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    Features

    Digestive Health: Getting to the Guts of Wellness

    Research continues to indicate how proper digestion influences overall health.

    Digestive Health: Getting to the Guts of Wellness
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    By Sean Moloughney, Editor11.01.17
    Healthy digestion has broad implications for overall wellness. With new research exploring the complex universe of bacteria living in the human gut, nutritional components like probiotics, prebiotics, enzymes, and fiber will be better positioned to help consumers who need relief.

    John Deaton, PhD, vice president of science and technology, Deerland Enzymes & Probiotics, Kennesaw, GA, noted that, according to the American Gastroenterological Association Institute, good digestive health describes a digestive system that has appropriate nutrient absorption, intestinal motility, immune function, and a balanced microbiota (the community of microorganisms that live in the gut).

    “The intestines contain more immune cells than the entire rest of the human body,” said Dr. Deaton. “In many cases, immune dysfunction begins with a ‘failure to communicate’ in the human gut. Considering 70% of the immune system is located in the digestive tract, maintaining a healthy gut is becoming a major focal point in the pursuit to support overall health and immunity.”

    When the digestive system is functioning properly it serves as a barrier to bacteria, viruses and pathogens, he continued. “Poor digestion leaves the body and the immune system with a lack of nutritional factors that support immune function and the function of the entire body. Research over the past two decades has revealed that gut health is critical to overall wellness and immunity, and that an unhealthy gut contributes to a wide range of health challenges. I’ve seen the evidence of this in my own research, through clinical studies on our various products designed to support digestion. Our studies have shown that numerous health conditions beyond digestive discomfort can be affected when digestion is optimized with the aid of a dietary supplement; for example, reduced frequency of headaches or even general physical pain. Many researchers believe that supporting digestive health and restoring the integrity of the gut barrier will be one of the most important goals of health professionals in the 21st century.”

    Shaheen Majeed, president-worldwide, Sabinsa, East Windsor, NJ, also noted that optimal digestive health support can help improve overall health, well-being, and happiness.
    “Problems related to the digestive system not functioning the way it is supposed to range from common issues like poor nutrient absorption, weight issues, nausea, bloating, constipation, stomach pain, and diarrhea to severe conditions like acid reflux, irritable bowel syndrome, immune and neurological problems, hormonal imbalance, and others.

    Digestive health can also impact quality of life, sleep, productivity, exercise, or socializing with friends. The most time-honored medical systems in the world, Traditional Chinese Medicine and Ayurveda, place a lot of emphasis on healthy digestive function as the core of good health.”

    Mike Bush, president, Ganeden, Cleveland, OH, said digestion in general is incredibly important for overall health because it involves absorption of nutrients to break things down. “It was initially thought that the digestive system simply processed food and absorbed nutrients. Now through things like the Human Microbiome Project and clinical research, we’re seeing that the gut is responsible for neurotransmitter production as well. The immune system resides in the gut, so digestion is clearly correlated to immune health. Inflammatory processes also respond to how well the gut is functioning.”

    Researchers are still at the early stages of understanding what exactly healthy digestion means and how trillions of microorganisms affect health and quality of living, he added. “It’s very much an evolutionary process the industry is going through.”

    Messaging around gut health is also changing, moving beyond just digestion and immune health, according to Alan Rillorta, director of marketing, AIDP, Inc., City of Industry, CA. Advancements in probiotics research are tying the gut into other areas of human health. “As a result, the new gut microbiome message also includes among its growing list: cognition, mood, energy, skin health, weight management, regularity, heart and metabolic health.  Clearly, good gut health is the key to overall human health.”

    According to Euromonitor, in 2016 digestive health positioned products grew 9% globally and reached approximately $55 billion in global retail sales, he noted. “Digestive health is now the third largest product category in the worldwide health and wellness market. The biggest change to the microbiome story is that now gut health is tied into many other areas of good health. This means that gut health will soon tap into, if not already, other health sectors such as weight loss, cognition, or energy.”

    The gut barrier is one of the most important components of the immune system, noted Julie Imperato, marketing manager, France-based Nexira. “Its main role is to absorb nutrients and to serve as one of our body’s most important barriers. It protects us from potential allergic reactions, as well as microbiological and chemical threats. A healthy digestive tract is characterized by the ability to process nutrients through the digestive tract in an efficient manner, in order to correctly nourish the entire organism. People who suffer from an unhealthy digestive tract experience uncomfortable conditions including heart burn, gas, constipation, diarrhea, nausea, abdominal pain and flatulence. Digestive discomfort can be highly debilitating with a strong impact on overall well-being and quality of life.”

    Consumers in Need
    With global growth of bowel pathologies such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD), overall interest in gut health and more specifically the gut barrier has grown, Ms. Imperato continued. “Today, IBS and IBD are common digestive problems affecting both women and men. Nearly 20% of the world’s population is impacted by IBS and millions of people are suffering from IBD. Consumers have a more curative than preventive attitude regarding their digestive health. Half of people are interested in preventive measures and six out of 10 people are interested in drinks and snacks for a better digestive health, according to research from Mintel.”

