By Lisa Olivo, Associate Editor04.02.18
What better way to encourage female empowerment than by providing women with safe, natural, and convenient health products? In today’s marketplace, a wide range of formulas are available to support the healthcare goals of women at all walks of life. According to the Council for Responsible Nutrition (CRN) 2017 Survey on Dietary Supplements (conducted by Ipsos Public Affairs), 50% of women reported taking supplements to support overall health and wellness benefits. Meanwhile, 34% said they use supplements to help fill nutritional gaps, and 28% seek out support for bone health. The top products female supplement users reported taking were multivitamins (73%), vitamin D (39%), calcium (31%), vitamin C (29%), and vitamin B/B Complex (26%).
“Depending on what stage of life a woman is at, and as women age, their hormones fluctuate and their needs greatly vary,” observed Dr. Paul Clayton, chief scientific advisor at Gencor, Irvine, CA. “Women today are seeking natural ingredients for their specific health needs that are effective, research-based and safe with little to no side effects. Women want ingredients that will treat their health concerns and address multiple symptoms, but still shy away from the ‘one-size-fits-all’ approach.”
Individual Approach
With such a wide spectrum of health issues impacting women across their lifespan, an increasing number of savvy female supplement users are looking to cultivate nutritional regimens tailored toward their individual wellness concerns.
Consumer health analyst at London-based Euromonitor International, Keena Roberts, said an overriding trend in the women’s health supplement space is a move away from standard multivitamin formats. Instead, she said women are taking multiple, single-ingredient supplements and creating their own wellness formulas targeting their specific health concerns.
“Individualization is a huge trend,” said Ms. Roberts. “People don’t really want to take a ‘catch all’ pill like they have in the past. They’re moving away from the idea that this one multivitamin formula is appropriate for every person. Women are feeling empowered by the idea that they can avoid any ingredients they don’t want, and just take what they need for their own specific health profile.”
Part of this push away from multivitamin formulas involves the “free-from” trend seen in the food and beverage category. Consumers are looking to avoid what they perceive as unnecessary, or unnatural ingredients. “People are really weary of the concept of ‘chemicals’ in their foods and supplements, so they really are more comfortable with the idea of only taking what they need,” Ms. Roberts observed.
When a consumer does take a multivitamin, the product often caters to her specific demographic, or markets benefits for a specific health concern. As an example, Ms. Roberts pointed to the dietary supplement Centrum Silver, a multivitamin formula designed for women 50+, which promotes its support of bone, heart, brain, and eye health on the front of its package.
Ms. Roberts indicated that today’s female supplement user is proactive in seeking out information on nutritional ingredients and is increasingly educated about the ways in which these products can benefit their health. “Female consumers know their stuff, and are turning to the Internet, and their peer group through social media to research their symptoms. They’re asking what supplements may have worked well for their friends going through these same issues. It’s with this information that they’re creating their own individualized supplement regimen.”
Laura A. Mahecha, industry manager, Healthcare and I&I products, for the consulting and market intelligence experts at Kline Group, New York, NY, also noted the rise of informed consumers, particularly among millennial women, who are seeking out more information about products they’re putting in their bodies. “Clean labels are starting to become a factor in the nutritional supplements market after taking hold among millennial consumers when it comes to foods, beverages, and personal care products. New brands such as Ritual and Tespo are said to be pure and provide clean labels for consumers. These brands are not mainstream yet and are sold online or via subscription, and appeal to health-conscious consumers, particularly millennials, who are interested in using products with clean labels.” Mainstream brands resonating with millennial women by promoting that they are “free from” harmful or non-beneficial ingredients include Olly and Smarty Pants, she added.
Menopause & Aging
As the global population ages, more women are dealing with menopause, and the various ways this phase of life can impact their health.
“According to the North American Menopause Society (NAMS), about 6,000 women reach menopause daily,” said Dr. Clayton of Gencor. “With the growing aging population and the various changes in hormone levels women face during this time, we are seeing a surge in natural remedies for menopausal symptoms.”
Maintaining good health into their golden years is a significant concern for many aging women, which is leading them to consider natural products and dietary supplements to prolong their healthy, active lifestyles.
“Today’s woman is lucky in that she has many innovative products and ingredients available to her to help maintain optimal health, at any age,” posited Samantha Ford, business development director for AIDP, City of Industry, CA. “Staying active well into their later years is a big priority for women. The saying ‘today’s 60 is the new 40’ is also a testament to women wanting to look and feel their best, no matter their age.”
Ms. Roberts of Euromonitor pointed to the issues of decreased estrogen levels and loss of bone mass as huge concerns for women dealing with menopause. She highlighted ingredients such as calcium, as well as phosphorous, magnesium, B vitamins, selenium, and zinc, as being of significant importance to this demographic.
“Ninety percent of peak bone mass is attained before age 20, with peak bone mass being reached between the ages of 30 and 35 for women,” explained Kate Quackenbush, director of communications with NattoPharma, global leader in vitamin K2 research and development and exclusive global supplier of MenaQ7 Vitamin K2 as MK-7.
NattoPharma is based in Oslo, Norway, and its North American subsidiary is based in Edison, NJ. “With menopause, women experience rapid decline in bone loss. This loss eventually slows, but it continues throughout post-menopausal years.”
Additionally, Ms. Quackenbush emphasized how issues surrounding cardiovascular disease (CVD) are of critical importance to aging women. “Once thought of as a man’s disease, more women are now afflicted with CVD.” She cited data from the American Heart Association indicating women are outpacing men when it comes to CVD; in the U.S., 70.9% of women aged 60-79 have CVD (compared to 70.2% of men), while among those 80+, 87.1% of women have CVD (with men at 83%).
Vitamin K2, she said, can serve women by simultaneously supporting bone health and cardiovascular health, with the backing of strong scientific research. “Porous bones and the development of cardiovascular diseases are not simply age-related. Rather, they are indicative of chronic vitamin K2 deficiency,” stated Ms. Quackenbush.
A three-year study of 244 healthy post-menopausal women taking 180 mcg dose of MenaQ7 vitamin K2 as MK-7 daily yielded unprecedented results for the support of bone health, she said. First, researchers found that clinically statistically significant protection of the vertebrae and the hip (femoral neck) against bone loss resulted from a daily nutritional dose of MenaQ7. After three years of supplementation, maintenance in both bone mineral content and bone mineral density were statistically significant in the MenaQ7 group, as well as statistically improved bone strength (Osteoporosis International, 2013).
