Dr. A. Elizabeth Sloan10.01.03
This nutraceuticals industry certainly has a lot to look forward to in the upcoming months/years. For instance, never before have there been recommended intakes issued from the National Academy of Sciences' (NAS) Food and Nutrition Board (FNB) on dietary fiber, nine essential amino acids, carbohydrates and fatty acids. Additionally, relaxed FDA claims procedures, pending government campaigns on obesity and diabetes and a new Food Pyramid will all play a role in the industry's bright future. And while there are challenges lingering, such as ephedra, which has more or less been abandoned by leading nutrition marketers, and glucosamine, which is experiencing flat sales, calcium continues to climb higher and higher. Welcome to the world of nutraceuticals, which is undergoing several changes that will likely pave the way to tremendous opportunities.
Ironically as Americans continue to indulge, they are becoming more aggressive in their quest for health. In 2002, the number of food shoppers "very" concerned about nutrition has bounced back to a record high last seen in 1995. Self-care continues to be a key driver for food purchases. In fact, 2002 saw nearly three-quarters (71%) of shoppers trying to reduce the risk of developing a health problem through food purchases, up from 54% in 1998; 68% were looking to self manage or treat a condition, up from 31% in 1998 and 66% continued to follow the advice of a physician, up from 55% in 19981. According to Nutrition Business Journal (NBJ), San Diego, CA, functional foods grew approximately 9% to almost $21 billion in 2002. Nutrition bars saw growth of 32%, while meal replacement beverages and the cereal segment made strong gains as well2.
On the dietary supplement front, 150 million Americans used some form of dietary supplement, with 106 million taking a vitamin or mineral supplement daily and 33 million claiming to be regular herbal users3. Nine out of 10 took over-the-counter (OTC) medications along with their supplements; 64% a prescription (Rx) medication and one-third treated a health condition with a dietary supplement.
Unilever blamed a 13% drop in Slim-Fast meal replacement sales on the popularity of high protein/low carb diets (HP/LC), while wary consumers continue to forego hundreds of millions of dollars in "metabo"/ephedra diet aid sales. The diet liquid nutritionals have had a tough time as they continue to be blindsided by well-marketed calorie/nutrient beverages like Snapple-A-Day and Nouriche, and weight-branded ice cream snacks too. As the diet industry scrambles to regain its focus, demand continues to soar!
While traditionally a trendy business with only one or two product categories in vogue, for the first time last year all segments in the $40 billion U.S. weight loss market posted sales gains4 (Figure 1). The 2003 Health & Wellness Trends Report, which is released annually by The Natural Marketing Institute (NMI), Harleysville, PA, confirms that weight loss products enjoyed nearly 4% annual growth in household penetration for the past four years. The report also said that nearly one-third of the general population purchased a weight control product in 20025. And, with consumers-and brand users, including Atkins, Metabolife, Weight Watchers and Slim-Fast-using multiple dieting methods at the same time, the opportunity for a diversity of new products is at an all time high. For consumers trying to lose weight last year, NMI said that just over half (53%) of adults used smaller portions, 37% a low-fat diet, 35% less sugar, 26% fewer carbs, 22% counted calories, 14% high protein foods, 19% a point system, 8% packaged controlled foods and 5% a very low calorie diet (VLCD). In terms of products, 23% used meal replacement beverages, 17% Rx medications, 15% meal replacement bars and 13% weight loss supplements. Among users, however, Rx medications were ranked as most effective.
A number of weight loss macro trends are creating new market options. Managing weight for health reasons has increased at two and a half times the rate of appearance motivated "dieting"with compounded annual growth rates (CAGRs) of 25% and 11%, respectively. Nearly one-third of Americans managed their weight for health vs. 42% for appearance last year. Seven out of 10 health-motivated "dieters" are "concerned a lot" about obesity-60% higher than the general population. Atkins (54%) and Weight Watchers' (48%) brand users were the most likely to be dieting for health. Americans also have more weight to lose than a decade ago and are becoming obese at a younger age, with 25% becoming obese by age 37. According to the 2003 Trend Survey produced by HealthFocus International, Atlanta, GA, 29% of food shoppers want to lose 20 pounds or more and 23% want to drop 11-20 pounds6. Further, a survey of 32,500 eDiets subscribers found that on average women weigh 155 pounds, which is 21 pounds over their ideal weight and 5 points above their BMI. Men tipped the scales at 201 pounds, which is 41 pounds over their ideal weight and 7 points above their BMI7.
Sales of "Lite, Lean & Less Of" related food brands are also rebounding, according to Information Resources Inc. (IRI), Chicago, IL8. Sales of IRI's grouping of 1093 meal solutions, which includes all major players in the prepared foods arena, such as Healthy Choice, SnackWells, Weight Watchers and Stouffer's Lean Cuisine, had sales totaling just under $5 billion in 2002, up 4.5% over 2001. IRI's analysis of the brands driving sales reveals that weight loss and dieting are the major consumer drivers of current growth, as opposed to reducing fat intake, where brands have dropped approximately 9%.
HealthFocus reports that while still strong (88%), confidence in managing weight through diet has been steadily declining since 1990, increasing the opportunity for non-food options6. However, according to a March-April 2003 Mintel (Chicago, IL) survey, 70% of shoppers expressed concerned about the negative effects of diet pills, with only 29% citing them as effective9. At the same time, green tea, caffeine, conjugated linoleic acid (CLA) and chromium picolinate are gaining in popularity, as are satiety-driven foods and beverages.
Insulin resistance and pre-diabetes represent two enormous new market opportunities in the dynamic diabetic marketplace, targeting potentially 30 to 80 million Americans. Risk factors-popularized as "Syndrome X" or "Metabolic Syndrome"-include a family history of diabetes, excess abdominal weight, high triglycerides, LDL cholesterol and blood pressure and fasting glucose >110 mg/dL. The National Institutes of Health (NIH), Bethesda, MD, estimates that 26 million suffer from pre-diabetes where glucose levels are higher than normal but not yet in the diabetic range, while another 17 million suffer from diabetes, six million of which go undiagnosed. Insulin resistance and pre-diabetes have no symptoms10.
