Shoppers are proactive, with over half saying they always or usually choose foods/beverages to improve digestion. In fact, improving digestion is the top health benefit shoppers are seeking from foods/beverages.
Globally, 45% of shoppers are extremely or very concerned about digestive problems, and 20% say they are personally affected by digestive issues. Despite higher concern and incidence for digestive problems, shoppers are less focused on treating specific issues and more interested in holistic gut health benefits, according to HealthFocus data.
When selecting foods/beverages for a healthy digestive system, shoppers are primarily motivated by maintaining general health and wellness rather than treating a specific problem.
People are making the connection between gut health and overall health, with more than 70% of global shoppers saying their digestive health plays an extremely or very important role in their overall physical health; six out of 10 link digestive health to immunity, energy, weight management, mood, healthy aging, and stress.
Not only do shoppers believe in the link between gut health and overall health, but over half are extremely or very interested in the gut microbiome; nine out of 10 shoppers are at least somewhat interested.
As for ingredients related to digestive health, over 70% are interested in fiber and whole grains; six out of 10 are interested in probiotics; and around half are interested in prebiotics, ancient grains, and active cultures.
Of those interested, over 35% are willing to pay a premium for products that include fiber, whole grains and probiotics. Nearly 30% are willing to pay more for prebiotics, and around 20% would pay more for ancient grains and active cultures.
Demographically, parents stand out from other shoppers with a stronger focus on gut health. They are more concerned about digestive problems and place more importance on their digestive health. They are also more proactive with over 60% always or usually selecting foods/beverages to improve digestion. They also have a stronger belief in the connection between gut health and overall health, and are more interested in the gut microbiome compared to other shoppers.
HealthFocus noted key distinctions by age. While the importance of digestive health and the incidence of digestive problems is similar across age cohorts, younger shoppers are more concerned about digestive issues and are more proactive in selecting products to improve digestion. Younger shoppers also have a stronger belief in the link between digestive health and overall health.
From a scientific perspective, a growing body of research supports the idea that “millions of microorganisms (microbiota) not only live in our gut, but are also critical to our overall health and well-being,” noted Justin Green, PhD, director of scientific affairs, Embria Health Sciences. “In fact, emerging research suggests links between gut health and the immune system, mood, mental health, cardiovascular health and more.”
The oldest systems of medicine, including Ayurveda, place great importance on digestive health, noted Shaheen Majeed, president worldwide, Sabinsa. “Obtaining nutrients from food requires three important processes: digestion, absorption, and assimilation. Out of the three processes, digestion is the first and most important because we can only obtain nutrients after food is turned into a usable form. If digestion does not happen properly, the whole metabolism is altered, affecting health and wellness.” Proper digestion depends on a healthy gut environment, he added, noting that about 400 microbial species have been identified in the human gut microbiome.
Digestion is absolutely central to health, according to Sam Michini, vice president of marketing and strategy, Deerland Probiotics & Enzymes. “Although the saying ‘you are what you eat’ is true, there is a more defined truth to the saying, ‘you are what you digest and absorb.’ A healthy functioning digestive system supports effective absorption of nutrients. When compromised digestive function impairs absorption of nutrients, those nutrients simply pass through, and in extreme cases, cause a nutrient deficiency.”
Ramon Luna, marketing coordinator, Ecuadorian Rainforest, also suggested digestive health is “fundamental” to overall health. “It’s the first step in assuring proper nutrient absorption as well as normal bodily function. Because of this, it’s vital for people to keep digestive health as strong as possible.”
The gut microbiome continues to reveal itself as a key to health and wellness, noted Sid Shastri, director of product development at Kaneka Probiotics. “As research strengthens this link, the category will only continue to expand. Gut health is a foundation for systemic health.”
A 2019 report from Acumen Research and Consulting projected the probiotics market could reach $78 billion by 2026.
More consumers today recognize the relationship between digestive health and overall health, said Francesca de Rensis, marketing director, Indena S.p.A. “They’re hearing and reading about the microbiome, probiotics, prebiotics and ‘gut-brain axis’ from their friends and through mainstream media. This has resulted in continued market growth for both foods and supplements featuring digestive health benefits.”