Additionally, this same group of women was examined using pulse wave velocity and ultrasound techniques. Researchers observed the Beta Stiffness Index in the MenaQ7 group with initial high arterial stiffness had decreased significantly compared to the slight increase in the placebo group after three years of supplementation at a nutritional daily dose (Thrombosis and Haemostasis, 2015). Results confirmed that MenaQ7 not only inhibited age-related stiffening of the artery walls, but also made a statistically significant improvement in vascular elasticity.
“These findings are significant because this is the first time any form of vitamin K has shown these benefits,” noted Ms. Quackenbuch. “This is also true for other therapies—to date, no compound has demonstrated these benefits.”
A less recognized, but emerging ingredient for bone health is vitamin E. “Vitamin E is not the first supplement that comes to mind when thinking of bone health, as opposed to the more popular vitamins D and K, and calcium,” commented Anne Trias, MS, American River Nutrition, Inc., Hadley, MA. However, over the past decade one form of vitamin E—tocotrienol—has been researched extensively for this application. “The pre-clinical evidence is strong, with study models mimicking a variety of osteoporosis risk factors as caused by estrogen and testosterone deficiency, oxidation, drug side effects, and a poor diet,” noted Ms. Trias. “These studies concluded that tocotrienols promote bone formation and encouraged researchers to seek a translational approach. In response, a clinical study was conducted in post-menopausal women with osteopenia.”
A study recently published in Osteoporosis International (January 2018), examined tocotrienol’s link to bone health in osteopenic women. According to the National Osteoporosis Foundation, 22 million American women have osteopenia, which is defined by a thinning of bone mass, and is a precursor and serious risk factor for the development of osteoporosis.
In the 12-week, randomized, double-blind, placebo-controlled clinical trial of 87 postmenopausal women, American River Nutrition’s DeltaGold annatto-derived tocotrienol was administered at two dosages daily (300 and 600 mg). “Results suggest that tocotrienols stabilized bone formation as signified by an increase of about 40-100% in the serum bone-specific alkaline phosphatase (BALP) to urine N-terminal telopeptide (NTX) ratio, and inhibited breakdown of bone as evidenced by a 7-24% decrease in the nuclear factorkappaB ligand (sRANKL) to and serum osteoprotegerin (OPG) ratio,” Ms. Trias reported. “The osteoprotective effects of tocotrienol may be in part mediated through a reduction of oxidative stress, which was indicated by a 49% decrease in the oxidative stress marker 8-hydroxy-2’-deoxyguanosine (8-OHdG).”
Aging consumers are also linking bone health with their concerns regarding the strength and flexibility of their joints, according to Ms. Ford of AIDP.
The company offers KoAct, a patented chelate of collagen and calcium, which has been clinically proven to improve bone mineral density, bone strength, and flexibility, according to the company. Bone mass, Ms. Ford explained, is made up of 75% calcium and inorganic minerals, and 25% collagen. “The collagen component is critical to bone structure and function because it helps keep bones flexible and absorb impact, especially during physical activity. KoAct is ideal for women who pursue active lifestyles or those concerned with bone health.” AIDP’s unique collagen formula delivers support for bone mineral density, in addition to a fibrous protein network that supports bone structure and helps bone withstand daily impact.
Additionally, AIDP offers KollaGen II-xs a specialized collagen type II ingredient designed to support joint health, including range of motion, flexibility, and overall joint comfort; as well as a relatively new ingredient, TendoGuard, a proprietary (patented) dietary supplement formula that provides a blend of 100% avian eggshell membrane and sternum cartilage to support healthy mechanical properties of connective tissue.
Collagen doesn’t just support healthy bones and joints but can also offer benefits for aging skin. “Beauty truly starts from within,” said Ms. Ford of AIDP. “While nothing can replace a healthy diet and active, balanced lifestyle, there are a number of natural ingredient solutions that can boost the look and feel of skin by working from within. Perhaps one of the hottest trends in this category is collagen.”
Aging depletes the body’s natural supply of collagen, according to Ms. Ford, and supplementation helps preserve skin elasticity. “The body contains roughly 30% collagen, 70% of which is in our skin. With aging, collagen production slows down on the inside, causing the skin to lose its elasticity and suppleness on the outside.”
Research has shown that supplementing with collagen can help restore skin elasticity, improve skin firmness, hydration, and reduce the appearance of some fine lines and wrinkles, she said. “AIDP’s Naticol is a collagen that’s been clinically shown to improve skin appearance with as little as 2.5 grams per day.”
Fluctuating hormone levels during menopause can impact quality of life in a variety of ways, ranging from hot flashes to sexual function.
One popular ingredient that can help women maintain a healthy hormonal balance is fenugreek or fenugreek extract, Dr. Clayton noted. Gencor offers Libifem, a branded fenugreek extract containing saponins, which support healthy levels of estradiol in women.
“Recently, this extract has been clinically shown to help alleviate typical symptoms of menopause as well as promote healthy sexual desire and vitality in women,” Dr. Clayton noted. “Gencor has conducted extensive pre-clinical and clinical research on Libifem with the results showing a significant reduction in menopausal symptoms and frequency of hot flashes and night sweats by over 50%.”
Libifem also offers an herbal solution targeting the female hormonal estradiol, thus helping to boost sexual desire. “The loss of sexual desire affects one in every four women and can affect adult women of all ages. But despite its prevalence, there are only a few supplement options available. Libifem is an ingredient that can support both female sexual health and improve quality of life during menopause.”
Pregnancy & Reproductive Health
As millennial women enter their peak reproductive years, new moms and moms-to-be are seeking out nutritional products that are safe, natural, and transparently formulated.
Consumer research from New York, NY-based investment banking firm William Hood & Company suggested millennial moms are the “chief millennial officer” in their families, representing a $200 billion spending block in the U.S. Millennial moms are favoring personalized products that are convenient and easy to use; are transparently produced and labeled; and offer a boost for overall health. There are currently over 16 million millennial moms in the U.S., with 1 million joining their ranks each year.
“It is well-known that women influence 70-80% of all household spending, while also being key information gatherers when it comes to what they themselves consume, and what is put in their family’s bodies,” said Ms. Trias of American River Nutrition. Mothers are particularly discerning consumers, she suggested, and are carefully evaluating what’s listed on product labels.
While efficacy is a key consideration for this group, the desire for clean label ingredients is often a deciding factor, particularly during pregnancy.