With more than one million new cases per year, diabetes mellitus classifies as an epidemic. Type 2 or non-insulin dependent diabetes-the type often controlled by diet, exercise, weight loss and oral medications and seen almost exclusively in adults-now afflicts 4% of children and is growing rapidly. Multisponsor Surveys, Inc., Princeton, NJ, projected that diabetes will climb 19% between 1999 and 2010, ranking it behind menopause, prostate cancer and heart disease as America's fastest growing health conditions11. Worldwide, The International Diabetes Federation (IDF), Brussels, Belgium, claims that diabetes afflicts one in 20 European adults and more than 150 million globally. IDF also projects the disease will rise to 300 million by the year 202512.
According to NMI, nearly two-thirds of American households are trying to prevent developing diabetes5, while HealthFocus finds that 37% of food shoppers are extremely/very concerned about diabetes6. NBJ reports that diabetes-specific dietary supplement sales reached $438 million in 2001, up nearly 7%, while Rx medications raked in $4.6 billion in sales13.Clearly, market interest in blood sugar, insulin and the glycemic index has been underestimated for some time.
The average diagnosed diabetic spends about $3000 per year in his/her pharmacy managing/treating the disease14. Frost and Sullivan, New York, NY, projects glucose self-monitoring kit sales will jump from $2.6 billion to $4.5 billion by the year 200915. Purchase, NY-based Nutrition 21's Diachrome (chromium picolinate and biotin) and Chromax, as well as Minneapolis, MN-based Acatris Inc.'s FenuLife fenugreek extract are among the new ingredients aimed at blood sugar control. Other ingredients being targeted for blood sugar control include chromium, alpha-lipoic acid, Gymnema sylvestre, magnesium, selenium, prebiotics, psyllium, zinc, fatty acids/omega 3s, banaba, nearly all forms of ginseng, bitter melon, nopal, karela, tronadora, vanadium, aloe vera and maitake mushroom.
With three-three quarters of diabetics suffering from high blood pressure and two-thirds suffering from nervous disorders, a higher risk for heart disease, blindness and kidney disease, supplements that help prevent/manage diabetes and its inherent risks are in high demand. For example, Twinlab, Hauppauge, NY, has responded to the trend with its Dia-Balance Diabetic Health Formula line, which includes weight, eye, circulation, glucose control and multivitamin varieties. Other supplements geared toward insulin health include Trace Minerals Research's Insulin Health X-Factor and Doctors A-Z's Glucosol.
With four out of 10 consumers aware of dietary fiber's role in the prevention and management of diabetes, innovative forms of fiber and prebiotics, such as psyllium, resistant starch, fructo-oligosaccharides and glucomannan, as well as old forms, such as whole grains, are finding a new role in this emerging market. Bridgewater, NJ-based National Starch won the Institute of Food Technologists' 2003 Industrial Achievement Award for its Novelose and Hi-Maize resistant starches. Clinical studies confirm that resistant starch helps maintain blood sugar levels, promote digestive health, enhance mineral absorption and improve insulin sensitivity. Blood sugar levels also play an important role in energy management, weight control, cravings and hunger pangs. Peanut butter and nuts, particularly almonds; pterostilbene, found in grapes, although not wine; dairy products, particularly their CLA component and soy protein/flaxseed lignan-rich combinations are also getting attention in the diabetes arena. Lastly, low glycemic index foods, such as beans, are also fast-emerging.
The situation for making claims is difficult, especially in the U.S. On the international scene, Sweden permits a "balance your blood sugar" claim for yogurt containing oat bran, while New Zealand permits a glycemic index rating and Australia allows a low glycemic symbol to be put on food labels. In the U.S., however, the FNB did not lend its support to a recommendation involving the glycemic index when it filed its report on recommended levels of macronutrients.
The HP/LC market is estimated at $2.5 billion16. Sales of Atkins Nutritionals 100+ low carb products were up 95% over last year and are projected to double in 2003. Atkins also enjoyed the highest gains among the top 10 meal replacement beverage brands17. In the bar arena, Atkins Diet Advantage and Zone Perfect bars jumped 45% and 104% in unit sales, respectively18. CarboLite's sales are also expected to double from $35 million to $70 million this year18. Market veteran Ketogenics has been warning other marketers to refrain from using the word "keto."
NMI reports that nearly two-thirds of Americans used high protein or low carb products in 2002-21% of all U.S. households increased their use of low carb foods last year and 16% high protein5. CarboLite's new At Last! low glycemic index candy bar, Russell Stover's low carb candy line and LeCarb low carb milk are among the latest market launches.
Thirty-five million Americans are currently on a HP/LC regimen, with 24 million having tried the Atkins plan16-60% for weight loss, 11% for health, 7% energy and 1% to be trendy19. A Gallup/Wheat Industry Council survey also found that 61% of consumers think HP/LC diets are safe-56% work for weight loss, 58% believe carbs must be eliminated from the body for weight loss and 48% feel starch should be avoided20.
As for the future, it looks as strong as the present. FNB's guidelines on macronutrients advised a reduction in added and refined sugar to 25% of total calories and a drop in total carb intake from an average of 230-280 grams per day to 130 grams per day, setting no cautionary "Upper Limit" for protein. Additionally, carbs and protein jumped into the second highest level of media coverage recorded by Sloan Trends & Solutions, Escondido, CA, right behind the leading topics-women's health, functional foods, heart disease and fat! More important, the media has reversed its initial negative position on high protein diets, up from 42% positive in 2002 to 83% in the last trimester21. New studies also indicate that HP/LC diets may be more heart friendly than originally thought. On the downside, the lack of a government definition for "lite" or "low carb" will temper the market, as will ongoing consumer confusion about good vs. bad carbs.
As the HP/LC market matures, protein fortification will also be an attractive product attribute. With soyfood sales estimated to move beyond the $5 billion mark by 2006, soy protein remains a key player in the high protein market22 (Figure 2). The use of soy protein meat alternatives in frozen foods has sent sales of products such as Boca Foods lasagna and Morningside Farms pizza flying, up 103% last year across all channels and 104% in mass markets. According to a SPINS (San Francisco, CA)/Soyatech (Bar Harbor, ME) report, "Soyfoods: The U.S. Market 2003," soy-based yogurts jumped 26% overall, 44% in the mass market and frozen desserts were up 37% overall, 45% in the mass market. In its report, NMI revealed that 39% of adults believe their diet is deficient in soy and 36% believe they don't get enough soy isoflavones, while New York, NY-based Marketresearch.com's report, "U.S. Market for Soy Foods and Beverages 2003," confirmed that 65% of women are still willing to try soy supplements for health maintenance of various life stages-32% already use them23.