In recent year, scientists have developed better understanding about the relationship between nutrition, supplementation, and overall well-being, according to Majeed. “Research has shown that digestive health derives from the microorganisms residing in the gut. It has even been shown that a woman’s microbiome during pregnancy can affect the health and wellness of the child throughout her life.”
Studies also show the gut microbiome can influence the immune system and cognition, he added. “Clearly, gut health is important beyond its role in digestion. We’ve also found an interesting way to reduce muscle soreness using digestive enzymes, which may indicate other previously unsuspected connections between the body’s tools in the gut and other physical conditions.”
The most significant scientific development into how nutrition and supplementation impact digestive wellness is the identification and understanding of the microbiome and the microbiota it contains, according to Michini. “Discoveries of new strains are ongoing, as is the understanding of the scope and diversity of the trillions of different bacteria. The microbiome is an intricate ecosystem that can easily be impacted by the types of foods eaten, stress, and other factors. Research continues to link a favorably balanced microbiome with good health, and an imbalanced microbiome with ill health.”
Further, there is an acceleration of clinical studies that continue to investigate the links between specific strains and digestion, as well as on food sensitivities, breakdown and absorption of macronutrients, and even links with cardiovascular health, he added.
Scientific advancements have allowed researchers to better measure what may be occurring in the digestive system, said Rensis. “One such advancement is with human gut model systems that mimic what happens in the human gut. These models show how ingredients may provide benefits for digestive health and offer accelerated, cost effective initial results. Once these initial benefits have been demonstrated, further research can be done with human clinical studies.”
The role of dietary fiber in support of gut health continues to be clinically researched, including further understanding the influence prebiotics have on the gut microbiota, said Patricia Williamson, PhD, principal scientist, scientific and regulatory affairs, Cargill. “However, we continue to learn more about prebiotic benefits beyond gut health. Similarly, we continue to seek a greater understanding of how changes in the gut microflora can cause physiological benefits. Some recognized benefits of dietary fiber consumption include gut health support, bone health support, and weight management. We know dietary fiber is an under-consumed nutrient throughout most of the globe. By fortifying more products with chicory root fiber and other dietary fibers, we can help consumers achieve the nutrition and health benefits they desire within foods they are already consuming.”
Green noted an interesting development in the concept that nutrients in foods or supplements do not need to be absorbed in the upper gastrointestinal tract to have a beneficial health impact, but rather can interact with the gut or gut lining to cause a benefit. “Some examples include affecting the microbiota (whether by adding to it with probiotics or modulating it with prebiotics) to strengthen the many roles the microbiota already plays.”
It’s also becoming clear that conversion of nutrients by the microbiota changes these molecules into factors that may be more bioavailable and/or more bioactive, he added. “A phytonutrient that is not normally absorbed may still be important in nutrition or supplementation if it is converted into a factor that is absorbed and can have a beneficial effect.”
Food and supplements interacting with the gut microbiota can also affect the immune system. “After all, a large proportion of our immune system is in the gastrointestinal tract,” said Green. “This interaction can have effects on both the body’s overall immune response (including inflammation) and digestive health.”
According to Shastri, a “watershed moment” revealing the importance of microbes in gut health came in 2005, when the Nobel Prize in Physiology or Medicine was awarded to Barry Marshall and Robin Warren “for their discovery of the bacterium Helicobacter pylori and its role in gastritis and peptic ulcer disease.”
“The importance of microbes in health and microbiome composition has sprouted a tremendous number of clinical trials since that point,” said Shastri. “Today, we know that the microbiome can impact a wide variety of conditions ranging from childhood asthma, bile acid metabolism, gall stone formation, IBS, and cardiovascular health.”
“A diverse microbiome is a healthy microbiome,” he added. For example, “taking a targeted probiotic formula such as Floradapt’s Intensive GI product, helps maintain a healthy gut microbiome through innovative mechanisms of action and promotes diversity of the microbiome. In addition to two human published clinical studies, the IGI strains in vitro demonstrated ability to protect the gut barrier (Immunology and Cell Biology, 2014).”
Consumer recognition of probiotics for digestive health has increased considerably over the last decade. Today, researchers are evaluating specific strains for other benefits, noted Scott Steinford, CEO, Health Wright Products, who said more cardio-protective and synbiotic products are gaining interest. There’s also more emphasis on personalized strains.
