There is so much science accumulating around the issue of chronic inflammation that the development of products to alleviate the condition is inevitable,” said Guy Johnson, principal of Kalamazoo, MI-based Johnson Nutrition Solutions LLC. This was the message from a recent session, “Inflammation: The Next Business Opportunity,” during the Institute of Food Technologists (IFT) annual convention in June 2011.
 
A panel of experts on various aspects of inflammation and consumer insights zeroed in on the complications caused by chronic inflammation, such as high blood pressure, heart disease and cancer. They also explored the potential to alleviate the condition through development of targeted food and beverage products.
 
Inflammation is most certainly an issue where consumer understanding is lagging behind the science. But, historically, that has been the case for many advances in nutrition. Overcoming this barrier involves starting the education process now and creating an understanding that inflammation is related to many of the issues that concern consumers most. The magic will be creating this understanding at a level the consumer can grasp.
 
Inflammation represents one of the hottest areas of medical research; hardly a week goes by without the publication of yet another study uncovering a new way that chronic inflammation does harm to the body. For example, it destabilizes cholesterol deposits in the coronary arteries, leading to heart attacks and potentially even strokes. It chews up nerve cells in the brains of Alzheimer’s victims. It may even foster the proliferation of abnormal cells and facilitate their transformation into cancer. In other words, chronic inflammation may be the engine that drives many of the most feared illnesses of middle and old age.
 
An age-old immunological defense mechanism, inflammation occurs when the body suffers an injury and attempts to heal itself or attack infections caused by pathogens or irritants. As with most beneficial mechanisms, there is a downside when persistent stimulation occurs and results in harmful chronic inflammation. In fact, chronic inflammation is responsible for the most prevalent conditions affecting Americans today: obesity, high blood pressure, high cholesterol and cardiovascular disease.
 
However, it’s difficult for consumers to understand what they can’t see. And so identifying where connections can be made to help shoppers grasp the significance of inflammation in the context of what matters to them is key. For example, the HealthFocus 2010 Trend Survey, which explores the health and nutrition views of more than 2000 consumers, found that although they are not very knowledgeable about inflammation, consumers are very interested in products that can alleviate the health conditions that concern them the most. This is the link that can help make inflammatory response relevant to them.
 
Fortunately, today’s technology allows us to analyze the degree of inflammation within the body and use specific healthy lifestyle interventions (e.g., diet) to reduce the level of inflammation. That’s good for functional foods and beverages as well because manufacturers have the opportunity to showcase the effectiveness of their products, much like can be shown for the well-known cholesterol measurement.
 
However, another challenge facing food and beverage manufacturers that are considering competing in this market is the growing number of consumers who, regardless of how healthy they actually are, believe they lead a healthy or very healthy lifestyle. This group, which grew from 53% in 2000 to 76% in 2010, may not see a reason to buy a product to prevent a condition for which they don’t believe they are at risk, or one that alleviates a condition they believe is already well-controlled.
 
This crucial disconnect must be addressed and manufacturers will need to communicate successfully the advantages of foods that fight chronic inflammation to consumers, who are increasingly becoming aware of the long-term benefits of using diet to reduce or eliminate this condition.
 
The Inflammation Effect
 
Chronic inflammation is the result of persistent stressors on the human body. An underlying problem is that the modern Western diet relies heavily on foods that are chronic stressors, according to panelist Britt Burton-Freeman of the Bedford Park, IL-based Institute of Food Safety and Health (IFSH) at the Illinois Institute of Technology (IIT), a food science research institute that produces knowledge-based outcomes in food safety, food defense and nutrition.
 
Ms. Burton-Freeman explained that C-reactive protein (CRP) is a clinical biomarker of inflammation, and high levels of CRP in the bloodstream are indicative of chronic inflammation. In general, a CRP level above 3 mg/L puts one at high risk for inflammatory diseases.
 
Foods that promote inflammation—saturated fats, trans fats, corn and soybean oil, refined carbohydrates, sugars, red meat and dairy—all play a prominent role in the American diet today.
 