    In today’s fast-paced world, lifestyle and dietary changes are causing a number of discomforts. The digestive system is the most affected, causing, for example, disturbed activity of digestive enzymes, or enzyme insufficiency, and imbalance in gut microbe populations, said Mr. Majeed. According to the National Digestive Diseases Information Clearinghouse (NDDIC), an information service under the U.S. Department of Health and Human Services, about 60-70 million people are affected by digestive health-related conditions. “At some point, everyone is vulnerable to problems related to altered digestive process,” he said.

    “Consumers from all walks of life are now more aware of the impact a healthy digestive system has on their overall health and wellness, and they are exploring ways to manage and improve digestive health,” Mr. Majeed continued. “As a result, they are reaching out for health ingredients that are natural and safe to support the digestive system.”

    Different microorganisms, viz. bacteria, archaea, viruses, and eukaryotes that reside in and on our bodies make up the human microbiome, he added. “Increased efforts and advancements in modern research have helped us to understand the tremendous potential of this microbiome to impact our physiology, both in health and in disease. These ‘helpful’ and ‘friendly’ microbes are known to influence our metabolic functions, protect against pathogens, and provide immune support.

    “These microbes are generally termed ‘probiotics’ that line the digestive tract and play a significant role in beneficial functions like nutrient absorption, healing digestive issues, mental health illness, allergic disorders, fight infection, and many more,” said Mr. Majeed. “With growing knowledge about probiotics their sale as functional ingredients and dietary supplements have zoomed in recent times. According to Global Market Insights Inc., probiotics’ market size is expected to surpass $64 billion by 2023.”

    Increased Understanding
    Roughly a quarter of U.S. adults specially seek out foods and beverages with high amounts of probiotics or prebiotics, according to a national consumer survey conducted by market research firm Packaged Facts.

    With the increased focus on their potential in recent years, probiotics have emerged as one of the biggest trends today in the food and beverage industry. These products range from the familiar (i.e., yogurt, kefir, kombucha, and infant nutrition) to the cutting edge (probiotics in soda, coffee, tea, soups, and even beer). But regardless of their mainstream status or lack thereof, probiotic and prebiotic products are inherently associated with the hottest wellness trends. These products intertwine themselves with a multitude of other superfood trends, nutritional hot topics, and functional areas—ranging from ancient grains to sports nutrition—further splintering the overall probiotic and prebiotic fortification trend.

    “Probiotics have emerged as a driving trend in the industry,” said David Sprinkle, research director, Packaged Facts. “And given the core importance of gut health, this suggests continued potential for growth of probiotic- and prebiotic-containing foods, as consumers continue to learn more about them and next-generation products make their case in the market.”

    Among probiotic and prebiotic proponents, millennials ages 18-34 have relatively higher interest in probiotic foods and beverages compared to Gen Xers and Baby Boomers, a revelation keeping with the elevated interest in functional foods generally among millennials. Acceptable by this young yet influential consumer segment is an important reason why Packaged Facts forecasts continued positive momentum for probiotic and prebiotics products.

    Beyond millennials, Packaged Facts’ survey found there’s even higher interest in probiotics among those who shop for food in the natural channel, which retains its role as the most significant retail sector for food and nutritional trends.

    According to a 2017 consumer survey from SSI conducted on behalf of Ganeden, 76% of consumers are aware of probiotics overall. Of those consumers, 93% are aware that probiotics can support digestive health and 82% are aware that probiotics can support immune health.

    Parents and millennials were the groups most interested in purchasing probiotic-fortified products, and were willing to pay the most more for those products; 87% of parents would be more likely to buy a product for their children if it was fortified with a probiotic.

    Additionally, 79% of consumers would rather consume probiotics in foods and beverages vs. supplements; 50% of consumers who don’t typically purchase snack foods would do so if they were fortified with a health-promoting ingredient.

    Most consumers who incorporate enzymes into their supplement plan are well educated, according to Dr. Deaton. They invest time researching the products that are best for them, they have brand loyalty, and typically lead healthier and more active lifestyles. 

    “Because our bodies’ natural ability to produce digestive enzymes declines as we age, enzyme supplements are also a popular choice to aid in digestion,” he added. “Enzyme supplements continue to gain recognition among consumers for their role in digestive health and bioavailability of nutrients from foods. The ability to breakdown food into its basic and useful components is of critical concern for consumers interested in functional nutrition for growth, development, and supporting healthy aging.”

    Ingredients in Focus
    The human digestive tract contains about 400 different bacterial species that reduce the growth of harmful bacteria and promote a healthy digestive system, Mr. Majeed said. “And lactic acid-producing bacteria (e.g., Lactobacillus coagulans) are the largest inhabitant group among all. The role of lactic acid-producing bacteria in gastrointestinal microecology has been the subject of extensive research. These microbes are known to possess several potential health or nutritional benefits, including improved nutritional value of food, control of intestinal infections, and helping fight certain allergic conditions. In addition they are found to be helpful in managing certain health conditions like colitis, metabolic syndrome, irritable bowel syndrome, etc.”

