracted research for the last two decades, Prof. Francesco Marotta believes this is a theme of constant expansion as novel technologies allow for more overall health and multiorgan involvement related-studies to happen.
Krail shares that researchers are certainly exploring the links between gut health and overall immunity, providing an increased opportunity for brand owners to develop products supporting the gut-immune axis. Ingredients that support immune function boost immune response, dampen allergic responses and inhibit anti-viral activity—all whilst supporting gut health—represent a unique market opportunity. He highlights that fucoidan is one such ingredient, whilst another called out by Ackermann is arabinoxylan plant fibre extract, which promotes healthy gut bacteria growth and a healthy microbiome.
Probiotics enhance immune and respiratory health – article
Further, Bongoni sees that research trends in probiotics are taking two directions: personalisation at the individual level, and personalisation at the target activity level. Even before COVID-19, probiotic research has been trending towards immunity, inflammation and disease prevention.
Linking digestive health to the concept of personalised products tailored to unique consumer needs, such as immune health, Montgomery says that formulators should remember that strains are not a ‘one size fits all’ solution. As they source a new product strain, they must also consider consumers’ unique lifestyle needs, including how immune function differs depending on age.
Exploring the unique opportunity for synbiotics
Given how popular probiotics and prebiotics are amongst consumers, it is unsurprising that formulators are looking to combine both in the same product to optimise consumers’ experience. However, from the consumer perspective, ‘synbiotics’ is a new and unfamiliar concept making education critical. Even industry partners and researchers need support in interpreting the data that is generated, says Bongoni.
When thinking about the efficacy of synbiotic products, Montgomery says fully efficacious doses of both types of ingredients are critical. “In this case, the probiotic doesn't need to utilise the prebiotic directly; however, the probiotic can have a specific health effect, and the prebiotic will help indigenous microbiota among other health benefits it brings," she says. Ackermann adds that “supplying prebiotics and probiotics in tandem is thought to help improve the activity of beneficial microorganisms in the gut and gives the bacteria a better chance of surviving, thus positively impacting the microbiome.”
However, she notes synbiotics present a complex formulation challenge. “To truly be a synbiotic product, the prebiotic presence must improve the probiotic's survival and ability to colonise in the microbiome,” she says. “Simply combining any prebiotic and probiotic does not necessarily create a true synbiotic. Luckily for manufacturers, there are more prebiotic fibre options available than ever before to utilise."
Medlin believes this is a great time for the market to capitalise on synbiotic products as the consumer remains confused about the differences and connections between pre- and probiotics. Indeed, Hughes says, "In terms of synbiotics, this is a claim that consumers will not be overly familiar with. It is important not to overestimate consumer awareness of the science behind digestive health products.
"Whilst awareness of prebiotics is growing, consumers are less aware of the benefits of these ingredients (even less so when it comes to postbiotics) and will more likely to be motivated by probiotic claims on general everyday food and drink products, as opposed to seeking out claims around prebiotics or products labelled as synbiotics. If this market is to grow, more needs to be done towards educating consumers."
Digestive health, psychobiotics and mental health
According to Hughes, psychobiotics will strongly appeal to consumers as they recognise the interconnection between brain, gut and immune health. He says, “In recent years, consumers have been more attentive to brain health and its link with the wider body. In an era of uncertainty when consumers have an array of worries and regularly feel stressed, they want products that help protect the brain, especially if such products communicate credibly and transparently the additional benefits of such products.”
Ackermann notes that the microbiome was only fully mapped a few years ago, and scientists are continuing to learn more about how the gut microbiome can affect brain health. This connection, known as the gut-brain axis, could lead to more insights into how tweaking the microbiome could prevent or treat cognitive and autoimmune diseases. Investing in clinical trials is pivotal to better understanding this link.
As consumers become more aware of the microbiota-gut-brain axis, increased demand for more individualised brain health products is expected, Montgomery shares. In fact, she cited research from Innova Market Insights3 showing a 34% growth of probiotics for boosting mood in the last five years worldwide.
She adds that formulators can consider pairing psychobiotics with natural compounds, such as ashwagandha and L-theanine, to help consumers manage stress. This allows formulators to develop new probiotic blends that stand out on the shelves while assisting consumers cultivating a sense of calm.
Dr Michael Baumann, global strategic marketing manager for dietary supplements at IFF, further adds that "driven by the pandemic, stress management and sleep support are two categories that have gained significantly greater attention from consumers in 2020. Consequently, brand owners have put more emphasis on those health claims.”
He cited a NutraIngredients survey4, showing 72% of dietary supplement manufacturers ranked stress management claims as very important, followed by 55% saying the same for sleep support claims.