“Enhanced delivery formats often tout increased absorption of nutrients, but they have added ingredients that do not conform with clean label expectations,” cautioned Ms. Trias. “Therefore, women may choose supplements with the least number of additives and foreign-sounding components, and simply rely on fat emulsification (through food) to enhance absorption of fat-soluble ingredients such as vitamins A, D, E (tocopherols and tocotrienols), and K.”
Today’s moms are also looking for clinically backed ingredients when selecting a nutritional supplement. Luckily, emerging research continues to validate numerous supplements for supporting women’s health during conception, pregnancy, lactation, and beyond.
A 2018 study published in BMJ Open found women who consumed probiotic milk during pregnancy had a reduced risk of developing preeclampsia in late pregnancy. The observational study examining the Norwegian Mother and Child Cohort Study also found women who drank probiotic milk at the beginning of their pregnancy had a lower risk of spontaneous preterm delivery. The researchers concluded that “if future randomized controlled trials could establish a causal association between probiotics consumption and reduced risk of preeclampsia and preterm delivery, recommending probiotics would be a promising public health measure to reduce these adverse pregnancy outcomes.”
Another study recently published in PLOS Medicine examined pregnant women taking fish oil supplements and suggested consuming omega-3s during pregnancy could help reduce the incidence of food allergies in their offspring. The large analysis of past trials by Imperial College London found consumption of fish oil was linked to a 30% reduction in egg allergy risk by the age of one. In addition, the study found benefits for probiotic supplementation. Pregnant mothers who used probiotic supplements had a 22% reduction in the risk of eczema developing in their children up until the age of three.
A 2017 systemic review published in Nutrients evaluated mounting evidence suggesting pregnant women with low vitamin D levels are at an increased risk for hypertensive disorders. While results of the review were inconclusive, the researchers urged the need for further research on the subject.
Research has also made a strong case for including vitamin K2 in prenatal supplements, Ms. Quackenbush of NattoPharma said, not only to support the mother, but to combat the prevalence of deficiency in children and to provide them the support of this vital nutrient.
“Studies indicate that maternal supplementation with vitamin K can help mitigate the problem of a low transfer of maternal K across the placenta barrier (Food and Nutrition Board, Institute of Medicine, 2001).”
Menstruation & PMS
The uncomfortable and challenging physical and emotional symptoms associated with premenstrual syndrome (PMS) and menstruation can be a hardship for women. As more women are looking to curtail their use of pharmaceutical and even OTC drugs, supplements with natural ingredients have become an appealing alternative for women attempting to offset the negative impact of these monthly symptoms.
“The struggle with PMS is all too familiar,” said Sonny Stafford, vice president of marketing, JDS Therapeutics, Purchase NY. “Many women struggle with irritability, mood swings, and a general feeling of unease called dysphoria in the days leading up to their menstrual period. When these symptoms happen month after month and are bothersome or disruptive, the condition is called PMS.”
According to statistics from the Office of Women’s Health, U.S. Department of Health and Human Services, over 90% of women report experiencing symptoms of PMS, which can include bloating, headaches, and moodiness.
“Millions of women from teenagers to women in their early 40s suffer from PMS. To combat the most disruptive symptoms, some healthcare professionals prescribe birth control pills, antidepressants, or anti-anxiety medications, but these have side effects and can be habit-forming,” explained Mr. Stafford. “There is no one-size-fits-all answer for those suffering from PMS symptoms, but there are some very good plant-based options like Serenol.”
JDS Therapeutics offers Serenol, a clinically effective dietary supplement that has been shown to be safe and effective at treating more of the emotional and some physical symptoms of PMS. Active ingredients in Serenol include a flower pollen extract, Chromax chromium picolinate, and a low dose of royal jelly.
Describing the science supporting this product, Mr. Stafford cited several studies. “The ingredients in Serenol have been shown to help with irritability, mood fluctuations, water retention, sleep disturbances, food cravings, and premenstrual weight gain, with side effects no different from a sugar pill and no observed drug interactions.”
Urinary Tract Health
Urinary tract infection (UTI) is one of the most common types of infection and accounts for around 8.1 million visits to a doctor every year, according to John Deaton, PhD, vice president of science and technology for Deerland Enzymes & Probiotics, Kennesaw, GA. “More than half of all women will experience at least one UTI during their lifetime, with 20-30% experiencing recurrent UTIs.”
The primary catalyst of most UTIs is Escherichia coli, a common bacterium found in the normal flora of the intestine. “These bacteria that live in the gut can spread to the urinary tract, attach to the surface and cause an infection,” explained Dr. Deaton. He suggested that regular use of probiotics could potentially help reduce the risk of UTIs, especially after a course of antibiotics. “Women with recurring UTIs may benefit from a more targeted approach, aiming to decrease the occurrence of the E. coli that so often is the culprit.”
Deerland’s prebiotic ingredient PreforPro is designed to support urinary tract health by crowding out the bad bacteria in the gut, such as E. coli, and reducing the likelihood of UTI. Dr. Deaton said PreforPro “goes to work on these undesirable bacteria in the gut by destabilizing the bacterial cell wall, releasing nutrients into the environment which can then be consumed by the good bacteria within the GI tract.” He added that unlike traditional prebiotics, which are fiber or carbohydrate-based, PreforPro doesn’t cause unwanted side effects like gas and bloating.
Digestive Health
Digestive health issues have emerged as a top concern among female consumers, leading to interest among women young and old. “Women’s gastrointestinal (GI) systems are vastly different than that of men’s,” said Dr. Deaton. Besides the obvious physical dissimilarities, he said female hormones have a tremendous effect on the digestive tract.
He pointed to hormonal issues as well as a GI system that’s more sensitive to irritants as prime reasons why women are more likely to suffer from digestive issues and stomach upset than men. For instance, he said women are five times more likely to develop irritable bowel syndrome (IBS) compared to men.
“As young women move out of adolescence and the menstrual cycle gets more regular, some may begin to experience alternating bouts of constipation or diarrhea. In addition, premenstrual syndrome (PMS) could come with digestive issues like gas and bloating,” said Dr. Deaton. Pregnant women, he added, are highly likely to experience constipation.
Probiotics offer unique support for a woman’s digestive system by helping maintain a healthy balance in the intestinal microbiota, he noted. “In a clinical study, the probiotic strain Bacillus subtilis DE111 was shown to support a healthy bowel index, improving occasional constipation and/or diarrhea among the participants (Journal of Probiotics & Health, 2018).”
