At Vitafoods Europe 2021, panels of experts on raw materials, contract manufacturing, research, and finished products in the nutraceuticals space discussed the latest innovations and trends in the closely-linked nutritional pursuits of gut health and immune support.
 
This category is made up of supplements, functional foods, and functional beverages containing key antioxidants, micro- and macro-nutrients, probiotics, and other bioactive compounds that can aid in the process of supporting digestion and immune health.
 
Many similarities between gut and immune health have been uncovered, especially when it comes to the root causes of declines in the capacity to fight off common illnesses, as well as indigestion, heartburn, and other digestive issues. The health benefits achievable with nutritional products, according to research, can extend well beyond minute reductions in the risk of developing chronic diseases. Many ingredients are clinically substantiated to offer acute benefits to digestion, immune function, or both.
 
“Research shows that there’s a huge connection between digestive health and immunity,” said Steve French, senior vice president at Natural Marketing Institute (NMI). According to NMI surveys, half of consumers state that a healthy digestive system is beneficial to the immune system. With spikes in immunity and gut health sales, along with online searches, consumers recognize that what’s good for the gut is good for overall resilience against pathogens and other stressors on the immune system.
 
“Since COVID-19 began, it’s been very important to communicate the interconnected roles of digestive issues with those who are managing stress, sleep disturbances, or a lack of energy,” said French. “Sixty percent of consumers who are managing sleep issues are also managing digestive issues, and this circle of connected health issues also applies to consumers who are managing immune problems.”
 
Likewise, Andrew Myers, chief science officer of nutritional products at Catalent said that COVID-19 has likely made the category of immune health one that is much less seasonal than ever before. “Historically, there’s always been a seasonal spike in need for immune products corresponding with changes of the seasons, however, we now see a year-long interest in seasonally-relevant ingredients such as echinacea. However, with chronic intakes of nutritionals or botanicals over the long-term we need to be careful that we’re not over-activating the immune system. Instead, we should look to use foundational nutrients for proper immune support and function.”
 
“D3 is emerging as a preferred source of vitamin D, which is considered a root of the immune health market,” said Claudia Valla, representative at Catalent. “New D3 sources are becoming suitable for both vegans and vegetarians, and key combinations can include algal oil, beta-glucan, vitamin K2, vitamin C, zinc, and selenium, all of which play important roles in immune function. Vitamin K2 pairing with vitamin D is one of the fastest and most successful, thanks to emerging research which suggests that these two vitamins have complementary mechanisms of action.”
 
Additionally, “plant-based solutions have become mainstream,” Moran Werner Saido, product manager at IFF Health said. “Immunity solutions across the lifespan should include herbals such as echinacea, sourced through a traditional method of preparation such as cold pressing which is shown to work as an immune tonic against the common cold,” or “pelargonium, which has synergistic effects with echinacea.”
 
Likewise, many of the panelists addressed the emphasis that COVID-19 placed on what happens to immune systems with age. Many feel that a burgeoning specialty market category catering to the “aging immune system” might be spurred by ongoing concerns consumers have about the role immunity plays in their overall resiliency and longevity.
 
“Two thirds of American adults seek out foods that improve innate immune function,” said French. “Fifty-one percent of consumers state that they are looking to detoxify their diets in order to improve their overall health; and people are using a wide array of products to do so, including supplements, foods, OTCs, and drugs. The approach to gut and immune health is multimodal […] people are using more than one method to manage both their immune and digestive issues.”
 
Nuanced Approaches
Formulators of gut and immune health products called for the industry to explore a variety of nuances within these two categories that could make products more specific to certain clinical endpoints—whether it be looking for short-term remedies, long-term nutritional support, or something which could also target specific issues that may affect immunity or digestion.
 
“The principal activity of the immune system is surveillance, which is innate immunity. Adaptive immunity is when our defense system is engaged, which comes into play to protect us from pathogens, or other offensive organisms,” Myers said. “One possibility is for companies to formulate immunity products based on the primary and secondary functions of the immune system, and really communicate with consumers that way. It’s also important to take into account how stress, sleep, overall nutrition, and the use of medications can impact how the immune system functions, and when we’re at risk of having an immune function which is depleted or less effective.”
 