The greatest opportunity for probiotics lies in:
- Digestive health
- Mental performance
- Immunity support
According to Hughes, consumers are suffering from a variety of mental wellbeing problems. Already well established before 2019, these problems have been intensified by COVID-19 and high levels of uncertainty. He adds: “More than four in ten consumers have become more conscious about their mental wellbeing in the last twelve months, whilst the proportion of consumers who say they have poor sleep health has shot up.
As the impact of COVID-19 continues to linger, mental wellbeing issues such as stress, fatigue, and an inability to relax will continue to be common. At the same time, consumers recognise that poor mental wellbeing doesn't just impact mood and energy levels but can also impact the immune system. As such, demand will be high for products that help aid mental wellbeing.”
Gut microbiota varies between younger and older population – article
3 Innova Market Insights
4 NutraIngredients, USA State of the Industry Survey 2020
Innovation in delivery
Consumers driving demand for food formats
As consumers live through uncertain times, they are also challenged to follow healthier lifestyles. Despite their best intentions, consumers can struggle to stick to healthy diet plans, and this is because such eating and drinking habits are associated with compromise. This can prove a challenge for consumers, says Hughes, especially when they turn to indulgent products for moments of escapism in times of uncertainty. “As such, delivery formats need to be convenient and hassle-free so that consumers can easily incorporate products into daily diets in the long-term. This is something that the industry is responding to through convenient product formats and also promoting digestive health claims on everyday products that consumers already turn to regularly.”
There are multiple examples available. Brand owner and nutritionist, Lee Holmes, shares she is noticing the strong presence of prebiotic yoghurts in Australia while Medlin observes probiotics being added to new products, including specialised delivery formats like straws. She further considers the challenges of adding probiotics to unconventional products, noting that there are considerations related to delivering live probiotics via foods and beverages, rather than more traditional supplement formats. Bondoni adds that when the gut health links to probiotics, prebiotics and even multivitamin supplements, current innovations (but also challenges) are around microencapsulation or slow-delivery capsules for release of the bioactive in small or large intestines or colon where you notice most of the microbial activity.
One way formulators can tackle these challenging food and beverage applications is through the use of spore-forming probiotic bacteria
Jennifer Montgomery, IFF Health
Montgomery summarises that when it comes to developing probiotic products in new formats, working with a supplier that understands stability is key. Often, emerging formats require probiotic formulation expertise to ensure claims are valid through the end of the product shelf life. It's also helpful to work with a supplier that has expertise in some of the other key ingredients needed to make these new formats. “In general, we see a growing demand for probiotics in a wide range of food and beverage formats that traditionally have not been viable. These include products like kombucha, fruit juices or bars that have high water activity,” says Montgomery.
Baumann also shares: “As consumers reach for a dietary supplement, they want something easy to consume and pleasant-tasting while delivering the desired benefits for immune and digestive health and label claims such as plant-based, clean-label, etc. Our customers tell us they face various challenges when developing the next generation of supplement products addressing those preferences.” The most frequently mentioned challenges are related to ensuring the ingredients enable specific health claims like low sugar; delivering on consumer preferences for an optimal sensory experience; finding plant-based ingredients that perform as desired; developing formats that will allow better consumer compliance.
Supplement manufacturers and brand owners looking to deliver the solutions that customers desire should seek savvy ingredient suppliers to help overcome these formulation challenges. Baumann also highlights that brands have begun offering a portfolio of digestive health product formats that better address personal consumer needs and preference, such as gummies. Additionally, product developers are optimising formulations for improved swallowability to enhance patient compliance, appealing to the paediatric and geriatric populations.
Montgomery further shares: “one way formulators can tackle these challenging food and beverage applications is through the use of spore-forming probiotic bacteria, ensuring probiotic viability from formulation through product shelf life. Since many probiotic spores have a protective layer—which allows viability in conditions such as high heat, high water activity or highly acidic ingredients—they've become a more popular choice for formulators looking to develop an application with a low pH, high water activity or long shelf life. Spores like this create an opportunity for brand owners to launch products in on-trend formats such as gummies, fermented teas, bars and snacks, where conditions may not support probiotics from the more established lactic acid bacteria category.”
Looking to the future of prebiotics, Prof. Marotta predicts slow release and mini-drinks may get more spotlight in the future. Ackermann, however, expects to see more companies developing products with novel prebiotic fibres, such as permissible indulgent foods like ice creams, chocolates or crackers. Additionally, coffee offers potential to add functional ingredients, such as prebiotic fibre, allowing consumers to incorporate the supplements into their existing daily routine more seamlessly.