Prebiotic fiber is also gaining more attention among female supplement users for its support of digestive health issues. “It’s no secret that good health starts with optimal digestion, and ingredients for digestive health are a huge market for women,” said Ms. Ford of AIDP. “Probiotics and prebiotics are getting a lot of attention in the media, and more and more functional ingredient companies like AIDP are researching and innovating in this area.”
AIDP’s PreticX XOS (xylooligosaccharide) prebiotic has been shown in human clinical studies to boost healthy bifidobacteria, while reducing unhealthy bacteria in the gut. “A major advantage of PreticX is its clinical effectiveness at low dosages, compared to other ingredients in this space, thereby greatly reducing undesirable side effects.”
Another example is AIDP’s Livaux prebiotic, a whole kiwifruit ingredient shown to increase healthy Faecalibacterium prausnitzii (F.prau). “F.prau is the most abundant bacteria species in the gut, accounting for about 8% of the total colonic microbiota, and is extremely important for production of short chain fatty acids in the gut,” explained Ms. Ford. “Its major roles include maintaining gut barrier function and reducing oxidative stress. Despite its importance, F. prau is sensitive to oxygen and cannot be obtained through supplemented probiotics, lending to the uniqueness of Livaux and its ability to naturally support healthy F. prau levels.”
Emerging Health Indications
Ms. Mahecha with Kline Group predicted scientific research on the body’s microbiome could yield exciting solutions for digestive health, particularly for women. Looking ahead, she anticipated “considerable innovations if new probiotics can be formulated to impact the microbiome to be more effective for prevention of digestive ailments, improving immunity, nutrient absorption, or boosting metabolism.”
Dr. Deaton echoed this sentiment, suggesting the continued study of probiotics will open up their use to expanding health applications outside of digestive health. “Probiotics also play a role in maintaining vaginal health, by helping to maintain a slightly acidic environment within the vagina. This helps to reduce the overgrowth of harmful bacteria. Research shows that Lactobaccilus rhamnosus colonizes the intestine as well as vagina, and offers additional benefits in mood health, digestive health, and maintaining healthy body weight.”
Additionally, he said healthy gut bacteria helps regulate hormones, including estrogen and the thyroid. “The actual activation of many hormones happens, in large part, as a response to the action of gut bacteria. The probiotic strain Lactobaccilus reuteri has been shown to support thyroid health, in addition to its benefits for gut and vaginal health.”
Gencor’s Dr. Clayton referenced ongoing controversy around the safety of hormone replacement therapy as an issue that will continue to drive women to safe, natural alternatives.
“Women are looking more and more to natural botanical solutions to address age-related health concerns and are wanting supplements that are clinically-studied, safe and unadulterated.” He also suggested botanicals supporting women’s sexual health could be a future area of growth. “In the past, there have not been many botanical health options for women regarding healthy sexual function and menopause, however, with the aging population growing, there is a need to formulate new products to help address this core base of consumers.”
A primary concern emerging among women in their reproductive years is the issue of infertility. In the U.S., approximately 10% of women (6.1 million) ages 15-44 have difficulty getting pregnant or staying pregnant, according to the Centers for Disease Control and Prevention (CDC).
In response, a variety of dietary supplements supporting reproductive health and pre-conception have popped up on store shelves. The brand Premama offers a Fertility Reproductive Support Supplement—a drink mix formulated with Myo-Inositol, an ingredient clinically shown to support and improve ovulatory function and egg quality. In addition, as part of a multi stage supplement program supporting conception, pregnancy, and lactation, Premama developed a Birth Control Cleanse berry-flavored drink mix designed to prepare a woman’s body for pregnancy.
Rainbow Light also launched its new Rainbow Light Vibrance For The First Thousand Days product line, featuring six different multivitamins for women planning to conceive, moms-to-be, new moms, and toddlers. The first supplement in the regimen is a Pre-Conception Multivitamin formulated to maintain health and prepare for conception, providing highly absorbable folate to reduce the risk of neural tube defects in infants.
The line also includes a Trimester 1 Prenatal Multivitamin with folate plus choline for baby’s healthy brain and neural tube development; Trimester 2 Prenatal Multivitamin featuring chromium to support normal healthy blood sugar for mom; Trimester 3 Prenatal Multivitamin, which targets promoting the baby’s growth and development while supporting the mom’s healthy circulation and normal blood sugar; and a Postnatal Multivitamin designed to support energy, lactation, and postpartum healing while offering a customized Lactation Blend to support healthy milk production and hormone balance for breastfeeding. The First Thousand Days product line also offers a NutriStart Plus Multivitamin Powder for toddlers.
“Depending on what stage of life a woman is at, and as women age, their hormones fluctuate and their needs greatly vary,” observed Dr. Paul Clayton, chief scientific advisor at Gencor, Irvine, CA. “Women today are seeking natural ingredients for their specific health needs that are effective, research-based and safe with little to no side effects. Women want ingredients that will treat their health concerns and address multiple symptoms, but still shy away from the ‘one-size-fits-all’ approach.”
Individual Approach
With such a wide spectrum of health issues impacting women across their lifespan, an increasing number of savvy female supplement users are looking to cultivate nutritional regimens tailored toward their individual wellness concerns.
Consumer health analyst at London-based Euromonitor International, Keena Roberts, said an overriding trend in the women’s health supplement space is a move away from standard multivitamin formats. Instead, she said women are taking multiple, single-ingredient supplements and creating their own wellness formulas targeting their specific health concerns.
“Individualization is a huge trend,” said Ms. Roberts. “People don’t really want to take a ‘catch all’ pill like they have in the past. They’re moving away from the idea that this one multivitamin formula is appropriate for every person. Women are feeling empowered by the idea that they can avoid any ingredients they don’t want, and just take what they need for their own specific health profile.”
Part of this push away from multivitamin formulas involves the “free-from” trend seen in the food and beverage category. Consumers are looking to avoid what they perceive as unnecessary, or unnatural ingredients. “People are really weary of the concept of ‘chemicals’ in their foods and supplements, so they really are more comfortable with the idea of only taking what they need,” Ms. Roberts observed.
When a consumer does take a multivitamin, the product often caters to her specific demographic, or markets benefits for a specific health concern. As an example, Ms. Roberts pointed to the dietary supplement Centrum Silver, a multivitamin formula designed for women 50+, which promotes its support of bone, heart, brain, and eye health on the front of its package.
