Alan Richman10.01.09
At its most basic, the digestive system is like a revolving door. Something goes in on one side and comes out the other. The crucial difference is that not everything comes out. The goal of maintaining optimal digestive health is to make sure that what is left behind is the good stuff and not, pardon the expression, the crap.
Consumers put up with enough "crap" in items like junk food, as well as food additives, pesticide residues and growth hormones. So perhaps it's not surprising that Americans suffering from gastric distress rush off to doctors' offices upwards of 33 million times a year and wind up in hospitals more than 3.6 million times each year.
S.K. Dash, PhD, president of UAS Laboratories in Eden Prairie, MN, cites the following annual statistics attributable to digestive diseases:
Nearly 200 million sick days
Almost 17 million days lost from school
Nearly 200,000 deaths
Translating this into dollars lost, Dr. Dash said, "The most costly digestive diseases are gastrointestinal disorders such as diarrheal infections ($4.7 billion); gallbladder disease ($4.5 billion); colorectal cancer ($4.5 billion); liver disease ($3.2 billion); and peptic ulcer disease ($2.5 billion)."
Even this may be understating the situation, however, as it doesn't take into account less serious ailments such as heartburn, constipation and GERD (gastroesophageal reflux disease), among others.
Dan Murray, vice president of business development, Xsto Solutions, Morristown, NJ, believes some conventional therapies may be the underlying cause of some of these digestive issues. "Conventional therapies for digestive problems have identified low pH gastric juices as harmful irritants and therefore focused on suppressing or eliminating stomach acid. This is problematic because stomach acid plays a key role in properly digesting food AND killing harmful bacteria," he said. "Perhaps we should look at pain relievers as the problem, rather than low pH stomach acid. The New England Journal of Medicine once identified the chronic use of NSAIDs for pain relief as a 'silent epidemic.' Regular use of NSAIDs suppresses the body's natural production of prostaglandin, a key component of mucosal lining in the GI tract. Without a healthy mucosal lining, stomach acid can become an irritant and lead to heartburn and eventually ulcers."
Then again some believe it is the very treatments prescribed to ameliorate digestive issues that are the problem. A recent study published in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute showed that acid-reducing medicines might lead to dependency. More specifically, treatment with proton pump inhibitors (PPIs) for eight weeks induced acid-related symptoms like heartburn, acid regurgitation and dyspepsia once treatment was withdrawn in healthy individuals.
"The observation that more than 40% of healthy volunteers, who have never been bothered by heartburn, acid regurgitation or dyspepsia, develop such symptoms in the weeks after cessation of PPIs is remarkable and has potentially important clinical and economic implications," said Christina Reimer, MD, of Copenhagen University and lead author of the study. "This study indicates unrecognized aspects of PPI withdrawal and is a very strong indication of a clinically significant acid rebound phenomenon that needs to be investigated in proper patient populations."
The use of PPIs for acid-related symptoms and disorders is extensive and rapidly escalating, according to the AGA. While the incidence of new patients being treated with PPIs remains stable, the prevalence of long-term treatment is rising, the reasons for which are not fully known. Studies have shown that up to 33% of patients who initiate PPI treatment continue to refill their prescriptions without an obvious indication for maintenance therapy. Rebound acid hypersecretion, defined as an increase in gastric acid secretion above pre-treatment levels following antisecretory therapy, is observed within two weeks after withdrawal of treatment and could theoretically lead to acid-related symptoms such as heartburn, acid regurgitation or dyspepsia that might result in resumption of therapy.
"Rather than suppressing acid, we should be focused on supporting normal digestive function," Mr. Murray added. "A limited number of dietary supplement ingredients, like zinc-carnosine for example, support a healthy digestive system, avoiding the issues that lead to symptoms and discomfort. With a healthy mucosal lining, we can handle stomach acid without heartburn and irritation (and zinc-carnosine supports a healthy mucosal lining)."
Emphasizing that her company's sole focus is digestive care, Brenda Watson, president and founder of ReNew Life Formulas, Palm Harbor, FL, asserts, "Approximately 70% of the body's immune defenses are located in the digestive tract. For this reason, optimum digestive function is often considered the foundation for the health and well-being of the entire body."
Nena Dockery, technical services manager for Forsyth, MO-based National Enzyme Company (NEC), offers the following facts and figures:
60-70 million people have some sort of digestive disorder. This statistic is not new, dating to 1996, and the numbers are probably much higher now.
IBS affects 9-23% of all people worldwide, mostly women. It is one of the most common disorders diagnosed by doctors.
More than 9.5 million Americans experience indigestion on a regular basis.
Between 5-7% globally and 10-20% of Americans experience GERD symptoms daily.
56 million people have heartburn ranging from mild to serious. Around 60 million Americans have it at least once a month, and 15 million have it daily.
More than 3 million people have recurrent constipation.
OTC gastrointestinal remedies are a multibillion-dollar business. In 2007, five products aimed at gut health were switched from prescription to over-the-counter status.
To paraphrase the Apollo 13 astronauts, "Houston-and all points north, south, east and west-we have a problem."
The most effective solution would be to feed the world better-more calories and added nutrients for people in impoverished nations, and reduced portions and less fat for Americans and others in developed nations (meaning anywhere McDonald's has more than one location).
Fortunately, the nutraceuticals industry is strategically situated to be a key contributor to these efforts going forward. This is, after all, the industry that developed and continues to market the "big three" of digestive health-enzymes, probiotics and fiber. And it is the industry that introduced yogurt, kefir and other fermented foods to the American diet. These are the ingredients and products that present the best hope of righting the world's digestive wrongs.
The good news is product marketers are really starting to get the message. According to Mintel International, Chicago, IL, digestive health reigns supreme in terms of global functional food development, with more than 165 new functional foods claiming digestive benefits in 2008. In fact, nearly four in 10 functional food consumers go for products sporting a digestive health claim. Given the high awareness and increasing acceptance of high fiber claims and probiotics, Mintel predicts that digestion will likely continue leading functional food product development in the future.
Probiotics have been defined by the Food and Agriculture Organization (FAO) of the United Nations as "live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host." Often referred to as "the good bacteria," they can be consumed in foods, beverages or in supplement formats. They often are accompanied by a so-called prebiotic substance on which they can feed and multiply. Examples of prebiotics include inulin and fructooligosaccharides (FOS).
White Plains, NY-based Dannon, part of the world-famous mainstream yogurt manufacturer Danone, has made no secret of its belief in probiotics, backing its Activia brand with huge marketing budgets that natural products companies can only dream about. Dannon describes Activia as a low-fat yogurt that contains Bifidus Regularis, a trademarked "natural probiotic culture that can help regulate your digestive system by helping reduce long intestinal transit time."
General Mills, another household name, also is beating the drum for yogurt, Yoplait specifically. Early in June, the Minneapolis, MN-based company released results of a clinical study in which people eating Yoplait's YoPlus improved their general health. The six-week study was conducted at the University of North Carolina. YoPlus contains Bifidobacterium lactis and inulin. Tamar Ringel-Kulka, one of the researchers, stated, "A yogurt containing probiotics and fiber is a promising choice for those who experience occasional digestive health issues."
Steve Demos, founder of White Wave Foods, which successfully went mainstream with Silk soymilk, is trying to do it again with GoodBelly, an organic probiotic fruit drink line that recently announced an upgrade to 20 billion live and active probiotic cultures per 8-oz. serving. NextFoods, the company Demos has formed with Todd Beckman, another White Wave alumnus, says GoodBelly is now being sold at nearly 4000 stores nationwide, including Whole Foods Market, King Soopers, Safeway, Publix, Wegmans, HEB, Albertsons (in southern California, Nevada and Colorado) and select Super Target stores.