How can dietary choices reduce inflammation? She revealed that certain foods can have a profound effect on the human body by reducing or eliminating the inflammatory response. Fruits, vegetables, whole grains and legumes contain bioactive phytonutrients, which disrupt the cell receptors that promote inflammation. A low-fat diet with an abundance of fruits, vegetables and whole grains not only reduces inflammatory responses, but also the body’s level of CRP. Those foods, as well as fish, are full of substances that disable free radicals. The net result is a reduction in the incidence of inflammatory disease.
 
Food Processing Challenges
 
From a product development standpoint, the goal is to prepare and process foods using methods that not only maintain the healthfulness of anti-inflammatory food, but also deliver bioactive components in a way that will be most effective to the human body.
 
“Food is the delivery system for dietary intervention,” said panelist Mario Ferruzzi of Purdue University, West Lafayette, IN. “Stability and bioavailability of bioactive [compounds] are key to the delivery of benefits from food.” Manufacturers must consider the effects processing and shelf stability have on the phytochemicals, which are the beneficial bioactive compounds of fruits and vegetables. These effects can be damaging but they can also be helpful. Thermal processing, for example, greatly improves the bioavailability of beta-carotene in spinach and carrots.
 
“Extracting the anti-inflammatory properties and incorporating them into processed food and beverage applications is a work in progress,” he explained.  “Maintaining stability and bioavailability through the manufacturing and consumer preparation processes may prove challenging. More work needs to be done to assess the best ways to ensure consistent delivery of the phytochemicals with anti-inflammatory properties.”
 
A Resonant Message
 
However, this level of understanding is far too complex for the average consumer, according to the HealthFocus Trend Survey. Even though 80% of U.S. shoppers know the food they consume is an important part of preventive health measures, very few know specific details as to why and how. In fact, the majority of consumers don’t have the time to decipher detailed information, so product messages must be simple as well as resonant.
 
The backdrop of shopper understanding hasn’t changed much. Consumers are open to the concept that there is a relationship between prevention and diet and a majority even believe that certain foods can help reduce inflammation. So most shoppers know the linkage is there. They’ve learned that anti-inflammatory omega 3s are good for them and some have made the connection that specific foods with omega 3s are good for heart health. So in spite of the various levels of understanding regarding what the ingredient does for them, more and more people are increasing their consumption of omega 3s. The same is true for antioxidants. The mechanism is not as well understood as the effects.
 
The message has to be something shoppers can understand, because according to the HealthFocus Trend Survey, three fourths of shoppers feel they are in control of their health and are in good health. And even if they are not, the majority think they are knowledgeable about nutrition and health. So while they definitely feel they can improve, they also believe they are doing a decent job.
 
But one in three of the respondents in the study has heart disease, high cholesterol, high blood pressure, arthritis or is obese. Since they already think they are the gatekeepers of their own health, regardless of their ability, the question is: how do we bring them into the inflammation discussion? Because if the message is not something they can understand, it just becomes part of the cacophony of noise around health and nutrition that the consumer is trying to follow.
 
So, how do we talk about inflammation? There are three considerations. First, be prepared to educate consumers. Second, for the mainstream shopper, the message has to be more about the effects than the mechanism. They have shown a very high interest in the benefits related to reduced inflammation. The degree of detail on the mechanism depends on who the target group might be. Third, to reach the majority of shoppers, the discussion has to be more about prevention than cure. In general, most consumers choose healthier foods and beverages in a complementary light rather than a curative light, so the best opportunities may be in prevention. In fact, only 8% say the primary reason for choosing healthier foods and beverages is to treat or control an illness. However, when shoppers have a serious illness like high blood pressure or heart disease, the percentage shoots to 23%. A very high percentage of those with heart disease and high blood pressure are also treating it with medication. So while their interest may be considerably higher, diet will still likely be a complementary approach.
 
In studies on heart health products, HealthFocus has found shoppers still say that taste is most important. So if brands fall far below others in their category on this attribute, it is difficult to create the momentum needed even if the science behind the heart health claims is perfect. Today, health is one attribute in a brand; it is not always the driving attribute. So even if we have a resonant message about inflammation, we also have to recognize that will not be the only reason a shopper goes after a product. Remember, most of them already think they are healthy!
 
The needs of consumers are well matched for the inflammation message. You need to create a message the shopper cares about. Consumers don’t need to understand the science to the highest degree; but they do need to have faith in the message, and that’s what makes the underlying science extremely important.