As marketers look to differentiate, expect more attention to be given to the source of protein as well as new protein combinations, including whey/soy mixtures. Armed with an arsenal of "hard-to-get-to" health benefits-aids mineral absorption, athletic performance, immune enhancement, appetite suppression, lean muscle mass, antioxidant activity, anti-blood pressure, anti-pathogenic and anti-cancer properties-whey protein, peptides and other milk components are coming on strong24. Davisco's BioZate1, which lowers blood pressure similar to the results seen in the DASH Diet study, may shortly provide a non-drug option for the 53 million American adults afflicted with hypertension.
Peas, eggs, fish, gelatin, dried yeast and wheat proteins are also getting attention. Dried yeast is rich in B vitamins, contains more than 12 minerals, on a dry weight basis is almost half protein and 20% of the carbohydrates are oligosaccharides. Lastly, first-ever RDI's for nine essential amino acids, including requirements for isoleucine, leucine, lysine, methionine, cysteine, phenylalanine, tyrosine, valine threonine, tryptophan, and histidine, will spawn a new generation of amino acid-directed products, flags and "contains" claims, as well as provide new options for benefit claims.
Sugar is closing in on fat as the top nutrition concern. Gallup's "2003 Study of Dieting" reported that two-thirds of consumers said it was important to limit their sugar intake, up 8 points over the 2002 figure, just behind the limiting fat figure, which was down 8 points25. In addition, "The 2003 Gallup Target Market Report on Sugar Consumption" found that 54% of adults always/almost always read the label for sugar content26.
Multisponsor's Pre-teen survey found that four in 10 mothers with kids ages six to 12 made a strong effort to limit their child's sugar intake last year, while only 23% concentrated on limiting fat27. The move to avoid sugar is breathing new life into the reduced calorie sweetener market, especially for those compounds derived from sugar or other natural sweeteners, many of which have other desirable health benefits. For example, tagatose delivers health benefits similar to a prebiotic, is safe for diabetics and allows labels to claim "sugar free." Isomalt, which can replace sugar in a 1:1 ratio providing bulk and texture, is tooth friendly, has a low glycemic index and half the calories of sugar.
Heart disease and cancer still top the list of Americans' health concerns, and with heart disease projected to increase almost 20% by 2010, risk factor reduction continues to represent a major opportunity11. HealthFocus reports that 44% of shoppers say a "helps to maintain healthy cholesterol levels" claim on the label is very/extremely important followed by 43% looking for a "low in saturated fat" claim, 42% eyeing the "may reduce the risk of heart disease" claim and 41% going with the "cholesterol free" claim6. With 101 million adults suffering from high cholesterol levels, 53 million afflicted with high blood pressure and millions plagued by the undesirable side effects of prescription medications, the market for "heart helping" supplements and foods will continue to grow. Half (53%) of grocery shoppers want new products and information that address cholesterol-lowering, while 52% are interested in maintaining proper blood pressure1.
With more than 1600 studies supporting a wide array of health benefits ranging from blood sugar control to neurological development, omega 3 fatty acids are perfectly positioned to capture the heart health market. Perhaps, more than any other individual ingredient, omega 3s align well with several cardiovascular disease (CVD) risk factors, including cholesterol and triglyceride lowering, decreased platelet aggregation, improvement of hypertension and lowered risk of sudden cardiac death. Awareness is also high. In fact, Gallup/Multisponsor reports that 58% of consumers were aware of omega 3s in 2002, up from 46% in 199928. Fish oils/omega 3s also led growth in the specialty supplement arena in 2000, according to NBJ, with a 32% gain and sales reaching $134 million-$40 million in the mass market. Plant oils including flax, evening primrose, borage and others grew 17% to sales of $154 million29.
HealthFocus points out that 59% of shoppers want more information about omega 3s and heart health, 47% have heard "a lot" about omega 3s and heart health and that 21% increased their use of omega 3 fatty acids last year. But perhaps most important, on September 1st, omega 3 fatty acids' effectiveness in reducing the risk of coronary heart disease became the first formal petition for a qualified health claim filed under the FDA's new regulatory scheme-and it's about time! The FNB set the first ever U.S. recommended dietary intake levels for alpha-linoleic and linoleic fatty acids, which are omega precursors, last November, recognizing the deficiency of omega 3s in the American diet.
According to NMI, one-third of consumers consider themselves deficient in omega 3s, while almost two out of 10 consumers have taken an omega 3 supplement. The top five foods Americans would be interested in trying if fortified with omega 3s, according to a Gallup study conducted for Roche Vitamins, Parsippany, NJ, are cooking oil, margarine, fish sticks, salad dressing and pasta. According to Sloan Trends' TrendSense Model, which predicts the timing for an ingredient to reach the mass market and the magnitude of a trend, omega 3s crossed over into the mass market last year and currently represent a lost opportunity for mass food and nutrition marketers.
With an FDA approved health claim, plant sterols and stanols are also fast-gaining attention. In fact, HealthFocus found that 61% of consumers want to lean more about plant stanols and cholesterol reduction.
Likewise, homocysteine remains another virtually untapped market, already of mainstream proportions, according to Sloan Trends' TrendSense system. Energy boosting B vitamins are stepping up to the plate in terms of homocysteine level management. According to NBJ, B vitamins experienced nearly 6% sales growth last year-leading growth in the over $3 billion multivitamin category30.
It's not surprising that "super fibers," which offer cholesterol and triglyceride lowering properties, are finally fashionable. Even dietary fiber has returned to the spotlight. According to NMI, one-third of adults consider their diet deficient in fiber, while 29% say they are deficient in whole grains. To make up for this, nearly one-third of households increased their use of high fiber products last year. Median intakes of approximately 14 grams of fiber a day for women, almost 19 grams for men and between 12-18 grams for kids, are well under the new FNB 25 gram per day recommendation. Even more exciting, the new definition of dietary fiber includes a provision for functional fiber, i.e., synthetic or isolated forms that have a beneficial physiological effect.