“Probiotic manufacturers are consistently seeing brands wanting to formulate for conditions beyond gut health, especially bone health and immune health. And the science supporting those conditions is growing. This is where personalization is coming in. Consumers are looking for customized options. This is making it even more essential on the manufacturing side to make sure they’re manufactured correctly or the bugs won’t survive.”
Probiotics can be challenging for manufacturers, though. Ensuring viability and quality through expiry is critical, said Steinford. Optimized temperatures are essential throughout every step of the manufacturing process, he continued. “For example, at Health Wright Products, we provide a climate and humidity-controlled environment throughout every stage of the production process. In addition, various packaging formats can be utilized to help maintain the stability and protect product. While glass and plastic bottles and CSP vials have traditionally been used to protect probiotic products, and are viable packaging options, blister packs now offer state-of-the-art sealing capabilities and can provide an even better stability profile for probiotics.”
Blister packaging is beginning to offer increasing efficiency, said Steinford. “This is especially valuable in today’s environment as the capsule is protected in its own cavity, offering longer shelf life and stability, and single touch, helping prevent contamination.”
Overall, consumers are placing increased emphasis on digestive health, noted Pam Stauffer, global marketing programs manager, Cargill. “We also know consumers are becoming more familiar with the importance of ingredients like fiber, probiotics, and prebiotics. In the most recent International Food and Information Council Foundation Food & Health Survey, 45% of U.S. consumers ranked prebiotics as healthy, an increase from the previous year, when just 36% of respondents gave the
While consumer understanding about science and nutrition is “in continuous development,” Stauffer said, “innovative brands can build a compelling story around the idea that simple ingredients like chicory root fiber can promote a healthy digestive system, healthy gut microbiome, and overall well-being.
In a competitive market, Majeed suggested brands can differentiate their offerings by providing solid research to support their material’s activities, validated through systematically devised clinical studies. “Products offered with a simplified description of their mechanism of action that can be understood by the non-scientists among us can draw the attention of the consumer searching for digestive health support in the supplement aisles,” he added.
Steinford called for brands to stop formulating to a “more is better mentality.” Instead, companies should, ideally, ensure there’s science on both the individual ingredients in a formulation, and their combination, to ensure the probiotic species do not compete within the microbiome.
More people expect their natural products to be organic and sustainable, noted Luna. “Giving people the ability to share a feel-good story about their products not only helps you stand out on the shelves but will also help with word of mouth.”
Consumers are always looking for new, better ways to support their health, said Green. “Savvy product manufacturers can take advantage of the growing consumer population with knowledge of the gut microbiota and increased interest in digestive health with products that address these concerns.”
Postbiotic fermentates like EpiCor can help, said Green. “While this category designation is relatively new to the natural products industry, they offer increased stability and consistency, and some, like EpiCor, are backed by science. Fifteen published studies, including eight human clinical trials, support EpiCor’s health benefits related to both digestive and immune support.”
At Indena, Rensis said the company believes the foundation of any successful product is solid science. “Having a product that has proven digestive health benefits along with a continued focus and investment in ongoing research will go a long way to differentiate a brand over the long term.”
Michini suggested brands may align digestive support products with dietary trends such as paleo, keto, gluten-free, and sports nutrition. “Consumers’ attitudes about wellness are shifting toward a more holistic approach, integrating concepts rather than isolating them. Meaning consumers view their health goals in terms of how a healthy diet positively impacts digestion, which improves energy use, sleep, mood, and other parameters. Also, when utilizing branded ingredients that have a scientific story to tell, take advantage of that story to create targeted marketing messages that tie fluently into your own brand.”
Historically, the digestive health marketplace has been driven by probiotics, with some fibers, enzymes, etc. also playing a role, said Jason Leibert, vice president, business development, MSPrebiotic. “We anticipate that prebiotics, which are arguably ‘food for probiotics,’ will begin driving this marketplace within a 5-year window. This will be fueled in part by emerging research but also by regulatory and consumer understanding of the category.”