Ms. Roberts indicated that today’s female supplement user is proactive in seeking out information on nutritional ingredients and is increasingly educated about the ways in which these products can benefit their health. “Female consumers know their stuff, and are turning to the Internet, and their peer group through social media to research their symptoms. They’re asking what supplements may have worked well for their friends going through these same issues. It’s with this information that they’re creating their own individualized supplement regimen.”
Laura A. Mahecha, industry manager, Healthcare and I&I products, for the consulting and market intelligence experts at Kline Group, New York, NY, also noted the rise of informed consumers, particularly among millennial women, who are seeking out more information about products they’re putting in their bodies. “Clean labels are starting to become a factor in the nutritional supplements market after taking hold among millennial consumers when it comes to foods, beverages, and personal care products. New brands such as Ritual and Tespo are said to be pure and provide clean labels for consumers. These brands are not mainstream yet and are sold online or via subscription, and appeal to health-conscious consumers, particularly millennials, who are interested in using products with clean labels.” Mainstream brands resonating with millennial women by promoting that they are “free from” harmful or non-beneficial ingredients include Olly and Smarty Pants, she added.
Menopause & Aging
As the global population ages, more women are dealing with menopause, and the various ways this phase of life can impact their health.
“According to the North American Menopause Society (NAMS), about 6,000 women reach menopause daily,” said Dr. Clayton of Gencor. “With the growing aging population and the various changes in hormone levels women face during this time, we are seeing a surge in natural remedies for menopausal symptoms.”
Maintaining good health into their golden years is a significant concern for many aging women, which is leading them to consider natural products and dietary supplements to prolong their healthy, active lifestyles.
“Today’s woman is lucky in that she has many innovative products and ingredients available to her to help maintain optimal health, at any age,” posited Samantha Ford, business development director for AIDP, City of Industry, CA. “Staying active well into their later years is a big priority for women. The saying ‘today’s 60 is the new 40’ is also a testament to women wanting to look and feel their best, no matter their age.”
Ms. Roberts of Euromonitor pointed to the issues of decreased estrogen levels and loss of bone mass as huge concerns for women dealing with menopause. She highlighted ingredients such as calcium, as well as phosphorous, magnesium, B vitamins, selenium, and zinc, as being of significant importance to this demographic.
“Ninety percent of peak bone mass is attained before age 20, with peak bone mass being reached between the ages of 30 and 35 for women,” explained Kate Quackenbush, director of communications with NattoPharma, global leader in vitamin K2 research and development and exclusive global supplier of MenaQ7 Vitamin K2 as MK-7.
NattoPharma is based in Oslo, Norway, and its North American subsidiary is based in Edison, NJ. “With menopause, women experience rapid decline in bone loss. This loss eventually slows, but it continues throughout post-menopausal years.”
Additionally, Ms. Quackenbush emphasized how issues surrounding cardiovascular disease (CVD) are of critical importance to aging women. “Once thought of as a man’s disease, more women are now afflicted with CVD.” She cited data from the American Heart Association indicating women are outpacing men when it comes to CVD; in the U.S., 70.9% of women aged 60-79 have CVD (compared to 70.2% of men), while among those 80+, 87.1% of women have CVD (with men at 83%).
Vitamin K2, she said, can serve women by simultaneously supporting bone health and cardiovascular health, with the backing of strong scientific research. “Porous bones and the development of cardiovascular diseases are not simply age-related. Rather, they are indicative of chronic vitamin K2 deficiency,” stated Ms. Quackenbush.
A three-year study of 244 healthy post-menopausal women taking 180 mcg dose of MenaQ7 vitamin K2 as MK-7 daily yielded unprecedented results for the support of bone health, she said. First, researchers found that clinically statistically significant protection of the vertebrae and the hip (femoral neck) against bone loss resulted from a daily nutritional dose of MenaQ7. After three years of supplementation, maintenance in both bone mineral content and bone mineral density were statistically significant in the MenaQ7 group, as well as statistically improved bone strength (Osteoporosis International, 2013).
Additionally, this same group of women was examined using pulse wave velocity and ultrasound techniques. Researchers observed the Beta Stiffness Index in the MenaQ7 group with initial high arterial stiffness had decreased significantly compared to the slight increase in the placebo group after three years of supplementation at a nutritional daily dose (Thrombosis and Haemostasis, 2015). Results confirmed that MenaQ7 not only inhibited age-related stiffening of the artery walls, but also made a statistically significant improvement in vascular elasticity.
“These findings are significant because this is the first time any form of vitamin K has shown these benefits,” noted Ms. Quackenbuch. “This is also true for other therapies—to date, no compound has demonstrated these benefits.”
A less recognized, but emerging ingredient for bone health is vitamin E. “Vitamin E is not the first supplement that comes to mind when thinking of bone health, as opposed to the more popular vitamins D and K, and calcium,” commented Anne Trias, MS, American River Nutrition, Inc., Hadley, MA. However, over the past decade one form of vitamin E—tocotrienol—has been researched extensively for this application. “The pre-clinical evidence is strong, with study models mimicking a variety of osteoporosis risk factors as caused by estrogen and testosterone deficiency, oxidation, drug side effects, and a poor diet,” noted Ms. Trias. “These studies concluded that tocotrienols promote bone formation and encouraged researchers to seek a translational approach. In response, a clinical study was conducted in post-menopausal women with osteopenia.”
A study recently published in Osteoporosis International (January 2018), examined tocotrienol’s link to bone health in osteopenic women. According to the National Osteoporosis Foundation, 22 million American women have osteopenia, which is defined by a thinning of bone mass, and is a precursor and serious risk factor for the development of osteoporosis.
In the 12-week, randomized, double-blind, placebo-controlled clinical trial of 87 postmenopausal women, American River Nutrition’s DeltaGold annatto-derived tocotrienol was administered at two dosages daily (300 and 600 mg). “Results suggest that tocotrienols stabilized bone formation as signified by an increase of about 40-100% in the serum bone-specific alkaline phosphatase (BALP) to urine N-terminal telopeptide (NTX) ratio, and inhibited breakdown of bone as evidenced by a 7-24% decrease in the nuclear factorkappaB ligand (sRANKL) to and serum osteoprotegerin (OPG) ratio,” Ms. Trias reported. “The osteoprotective effects of tocotrienol may be in part mediated through a reduction of oxidative stress, which was indicated by a 49% decrease in the oxidative stress marker 8-hydroxy-2’-deoxyguanosine (8-OHdG).”