Promotional efforts like these boost not only Activia, Yoplait and GoodBelly, but also help build acceptance of the category as a whole. Frost & Sullivan, a worldwide market research firm with U.S. offices in New York and three other cities, reported $698 million in North American sales of probiotics during 2006, and projected growth to almost $2 billion by 2013, a compound annual growth rate of nearly 14%.
Riding this wave are companies like Ganeden Biotech, Mayfield Heights, OH, which is a leading provider of probiotics in the U.S. In fact, it has helped various companies introduce more than 18 new probiotic-enhanced products in this past year alone. "These include products such as nutritional supplements, pasta, frozen yogurt, health bars, no calorie sweeteners and thin strips," said Mike Bush, vice president of business development. "All the products contain the probiotic GanedenBC30 (Bacillus coagulans GBI-30, 6086), which has been shown to survive the stomach acids to arrive in the intestines where probiotics can have the biggest digestive health benefit."
UAS Laboratories specializes in probiotics, and not just any probiotics, but its own trademarked strain of Lactobacillus acidophilus. According to Dr. Dash, this "specially isolated and cultured strain [called DDS-1] produce[s] enzymes (such as proteases and lipases) to aid the body's digestion of proteins and fats, respectively. Other documented benefits, perhaps of even greater significance, [are] the strain's antibacterial actions, which [are] essentially equivalent to those of antibiotics."
Wanda O'Donnell, president of O'Donnell Formulas, Inc., in San Marcos, CA, is partial to the Brevi Bacillus Laterosporus (BOD) strain, which she describes as a very potent probiotic encased in a spore. "The encasement allows this probiotic to survive the stomach acids and form colonies that will help maintain a healthy colon," she said.
Pointing out that BOD was first introduced to the market in the late 1980s, Ms. O'Donnell notes that much has changed in the past 20-30 years. For example, she says, "It has now become acceptable to talk publicly about bloating, gas, diarrhea, constipation, acid reflux and other uncomfortable sensations." With the unmentionable no longer being unmentionable, more of the millions who suffer from digestive discomforts have a clearer path to receiving the care and attention they need.
At the SupplySide East conference held in New Jersey this past April, James LaValle, RPh, CCN, ND, presented a seminar sponsored by Mission Viejo, CA-based Wakunaga of America Co., Ltd. Dr. LaValle cited remarks by a National Institutes of Health (NIH) scientist affirming that there is "more and more evidence being discovered to show that probiotics have a positive influence on gut health."
Noting that hundreds of different strains have now been identified, Dr. LaValle urged his audience to choose products that "guarantee stability and potency at the date of expiration."
Not coincidentally, Wakunaga announced in March that it was in the process of extending expiration dates on its shelf-stable (no refrigeration needed) major probiotic formulas. The company said that its products would be viable for three to four years, compared with one to two years, which is typical of the category.
Wakunaga's entries in the field are sold under the Kyo-Dophilus trade name and include: The Friendly Trio, containing L. acidophilus, B. bifidum and B. longum; Kyo-Dophilus 9, a blend of nine different strains; Kyo-Dophilus with Enzymes; One Per Day, with 3 billion live microorganisms; a chewable tablet for children; a vegetarian option; and, launched early this year, the firm's first probiotic powder formula.
Los Angeles, CA-based Jarrow Formulas offers many different types of products that work in the digestive system, including several varieties of probiotics, prebiotics and fibers, digestive enzymes, and such specialty products as bile acids, mastic gum and zinc carnosate.
Its leading probiotic selections, according to Kevin Connolly, PhD, director of scientific affairs and product development, are: Ultra Jarro-Dophilus, with each capsule containing 40 billion total probiotic bacteria; Jarro-Dophilus CDS, composed of seven well-known, clinically documented strains; and Jarro-Dophilus EPS, which is stable at room temperature and has an enteric coating to protect the probiotic bacteria from stomach acid.
Working from a foundation originating in Indo-Tibetan tradition, Piscataway, NJ-based Sabinsa Corporation offers products that utilize not only probiotics, but enzymes, fiber and more. One of its leading probiotic entries is LactoWise, a preparation that combines the room-temperature stable probiotic Bacillus coagulans (Lactobacillus sporogenes) with water-soluble fibers from fenugreek seeds. The latter act as a source of healthy dietary fibers and as a food for the lactobacillus.
In terms of the offerings from ReNew Life, its Ultimate Flora probiotic supplements have an "enteric coating on each capsule to help protect them from the harsh, acidic environment of the stomach and deliver the beneficial probiotics directly to the intestines where they are needed most."
Yakult USA, Inc., the Torrance, CA-based branch of a company that has been selling probiotic formulations in Japan for almost 75 years, recently started selling its "shot-size" (2.7 fl. oz.) beverage containing 8 billion probiotic bacteria per serving in select U.S. markets. Sold in a five-pack, the product uses a proprietary strain called Lactobacillus casei Shirota, which, the company claims, has been "shown to survive harsh acid levels in the stomach and arrive in the intestines alive."
American Health, a division of NBTY, Inc. in Ronkonkoma, NY, carries both probiotics and enzymes for digestive health. According to Angelica Vrablic, PhD, manager of nutrition research, the probiotic offerings feature lactobacillus and come in the following formats: chewable wafers, capsules and liquids.
Deerland Enzymes, a Kennesaw, GA-based supplier of probiotic and enzyme-based solutions, sees both continuing to gain market share. CEO Scott Ravech remarks, "The challenge of developing more efficient and stable delivery options for these compounds, without sacrificing enzyme efficacy, in both food and capsule/tablet form are being addressed by suppliers and manufacturers."
Despite its name, Enzymatic Therapy, Inc., in Green Bay, WI, also prominently features a line of probiotics. Matt Schueller, senior vice president of marketing, says the company promotes itself as "digestive experts" and focuses on what consumers want most-"products that produce quick results."
All products in Enzymatic Therapy's Pearls family are guaranteed through their entire shelf life and require no refrigeration. The line includes: Acidophilus Pearls, for proactive support; Pearls IC, for maximum control of occasional gas, bloating and constipation; Pearls Immune, containing Activ-Ferrin (lactoferrin); Pearls YB, a yeast-balancing formula; and Pearls X-Press, to restore digestive health after a cleanse or while traveling.
Evolve, a probiotic-laced kefir smoothie from Mountainside Farms, Jamaica, NY, comes in three flavors-Plain, Strawberry or Peach-and is priced at $3.79 SRP for a 32-oz. bottle. Kefir is a fermented milk beverage that has been used for centuries and is reputed to confer numerous health benefits, most notably by rebalancing the microflora in the gut.
Michael Shahani, director of operations for Nebraska Cultures, Inc., headquartered in Walnut Creek, CA, reports that his company's "flagship product," L. acidophilus DDS-1, "has been shown to supplant many pathogenic bacteria, to produce natural enzymes, including lactase, to produce B vitamins and folic acid, to suppress candida and H. pylori, to modify immune function, to alleviate diarrhea and constipation, to alleviate dermatological disorders such as eczema and diaper rash, and to lower cholesterol levels in blood." Mr. Shahani credits most of his firm's success to the efforts of its founder, Dr. Khem Shahani, who conducted more than 40 years of research at the University of Nebraska, publishing more than 80 papers on probiotics during that time.
