Recently I’ve been reflecting on why some health issues are more successfully addressed with nutraceuticals than others. For instance, cardiovascular/heart health and glycemic control/diabetes touch large groups of consumers and represent significant healthcare issues. And it has been demonstrated that nutritional interventions afford benefits to both markets. But based on retail sales data, it appears that while heart health is a very significant nutraceutical market, glycemic control/ diabetes market is significantly smaller.

At the risk of oversimplifying two significant public health issues, I believe there are two major factors differentiating these two markets in the mind of a nutraceutical products consumer—consumer awareness and healthcare professional support.

Consumer Awareness

It is well known that for a market to initiate and sustain growth, consumers’ knowledge is important on multiple levels. Following is a brief summary of factors relevant in understanding and utilizing consumer awareness to achieve a competitive edge.

An unmet need. Consumers must first be aware they have a need that is not currently being adequately addressed. From past research, it has been observed that consumers treating or preventing heart health and glycemic control-related concerns feel that each plays an important role in their lives and requires intervention. Notably, consumers who have or are concerned with one of the two named health concerns are also often dealing with the other. Yet the heart health nutraceutical market is notably more developed than the glycemic control market.
 
The consumer’s belief. Another factor that deserves close attention is the consumer’s belief in the power of nutraceuticals. In another words, do consumers believe nutraceuticals or dietary supplements can safely and effectively address their health concerns? Relative to the use of supplements, both heart health and glycemic control-related concerns are often preventative as compared to management of the disease through the use of drugs. Thus, unless there is rock-solid evidence of efficacy, consumers have less confidence in the efficacy of supplements providing preventive benefits than in those providing therapeutic benefits. The benefit must be “felt” within a relatively short period.
 
Product awareness. For consumers who believe nutraceuticals can address their health concerns, the next question is are they even aware of an ingredient or branded product that will address their concern? Now this is an area where heart health and glycemic control really begin to diverge, at least in the nutraceuticals market.

When “heart health consumers” are asked to identify nutrients that can provide benefit for their health concern, a significant majority can name, for instance, omega 3 fatty acids; the #1 selling heart health ingredient or soluble fiber from oats. On the other hand, when consumers who are concerned about “blood sugar” are asked to identify nutrients that address this health concern, only a few can name one.
 
Obviously, without awareness of an efficacious ingredient there is little likelihood consumers will trial a product.

The Healthcare Professional

Another striking difference between the heart health and glycemic control markets is the role of the healthcare professional.
 
Traditionally, allopathic physicians have not been strong proponents of dietary supplements, with the possible exception of vitamins and minerals. We have seen change in these practices, which by and large is driven by use of omega 3s for heart health benefits. In fact, most physicians today freely support, if not recommend dietary supplementation with omega 3 fatty acids to address elevated serum lipids. I believe a variety of factors have led to this change in physicians’ attitudes, including a proliferation of clinical substantiation in peer-reviewed journals, FDA approval of a pharmaceutical omega 3 product and increasing patient expectations of their physicians.

However, when physicians are either asked their opinion or for their recommendation regarding nutritional interventions for a blood sugar-related condition, only a few are likely to proactively recommend a supplement. Physicians in general are not aware of the efficaciousness of supplements addressing glycemic control and hence unlikely to recommend nutritional-based solutions.
 
Building large nutritional brands utilizing healthcare professional influence is not a new trend. In the early 1980s, I participated in the development of a billion-dollar medical food brand leveraging recommendations of healthcare professionals. More recently, Glucerna, a line extension of the Ensure brand, was created to assist in the management of blood sugar and is rapidly approaching $1 billion in global sales.

Increasingly healthcare professionals are expected by their patients to be knowledgeable and offer advice on the use of alternative therapies, including dietary supplements. Supported by clinical research sponsored by the supplement industry, academia and pharmaceutical companies, today’s healthcare professionals are becoming more educated and proactive in adding dietary supplements to their arsenal to battle these growing public health issues.

The Opportunity

Glycemic control and specifically diabetes constitute a significant public health concern and a huge market. Nearly 26 million children and adults in the U.S.—8.3% of the population—have diabetes, with approximately 2 million new cases being diagnosed each year (see Figure 1). On top of that, 79 million people in the U.S. have prediabetes.

Additionally, there are several health complications that directly contribute to diabetes, including: heart disease and stroke, high blood pressure, blindness, kidney disease, nervous system disease (neuropathy) and amputation.

Given the size of the diabetic market, the associated healthcare costs are hardly a surprise. In 2007, the American Diabetes Association calculated the costs of diagnosed diabetes in the U.S. at $174 billion. Factoring in the additional costs of undiagnosed diabetes, prediabetes and gestational diabetes brought the total cost of diabetes to $218 billion!

Targeting a segment of the glycemic control market makes penetration with a reasonable budget far more likely. Whether the target is as broad as a specific health issue (e.g. type 1 or 2 diabetes, metabolic syndrome) or a demographic or psychographic segmentation, the message must be targeted, clear and compelling.

In the short-term it may not be realistic to expect physicians to proactively recommend dietary supplements for their diabetic patients. However, never underestimate the value of a positive “nod” when a patient inquires about supplement usage. Avoid trying to make supplements appear to be the cure of diabetes—they should simply be considered another tool in the arsenal of weapons. Even the more conservative physicians can accept this option.
 
Consider consumer awareness and healthcare professional support as two sides of the coin in the nutraceutical glycemic control: Address them both and enjoy market success.


Greg Stephens, RD, is president of Windrose Partners, a company serving clients in the the dietary supplement, functional food and natural product industries. Formerly vice president of strategic consulting with The Natural Marketing Institute (NMI) and vice president of Sales and Marketing for Nurture, Inc (OatVantage), he has 25 years of specialized expertise in the nutritional and pharmaceutical industries. His prior experience includes a progressive series of senior management positions with Abbott Nutrition (Ross Products Division of Abbott Laboratories), including development of global nutrition strategies for disease-specific growth platforms and business development for Abbott's medical foods portfolio. He can be reached at 215-860-5186; E-mail:gregstephens@windrosepartners.com