Sexual Dysfunction, Impotence and Stimulation. Despite the widespread publicity accompanying the introduction of Viagra, the U.S. market remains largely untapped with less than 15% of men who have erectile dysfunction trying the drug. Dietary supplements account for just over 3% of the sexual dysfunction/impotence market. With lower cost, a more natural image and relative anonymity of procurement, the area remains wide open to new brands and ingredients. An "Anti-Aging Products" report recently issued by The Freedonia Group, Cleveland, OH, projects that the sexual dysfunction/impotence market for pharmaceuticals will jump from $1.15 billion in 2002 to $4.38 billion by 2012. Supplements will also grow, projected to increase from $40 million in 2002 to $115 million by 201231.
The Beverage Boom. In 2002, beverages represented nearly half of the functional foods category, with over $10 billion in sales and a growth rate of almost 11%1. According to the Bellevue, WA-based Hartman Group and its new healthy beverage survey, six out of 10 consumers are likely/very likely to drink a non-alcoholic beverage to address a health concern and general health-bone strength and energy top the list. "All natural" is the leading product attribute now influencing the purchase of a healthy beverage (66%), followed by thirst (59%), nutritional content (49%), added vitamins/minerals (40%), number of calories (37%), habit (25%), organic (25%), quick pick-up/energy (24%), relaxation (20%), weight loss (19%) and meal replacement (17%) (Figure 3). Artificial colorings top the list of ingredients that consumers don't want in their healthy beverages, closely followed by artificial flavorings, saccharin, artificial sweeteners (NutraSweet) and caffeine. Just over one-third feels a healthy beverage should not be carbonated32. Interestingly, an analysis of 150 new energy beverages by Duiven, The Netherlands-based Innova's WIN database indicates that caffeine, taurine guarana and inositol are driving new beverage innovation33 (Figure 4).
The New Youth Market. With the number of young adults ages 15 to 24 fast-approaching 40 million, it's time to pay attention to teens. The beverages teens would most like to try are energy drinks; one-third of college women are involved in sports and one-third of teenage boys and girls have gone on a special diet to prevent acne. But, let's not forget kids. With 27 million children already afflicted with high cholesterol levels, two million with high blood pressure, 14% overweight, more than half below their recommended level of dietary fiber and 60% complaining of being tired and 15% falling asleep in school, it's only a matter of time before child-oriented macronutrient-driven and avoidance foods will be in great demand. Gallup's pre-teen survey found that Mom's of preteens are making a strong effort to increase consumption of calcium (35%), vitamins/minerals (28%), protein (23%), grains (18%), fiber (14%), calories (11%), complex carbs (10%) and omega 3s ( 7%)33. Conversely, two-thirds are making a strong effort to limit caffeine, artificial sweeteners, sugar, sodium, total fats, cholesterol and calories. Clearly, natural and homeopathic treatments are preferred when available.
Condition-Specific Treatments. Use of health formulas has doubled since 2000, with most popular products experiencing gains, led by bone health and arthritis/joint health34 (Figure 5). While consumers continue to be extremely/very concerned about tiredness/lack of energy (50%), eye health, (47%), arthritis (46%), high cholesterol (41%) and lack of mental focus (41%), several other conditions are ripe for natural remedies. Without a doubt, allergies, hay fever, sinus issues and snoring top the list. Four in 10 consumers have experienced an allergy problem within the last six months ranking fourth among America's most common ailments, right after back pain, cold/flu and headaches. More natural treatments for heart burn and diarrhea/stomach issues-even irritable bowel disease-are finding a welcome market with one-third and one quarter of Americans, respectively, saying they've suffered from these ailments long enough.NW
About the author: Dr. A. Elizabeth Sloan is president of Sloan Trends & Solutions, Escondido, CA. She can be reached at 760-741-9611; Fax: 760-741-9711; E-mail: sloantrend@attglobal.net.
References
1.Food Marketing Institute, 1999 & 2002. "Shopping for Health," Food Marketing Institute, Washington, D.C. www.fmi.org.
2.Nutrition Business Journal, Feb/March 2003. "Functional Foods VI" Vol. VIII, No. 2/3, San Diego, CA. www.nutritionbusiness.com.
3.Prevention Magazine, 2002. "Prevention Dietary Supplement and OTC Medication Survey," Rodale Press, Emmaus, PA. www.prevention.com.
4.Marketdata Enterprises, Inc. "U.S. Weight Loss and Diet Control Market 2003," Tampa, FL. www.mkt-data-ent.com.
5.Natural Marketing Institute's "Health & Wellness Trends Report: 2003," Harleysville, PA. www.nmisolutions.com.
6.HealthFocus International's "2003 Trend Survey," Atlanta, GA. hfocus@bellsouth.net.
7.EDiets. "On-line Subscriber Survey," West Palm Beach, FL. www.ediets.com.
8.Information Resources, Inc. (IRI) 2002. IRI "Supermarket Review Database" (excluding Wal-Mart, average dollar annual growth Y/E Feb) 2003, Chicago, IL. www.infores.com.
9.Mintel/GNPD, 2003. "Mintel New Product Global Database. March-April 2003 Survey," Chicago, IL. www.GNPD.com.
10.National Institutes of Health, 2003. "National Institute of Diabetes, Digestive Diseases and Kidney's Facts and Figures," Bethesda, MD. www.nih.gov.
11.Multisponsor Surveys, 2000. "Gallup Focus Report on Market for Nutritional Supplements Among Adults 50+," Princeton, NJ. www.multisponsor@snip.net.
12.International Diabetes Federation, 2003. "Facts and Figures," Brussels, Belgium. www.idf.org.
13.Nutrition Business Journal, July 2003. "Presented at the Newport Summit" by Grant Ferrier, Editor, San Diego, CA. www.nutritionbusiness.com.
14.Coopman, R, 2002. "Insulin Resistance Moves Into the Spotlight," Chain Drug Review, Vol. 24, No. 18. Oct. 28, 2002. Page 29, 35.
15.Frost and Sullivan, 2003. Cited in: "Demand for Glucose Monitors Grow," Chain Drug Review, Vol. 25, No. 8, April 28, 2003. p.26.
16.Rawe, Judy, 2003. "Snackers Go Low Carb," Time Magazine. Aug, 8, 2003.
17.Information Resources, Inc., 2003. "Weight Control Liquids/Powders, Total of drug stores, supermarkets and discount stores excluding Wal-Mart Stores, Inc. for the 52 weeks ending 2/23/03." Chicago, IL. www.infores.com.