According to Tim Gamble, vice president of Redmond, WA-based Nutraceutix, Inc., his company has been producing probiotics for 25 years and today delivers organisms from a library of more than two dozen, in bulk powder and fully finished dietary supplement forms. While nothing is totally recession-proof, Mr. Gamble remains high on the prospects for probiotics. "Even with the economic downturn and the [effect] it has had on overall dietary supplement spending, sales of probiotics, at least from our firm's perspective, have increased fast enough to overcome any general decrease affecting the category," he says.
At Nutrition Now, Inc., located in Vancouver, WA, the leading digestive health product is PB 8 Pro-Biotic Acidophilus, which combines the prebiotic inulin with eight strains of probiotic bacteria, which are naturally found in the gastrointestinal tract.
Kate Jones, the company's president, says, "These bacteria encourage proper bowel function, improve digestive efficiency by adding important B vitamins and enzymes like lactase, which helps digest dairy products. Probiotics also help recycle toxins."
From Cottonwood, AZ, come iFlora probiotics manufactured by Nutri-Health Supplements, LLC, and Sedona Labs. Lisa Peterson Love, marketing director, says that featured products in the iFlora line include a Multi-Probiotic Formula that features 16 probiotic strains, encompassing Lactobacilli, Lactococcus, Streptococcus and Bifidobacteria; a child-specific formula that contains seven strains known to be prevalent in young children; and a formula that is designed especially for women. The latter contains certain probiotic strains such as Lactobacillus rhamnosus, which may help support healthy digestion during stress.
As the name suggests, Specialty Enzymes & Biochemicals Co., of Chino, CA, is a major manufacturer of enzymes. In addition, it also supplies a range of probiotics, including Lactobacillus sporogenes (Bacillus coagulans) and Saccharomyces boulardii.
Mike Smith, the company's sales and marketing manager, credits the 2005 launch of Activia with an "exponential increase in public awareness about probiotics." Noting the increasing numbers of functional foods that include probiotics, he predicts strong sales of these products for years to come.
Super strain probiotics are the only products produced and marketed by Natren. The company, headquartered in Westlake Village, CA, has been doing this for a quarter century, using a full-culture process that retains the supernatant, a specially formulated medium that sustains and nourishes the bacteria. Natren's website states: "Our bacteria are never separated from this vital food source. The supernatant is an effective buffer against stomach acid, allowing more bacteria to reach their destination."
In addition, Natren relies on a "three-in-one" oil matrix system "to micro-enrobe bacteria in oxygen-free sunflower oil which separates the bacteria, keeping them healthy and strong."
According to Mr. Ravech of Deerland Enzymes, "Enzymes in general can influence nearly every chemical reaction in our bodies and in doing so can impact, in a very positive way, many aspects of the human condition. With respect to digestion, enzymes play critical roles in breaking down the foods we consume, making their nutrients more available to us to support life. They also play a role in food intolerances, tissue inflammation and overall gut conditions."
The 60 million adults who currently spend more than $10 billion annually on OTC antacids represent the target for one of Deerland's newest products, an enzyme-based alternative to antacids that is intentionally designed NOT to neutralize stomach acid like traditional antacids. Just as Xsto Solutions' Mr. Murray pointed out, Mr. Ravech said, "Acid in your stomach is there for a reason. Ongoing neutralization of stomach acid may [negatively] impact how nutrients are absorbed in the body."
The mechanism of action for this new product will be to develop an acid-stable gel that "floats" atop the stomach contents, forming a physical barrier to acid reflux (heartburn). Mr. Ravech says this gel barrier may last for more than an hour (generally much longer than antacids), and eventually will pass to the intestines and be eliminated.
NEC's Ms. Dockery says her company formulates with enzymes derived from plant, animal and microbial source organisms. In her view, microbial sources (including fungal/yeast and bacteria) provide the most versatility and are stable throughout a broad pH range, which enables them to provide efficacy throughout the entire gastrointestinal tract. One of NEC's leading products is BioCore AR, which it promotes as "a soothing digestive aid" that is intended to compete with pharmaceutical antacids.
Relying on vegetarian and vegan sources, Port Charlotte, FL-based Enzymedica produces enzymes that have no fillers or binders and are free of common allergens. Products are designed to address specific applications and sensitivities. "For example," says Maday Labrador, MS, director of technical resources, "we have a product called Lacto, which supports individuals who suffer from lactose intolerance."
Noting SPINS data showing that the digestive aids and enzymes category is on a three-year upward sales trend, with percentage growth rates much greater than those in the overall supplements segment, Enzymedica predicts continued success for the foreseeable future. According to Ms. Labrador, "Seventy five percent of people throughout the world are estimated to be lactase-deficient. Studies show that adding enzymes to milk five minutes before consumption produced 62% reduction in hydrogen excretion (hydrogen levels in the breath are a good measure of the body's ability or inability to break down lactose)."
Mr. Connolly of Jarrow Formulas says his company's enzyme offerings include Jarro-Zymes Plus, using porcine pancreatic enzymes, and Jarro-Zymes Plus (vegetarian), using a special formulation of acid-stable microbial and fungal enzymes. He says porcine pancreas contains a complex of natural enzymes including protease, amylase, lipase, trypsin, chymotrypsin, esterase, peptidase, nuclease, elastase and collagenase, a content similar to that of human pancreatic enzymes. The vegetarian version, with activities similar to pancreatin, contains amylase and lipase, along with a complex of endo- and exo-peptidases that are active over a wide range of gastrointestinal pH. Lactase is added to facilitate the digestion of lactose.
Sabinsa's Dige Zyme consists of a blend of major groups of enzymes, including the microorganism Aspergillus oryzae, and lactase, which is designed to assist the aging digestive tract. According to Vladimir Badmaev, MD, PhD, the company's vice president of scientific and medical affairs, aging brings about "markedly diminished activity" of enzymes in the digestive tract. "This may initially be manifested by a gastrointestinal discomfort such as gas, bloating, headache, nausea, intestinal cramps, diarrhea and also constipation. A chronic deficiency, on the other hand, may result in malabsorption or depletion of nutrients." Lacking enzymes, nutrients may remain in an undigested form, making it impossible for them to cross the barrier between gut and blood vessels. Without bioavailability, they are unable to aid in the metabolic processes essential to cellular health.
Dr. Badmaev notes that the fermentation process used in preparation of Dige Zyme was developed in Japan in 1894, and continues to be used in that country at the present time.
American Health's Ms. Vrablic claims that her company's papaya enzymes have long been regarded as the "After Meal" supplement.
ReNew Life's Ultimate Fish Oils provide concentrated omega 3 support for bowel integrity, enhanced digestion and overall health. And, says Ms. Watson, they have "added lipase-a powerful fat-digesting enzyme-that assists with digestion and helps to significantly reduce any fishy burps."
According to Enzymatic Therapy, its Mega-Zyme digestive and systemic enzymes are most similar to the body's own. Mr. Schueller says, "When taken between meals, Mega-Zyme can relieve occasional inflammation due to exercise or overuse, as well as support deep immune health."
Thanks to an enteric coating, NextZyme Dual Digestive Enzymes from Nutri-Health Supplements, LLC, and Sedona Labs is an all-vegetarian formula that delivers enzymes at the proper pH to the stomach and the small intestine. The company's ZymaFlora Acid Balance Formula features the same enzyme formula as NextZyme with the addition of five strains of probiotics.