With a heightened awareness consumers have in the post-pandemic landscape regarding the multimodal factors at play in immune health, it’s important for companies to communicate the many unnoticed factors at play in immune and gut health, Saido said.
 
Likewise, the impact of gut health concerns on consumer populations may very well be widely underestimated. Nutraceutical companies should consider speaking to the serious and seemingly ever-increasing prevalence of digestive health issues that are affecting people who live modern lifestyles with modern diets.
 
The Western diet is notorious for a lack of fibrous vegetables, which Matthew Titlow, CEO of Compound Solutions, attributes to the overall increase in digestive troubles seen in consumers today. “A lack of fibrous vegetables means a lack of short-chain fatty acids, and reduced gut barrier function,” he said, which led to the launch of CoreBiome, a proprietary form of the short-chain fatty acid butyrate at its most bioavailable form.
 
As a core element of gut barrier function, having a refined SCFA to strengthen the activity of gut health formulations could be critical to the efficacy of a wide range of gut health and pro- and prebiotic products. “This trend of marketing products as all-in-one is selling at staggering levels in the U.S. Consumers want something simple that can be used with regularity,” Titlow said.
 
“Disorders such as IBS, indigestion, and heartburn are really common across the world,” noted Tony Gay, head of technical sales and NPD at Prinova. “United European Gastroenterology reports that these disorders may affect as many as 21% of people in Europe, and there’s a growing range of applications to meet consumers’ needs.” The global industry can likely learn a lot from the Asian marketplace, which is responsible for 51% of launches of gut health products for many different age groups and specific purposes.
 
“Dairy is very prevalent, followed by baby food, with nutritional drinks coming in third,” Gay said. “Powdered formats are very common, and just as important are digestive enzymes, live cultures, and digestive fibers, which can help with a variety of generalized and specific conditions with some overlap in benefits in areas such as constipation, IBS, diarrhea, and more.”
 
Primetime for Probiotics
Of all the ingredient categories which speak to the overlap of gut and immune health the most, perhaps the pre- and probiotics sector may offer the greatest opportunities for growth. Aside from ancient remedies and foods, the notion of supplementing with beneficial bacteria, or the indigestible fibers these bacteria feed off of, is a relatively nascent pursuit. Though the amount of research into beneficial bacteria has increased exponentially, there is still much to learn about the mechanisms at play behind the millions of bacterial strains which have an effect on human health.
 
French said that although the probiotics and prebiotics market has expanded by almost 400% since 2009, with fiber supplements growing 118%, only one in four consumers believe that probiotics can confer immune support benefits to those who use them. The majority (61%) of probiotics users purchase them exclusively to improve digestion, representing a potential shortfall in how well probiotics have been marketed for immune support purposes.
 
Market Differentiators
One of the key market differentiators in the gut and immune health space is a product for which there is proof of high bioavailability and absorption, French said. Concerns surrounding how digestible a given formula is become even more acute in the context of other health conditions; 63% of dietary supplement consumers NMI surveyed want more clinical proof that products are being fully absorbed by the body.
 
“We see the most growth in delivery methods which are highly absorbable and have the greatest ‘ease of use,’” French said. Where gummies and soft chews are seeing the most growth, liquid-filled capsules, RTDs, and functional foods are seeing some declines. “The biggest purchase drivers indicated in our surveys are unquestionable safety, easy to digest, clinical proof that it works, easy to swallow, and availability in easy-to-consume formats, especially in aging populations across the world.”
 
“Consumers think it’s worth paying more for products of higher quality, which encompasses trust and transparency,” Lori Lathrop Stern, science liaison at IFF Health, concurred. “There are evolving ethical, environmental, and clean-label consumer demands, and two in three consumers globally make purchasing decisions based on a company’s transparency. This will dominate in 2021 as consumers search for brands they can trust.”