Prebiotics are generally fermentable fibers found in plant-based foods that stimulate the growth of healthy bacteria in the human gut, he said. “Certain prebiotics like inulin, fructooligosaccharides (FOS), and various xylooligosaccharides (XOS) are commonly found in foods like onions, garlic, and whole wheat products, while resistant starches are scarce in foods.”
The Global Prebiotic Association defined prebiotics as “a nutritional product and/or ingredient selectively utilized in the microbiome, producing health benefits.”
Len Monheit, executive director of the Global Prebiotic Association, and CEO of Trust Transparency Center, described the mechanisms of actions as “support and feed,” “increase and produce,” and “balance and optimize,” referring to how these ingredient work within the microbiome.
“Common classes include several types of oligosaccharides, resistant starches from sources such as potato or green banana, pectins, some insoluble fibers from sources such as acacia, most recently, some polyphenols with fruit sources such as kiwi, cranberry and pomegranate, inulin—from a number of sources including chicory and Jerusalem artichoke.”
As non-digestible food ingredients, prebiotics bypass the small intestine, are fermented, and serve as food for the “good” bacteria in the gut, noted Michael Bush, president and CEO, Prenexus Health. “Gut bacteria produce nutrients for the colon, which in turn leads to a healthier digestive system. There are many naturally occurring prebiotics in fruits, vegetables, and whole grains such as artichokes, asparagus, bananas, barley, chicory root, garlic, legumes, oats, onions, and wheat.”
Today’s health-conscious consumers understand that prebiotics are not only important for digestive health, but also play a critical role in general wellness, said Bush. “Due to research, innovative manufacturers, and consumer demand for better-for-you products, prebiotics are emerging as the next super ingredient in the digestive health market, specifically XOS.
Monheit said data the Global Prebiotic Association has collected shows that supplement consumers are increasingly aware of prebiotics, “but also that they understand what prebiotics do, not just looking for the term, but also knowing again that this is much more than fiber. Dietitians too, in our research, increasingly know this.”
Overall, 80% of supplement users surveyed have heard of prebiotics (up from 68% last year); 33% of surveyed supplement users are using prebiotics at some level (up from 23% last year); and 39% of users are “regular” users (4+ times per week), up from 29% last year.
“As to driving awareness, the volume of news and research about the microbiome, the very viability of using prebiotics—you don’t need to worry so much about storage conditions and survivability, and newer candidates that don’t require multi-gram doses with some of the associated challenges and issues are a few factors.”
Research has “flipped the script on how we talk about dietary fiber,” Leibert said. “We previously believed that dietary fiber acted like a brush to scrub out our intestines, keeping us healthy by preventing the absorption of things like cholesterol and eliminating polyps before they became malignant tumors,” he noted. “Now we appreciate that many health benefits associated with dietary fiber intake are due to microbial fermentation of prebiotic fiber in our guts. Consuming prebiotics like resistant starch that were historically found in human diets but severely depleted in modern diets leads to important health benefits.”
New prebiotic research is published virtually every week in important scientific publications, said Leibert. “We expect to report findings from two separate clinical studies on our resistant potato starch this year.”
According to Bush, an example of science catching up to demand is the data surrounding XOS. “Some XOS prebiotics, such as Prenexus’ XOS95, are being found to provide health benefits at levels as low as 1 gram per day. This breakthrough is allowing brands to formulate efficacious products without having to resort to multiple servings or sensory issues.”
Emerging research is indicating a number of ways in which the gut microbiome can affect key bodily functions and influence health. “Over the next five years we will see the impact of prebiotics in the following areas: anti-inflammatory support, bone health, pre-diabetes, stress, cardio health/cholesterol, weight management, and nutrient absorption.”
The biggest scientific discoveries in prebiotics have been in better understanding mechanisms of action, leading to more appreciated prebiotics than just the fibers that were originally part of the category, said Monheit. “Also, the in vitro models and systems used have become more sophisticated, and mimic real in vivo systems more closely. We are also increasingly seeing ties to satiety, mood, blood sugar management, and overall inflammation showing that prebiotics are directly impactful in these pathways. So it’s more than just digestion, although gut health is still at the core of many of these mechanisms, and so synbiotic combinations are also increasing.”