Papain (green papaya extract) and bromelain, two popular proteinase enzymes, are featured ingredients of Daily Fruit & Fiber, one of the products in the new ThinBerry Diet & Cleanse Kit from Rainbow Light Nutritional Systems, Santa Cruz, CA. The kit's three elements include: ThinBerry Diet, a weight-loss formula containing decaffeinated green coffee berry, Svetol, standardized green tea and artichoke leaf; Daily Fruit & Fiber, with fiber from such whole food sources as apple, beet, organic flax, chia seed, fig, plum, pomegranate, pineapple, banana, millet and sunflower sprouts; and PM Purify, which contains herbs that support liver renewal, detoxification and morning regularity.
According to Mike Smith, digestive health blends from Specialty Enzymes & Biochemicals, including DigeSEB, VegPanzyme and DairySEB, all feature enzymes that are considered GRAS (generally recognized as safe) by the FDA.
As Mr. Smith sees it, there are two major reasons for continued double-digit sales growth in the enzyme category: 1. Word of mouth. "You don't see big headlines or stories about enzymes on the evening news. Yet, when people finally get relief of their digestive complaint by taking an enzyme supplement, they tend to tell others;" and 2. Increasing marketplace awareness of special digestive issues. Mr. Smith says these include such conditions as "lactose intolerance, gluten intolerance and other foods that consistently create indigestion and/or gas."
Meanwhile, he adds, with the exception of Beano from GlaxoSmithKline, there isn't much use of digestive enzymes in the pharmaceutical OTC marketplace. This leaves a huge window of opportunity for natural product suppliers and manufacturers.
In her March 2009 newsletter, Joyce Rosenblum, a certified holistic health counselor located in Mt. Laurel, NJ, cites a report indicating that fiber might be considered the Rodney Dangerfield of the digestive health category; it "don't get no respect!"
"You don't see commercials intoning 'Fiber: It's What's for Dinner' or see ads with celebrities sporting oat bran mustaches," the report points out. No, you get lame jokes about regularity and transit time. This is unfortunate, Ms. Rosenblum believes, because this non-digestible nutrient has many health benefits beyond its most celebrated role of moving things through the digestive system. Indeed, several studies have linked fiber consumption to a lower risk for type 2 diabetes, heart disease, diverticulitis, irritable bowel syndrome and heart disease. It may also lower the risk for some cancers, help reduce the absorption of cholesterol, and even be an aid in weight loss programs.
Yet, the report notes, the average American eats less than half the recommended 25 to 35 grams of fiber a day, opting instead for a fast-food diet filled with carbonated soda, sugar, fat and meat. And, Ms. Rosenblum explains, "Fiber is found only in plant foods, not animal-based products."
ReNew Life's fiber products include Organic Triple Fiber and FiberSMART. According to Ms. Watson, Organic Triple Fiber blends "flax, which contains high amounts of antioxidant-rich plant compounds called lignans; oat bran, which helps lower cholesterol and promote healthy cardiovascular function; and acacia fiber, which is essential for bowel regularity, healthy digestion and weight management, as well as helping to absorb and eliminate harmful toxins from the body." FiberSMART, developed specifically for those with "sensitive colons," contains added ingredients such as the prebiotic FOS and the amino acid L-glutamine to support a healthy intestinal lining.
The Enzymatic Therapy arsenal includes the following fiber-based digestive defenses: Fiber Fusion (in mixable Incrediberry or Luscious Lemon flavor powders, or in capsule form), which the company says will not "clump and turn into a non-dissolvable football in the stomach;" and Fiber Delights, a chewable supplement in Chocolate or Vanilla flavor.
At Jarrow Formulas, fiber is front and center in Fiber Perfect, a patented combination of natural dietary fibers, green algae, botanicals, organic acids and the cell wall components of beneficial bacteria. The product is designed to promote intestinal peristalsis (bowel movement), the growth of beneficial intestinal microflora and intestinal detoxification.
Keokuk, IA-based Roquette America's contribution to digestive health is Nutriose, a natural, soluble, prebiotic fiber from either corn or wheat. According to the company, Nutriose has great "dispersability and solubility in hot or cold water and a very low viscosity in solution." This, added to the fact that it has a neutral taste, makes it easy to add to foods without any need to reformulate or readjust flavor balance.
Sabinsa's FenuWise contains water soluble fenugreek fibers (which act as a prebiotic) combined with Bacillus coagulans probiotic.
Ron Udell, president and CEO of Opti Pure, located in Los Angeles, CA, says his company's leading fiber ingredient is xylo-oligosaccharide, or XOS. Like many prebiotic saccharides, otherwise known as sugars, XOS has a sweet, pleasant taste, similar to cane sugar. Unlike sugar, however, XOS is not absorbed by the body, so there is minimal caloric intake and no effect on insulin or blood sugar when ingested. Also, in contrast to many artificial sweeteners currently on the market, therapeutic doses of XOS do not create loose stool or diarrhea, a common side effect of sweeteners such as maltitol and sucralose. Most important, XOS contributes to gut health by stimulating the selective growth of beneficial Bifidobacterium.
Beyond the so-called big three-probiotics, enzymes and fiber-digestive health may be improved by many other substances, ranging from simple licorice to a variety of herbs.
Enzymatic Therapy has introduced the following chewable products formulated with deglycyrrhizinated licorice: DGL Original and DGL Fructose-Free (also sugar-free), which are designed to stimulate natural protective factors in the digestive tract, helping to relieve stomach discomfort immediately; and DGL Ultra, an extra-strength (10:1 concentration) extract in German Chocolate flavor for those who don't care for the taste of licorice.
Sabinsa believes strongly in the value of its BioPerine product, an extract of black pepper standardized for the alkaloid piperine. Dr. Badmaev says that the ingredient may enhance nutrient absorption and possibly bioavailability of various fat and water-soluble nutrients. Since nutrient absorption diminishes with aging of the digestive tract, the boost that can be gained from BioPerine could prove an important support to the organs responsible for digestion and absorption of food.
From Buffalo, NY-based Herbion come Entoban capsules and syrup, featuring the following herbal lineup: myrtleberry (Myrtus communis), bael fruit (Aegele marelos), lotur (Symplocos racemosa), oak galls (Quercus infectoria), East Indian screw tree (Helicteres isora), kurchi (Holarrhena antidysenterica), berberry (Berberis aristata), and acacia (Acacia Arabica). The company says this "unique combination" may help relieve an upset stomach, help maintain gastrointestinal health and function, help maintain intestinal flora and provide relief from occasional acid indigestion.
Steve Holtby, president and CEO of Soft Gel Technologies, Inc. (SGTI), a sister company of OptiPure, describes his firm's WasabiSol as "an exclusive softgel encapsulation of rhizome powder from Wasabia japonica, also commonly known as Japanese horseradish. Said to support enhanced liver detoxification and healthy immune function, wasabi belongs to the same plant family (Brassica) as other commonly-known cruciferous vegetables, such as broccoli, cabbage and cress. It is said to be valuable for antimicrobial, fungicidal and pesticidal activities, as well as its ability to remove toxins from the body. It also has exhibited strong antioxidant properties."
Other products from SGTI include: milk thistle extract, aloe vera, parsley seed oil and sunflower oil, lactase enzyme, and a combination containing green tea catechins, lecithin, vitamin E, chamomile and ginger. Custom formulations for digestion can also be encapsulated, said Mr. Holtby.