18.Information Resources, Inc., 2003. "Nutritional/Intrinsic Health Value Bars, Total of drug stores, supermarkets and discount stores excluding Wal-Mart Stores, Inc. for the 52 weeks ending 3/23/03." Chicago, IL. www.infores.com.
19.Lempert, P., 2003. "Low Carb: The Next Big Thing? The Answer is Yes. Facts, Figures & the Future." Sept. 8, 2000, P. Lempert@factsFiguresFuture.com.
20.Gallup/Wheat Industry Council, 2002. "Grains of Truth About Diet and Obesity," Parker, CO. www.wheatfoods.org.
21.Sloan Trends and Solutions, Inc, 2003. "2nd Trimester Report," Escondido CA. sloantrend@attglobal.net.
22.Soyatech and SPINS, 2003 "Soyfoods: The U.S. Market 2003," Bar Harbor, ME. www.SoyaTech.com. SPINS, Division of ACNielsen, San Francisco, CA. www.spins.com.
23.Marketresarch.com. Packaged Facts "The U.S. Market for Soy Foods and Beverages: Volume 2 in the Series. "The U.S. Market for foods and Beverages," Marketresearch.com, New York, NY. www.marketresearch.com.
24.Sloan Trends & Solutions, Inc. "Milk Components and Related Marketing Opportunities," Escondido, CA. sloantrend@attglobal.net.
25.Multisponsor surveys, Inc., 2003. "Gallup Study of Dieting & the Market for Diet Products & Services," Princeton, NJ. multisponsor@snip.net.
26.Multisponsor surveys, Inc., 2003. "Gallup Target market Report on Sugar Consumption." Princeton, NJ. multisponsor@snip.net.
27.Multisponsor surveys, Inc., 2003. "2002 Gallup Study on Pre-Teen Children's Nutrition & Eating Habits," Princeton, NJ. multisponsor@snip.net.
28.Roche Vitmains, Inc./Multisponsor Surveys, 2002. Study of Consumer Awareness of and Interest In PUFA/Omega-3 Oil.
29.Nutrition Business Journal, July 2003. "Niche Markets VI: Specialty Supplements: Fish and Plant Oils Swim Ahead in the Specialty Segment," Vol. VIII, No. 7, San Diego, CA.www.nutritionbusiness.com.
30.Nutrition Business Journal, May/June 2003. "Annual Industry Overview" VIII, No. 5, San Diego, CA. www.nutritionbusiness.com.
31.Freedonia Group, July 2003. "Anti-Aging Products Report," Cleveland, OH. www. Freedonia.com.
32.Hartman Group, April 2003. "Wellness Interactive Survey: Healthy Beverages," Healthy Beverage Study, Bellevue, WA. www.hartman-group.com.
33.Innova, 2003. "Functional Innovation in Beverages," Innova Food and Beverage Innovation Journal, Feb/March, p. 40-41. WIN Nutraceutical Database, Duiven, The Netherlands. www.win-food.com.
34.Multisponsor surveys, Inc., 2002. "2002 Gallup Study of Vitamin Use." Princeton, NJ. multisponsor@snip.net.
The Consumer and the Market in General
Ironically as Americans continue to indulge, they are becoming more aggressive in their quest for health. In 2002, the number of food shoppers "very" concerned about nutrition has bounced back to a record high last seen in 1995. Self-care continues to be a key driver for food purchases. In fact, 2002 saw nearly three-quarters (71%) of shoppers trying to reduce the risk of developing a health problem through food purchases, up from 54% in 1998; 68% were looking to self manage or treat a condition, up from 31% in 1998 and 66% continued to follow the advice of a physician, up from 55% in 19981. According to Nutrition Business Journal (NBJ), San Diego, CA, functional foods grew approximately 9% to almost $21 billion in 2002. Nutrition bars saw growth of 32%, while meal replacement beverages and the cereal segment made strong gains as well2.
On the dietary supplement front, 150 million Americans used some form of dietary supplement, with 106 million taking a vitamin or mineral supplement daily and 33 million claiming to be regular herbal users3. Nine out of 10 took over-the-counter (OTC) medications along with their supplements; 64% a prescription (Rx) medication and one-third treated a health condition with a dietary supplement.
Heavy on Weight
Unilever blamed a 13% drop in Slim-Fast meal replacement sales on the popularity of high protein/low carb diets (HP/LC), while wary consumers continue to forego hundreds of millions of dollars in "metabo"/ephedra diet aid sales. The diet liquid nutritionals have had a tough time as they continue to be blindsided by well-marketed calorie/nutrient beverages like Snapple-A-Day and Nouriche, and weight-branded ice cream snacks too. As the diet industry scrambles to regain its focus, demand continues to soar!
While traditionally a trendy business with only one or two product categories in vogue, for the first time last year all segments in the $40 billion U.S. weight loss market posted sales gains4 (Figure 1). The 2003 Health & Wellness Trends Report, which is released annually by The Natural Marketing Institute (NMI), Harleysville, PA, confirms that weight loss products enjoyed nearly 4% annual growth in household penetration for the past four years. The report also said that nearly one-third of the general population purchased a weight control product in 20025. And, with consumers-and brand users, including Atkins, Metabolife, Weight Watchers and Slim-Fast-using multiple dieting methods at the same time, the opportunity for a diversity of new products is at an all time high. For consumers trying to lose weight last year, NMI said that just over half (53%) of adults used smaller portions, 37% a low-fat diet, 35% less sugar, 26% fewer carbs, 22% counted calories, 14% high protein foods, 19% a point system, 8% packaged controlled foods and 5% a very low calorie diet (VLCD). In terms of products, 23% used meal replacement beverages, 17% Rx medications, 15% meal replacement bars and 13% weight loss supplements. Among users, however, Rx medications were ranked as most effective.