He continued: “We’re already seeing more products emerge that not only contain one or more probiotics, they are now synbiotics with prebiotics added to the formulation. I’d expect this to continue so that ultimately pure-play probiotics are less and less of the marketplace with mixed and multi-prebiotic formulations taking increased share. The market or pie will still grow significantly as gut and digestive health continues to be associated with more and more health conditions and pathways, and prebiotics will benefit from this overall growth too. Some of the newer prebiotics have lower dose requirements for efficacy, and this will trigger new product development across all of food, beverage, and supplement formats.”
Ingredients & Research
Overall, common digestive health products include prebiotics, probiotics, postbiotics, and enzyme supplements, noted Majeed. Recent research revealed that a probiotic along with a prebiotic helps to reduce intestinal damage. The probiotic, Bacillus coagulans MTCC 5856 (LactoSpore) along with water extract from cinnamon (Cinnamomum cassia and/or Cinnamomum burmanni) showed strong synergistic effects on phagocytosis and the effect on cholesterol and blood sugar levels (American Journal of Immunology, 2013).
In a clinical study, adults with irritable bowel syndrome (IBS) showed improvement from coexisting depression when they took a probiotic—Bacillus coagulans MTCC 5856 (2 Billion CFUs per day) where the placebo without probiotic did not report the same improvement (Food & Nutrition Research, 2018).
“In another recent study, it was found that both turmeric and curcuminoids have similar qualitative effects on the intestinal bacterial population,” said Majeed. “Curcuminoids, however, had a far larger quantitative effect, indicating that curcuminoids in turmeric are the decisive components in influencing the bacterial population. We think curcuminoids have a unique role in, and effect on, the gut microbiome in the sense that they are not only metabolized to useful products such as reductive metabolites like tetrahydrocurcumin (by E. coli) and to demethylated curcuminoids (by Blautia sp.), as demonstrated by previous researchers, but they also increase the population of several species in the gut microbiome (Journal of Evidence-Based Integrative Medicine, 2018).
Williamson, at Cargill, noted that studies have shown 5 grams of chicory root fiber per day not only add fiber to the diet, but can also help feed normal beneficial probiotic bacteria in the gut. “As a prebiotic, it enhances the growth of Lactobacillus and Bifidobacterium species. Consuming 5 grams of chicory root fiber per day stimulates the microflora in the digestive tract, helping to maintain a neutral balance.”
There are extensive clinical research studies published on chicory root fiber, she added. In 2018, the U.S. Food and Drug Administration (FDA) summarized its review of the science in support of the physiological benefits of soluble fibers including chicory root fiber (inulin).
Fiber-hearty ingredients are a strong foundation for digestive health, according to Luna. “As the Mayo Clinic points out, fiber has a number of benefits and the body naturally needs it to help keep the system fully functional. It’s worth noting that there are two distinct types of fiber: soluble and insoluble. For soluble fiber ingredients such as peas, carrots, and psyllium are ideal. For insoluble fiber, cauliflower and green beans are a good bet.”
EpiCor, a whole food fermentate, is a postbiotic ingredient clinically shown to beneficially modulate the gut microbiota and provide immune system support, according to Green. EpiCor is not a live organism. It is a postbiotic ingredient that is highly heat stable, can handle varying pH levels, and has a three-year shelf life. Postbiotics are bioactive compounds produced by food-grade micro-organisms during a fermentation process. Postbiotics include microbial cells, cell constituents, and metabolites, Green explained.
“Backed by over 75 years of fermentation expertise, EpiCor is made through a proprietary process that creates many metabolites,” he said.
“Emerging science suggests that whole food fermentate may support a healthy gut ecology and positively modulate gut microbiota. The latest published human clinical study conducted with EpiCor shows it can shift the gut microbiota at a daily dose of 500 mg (BMC Complementary and Alternative Medicine, 2017).”
“With a daily dose of just 500 mg, EpiCor can easily be formulated into small supplement delivery forms, as well as a wide variety of foods,” said Green.
Rensis said Indena’s Casperome utilizes the company’s proprietary Phytosome delivery system that makes boswellia natural extract effective at lower doses, as shown by a pharmacokinetic study demonstrating improved bioabsorption of the main boswellic acids.