The Numbers
Consumers put up with enough "crap" in items like junk food, as well as food additives, pesticide residues and growth hormones. So perhaps it's not surprising that Americans suffering from gastric distress rush off to doctors' offices upwards of 33 million times a year and wind up in hospitals more than 3.6 million times each year.
S.K. Dash, PhD, president of UAS Laboratories in Eden Prairie, MN, cites the following annual statistics attributable to digestive diseases:
Nearly 200 million sick days
Almost 17 million days lost from school
Nearly 200,000 deaths
Translating this into dollars lost, Dr. Dash said, "The most costly digestive diseases are gastrointestinal disorders such as diarrheal infections ($4.7 billion); gallbladder disease ($4.5 billion); colorectal cancer ($4.5 billion); liver disease ($3.2 billion); and peptic ulcer disease ($2.5 billion)."
Even this may be understating the situation, however, as it doesn't take into account less serious ailments such as heartburn, constipation and GERD (gastroesophageal reflux disease), among others.
Dan Murray, vice president of business development, Xsto Solutions, Morristown, NJ, believes some conventional therapies may be the underlying cause of some of these digestive issues. "Conventional therapies for digestive problems have identified low pH gastric juices as harmful irritants and therefore focused on suppressing or eliminating stomach acid. This is problematic because stomach acid plays a key role in properly digesting food AND killing harmful bacteria," he said. "Perhaps we should look at pain relievers as the problem, rather than low pH stomach acid. The New England Journal of Medicine once identified the chronic use of NSAIDs for pain relief as a 'silent epidemic.' Regular use of NSAIDs suppresses the body's natural production of prostaglandin, a key component of mucosal lining in the GI tract. Without a healthy mucosal lining, stomach acid can become an irritant and lead to heartburn and eventually ulcers."
Then again some believe it is the very treatments prescribed to ameliorate digestive issues that are the problem. A recent study published in Gastroenterology, the official journal of the American Gastroenterological Association (AGA) Institute showed that acid-reducing medicines might lead to dependency. More specifically, treatment with proton pump inhibitors (PPIs) for eight weeks induced acid-related symptoms like heartburn, acid regurgitation and dyspepsia once treatment was withdrawn in healthy individuals.
"The observation that more than 40% of healthy volunteers, who have never been bothered by heartburn, acid regurgitation or dyspepsia, develop such symptoms in the weeks after cessation of PPIs is remarkable and has potentially important clinical and economic implications," said Christina Reimer, MD, of Copenhagen University and lead author of the study. "This study indicates unrecognized aspects of PPI withdrawal and is a very strong indication of a clinically significant acid rebound phenomenon that needs to be investigated in proper patient populations."
The use of PPIs for acid-related symptoms and disorders is extensive and rapidly escalating, according to the AGA. While the incidence of new patients being treated with PPIs remains stable, the prevalence of long-term treatment is rising, the reasons for which are not fully known. Studies have shown that up to 33% of patients who initiate PPI treatment continue to refill their prescriptions without an obvious indication for maintenance therapy. Rebound acid hypersecretion, defined as an increase in gastric acid secretion above pre-treatment levels following antisecretory therapy, is observed within two weeks after withdrawal of treatment and could theoretically lead to acid-related symptoms such as heartburn, acid regurgitation or dyspepsia that might result in resumption of therapy.
"Rather than suppressing acid, we should be focused on supporting normal digestive function," Mr. Murray added. "A limited number of dietary supplement ingredients, like zinc-carnosine for example, support a healthy digestive system, avoiding the issues that lead to symptoms and discomfort. With a healthy mucosal lining, we can handle stomach acid without heartburn and irritation (and zinc-carnosine supports a healthy mucosal lining)."
Emphasizing that her company's sole focus is digestive care, Brenda Watson, president and founder of ReNew Life Formulas, Palm Harbor, FL, asserts, "Approximately 70% of the body's immune defenses are located in the digestive tract. For this reason, optimum digestive function is often considered the foundation for the health and well-being of the entire body."
Nena Dockery, technical services manager for Forsyth, MO-based National Enzyme Company (NEC), offers the following facts and figures:
60-70 million people have some sort of digestive disorder. This statistic is not new, dating to 1996, and the numbers are probably much higher now.
IBS affects 9-23% of all people worldwide, mostly women. It is one of the most common disorders diagnosed by doctors.
More than 9.5 million Americans experience indigestion on a regular basis.
Between 5-7% globally and 10-20% of Americans experience GERD symptoms daily.
56 million people have heartburn ranging from mild to serious. Around 60 million Americans have it at least once a month, and 15 million have it daily.
More than 3 million people have recurrent constipation.
OTC gastrointestinal remedies are a multibillion-dollar business. In 2007, five products aimed at gut health were switched from prescription to over-the-counter status.
To paraphrase the Apollo 13 astronauts, "Houston-and all points north, south, east and west-we have a problem."
How Do We Fix It?
The most effective solution would be to feed the world better-more calories and added nutrients for people in impoverished nations, and reduced portions and less fat for Americans and others in developed nations (meaning anywhere McDonald's has more than one location).
Fortunately, the nutraceuticals industry is strategically situated to be a key contributor to these efforts going forward. This is, after all, the industry that developed and continues to market the "big three" of digestive health-enzymes, probiotics and fiber. And it is the industry that introduced yogurt, kefir and other fermented foods to the American diet. These are the ingredients and products that present the best hope of righting the world's digestive wrongs.
The good news is product marketers are really starting to get the message. According to Mintel International, Chicago, IL, digestive health reigns supreme in terms of global functional food development, with more than 165 new functional foods claiming digestive benefits in 2008. In fact, nearly four in 10 functional food consumers go for products sporting a digestive health claim. Given the high awareness and increasing acceptance of high fiber claims and probiotics, Mintel predicts that digestion will likely continue leading functional food product development in the future.
Probiotics
Probiotics have been defined by the Food and Agriculture Organization (FAO) of the United Nations as "live microorganisms, which, when administered in adequate amounts, confer a health benefit on the host." Often referred to as "the good bacteria," they can be consumed in foods, beverages or in supplement formats. They often are accompanied by a so-called prebiotic substance on which they can feed and multiply. Examples of prebiotics include inulin and fructooligosaccharides (FOS).
White Plains, NY-based Dannon, part of the world-famous mainstream yogurt manufacturer Danone, has made no secret of its belief in probiotics, backing its Activia brand with huge marketing budgets that natural products companies can only dream about. Dannon describes Activia as a low-fat yogurt that contains Bifidus Regularis, a trademarked "natural probiotic culture that can help regulate your digestive system by helping reduce long intestinal transit time."
General Mills, another household name, also is beating the drum for yogurt, Yoplait specifically. Early in June, the Minneapolis, MN-based company released results of a clinical study in which people eating Yoplait's YoPlus improved their general health. The six-week study was conducted at the University of North Carolina. YoPlus contains Bifidobacterium lactis and inulin. Tamar Ringel-Kulka, one of the researchers, stated, "A yogurt containing probiotics and fiber is a promising choice for those who experience occasional digestive health issues."
Steve Demos, founder of White Wave Foods, which successfully went mainstream with Silk soymilk, is trying to do it again with GoodBelly, an organic probiotic fruit drink line that recently announced an upgrade to 20 billion live and active probiotic cultures per 8-oz. serving. NextFoods, the company Demos has formed with Todd Beckman, another White Wave alumnus, says GoodBelly is now being sold at nearly 4000 stores nationwide, including Whole Foods Market, King Soopers, Safeway, Publix, Wegmans, HEB, Albertsons (in southern California, Nevada and Colorado) and select Super Target stores.