Our expert contributors
Hannah Ackermann, RD
Hannah Ackermann, RD, is a registered dietitian who uses her food and nutrition expertise to help Comet Bio educate consumers and tell its ingredient story. Prior to joining Comet Bio, she worked in nutrition communications at leading global market research and public relations firms. Ackerman holds bachelor's degrees in nutritional science and journalism from Indiana University, Bloomington, and an MBA in marketing from Dominican University, Chicago.
Jennifer Montgomery, Probiotics Marketing Manager, IFF Health
Jennifer Montgomery studied marketing at the University of North Carolina Kenan Flagler Business School. She began her marketing career at Procter & Gamble, where she led pharmaceuticals and personal healthcare brands. Accepting a brand manager position at Dow Chemical in 2010, she also held other positions at Dow within the Sports Marketing group, including Olympic Incentive Program Director. In 2018, she became the NAFTA Marketing Manager for Probiotics at DuPont Nutrition & Biosciences (now IFF Health).
Kevin Krail, Business Development Manager, Marinova Pty Ltd
Kevin Krail has extensive international experience developing new markets for nutraceuticals, dietary supplements and novel functional food ingredients. Educated in the United States, he has a bachelor’s in engineering and an MBA from the University of Colorado. Krail has a very successful track record in commercialising science-based nutritional products and introducing global brands into new international markets.
Michael Baumann, PhD, Global Strategic Marketing Manager, Dietary Supplements, IFF
Michael Baumann, PhD, studied chemistry at the Clausthal University of Technology (Germany) and holds a doctorate from the Institute for Technical Chemistry. He started his career at the Dow Chemical Company as an R&D leader in 2001, exploring and advancing polymer development for various industrial and pharmaceutical applications. In 2015, Dr Baumann became Pharma Field Marketing Manager, EMEA, for Dow Pharma Solutions; following the 2018/2019 integration of Dow Pharma Solutions into DuPont Nutrition & Bioscience, he became Global Strategic Marketing Manager, Immediate Release Pharmaceutical Dosage Forms at DuPont. Following the recent merger of DuPont N&B with IFF, he now serves as the Global Strategic Marketing Manager for the Dietary Supplements within the Pharma Solutions division of IFF.
Mike Hughes, Head of Research and Insight, FMCG Gurus
Mike Hughes is head of research and insight and has more than 14 years' experience analysing consumer trends across the food, drink and supplement industry. Hughes has a particular interest in challenging industry perceptions when it comes to assumptions around how consumers think and behave and identify new and evolving trends across markets.
Prof. Francesco Marotta, MD, PhD (JPN), MACG (USA)
Prof. Francesco Marotta, MD, PhD expertise lies within gastroenterology, oxidative stress, ageing and nutrigenomics. Prof. Marotta holds an impressive and extensive publication list. He has cooperated with Nobel laureate Prof. Montagnier and is Honours Research Professor at the department of Nutrition Food Sciences at Texas W. University (USA). He is also part of the Advisory Board Panel of the Center for Life Science at Nazarbayev University and Ministry of Science Astana, Kazakhstan. Prof. Marotta further serves as an external examiner for PhD candidates at McGill University (Canada) and is a non-faculty lecturer in Nutrigenomics & Aging at Harvard University (USA), as well as the Chair of Vitality & Longevity, Medicine Science Commission at the Femtec World Federation. Prof. Marotta is also the co-founder of ReGenera R&D International for Aging Intervention.
Radhika Bongoni, PhD, MBA, BaseClear BV
Radhika Bongoni, PhD, heads business development at BaseClear BV, a 28-year-old microbial genomics service provider in Leiden Bioscience park of Netherlands. Dr Bongoni received her doctorate in food technology – Phytochemistry (2014) from Wageningen University & Research (the Netherlands) and an MBA (2015) from Tias School for Business & Society (the Netherlands). With techno-commercial expertise, she is involved in business growth, market trends, application-driven microbial genomics products & services, and market expansion. Prior to BaseClear, Dr Bongoni worked briefly for DSM innovation centre and Bioriginal BV.
Sophie Medlin, Consultant Dietitian
Sophie Medlin is a well-recognised consultant dietitian and is the chair for the British Dietetic Association for London. Medlin has expertise in gastrointestinal and colorectal health. She worked in acute hospitals specialising in gastrointestinal diseases before moving into academia, where she worked as a lecturer at King's College London. Medlin is a go-to spokesperson for media regarding evidence-based nutrition, regularly featuring in print, broadcast and social media. She is also the head of nutrition research for Heights, the Braincare company.