“Three human studies have demonstrated its effectiveness in supporting a healthy gut. Two of the studies showed that Casperome maintains intestinal mobility helping to reduce unwanted bloating. A third study evaluated the effect of Casperome usage over six months further confirming its efficacy, safety, and benefits.
The company’s Prodigest is a unique standardized botanical combination based on artichoke and ginger. Prodigest capitalizes on the synergy between artichoke and ginger extracts, said Rensis. “Its efficacy is based on the complementary benefits of artichoke, which promotes healthy digestive flow, with the antioxidant and healthy inflammatory activity of ginger. Prodigest has two human studies that have demonstrated optimized gastric motility and an effect on digestive discomforts, such as gastric fullness or bloating.”
Shastri said Kaneka’s Intensive G.I. formula combines three probiotic strains (L. plantarum KABP-021, L. plantarum KABP-022, and Pedicoccus acidilactisi KABP-023), which have been “clinically validated to replenish and reestablish the microbiota diversity.” The combination has been shown to improve quality of life scores helping to reduce common, everyday anxiety, nervousness, tension, or irritability associated with GI tract imbalances and/or discomfort, the company said.
“In a competitive market, innovative formulations and strains for specific health applications, like those found in the Floradapt portfolio will give probiotic/digestive products the edge,” said Shastri. “Human clinical studies have to be the foundation of a formulation, which will automatically differentiate their products. And, equally important is finding novel mechanisms of action to impact specific health targets.”
Michini noted Deerland’s specialties are prebiotics, probiotics, and enzymes, “ingredient categories that have direct impact upon digestive function.”
“Probiotics help balance the bacteria in the gut that affect healthy digestion, and smooth out the digestive process, especially for people who deal with bouts of gas, bloating and constipation. Prebiotics help the probiotics to proliferate. Enzymes are necessary to break down the food components. When digestive functioning is improved via prebiotics, probiotics and enzymes, other health areas are beneficiaries, too.”
Deerland’s most recent published clinical research conducted on its patented bacteriophage (phage) prebiotic PreforPro showed it improved the gut microbiota profile and systemic markers. After taking PreforPro for eight days, the researchers noted increased populations of the genera Eubacterium, one of the most abundant genera in the healthy human gut, according to Michini. Additionally, the researchers saw a reduction in the circulating pro-inflammatory cytokine Il-4, which is correlated with autoimmune and allergic responses. According to the researchers, these data highlight the potential of bacteriophages for selective modification of targeted microbial species without inducing dysbiosis. Further, they noted that bacteriophage consumption caused a shift towards a healthier gut environment
“Our Bacillus subtilis DE111 is a probiotic that has multiple clinical studies,” said Michini. “One demonstrated significant influence on gut microflora (Biomedical & Life Sciences, 2019) and another was tested in healthy individuals with alternating constipation and diarrhea. In this study, those who took DE111 (1 billion CFU) had an increase in normal stool types 3 and 4 from 54% to 64% (Journal of Probiotics & Health, 2017).”
ProHydrolase is an enzyme that helps the body to more effectively break down large protein peptides for better digestion and absorption, and therefore, utilization of the whey protein, Michini said. One unpublished study showed that taking the enzyme at a dose of 10 mg per gram of whey protein increased total amino acids in the blood by 20%. “This is attractive for the fitness enthusiast and athletic community, as ProHydrolase, through its ability to ensure higher amounts of whey are utilized in the body, helps build muscle and strength.”
Deerland’s Glutalytic is an enzyme blend shown to break down gluten proteins via two pathways of breaking peptide bonds. One human clinical study showed those who consumed Glutalytic experienced a significant reduction in gastrointestinal reflux from 1.64 to 1.14 as well as reduced food cravings in 14 days (Journal of Nutrition & Food Sciences, 2018).
Finally, Dairylytic, similar to Glutalytic, is a singularly purposeful enzyme that helps individuals with dairy sensitivities that are not solely related to lactose but also to their immune response to the protein compounds in dairy. “Dairylytic’s innovative combination of both lactase and protease enzymes has been shown in several in vitro studies to break down the lactose associated with intolerance, as well as make milk proteins that could cause an immune response easier to digest and absorb,” said Michini.