Promotional efforts like these boost not only Activia, Yoplait and GoodBelly, but also help build acceptance of the category as a whole. Frost & Sullivan, a worldwide market research firm with U.S. offices in New York and three other cities, reported $698 million in North American sales of probiotics during 2006, and projected growth to almost $2 billion by 2013, a compound annual growth rate of nearly 14%.
Riding this wave are companies like Ganeden Biotech, Mayfield Heights, OH, which is a leading provider of probiotics in the U.S. In fact, it has helped various companies introduce more than 18 new probiotic-enhanced products in this past year alone. "These include products such as nutritional supplements, pasta, frozen yogurt, health bars, no calorie sweeteners and thin strips," said Mike Bush, vice president of business development. "All the products contain the probiotic GanedenBC30 (Bacillus coagulans GBI-30, 6086), which has been shown to survive the stomach acids to arrive in the intestines where probiotics can have the biggest digestive health benefit."
UAS Laboratories specializes in probiotics, and not just any probiotics, but its own trademarked strain of Lactobacillus acidophilus. According to Dr. Dash, this "specially isolated and cultured strain [called DDS-1] produce[s] enzymes (such as proteases and lipases) to aid the body's digestion of proteins and fats, respectively. Other documented benefits, perhaps of even greater significance, [are] the strain's antibacterial actions, which [are] essentially equivalent to those of antibiotics."
Wanda O'Donnell, president of O'Donnell Formulas, Inc., in San Marcos, CA, is partial to the Brevi Bacillus Laterosporus (BOD) strain, which she describes as a very potent probiotic encased in a spore. "The encasement allows this probiotic to survive the stomach acids and form colonies that will help maintain a healthy colon," she said.
Pointing out that BOD was first introduced to the market in the late 1980s, Ms. O'Donnell notes that much has changed in the past 20-30 years. For example, she says, "It has now become acceptable to talk publicly about bloating, gas, diarrhea, constipation, acid reflux and other uncomfortable sensations." With the unmentionable no longer being unmentionable, more of the millions who suffer from digestive discomforts have a clearer path to receiving the care and attention they need.
At the SupplySide East conference held in New Jersey this past April, James LaValle, RPh, CCN, ND, presented a seminar sponsored by Mission Viejo, CA-based Wakunaga of America Co., Ltd. Dr. LaValle cited remarks by a National Institutes of Health (NIH) scientist affirming that there is "more and more evidence being discovered to show that probiotics have a positive influence on gut health."
Noting that hundreds of different strains have now been identified, Dr. LaValle urged his audience to choose products that "guarantee stability and potency at the date of expiration."
Not coincidentally, Wakunaga announced in March that it was in the process of extending expiration dates on its shelf-stable (no refrigeration needed) major probiotic formulas. The company said that its products would be viable for three to four years, compared with one to two years, which is typical of the category.
Wakunaga's entries in the field are sold under the Kyo-Dophilus trade name and include: The Friendly Trio, containing L. acidophilus, B. bifidum and B. longum; Kyo-Dophilus 9, a blend of nine different strains; Kyo-Dophilus with Enzymes; One Per Day, with 3 billion live microorganisms; a chewable tablet for children; a vegetarian option; and, launched early this year, the firm's first probiotic powder formula.
Los Angeles, CA-based Jarrow Formulas offers many different types of products that work in the digestive system, including several varieties of probiotics, prebiotics and fibers, digestive enzymes, and such specialty products as bile acids, mastic gum and zinc carnosate.
Its leading probiotic selections, according to Kevin Connolly, PhD, director of scientific affairs and product development, are: Ultra Jarro-Dophilus, with each capsule containing 40 billion total probiotic bacteria; Jarro-Dophilus CDS, composed of seven well-known, clinically documented strains; and Jarro-Dophilus EPS, which is stable at room temperature and has an enteric coating to protect the probiotic bacteria from stomach acid.
Working from a foundation originating in Indo-Tibetan tradition, Piscataway, NJ-based Sabinsa Corporation offers products that utilize not only probiotics, but enzymes, fiber and more. One of its leading probiotic entries is LactoWise, a preparation that combines the room-temperature stable probiotic Bacillus coagulans (Lactobacillus sporogenes) with water-soluble fibers from fenugreek seeds. The latter act as a source of healthy dietary fibers and as a food for the lactobacillus.
In terms of the offerings from ReNew Life, its Ultimate Flora probiotic supplements have an "enteric coating on each capsule to help protect them from the harsh, acidic environment of the stomach and deliver the beneficial probiotics directly to the intestines where they are needed most."
Yakult USA, Inc., the Torrance, CA-based branch of a company that has been selling probiotic formulations in Japan for almost 75 years, recently started selling its "shot-size" (2.7 fl. oz.) beverage containing 8 billion probiotic bacteria per serving in select U.S. markets. Sold in a five-pack, the product uses a proprietary strain called Lactobacillus casei Shirota, which, the company claims, has been "shown to survive harsh acid levels in the stomach and arrive in the intestines alive."
American Health, a division of NBTY, Inc. in Ronkonkoma, NY, carries both probiotics and enzymes for digestive health. According to Angelica Vrablic, PhD, manager of nutrition research, the probiotic offerings feature lactobacillus and come in the following formats: chewable wafers, capsules and liquids.
Deerland Enzymes, a Kennesaw, GA-based supplier of probiotic and enzyme-based solutions, sees both continuing to gain market share. CEO Scott Ravech remarks, "The challenge of developing more efficient and stable delivery options for these compounds, without sacrificing enzyme efficacy, in both food and capsule/tablet form are being addressed by suppliers and manufacturers."
Despite its name, Enzymatic Therapy, Inc., in Green Bay, WI, also prominently features a line of probiotics. Matt Schueller, senior vice president of marketing, says the company promotes itself as "digestive experts" and focuses on what consumers want most-"products that produce quick results."
All products in Enzymatic Therapy's Pearls family are guaranteed through their entire shelf life and require no refrigeration. The line includes: Acidophilus Pearls, for proactive support; Pearls IC, for maximum control of occasional gas, bloating and constipation; Pearls Immune, containing Activ-Ferrin (lactoferrin); Pearls YB, a yeast-balancing formula; and Pearls X-Press, to restore digestive health after a cleanse or while traveling.
Evolve, a probiotic-laced kefir smoothie from Mountainside Farms, Jamaica, NY, comes in three flavors-Plain, Strawberry or Peach-and is priced at $3.79 SRP for a 32-oz. bottle. Kefir is a fermented milk beverage that has been used for centuries and is reputed to confer numerous health benefits, most notably by rebalancing the microflora in the gut.
Michael Shahani, director of operations for Nebraska Cultures, Inc., headquartered in Walnut Creek, CA, reports that his company's "flagship product," L. acidophilus DDS-1, "has been shown to supplant many pathogenic bacteria, to produce natural enzymes, including lactase, to produce B vitamins and folic acid, to suppress candida and H. pylori, to modify immune function, to alleviate diarrhea and constipation, to alleviate dermatological disorders such as eczema and diaper rash, and to lower cholesterol levels in blood." Mr. Shahani credits most of his firm's success to the efforts of its founder, Dr. Khem Shahani, who conducted more than 40 years of research at the University of Nebraska, publishing more than 80 papers on probiotics during that time.