Aging consumers are also linking bone health with their concerns regarding the strength and flexibility of their joints, according to Ms. Ford of AIDP.
The company offers KoAct, a patented chelate of collagen and calcium, which has been clinically proven to improve bone mineral density, bone strength, and flexibility, according to the company. Bone mass, Ms. Ford explained, is made up of 75% calcium and inorganic minerals, and 25% collagen. “The collagen component is critical to bone structure and function because it helps keep bones flexible and absorb impact, especially during physical activity. KoAct is ideal for women who pursue active lifestyles or those concerned with bone health.” AIDP’s unique collagen formula delivers support for bone mineral density, in addition to a fibrous protein network that supports bone structure and helps bone withstand daily impact.
Additionally, AIDP offers KollaGen II-xs a specialized collagen type II ingredient designed to support joint health, including range of motion, flexibility, and overall joint comfort; as well as a relatively new ingredient, TendoGuard, a proprietary (patented) dietary supplement formula that provides a blend of 100% avian eggshell membrane and sternum cartilage to support healthy mechanical properties of connective tissue.
Collagen doesn’t just support healthy bones and joints but can also offer benefits for aging skin. “Beauty truly starts from within,” said Ms. Ford of AIDP. “While nothing can replace a healthy diet and active, balanced lifestyle, there are a number of natural ingredient solutions that can boost the look and feel of skin by working from within. Perhaps one of the hottest trends in this category is collagen.”
Aging depletes the body’s natural supply of collagen, according to Ms. Ford, and supplementation helps preserve skin elasticity. “The body contains roughly 30% collagen, 70% of which is in our skin. With aging, collagen production slows down on the inside, causing the skin to lose its elasticity and suppleness on the outside.”
Research has shown that supplementing with collagen can help restore skin elasticity, improve skin firmness, hydration, and reduce the appearance of some fine lines and wrinkles, she said. “AIDP’s Naticol is a collagen that’s been clinically shown to improve skin appearance with as little as 2.5 grams per day.”
Fluctuating hormone levels during menopause can impact quality of life in a variety of ways, ranging from hot flashes to sexual function.
One popular ingredient that can help women maintain a healthy hormonal balance is fenugreek or fenugreek extract, Dr. Clayton noted. Gencor offers Libifem, a branded fenugreek extract containing saponins, which support healthy levels of estradiol in women.
“Recently, this extract has been clinically shown to help alleviate typical symptoms of menopause as well as promote healthy sexual desire and vitality in women,” Dr. Clayton noted. “Gencor has conducted extensive pre-clinical and clinical research on Libifem with the results showing a significant reduction in menopausal symptoms and frequency of hot flashes and night sweats by over 50%.”
Libifem also offers an herbal solution targeting the female hormonal estradiol, thus helping to boost sexual desire. “The loss of sexual desire affects one in every four women and can affect adult women of all ages. But despite its prevalence, there are only a few supplement options available. Libifem is an ingredient that can support both female sexual health and improve quality of life during menopause.”
Pregnancy & Reproductive Health
As millennial women enter their peak reproductive years, new moms and moms-to-be are seeking out nutritional products that are safe, natural, and transparently formulated.
Consumer research from New York, NY-based investment banking firm William Hood & Company suggested millennial moms are the “chief millennial officer” in their families, representing a $200 billion spending block in the U.S. Millennial moms are favoring personalized products that are convenient and easy to use; are transparently produced and labeled; and offer a boost for overall health. There are currently over 16 million millennial moms in the U.S., with 1 million joining their ranks each year.
“It is well-known that women influence 70-80% of all household spending, while also being key information gatherers when it comes to what they themselves consume, and what is put in their family’s bodies,” said Ms. Trias of American River Nutrition. Mothers are particularly discerning consumers, she suggested, and are carefully evaluating what’s listed on product labels.
While efficacy is a key consideration for this group, the desire for clean label ingredients is often a deciding factor, particularly during pregnancy.
“Enhanced delivery formats often tout increased absorption of nutrients, but they have added ingredients that do not conform with clean label expectations,” cautioned Ms. Trias. “Therefore, women may choose supplements with the least number of additives and foreign-sounding components, and simply rely on fat emulsification (through food) to enhance absorption of fat-soluble ingredients such as vitamins A, D, E (tocopherols and tocotrienols), and K.”
Today’s moms are also looking for clinically backed ingredients when selecting a nutritional supplement. Luckily, emerging research continues to validate numerous supplements for supporting women’s health during conception, pregnancy, lactation, and beyond.
A 2018 study published in BMJ Open found women who consumed probiotic milk during pregnancy had a reduced risk of developing preeclampsia in late pregnancy. The observational study examining the Norwegian Mother and Child Cohort Study also found women who drank probiotic milk at the beginning of their pregnancy had a lower risk of spontaneous preterm delivery. The researchers concluded that “if future randomized controlled trials could establish a causal association between probiotics consumption and reduced risk of preeclampsia and preterm delivery, recommending probiotics would be a promising public health measure to reduce these adverse pregnancy outcomes.”
Another study recently published in PLOS Medicine examined pregnant women taking fish oil supplements and suggested consuming omega-3s during pregnancy could help reduce the incidence of food allergies in their offspring. The large analysis of past trials by Imperial College London found consumption of fish oil was linked to a 30% reduction in egg allergy risk by the age of one. In addition, the study found benefits for probiotic supplementation. Pregnant mothers who used probiotic supplements had a 22% reduction in the risk of eczema developing in their children up until the age of three.
A 2017 systemic review published in Nutrients evaluated mounting evidence suggesting pregnant women with low vitamin D levels are at an increased risk for hypertensive disorders. While results of the review were inconclusive, the researchers urged the need for further research on the subject.
Research has also made a strong case for including vitamin K2 in prenatal supplements, Ms. Quackenbush of NattoPharma said, not only to support the mother, but to combat the prevalence of deficiency in children and to provide them the support of this vital nutrient.
“Studies indicate that maternal supplementation with vitamin K can help mitigate the problem of a low transfer of maternal K across the placenta barrier (Food and Nutrition Board, Institute of Medicine, 2001).”
Menstruation & PMS
The uncomfortable and challenging physical and emotional symptoms associated with premenstrual syndrome (PMS) and menstruation can be a hardship for women. As more women are looking to curtail their use of pharmaceutical and even OTC drugs, supplements with natural ingredients have become an appealing alternative for women attempting to offset the negative impact of these monthly symptoms.