A number of weight loss macro trends are creating new market options. Managing weight for health reasons has increased at two and a half times the rate of appearance motivated "dieting"with compounded annual growth rates (CAGRs) of 25% and 11%, respectively. Nearly one-third of Americans managed their weight for health vs. 42% for appearance last year. Seven out of 10 health-motivated "dieters" are "concerned a lot" about obesity-60% higher than the general population. Atkins (54%) and Weight Watchers' (48%) brand users were the most likely to be dieting for health. Americans also have more weight to lose than a decade ago and are becoming obese at a younger age, with 25% becoming obese by age 37. According to the 2003 Trend Survey produced by HealthFocus International, Atlanta, GA, 29% of food shoppers want to lose 20 pounds or more and 23% want to drop 11-20 pounds6. Further, a survey of 32,500 eDiets subscribers found that on average women weigh 155 pounds, which is 21 pounds over their ideal weight and 5 points above their BMI. Men tipped the scales at 201 pounds, which is 41 pounds over their ideal weight and 7 points above their BMI7.
Sales of "Lite, Lean & Less Of" related food brands are also rebounding, according to Information Resources Inc. (IRI), Chicago, IL8. Sales of IRI's grouping of 1093 meal solutions, which includes all major players in the prepared foods arena, such as Healthy Choice, SnackWells, Weight Watchers and Stouffer's Lean Cuisine, had sales totaling just under $5 billion in 2002, up 4.5% over 2001. IRI's analysis of the brands driving sales reveals that weight loss and dieting are the major consumer drivers of current growth, as opposed to reducing fat intake, where brands have dropped approximately 9%.
HealthFocus reports that while still strong (88%), confidence in managing weight through diet has been steadily declining since 1990, increasing the opportunity for non-food options6. However, according to a March-April 2003 Mintel (Chicago, IL) survey, 70% of shoppers expressed concerned about the negative effects of diet pills, with only 29% citing them as effective9. At the same time, green tea, caffeine, conjugated linoleic acid (CLA) and chromium picolinate are gaining in popularity, as are satiety-driven foods and beverages.
Insulin Resistance and Pre-Diabetes
Insulin resistance and pre-diabetes represent two enormous new market opportunities in the dynamic diabetic marketplace, targeting potentially 30 to 80 million Americans. Risk factors-popularized as "Syndrome X" or "Metabolic Syndrome"-include a family history of diabetes, excess abdominal weight, high triglycerides, LDL cholesterol and blood pressure and fasting glucose >110 mg/dL. The National Institutes of Health (NIH), Bethesda, MD, estimates that 26 million suffer from pre-diabetes where glucose levels are higher than normal but not yet in the diabetic range, while another 17 million suffer from diabetes, six million of which go undiagnosed. Insulin resistance and pre-diabetes have no symptoms10.
With more than one million new cases per year, diabetes mellitus classifies as an epidemic. Type 2 or non-insulin dependent diabetes-the type often controlled by diet, exercise, weight loss and oral medications and seen almost exclusively in adults-now afflicts 4% of children and is growing rapidly. Multisponsor Surveys, Inc., Princeton, NJ, projected that diabetes will climb 19% between 1999 and 2010, ranking it behind menopause, prostate cancer and heart disease as America's fastest growing health conditions11. Worldwide, The International Diabetes Federation (IDF), Brussels, Belgium, claims that diabetes afflicts one in 20 European adults and more than 150 million globally. IDF also projects the disease will rise to 300 million by the year 202512.
According to NMI, nearly two-thirds of American households are trying to prevent developing diabetes5, while HealthFocus finds that 37% of food shoppers are extremely/very concerned about diabetes6. NBJ reports that diabetes-specific dietary supplement sales reached $438 million in 2001, up nearly 7%, while Rx medications raked in $4.6 billion in sales13.Clearly, market interest in blood sugar, insulin and the glycemic index has been underestimated for some time.
The average diagnosed diabetic spends about $3000 per year in his/her pharmacy managing/treating the disease14. Frost and Sullivan, New York, NY, projects glucose self-monitoring kit sales will jump from $2.6 billion to $4.5 billion by the year 200915. Purchase, NY-based Nutrition 21's Diachrome (chromium picolinate and biotin) and Chromax, as well as Minneapolis, MN-based Acatris Inc.'s FenuLife fenugreek extract are among the new ingredients aimed at blood sugar control. Other ingredients being targeted for blood sugar control include chromium, alpha-lipoic acid, Gymnema sylvestre, magnesium, selenium, prebiotics, psyllium, zinc, fatty acids/omega 3s, banaba, nearly all forms of ginseng, bitter melon, nopal, karela, tronadora, vanadium, aloe vera and maitake mushroom.
With three-three quarters of diabetics suffering from high blood pressure and two-thirds suffering from nervous disorders, a higher risk for heart disease, blindness and kidney disease, supplements that help prevent/manage diabetes and its inherent risks are in high demand. For example, Twinlab, Hauppauge, NY, has responded to the trend with its Dia-Balance Diabetic Health Formula line, which includes weight, eye, circulation, glucose control and multivitamin varieties. Other supplements geared toward insulin health include Trace Minerals Research's Insulin Health X-Factor and Doctors A-Z's Glucosol.
With four out of 10 consumers aware of dietary fiber's role in the prevention and management of diabetes, innovative forms of fiber and prebiotics, such as psyllium, resistant starch, fructo-oligosaccharides and glucomannan, as well as old forms, such as whole grains, are finding a new role in this emerging market. Bridgewater, NJ-based National Starch won the Institute of Food Technologists' 2003 Industrial Achievement Award for its Novelose and Hi-Maize resistant starches. Clinical studies confirm that resistant starch helps maintain blood sugar levels, promote digestive health, enhance mineral absorption and improve insulin sensitivity. Blood sugar levels also play an important role in energy management, weight control, cravings and hunger pangs. Peanut butter and nuts, particularly almonds; pterostilbene, found in grapes, although not wine; dairy products, particularly their CLA component and soy protein/flaxseed lignan-rich combinations are also getting attention in the diabetes arena. Lastly, low glycemic index foods, such as beans, are also fast-emerging.
The situation for making claims is difficult, especially in the U.S. On the international scene, Sweden permits a "balance your blood sugar" claim for yogurt containing oat bran, while New Zealand permits a glycemic index rating and Australia allows a low glycemic symbol to be put on food labels. In the U.S., however, the FNB did not lend its support to a recommendation involving the glycemic index when it filed its report on recommended levels of macronutrients.