According to Tim Gamble, vice president of Redmond, WA-based Nutraceutix, Inc., his company has been producing probiotics for 25 years and today delivers organisms from a library of more than two dozen, in bulk powder and fully finished dietary supplement forms. While nothing is totally recession-proof, Mr. Gamble remains high on the prospects for probiotics. "Even with the economic downturn and the [effect] it has had on overall dietary supplement spending, sales of probiotics, at least from our firm's perspective, have increased fast enough to overcome any general decrease affecting the category," he says.
At Nutrition Now, Inc., located in Vancouver, WA, the leading digestive health product is PB 8 Pro-Biotic Acidophilus, which combines the prebiotic inulin with eight strains of probiotic bacteria, which are naturally found in the gastrointestinal tract.
Kate Jones, the company's president, says, "These bacteria encourage proper bowel function, improve digestive efficiency by adding important B vitamins and enzymes like lactase, which helps digest dairy products. Probiotics also help recycle toxins."
From Cottonwood, AZ, come iFlora probiotics manufactured by Nutri-Health Supplements, LLC, and Sedona Labs. Lisa Peterson Love, marketing director, says that featured products in the iFlora line include a Multi-Probiotic Formula that features 16 probiotic strains, encompassing Lactobacilli, Lactococcus, Streptococcus and Bifidobacteria; a child-specific formula that contains seven strains known to be prevalent in young children; and a formula that is designed especially for women. The latter contains certain probiotic strains such as Lactobacillus rhamnosus, which may help support healthy digestion during stress.
As the name suggests, Specialty Enzymes & Biochemicals Co., of Chino, CA, is a major manufacturer of enzymes. In addition, it also supplies a range of probiotics, including Lactobacillus sporogenes (Bacillus coagulans) and Saccharomyces boulardii.
Mike Smith, the company's sales and marketing manager, credits the 2005 launch of Activia with an "exponential increase in public awareness about probiotics." Noting the increasing numbers of functional foods that include probiotics, he predicts strong sales of these products for years to come.
Super strain probiotics are the only products produced and marketed by Natren. The company, headquartered in Westlake Village, CA, has been doing this for a quarter century, using a full-culture process that retains the supernatant, a specially formulated medium that sustains and nourishes the bacteria. Natren's website states: "Our bacteria are never separated from this vital food source. The supernatant is an effective buffer against stomach acid, allowing more bacteria to reach their destination."
In addition, Natren relies on a "three-in-one" oil matrix system "to micro-enrobe bacteria in oxygen-free sunflower oil which separates the bacteria, keeping them healthy and strong."
Enzymes
According to Mr. Ravech of Deerland Enzymes, "Enzymes in general can influence nearly every chemical reaction in our bodies and in doing so can impact, in a very positive way, many aspects of the human condition. With respect to digestion, enzymes play critical roles in breaking down the foods we consume, making their nutrients more available to us to support life. They also play a role in food intolerances, tissue inflammation and overall gut conditions."
The 60 million adults who currently spend more than $10 billion annually on OTC antacids represent the target for one of Deerland's newest products, an enzyme-based alternative to antacids that is intentionally designed NOT to neutralize stomach acid like traditional antacids. Just as Xsto Solutions' Mr. Murray pointed out, Mr. Ravech said, "Acid in your stomach is there for a reason. Ongoing neutralization of stomach acid may [negatively] impact how nutrients are absorbed in the body."
The mechanism of action for this new product will be to develop an acid-stable gel that "floats" atop the stomach contents, forming a physical barrier to acid reflux (heartburn). Mr. Ravech says this gel barrier may last for more than an hour (generally much longer than antacids), and eventually will pass to the intestines and be eliminated.
NEC's Ms. Dockery says her company formulates with enzymes derived from plant, animal and microbial source organisms. In her view, microbial sources (including fungal/yeast and bacteria) provide the most versatility and are stable throughout a broad pH range, which enables them to provide efficacy throughout the entire gastrointestinal tract. One of NEC's leading products is BioCore AR, which it promotes as "a soothing digestive aid" that is intended to compete with pharmaceutical antacids.
Relying on vegetarian and vegan sources, Port Charlotte, FL-based Enzymedica produces enzymes that have no fillers or binders and are free of common allergens. Products are designed to address specific applications and sensitivities. "For example," says Maday Labrador, MS, director of technical resources, "we have a product called Lacto, which supports individuals who suffer from lactose intolerance."
Noting SPINS data showing that the digestive aids and enzymes category is on a three-year upward sales trend, with percentage growth rates much greater than those in the overall supplements segment, Enzymedica predicts continued success for the foreseeable future. According to Ms. Labrador, "Seventy five percent of people throughout the world are estimated to be lactase-deficient. Studies show that adding enzymes to milk five minutes before consumption produced 62% reduction in hydrogen excretion (hydrogen levels in the breath are a good measure of the body's ability or inability to break down lactose)."
Mr. Connolly of Jarrow Formulas says his company's enzyme offerings include Jarro-Zymes Plus, using porcine pancreatic enzymes, and Jarro-Zymes Plus (vegetarian), using a special formulation of acid-stable microbial and fungal enzymes. He says porcine pancreas contains a complex of natural enzymes including protease, amylase, lipase, trypsin, chymotrypsin, esterase, peptidase, nuclease, elastase and collagenase, a content similar to that of human pancreatic enzymes. The vegetarian version, with activities similar to pancreatin, contains amylase and lipase, along with a complex of endo- and exo-peptidases that are active over a wide range of gastrointestinal pH. Lactase is added to facilitate the digestion of lactose.
Sabinsa's Dige Zyme consists of a blend of major groups of enzymes, including the microorganism Aspergillus oryzae, and lactase, which is designed to assist the aging digestive tract. According to Vladimir Badmaev, MD, PhD, the company's vice president of scientific and medical affairs, aging brings about "markedly diminished activity" of enzymes in the digestive tract. "This may initially be manifested by a gastrointestinal discomfort such as gas, bloating, headache, nausea, intestinal cramps, diarrhea and also constipation. A chronic deficiency, on the other hand, may result in malabsorption or depletion of nutrients." Lacking enzymes, nutrients may remain in an undigested form, making it impossible for them to cross the barrier between gut and blood vessels. Without bioavailability, they are unable to aid in the metabolic processes essential to cellular health.
Dr. Badmaev notes that the fermentation process used in preparation of Dige Zyme was developed in Japan in 1894, and continues to be used in that country at the present time.
American Health's Ms. Vrablic claims that her company's papaya enzymes have long been regarded as the "After Meal" supplement.
ReNew Life's Ultimate Fish Oils provide concentrated omega 3 support for bowel integrity, enhanced digestion and overall health. And, says Ms. Watson, they have "added lipase-a powerful fat-digesting enzyme-that assists with digestion and helps to significantly reduce any fishy burps."
According to Enzymatic Therapy, its Mega-Zyme digestive and systemic enzymes are most similar to the body's own. Mr. Schueller says, "When taken between meals, Mega-Zyme can relieve occasional inflammation due to exercise or overuse, as well as support deep immune health."
Thanks to an enteric coating, NextZyme Dual Digestive Enzymes from Nutri-Health Supplements, LLC, and Sedona Labs is an all-vegetarian formula that delivers enzymes at the proper pH to the stomach and the small intestine. The company's ZymaFlora Acid Balance Formula features the same enzyme formula as NextZyme with the addition of five strains of probiotics.