“The struggle with PMS is all too familiar,” said Sonny Stafford, vice president of marketing, JDS Therapeutics, Purchase NY. “Many women struggle with irritability, mood swings, and a general feeling of unease called dysphoria in the days leading up to their menstrual period. When these symptoms happen month after month and are bothersome or disruptive, the condition is called PMS.”
According to statistics from the Office of Women’s Health, U.S. Department of Health and Human Services, over 90% of women report experiencing symptoms of PMS, which can include bloating, headaches, and moodiness.
“Millions of women from teenagers to women in their early 40s suffer from PMS. To combat the most disruptive symptoms, some healthcare professionals prescribe birth control pills, antidepressants, or anti-anxiety medications, but these have side effects and can be habit-forming,” explained Mr. Stafford. “There is no one-size-fits-all answer for those suffering from PMS symptoms, but there are some very good plant-based options like Serenol.”
JDS Therapeutics offers Serenol, a clinically effective dietary supplement that has been shown to be safe and effective at treating more of the emotional and some physical symptoms of PMS. Active ingredients in Serenol include a flower pollen extract, Chromax chromium picolinate, and a low dose of royal jelly.
Describing the science supporting this product, Mr. Stafford cited several studies. “The ingredients in Serenol have been shown to help with irritability, mood fluctuations, water retention, sleep disturbances, food cravings, and premenstrual weight gain, with side effects no different from a sugar pill and no observed drug interactions.”
Urinary Tract Health
Urinary tract infection (UTI) is one of the most common types of infection and accounts for around 8.1 million visits to a doctor every year, according to John Deaton, PhD, vice president of science and technology for Deerland Enzymes & Probiotics, Kennesaw, GA. “More than half of all women will experience at least one UTI during their lifetime, with 20-30% experiencing recurrent UTIs.”
The primary catalyst of most UTIs is Escherichia coli, a common bacterium found in the normal flora of the intestine. “These bacteria that live in the gut can spread to the urinary tract, attach to the surface and cause an infection,” explained Dr. Deaton. He suggested that regular use of probiotics could potentially help reduce the risk of UTIs, especially after a course of antibiotics. “Women with recurring UTIs may benefit from a more targeted approach, aiming to decrease the occurrence of the E. coli that so often is the culprit.”
Deerland’s prebiotic ingredient PreforPro is designed to support urinary tract health by crowding out the bad bacteria in the gut, such as E. coli, and reducing the likelihood of UTI. Dr. Deaton said PreforPro “goes to work on these undesirable bacteria in the gut by destabilizing the bacterial cell wall, releasing nutrients into the environment which can then be consumed by the good bacteria within the GI tract.” He added that unlike traditional prebiotics, which are fiber or carbohydrate-based, PreforPro doesn’t cause unwanted side effects like gas and bloating.
Digestive Health
Digestive health issues have emerged as a top concern among female consumers, leading to interest among women young and old. “Women’s gastrointestinal (GI) systems are vastly different than that of men’s,” said Dr. Deaton. Besides the obvious physical dissimilarities, he said female hormones have a tremendous effect on the digestive tract.
He pointed to hormonal issues as well as a GI system that’s more sensitive to irritants as prime reasons why women are more likely to suffer from digestive issues and stomach upset than men. For instance, he said women are five times more likely to develop irritable bowel syndrome (IBS) compared to men.
“As young women move out of adolescence and the menstrual cycle gets more regular, some may begin to experience alternating bouts of constipation or diarrhea. In addition, premenstrual syndrome (PMS) could come with digestive issues like gas and bloating,” said Dr. Deaton. Pregnant women, he added, are highly likely to experience constipation.
Probiotics offer unique support for a woman’s digestive system by helping maintain a healthy balance in the intestinal microbiota, he noted. “In a clinical study, the probiotic strain Bacillus subtilis DE111 was shown to support a healthy bowel index, improving occasional constipation and/or diarrhea among the participants (Journal of Probiotics & Health, 2018).”
Prebiotic fiber is also gaining more attention among female supplement users for its support of digestive health issues. “It’s no secret that good health starts with optimal digestion, and ingredients for digestive health are a huge market for women,” said Ms. Ford of AIDP. “Probiotics and prebiotics are getting a lot of attention in the media, and more and more functional ingredient companies like AIDP are researching and innovating in this area.”
AIDP’s PreticX XOS (xylooligosaccharide) prebiotic has been shown in human clinical studies to boost healthy bifidobacteria, while reducing unhealthy bacteria in the gut. “A major advantage of PreticX is its clinical effectiveness at low dosages, compared to other ingredients in this space, thereby greatly reducing undesirable side effects.”
Another example is AIDP’s Livaux prebiotic, a whole kiwifruit ingredient shown to increase healthy Faecalibacterium prausnitzii (F.prau). “F.prau is the most abundant bacteria species in the gut, accounting for about 8% of the total colonic microbiota, and is extremely important for production of short chain fatty acids in the gut,” explained Ms. Ford. “Its major roles include maintaining gut barrier function and reducing oxidative stress. Despite its importance, F. prau is sensitive to oxygen and cannot be obtained through supplemented probiotics, lending to the uniqueness of Livaux and its ability to naturally support healthy F. prau levels.”
Emerging Health Indications
Ms. Mahecha with Kline Group predicted scientific research on the body’s microbiome could yield exciting solutions for digestive health, particularly for women. Looking ahead, she anticipated “considerable innovations if new probiotics can be formulated to impact the microbiome to be more effective for prevention of digestive ailments, improving immunity, nutrient absorption, or boosting metabolism.”
Dr. Deaton echoed this sentiment, suggesting the continued study of probiotics will open up their use to expanding health applications outside of digestive health. “Probiotics also play a role in maintaining vaginal health, by helping to maintain a slightly acidic environment within the vagina. This helps to reduce the overgrowth of harmful bacteria. Research shows that Lactobaccilus rhamnosus colonizes the intestine as well as vagina, and offers additional benefits in mood health, digestive health, and maintaining healthy body weight.”
Additionally, he said healthy gut bacteria helps regulate hormones, including estrogen and the thyroid. “The actual activation of many hormones happens, in large part, as a response to the action of gut bacteria. The probiotic strain Lactobaccilus reuteri has been shown to support thyroid health, in addition to its benefits for gut and vaginal health.”
Gencor’s Dr. Clayton referenced ongoing controversy around the safety of hormone replacement therapy as an issue that will continue to drive women to safe, natural alternatives.