High on Protein, Down on Carbs, Sugar, Fat & More
The HP/LC market is estimated at $2.5 billion16. Sales of Atkins Nutritionals 100+ low carb products were up 95% over last year and are projected to double in 2003. Atkins also enjoyed the highest gains among the top 10 meal replacement beverage brands17. In the bar arena, Atkins Diet Advantage and Zone Perfect bars jumped 45% and 104% in unit sales, respectively18. CarboLite's sales are also expected to double from $35 million to $70 million this year18. Market veteran Ketogenics has been warning other marketers to refrain from using the word "keto."
NMI reports that nearly two-thirds of Americans used high protein or low carb products in 2002-21% of all U.S. households increased their use of low carb foods last year and 16% high protein5. CarboLite's new At Last! low glycemic index candy bar, Russell Stover's low carb candy line and LeCarb low carb milk are among the latest market launches.
Thirty-five million Americans are currently on a HP/LC regimen, with 24 million having tried the Atkins plan16-60% for weight loss, 11% for health, 7% energy and 1% to be trendy19. A Gallup/Wheat Industry Council survey also found that 61% of consumers think HP/LC diets are safe-56% work for weight loss, 58% believe carbs must be eliminated from the body for weight loss and 48% feel starch should be avoided20.
As for the future, it looks as strong as the present. FNB's guidelines on macronutrients advised a reduction in added and refined sugar to 25% of total calories and a drop in total carb intake from an average of 230-280 grams per day to 130 grams per day, setting no cautionary "Upper Limit" for protein. Additionally, carbs and protein jumped into the second highest level of media coverage recorded by Sloan Trends & Solutions, Escondido, CA, right behind the leading topics-women's health, functional foods, heart disease and fat! More important, the media has reversed its initial negative position on high protein diets, up from 42% positive in 2002 to 83% in the last trimester21. New studies also indicate that HP/LC diets may be more heart friendly than originally thought. On the downside, the lack of a government definition for "lite" or "low carb" will temper the market, as will ongoing consumer confusion about good vs. bad carbs.
As the HP/LC market matures, protein fortification will also be an attractive product attribute. With soyfood sales estimated to move beyond the $5 billion mark by 2006, soy protein remains a key player in the high protein market22 (Figure 2). The use of soy protein meat alternatives in frozen foods has sent sales of products such as Boca Foods lasagna and Morningside Farms pizza flying, up 103% last year across all channels and 104% in mass markets. According to a SPINS (San Francisco, CA)/Soyatech (Bar Harbor, ME) report, "Soyfoods: The U.S. Market 2003," soy-based yogurts jumped 26% overall, 44% in the mass market and frozen desserts were up 37% overall, 45% in the mass market. In its report, NMI revealed that 39% of adults believe their diet is deficient in soy and 36% believe they don't get enough soy isoflavones, while New York, NY-based Marketresearch.com's report, "U.S. Market for Soy Foods and Beverages 2003," confirmed that 65% of women are still willing to try soy supplements for health maintenance of various life stages-32% already use them23.
As marketers look to differentiate, expect more attention to be given to the source of protein as well as new protein combinations, including whey/soy mixtures. Armed with an arsenal of "hard-to-get-to" health benefits-aids mineral absorption, athletic performance, immune enhancement, appetite suppression, lean muscle mass, antioxidant activity, anti-blood pressure, anti-pathogenic and anti-cancer properties-whey protein, peptides and other milk components are coming on strong24. Davisco's BioZate1, which lowers blood pressure similar to the results seen in the DASH Diet study, may shortly provide a non-drug option for the 53 million American adults afflicted with hypertension.
Peas, eggs, fish, gelatin, dried yeast and wheat proteins are also getting attention. Dried yeast is rich in B vitamins, contains more than 12 minerals, on a dry weight basis is almost half protein and 20% of the carbohydrates are oligosaccharides. Lastly, first-ever RDI's for nine essential amino acids, including requirements for isoleucine, leucine, lysine, methionine, cysteine, phenylalanine, tyrosine, valine threonine, tryptophan, and histidine, will spawn a new generation of amino acid-directed products, flags and "contains" claims, as well as provide new options for benefit claims.
Sugar is closing in on fat as the top nutrition concern. Gallup's "2003 Study of Dieting" reported that two-thirds of consumers said it was important to limit their sugar intake, up 8 points over the 2002 figure, just behind the limiting fat figure, which was down 8 points25. In addition, "The 2003 Gallup Target Market Report on Sugar Consumption" found that 54% of adults always/almost always read the label for sugar content26.
Multisponsor's Pre-teen survey found that four in 10 mothers with kids ages six to 12 made a strong effort to limit their child's sugar intake last year, while only 23% concentrated on limiting fat27. The move to avoid sugar is breathing new life into the reduced calorie sweetener market, especially for those compounds derived from sugar or other natural sweeteners, many of which have other desirable health benefits. For example, tagatose delivers health benefits similar to a prebiotic, is safe for diabetics and allows labels to claim "sugar free." Isomalt, which can replace sugar in a 1:1 ratio providing bulk and texture, is tooth friendly, has a low glycemic index and half the calories of sugar.
All Heart
Heart disease and cancer still top the list of Americans' health concerns, and with heart disease projected to increase almost 20% by 2010, risk factor reduction continues to represent a major opportunity11. HealthFocus reports that 44% of shoppers say a "helps to maintain healthy cholesterol levels" claim on the label is very/extremely important followed by 43% looking for a "low in saturated fat" claim, 42% eyeing the "may reduce the risk of heart disease" claim and 41% going with the "cholesterol free" claim6. With 101 million adults suffering from high cholesterol levels, 53 million afflicted with high blood pressure and millions plagued by the undesirable side effects of prescription medications, the market for "heart helping" supplements and foods will continue to grow. Half (53%) of grocery shoppers want new products and information that address cholesterol-lowering, while 52% are interested in maintaining proper blood pressure1.
With more than 1600 studies supporting a wide array of health benefits ranging from blood sugar control to neurological development, omega 3 fatty acids are perfectly positioned to capture the heart health market. Perhaps, more than any other individual ingredient, omega 3s align well with several cardiovascular disease (CVD) risk factors, including cholesterol and triglyceride lowering, decreased platelet aggregation, improvement of hypertension and lowered risk of sudden cardiac death. Awareness is also high. In fact, Gallup/Multisponsor reports that 58% of consumers were aware of omega 3s in 2002, up from 46% in 199928. Fish oils/omega 3s also led growth in the specialty supplement arena in 2000, according to NBJ, with a 32% gain and sales reaching $134 million-$40 million in the mass market. Plant oils including flax, evening primrose, borage and others grew 17% to sales of $154 million29.