Papain (green papaya extract) and bromelain, two popular proteinase enzymes, are featured ingredients of Daily Fruit & Fiber, one of the products in the new ThinBerry Diet & Cleanse Kit from Rainbow Light Nutritional Systems, Santa Cruz, CA. The kit's three elements include: ThinBerry Diet, a weight-loss formula containing decaffeinated green coffee berry, Svetol, standardized green tea and artichoke leaf; Daily Fruit & Fiber, with fiber from such whole food sources as apple, beet, organic flax, chia seed, fig, plum, pomegranate, pineapple, banana, millet and sunflower sprouts; and PM Purify, which contains herbs that support liver renewal, detoxification and morning regularity.
According to Mike Smith, digestive health blends from Specialty Enzymes & Biochemicals, including DigeSEB, VegPanzyme and DairySEB, all feature enzymes that are considered GRAS (generally recognized as safe) by the FDA.
As Mr. Smith sees it, there are two major reasons for continued double-digit sales growth in the enzyme category: 1. Word of mouth. "You don't see big headlines or stories about enzymes on the evening news. Yet, when people finally get relief of their digestive complaint by taking an enzyme supplement, they tend to tell others;" and 2. Increasing marketplace awareness of special digestive issues. Mr. Smith says these include such conditions as "lactose intolerance, gluten intolerance and other foods that consistently create indigestion and/or gas."
Meanwhile, he adds, with the exception of Beano from GlaxoSmithKline, there isn't much use of digestive enzymes in the pharmaceutical OTC marketplace. This leaves a huge window of opportunity for natural product suppliers and manufacturers.
Fiber
In her March 2009 newsletter, Joyce Rosenblum, a certified holistic health counselor located in Mt. Laurel, NJ, cites a report indicating that fiber might be considered the Rodney Dangerfield of the digestive health category; it "don't get no respect!"
"You don't see commercials intoning 'Fiber: It's What's for Dinner' or see ads with celebrities sporting oat bran mustaches," the report points out. No, you get lame jokes about regularity and transit time. This is unfortunate, Ms. Rosenblum believes, because this non-digestible nutrient has many health benefits beyond its most celebrated role of moving things through the digestive system. Indeed, several studies have linked fiber consumption to a lower risk for type 2 diabetes, heart disease, diverticulitis, irritable bowel syndrome and heart disease. It may also lower the risk for some cancers, help reduce the absorption of cholesterol, and even be an aid in weight loss programs.
Yet, the report notes, the average American eats less than half the recommended 25 to 35 grams of fiber a day, opting instead for a fast-food diet filled with carbonated soda, sugar, fat and meat. And, Ms. Rosenblum explains, "Fiber is found only in plant foods, not animal-based products."
ReNew Life's fiber products include Organic Triple Fiber and FiberSMART. According to Ms. Watson, Organic Triple Fiber blends "flax, which contains high amounts of antioxidant-rich plant compounds called lignans; oat bran, which helps lower cholesterol and promote healthy cardiovascular function; and acacia fiber, which is essential for bowel regularity, healthy digestion and weight management, as well as helping to absorb and eliminate harmful toxins from the body." FiberSMART, developed specifically for those with "sensitive colons," contains added ingredients such as the prebiotic FOS and the amino acid L-glutamine to support a healthy intestinal lining.
The Enzymatic Therapy arsenal includes the following fiber-based digestive defenses: Fiber Fusion (in mixable Incrediberry or Luscious Lemon flavor powders, or in capsule form), which the company says will not "clump and turn into a non-dissolvable football in the stomach;" and Fiber Delights, a chewable supplement in Chocolate or Vanilla flavor.
At Jarrow Formulas, fiber is front and center in Fiber Perfect, a patented combination of natural dietary fibers, green algae, botanicals, organic acids and the cell wall components of beneficial bacteria. The product is designed to promote intestinal peristalsis (bowel movement), the growth of beneficial intestinal microflora and intestinal detoxification.
Keokuk, IA-based Roquette America's contribution to digestive health is Nutriose, a natural, soluble, prebiotic fiber from either corn or wheat. According to the company, Nutriose has great "dispersability and solubility in hot or cold water and a very low viscosity in solution." This, added to the fact that it has a neutral taste, makes it easy to add to foods without any need to reformulate or readjust flavor balance.
Sabinsa's FenuWise contains water soluble fenugreek fibers (which act as a prebiotic) combined with Bacillus coagulans probiotic.
Ron Udell, president and CEO of Opti Pure, located in Los Angeles, CA, says his company's leading fiber ingredient is xylo-oligosaccharide, or XOS. Like many prebiotic saccharides, otherwise known as sugars, XOS has a sweet, pleasant taste, similar to cane sugar. Unlike sugar, however, XOS is not absorbed by the body, so there is minimal caloric intake and no effect on insulin or blood sugar when ingested. Also, in contrast to many artificial sweeteners currently on the market, therapeutic doses of XOS do not create loose stool or diarrhea, a common side effect of sweeteners such as maltitol and sucralose. Most important, XOS contributes to gut health by stimulating the selective growth of beneficial Bifidobacterium.
Other Approaches
Beyond the so-called big three-probiotics, enzymes and fiber-digestive health may be improved by many other substances, ranging from simple licorice to a variety of herbs.
Enzymatic Therapy has introduced the following chewable products formulated with deglycyrrhizinated licorice: DGL Original and DGL Fructose-Free (also sugar-free), which are designed to stimulate natural protective factors in the digestive tract, helping to relieve stomach discomfort immediately; and DGL Ultra, an extra-strength (10:1 concentration) extract in German Chocolate flavor for those who don't care for the taste of licorice.
Sabinsa believes strongly in the value of its BioPerine product, an extract of black pepper standardized for the alkaloid piperine. Dr. Badmaev says that the ingredient may enhance nutrient absorption and possibly bioavailability of various fat and water-soluble nutrients. Since nutrient absorption diminishes with aging of the digestive tract, the boost that can be gained from BioPerine could prove an important support to the organs responsible for digestion and absorption of food.
From Buffalo, NY-based Herbion come Entoban capsules and syrup, featuring the following herbal lineup: myrtleberry (Myrtus communis), bael fruit (Aegele marelos), lotur (Symplocos racemosa), oak galls (Quercus infectoria), East Indian screw tree (Helicteres isora), kurchi (Holarrhena antidysenterica), berberry (Berberis aristata), and acacia (Acacia Arabica). The company says this "unique combination" may help relieve an upset stomach, help maintain gastrointestinal health and function, help maintain intestinal flora and provide relief from occasional acid indigestion.
Steve Holtby, president and CEO of Soft Gel Technologies, Inc. (SGTI), a sister company of OptiPure, describes his firm's WasabiSol as "an exclusive softgel encapsulation of rhizome powder from Wasabia japonica, also commonly known as Japanese horseradish. Said to support enhanced liver detoxification and healthy immune function, wasabi belongs to the same plant family (Brassica) as other commonly-known cruciferous vegetables, such as broccoli, cabbage and cress. It is said to be valuable for antimicrobial, fungicidal and pesticidal activities, as well as its ability to remove toxins from the body. It also has exhibited strong antioxidant properties."
Other products from SGTI include: milk thistle extract, aloe vera, parsley seed oil and sunflower oil, lactase enzyme, and a combination containing green tea catechins, lecithin, vitamin E, chamomile and ginger. Custom formulations for digestion can also be encapsulated, said Mr. Holtby.