“Women are looking more and more to natural botanical solutions to address age-related health concerns and are wanting supplements that are clinically-studied, safe and unadulterated.” He also suggested botanicals supporting women’s sexual health could be a future area of growth. “In the past, there have not been many botanical health options for women regarding healthy sexual function and menopause, however, with the aging population growing, there is a need to formulate new products to help address this core base of consumers.”
A primary concern emerging among women in their reproductive years is the issue of infertility. In the U.S., approximately 10% of women (6.1 million) ages 15-44 have difficulty getting pregnant or staying pregnant, according to the Centers for Disease Control and Prevention (CDC).
In response, a variety of dietary supplements supporting reproductive health and pre-conception have popped up on store shelves. The brand Premama offers a Fertility Reproductive Support Supplement—a drink mix formulated with Myo-Inositol, an ingredient clinically shown to support and improve ovulatory function and egg quality. In addition, as part of a multi stage supplement program supporting conception, pregnancy, and lactation, Premama developed a Birth Control Cleanse berry-flavored drink mix designed to prepare a woman’s body for pregnancy.
Rainbow Light also launched its new Rainbow Light Vibrance For The First Thousand Days product line, featuring six different multivitamins for women planning to conceive, moms-to-be, new moms, and toddlers. The first supplement in the regimen is a Pre-Conception Multivitamin formulated to maintain health and prepare for conception, providing highly absorbable folate to reduce the risk of neural tube defects in infants.
The line also includes a Trimester 1 Prenatal Multivitamin with folate plus choline for baby’s healthy brain and neural tube development; Trimester 2 Prenatal Multivitamin featuring chromium to support normal healthy blood sugar for mom; Trimester 3 Prenatal Multivitamin, which targets promoting the baby’s growth and development while supporting the mom’s healthy circulation and normal blood sugar; and a Postnatal Multivitamin designed to support energy, lactation, and postpartum healing while offering a customized Lactation Blend to support healthy milk production and hormone balance for breastfeeding. The First Thousand Days product line also offers a NutriStart Plus Multivitamin Powder for toddlers.
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Convenient, clean label, powder supplement tackles the subject of digestive regularity. Increasingly, women are seeking support for digestive health with the aid of dietary supplements. Stomach upset and constipation caused by hormonal imbalance are commonplace, driving female consumers to seek safe, discrete, and convenient solutions. “We all face digestive issues from time to time—gas, bloating, cramping, constipation, diarrhea, and general lack of energy due to various digestive issues,” said Mike Danielson, marketing representative, for Regular Girl. “It’s difficult to look and feel your best when we’re worried about our bodily functions. Some women feel bloated because they don’t ‘go’ daily. Others build their schedule around their morning bathroom habits. And traveling often only compounds these stressful issues.” In response, the Regular Girl supplement was introduced to support digestive health. The product, according to Mr. Danielson, was “developed to address a serious issue while having some fun at the same time. The personality of Regular Girl helps to get the conversation started and to share amongst friends.” A synbiotic blend of clinically proven prebiotic fiber and probiotics, Regular Girl aims to help women in supporting digestive regularity and overall health. Available in 30-day supply of scoopable powder or convenient On-The-Go stick packs, the powder supplement can be added to cold beverages or water with no taste, odor, or grit. Discussing the company’s hallmark product, Mr. Danielson highlighted its simple list of active ingredients, aligning the product with demand for clean label products. “The Regular Girl Original and On-The-Go powder consists of prebiotic fiber [utilizing Taiyo International’s Sunfiber ingredient] and probiotics [Bifidobacterium lactis], and nothing else. It’s tasteless, colorless, odorless and has no mouthfeel or thickening. It’s easy to incorporate into your favorite beverages as well as smoothies, yogurt, cereal and more.” He added that some other probiotic formulas may include carriers, flow agents, and preservatives. The only ingredient added to the probiotic formula was prebiotic fiber to help support the cultivation of beneficial bacteria in the gut. “We need to have prebiotic fiber along with our probiotics to help proliferate the probiotics that we are consuming, but more importantly to help proliferate the healthy bacteria that we already have in our gut,” he explained. “We’ve made it convenient and more efficacious by combing the two and removing the unnecessary ingredients that none of us want or need.” FODMAP Avoidance. A key trend the company has observed in the women’s health and digestive health space is the avoidance of FODMAPs (Fermentable Oligo-saccharides, Disaccharides, Mono-saccharides and Polyols)—a group of short chain carbohydrates that are poorly absorbed in the small intestine. FODMAPs are known to cause gas-related pain, intestinal distention, constipation and/or diarrhea in people suffering from functional gastrointestinal disorders (FGIDs) and irritable bowel syndrome (IBS). “If you have ever experienced slight to extreme gas and bloating after eating certain foods, you have experienced the effect of FODMAPs,” said Mr. Danielson. “Low FODMAP diets help to reduce these symptoms.” Avoidance of digestive irritants such as FODMAPs and gluten may lead to some nutritional setbacks, particularly when it comes to consuming adequate fiber. “It’s important to understand that when reducing gluten or FODMAPs from the diet, we are inherently also decreasing other nutrient intake, specifically dietary fiber, which can often exacerbate our digestive issues,” cautioned Mr. Danielson. Because many high-fiber foods are also high in FODMAPs, people with FGID and IBS typically have difficulty meeting the recommended daily intake of 25-30 grams of fiber in their diets. “That means they may not get enough soluble fiber, which is essential for gut health and regularity. Even more problematic, many of the dietary fiber supplements containing inulin, wheat dextrin, and IMOs are high FODMAP fibers and should be avoided by those looking to reduce FODMAPs in their diet.” The company’s Regular Girl formula was recently granted Low FODMAP Certification from Monash University, which established a certification program that translates the science of a low FODMAP diet into practice. “Regular Girl is proud to be the first prebiotic fiber and probiotic blend to achieve this important certification,” he said. More to Come. With the success of its initial product launch, the company is expanding its lineup to offer a variety of healthy solutions for women. The company recently unveiled Regular Girl Wellness, a supplement with prebiotic fiber, probiotics, and cranberry juice powder to support both digestive and urinary tract health; Regular Girl Active, a blend of prebiotic fiber, probiotics, and pea protein for the active woman looking for support with digestion as well as muscle strength, and recovery; and Regular Girl Indulgence, chocolates formulated with prebiotic fiber, probiotics and Allulose, a natural sugar that has minimal effect on calories and blood sugar. |