HealthFocus points out that 59% of shoppers want more information about omega 3s and heart health, 47% have heard "a lot" about omega 3s and heart health and that 21% increased their use of omega 3 fatty acids last year. But perhaps most important, on September 1st, omega 3 fatty acids' effectiveness in reducing the risk of coronary heart disease became the first formal petition for a qualified health claim filed under the FDA's new regulatory scheme-and it's about time! The FNB set the first ever U.S. recommended dietary intake levels for alpha-linoleic and linoleic fatty acids, which are omega precursors, last November, recognizing the deficiency of omega 3s in the American diet.
According to NMI, one-third of consumers consider themselves deficient in omega 3s, while almost two out of 10 consumers have taken an omega 3 supplement. The top five foods Americans would be interested in trying if fortified with omega 3s, according to a Gallup study conducted for Roche Vitamins, Parsippany, NJ, are cooking oil, margarine, fish sticks, salad dressing and pasta. According to Sloan Trends' TrendSense Model, which predicts the timing for an ingredient to reach the mass market and the magnitude of a trend, omega 3s crossed over into the mass market last year and currently represent a lost opportunity for mass food and nutrition marketers.
With an FDA approved health claim, plant sterols and stanols are also fast-gaining attention. In fact, HealthFocus found that 61% of consumers want to lean more about plant stanols and cholesterol reduction.
Likewise, homocysteine remains another virtually untapped market, already of mainstream proportions, according to Sloan Trends' TrendSense system. Energy boosting B vitamins are stepping up to the plate in terms of homocysteine level management. According to NBJ, B vitamins experienced nearly 6% sales growth last year-leading growth in the over $3 billion multivitamin category30.
It's not surprising that "super fibers," which offer cholesterol and triglyceride lowering properties, are finally fashionable. Even dietary fiber has returned to the spotlight. According to NMI, one-third of adults consider their diet deficient in fiber, while 29% say they are deficient in whole grains. To make up for this, nearly one-third of households increased their use of high fiber products last year. Median intakes of approximately 14 grams of fiber a day for women, almost 19 grams for men and between 12-18 grams for kids, are well under the new FNB 25 gram per day recommendation. Even more exciting, the new definition of dietary fiber includes a provision for functional fiber, i.e., synthetic or isolated forms that have a beneficial physiological effect.
Markets to Watch and Work on
Sexual Dysfunction, Impotence and Stimulation. Despite the widespread publicity accompanying the introduction of Viagra, the U.S. market remains largely untapped with less than 15% of men who have erectile dysfunction trying the drug. Dietary supplements account for just over 3% of the sexual dysfunction/impotence market. With lower cost, a more natural image and relative anonymity of procurement, the area remains wide open to new brands and ingredients. An "Anti-Aging Products" report recently issued by The Freedonia Group, Cleveland, OH, projects that the sexual dysfunction/impotence market for pharmaceuticals will jump from $1.15 billion in 2002 to $4.38 billion by 2012. Supplements will also grow, projected to increase from $40 million in 2002 to $115 million by 201231.
The Beverage Boom. In 2002, beverages represented nearly half of the functional foods category, with over $10 billion in sales and a growth rate of almost 11%1. According to the Bellevue, WA-based Hartman Group and its new healthy beverage survey, six out of 10 consumers are likely/very likely to drink a non-alcoholic beverage to address a health concern and general health-bone strength and energy top the list. "All natural" is the leading product attribute now influencing the purchase of a healthy beverage (66%), followed by thirst (59%), nutritional content (49%), added vitamins/minerals (40%), number of calories (37%), habit (25%), organic (25%), quick pick-up/energy (24%), relaxation (20%), weight loss (19%) and meal replacement (17%) (Figure 3). Artificial colorings top the list of ingredients that consumers don't want in their healthy beverages, closely followed by artificial flavorings, saccharin, artificial sweeteners (NutraSweet) and caffeine. Just over one-third feels a healthy beverage should not be carbonated32. Interestingly, an analysis of 150 new energy beverages by Duiven, The Netherlands-based Innova's WIN database indicates that caffeine, taurine guarana and inositol are driving new beverage innovation33 (Figure 4).
The New Youth Market. With the number of young adults ages 15 to 24 fast-approaching 40 million, it's time to pay attention to teens. The beverages teens would most like to try are energy drinks; one-third of college women are involved in sports and one-third of teenage boys and girls have gone on a special diet to prevent acne. But, let's not forget kids. With 27 million children already afflicted with high cholesterol levels, two million with high blood pressure, 14% overweight, more than half below their recommended level of dietary fiber and 60% complaining of being tired and 15% falling asleep in school, it's only a matter of time before child-oriented macronutrient-driven and avoidance foods will be in great demand. Gallup's pre-teen survey found that Mom's of preteens are making a strong effort to increase consumption of calcium (35%), vitamins/minerals (28%), protein (23%), grains (18%), fiber (14%), calories (11%), complex carbs (10%) and omega 3s ( 7%)33. Conversely, two-thirds are making a strong effort to limit caffeine, artificial sweeteners, sugar, sodium, total fats, cholesterol and calories. Clearly, natural and homeopathic treatments are preferred when available.
Condition-Specific Treatments. Use of health formulas has doubled since 2000, with most popular products experiencing gains, led by bone health and arthritis/joint health34 (Figure 5). While consumers continue to be extremely/very concerned about tiredness/lack of energy (50%), eye health, (47%), arthritis (46%), high cholesterol (41%) and lack of mental focus (41%), several other conditions are ripe for natural remedies. Without a doubt, allergies, hay fever, sinus issues and snoring top the list. Four in 10 consumers have experienced an allergy problem within the last six months ranking fourth among America's most common ailments, right after back pain, cold/flu and headaches. More natural treatments for heart burn and diarrhea/stomach issues-even irritable bowel disease-are finding a welcome market with one-third and one quarter of Americans, respectively, saying they've suffered from these ailments long enough.NW
About the author: Dr. A. Elizabeth Sloan is president of Sloan Trends & Solutions, Escondido, CA. She can be reached at 760-741-9611; Fax: 760-741-9711; E-mail: sloantrend@attglobal.net.
References
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