    Probiotics such as Lactobacillus and Bifidobacteria have been well studied, and the science is supportive of the benefits of these non-spore probiotic strains, said Dr. Deaton. “Since different strains offer specific benefits, our customers are increasingly seeking a multi-strain formulation of both non-spore and spore forming probiotics. Based on this demand, more science is emerging to support the benefits of spore forming probiotic strains, such as Bacillus subtilis.”

    Additionally, a growing body of evidence suggests that enzyme supplementation plays an integral role in the management of various digestive disorders, and can also be beneficial for other conditions associated with poor digestion, including lactose intolerance. “Going forward, plant-based and microbe-derived enzymes are believed to offer great promise in the advancement of digestive enzyme therapy.”

    The ability to breakdown food into its basic and useful components is of critical concern for consumers interested in functional nutrition, said Dr. Deaton. “The role of digestive enzymes is to break down food-derived fats, carbohydrates, and proteins into smaller substances that our bodies can use. Although the body produces its own digestive enzymes, it may not be enough to completely break down cooked or processed foods.”

    AIDP’s Mr. Rillorta noted there are several probiotic strains and prebiotic ingredients readily available in the market. “Many probiotic strains are available as live culture, freeze dried culture, or spores. Prebiotics, by contrast include carbohydrates such as soluble fibers from plant foods that cannot be digested by the human body. These carbohydrates are used as food by beneficial probiotics, encouraging them to multiply, thereby improving the gut microbiome balance.”

    The advantage of a diet rich in fiber is not only related to the digestive process but also to an increase of bulk, softened stool and a shorter time through the intestinal tract, said Nexira’s Ms. Imperato. “Fibers are considered to increase stool production, to prevent constipation, and may have some prevention effects on colorectal cancer. They also increase satiety sensation which reduces calorie intake; consequently, they may have some benefits for weight management. Moreover, soluble dietary fibers could enable additional positive health activities including colonic fermentation stimulation, reduction of cholesterolemia and a reduction of post-pandrial glycemia and/or insulin.”

    Formulation Considerations
    The primary challenge in all things probiotics is stability of the product, said Mr. Bush. “Anyone can put bacteria in a product and say probiotics are in there, but ensuring they are available when the product is consumed is the real challenge.” Product developers must select microorganisms for the right product, he added.

    Formulators should take care when designing, manufacturing, transporting, or considering long-term storage of a probiotic formula as their stability can be sensitive pertaining to temperature, water humidity, and multi-strain compatibility, said Mr. Rillorta. “Product developers should partner with manufacturers or suppliers who have formulation expertise with the probiotic ingredients they offer. Many prebiotic ingredients are quite stable across a wide range of pH and temperatures. Thus, they work well in various delivery formats either as a standalone ingredient, combined with other prebiotics, or when water activity is low enough, in symbiotic formulations which contain both probiotics and prebiotics together.”

    The majority of the digestive enzyme supplements currently on the market are from animal sources, so enzyme origin would be a great concern for a customer who is vegetarian or vegan, said Mr. Majeed. “Microbial enzymes, often called ‘plant-derived,’ are of bacterial or fungal origin and are produced through fermentation using these microorganisms. Manufacturers can use plant-derived enzymes to produce supplements for commercial purpose. Another advantage of using microbe-derived enzymes is that they may be used at a lower dosage and possess a broader pH range of activity compared to animal-based enzymes.”

    Dr. Deaton said it’s important to understand that the potency of enzymes, referred to as “activity,” is not measured in the same way as other nutritional supplements. “Enzymes are not measured by weight, so the number of milligrams of a product would not describe the true potency. Plus, different enzymes use different units of measurement to determine potency.”

    It takes extensive knowledge and experience working with enzymes and/or probiotics in order to formulate an effective enzyme and/or probiotic based supplement, he added.
    Overall, researchers are just scratching the surface of understanding the complexities of gut health, according to Mr. Rillorta. “In a recent publication (PLOS Biology, August, 2016), the gut flora is estimated to contain about 0.2 kg worth, or 40 trillion bacteria that line the intestinal tract, and is estimated to represent up to 1,000 different species. That’s more gut bacteria cells in our stomach than there are human cells. As you can imagine, there’s a lot of bacteria to identify and study. Over the next 5 to 10 years we’ll begin to have a better understanding of what different probiotic species do both individually and in combination, and as a result we’ll see more pro and prebiotic products marketed toward specific functions and uses.”

    As research progresses, a more complete picture of how billions of organisms of the microbiome interact and respond to changes in the diet will come into focus, said Dr. Deaton. “When we’re able to profile the microbial population of a healthy individual and compare it to that of someone with a specific health condition, opportunities to influence the shifting of bacterial population through diet and supplementation will continue to emerge.” 
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