September 2001

Developing Products for an Aging Population

By Angela Miraglio M.S., R.D.
Contributing Editor

Its no secret as a nation, we are growing older. Statisticians like to point out that every seven seconds for the next decade someone will turn 50. According to the Administration on Aging, Washington, D.C., there are approximately 34.9 million Americans age 65 and over. This represents 12.7% of the population, or about one in every eight Americans. They project that in 2030 about 70 million Americans will be over age 65 (20% of the population).

A report on health foods, conducted by Business Trend Analysts Inc., Commack, NY, projects that by 2010 almost 40% of the population will be over age 45 the age when health problems increase dramatically. Of equal significance is the growth of the age 85 and older group acknowledged as the fastest growing segment of the older population. According to Hyatsville, MD-based Federal Interagency Forum on Aging-Related Statistics, aging in the 21st century will be characterized by a steep rise in the population age 85 and older, and increased racial and ethnic diversity. Older Americans are living longer, feeling better and are more prosperous.

Consumer attitudes
A number of surveys indicate that todays consumers are interested in the health aspects of their diets. Recently released data from the 2001-02 National Report on Consumer Attitudes About Nutrition, United Soybean Board, Chesterfield, MO, shows that nine in 10 consumers are at least somewhat concerned about the nutritional content of the food they eat, and 72% of consumers have changed their eating habits within the past three to five years, up from 68% in 2000.

Data and key findings from the 2001 HealthFocus Trend Report, HealthFocus, Inc., Atlanta, gives some insight into the mature consumer, which is segmented into three age groups boomers, age 37 to 55 years; swing generation, age 56 to 66 years; and elders, 67+ years. Among the insights:

Connection between nutrition and health. Two out of three shoppers say diet is very important; 77% over the age of 50 always or usually choose foods for healthful reasons; 50% are very careful about what they eat.
Entitlement and choice. Boomers feel a strong sense of entitlement to solutions that will enhance their quality of life and extend their middle years.
Taste rules. Taste is the barrier to choosing healthier foods. Some resentment towards the high cost of healthy choices is surfacing.
Self-medication and self-education. Consumers are confident in their ability to manage their own health.
Nutritional individualization. Almost three out of four (74%) agree that everyone has different nutritional needs. Fifty-six percent of boomers see a connection between food and medicine; 51% of the swing generation and 49% of elders have the same view.
Motivating choices. Boomers are more likely to make healthy choices for family members (19%), while the swing generation and elders are more likely to make healthy choices to enhance daily health (25% and 26%, respectively), or to control existing health problems (20% and 24%, respectively).
Health concerns. Boomers rank top health concerns as cardiovascular/heart disease, tiredness/lack of energy, and breast cancer. The swing generation lists cardiovascular/heart disease, arthritis and high cholesterol. Elders cite arthritis, cardiovascular/heart disease and eye health as their primary concerns.
Filling gaps. Daily supplements are important to 68% of all shoppers (up from 49% in 1994), and fortified foods and beverages also are trending upward.

HealthFocus projects, As the baby boomers move into their mature years, they will demand greater attention to health solutions related to aging. They will be more vigilant about diet than theyve been in their younger years, they will pay more attention to what they eat and they will become more agreeable to making changes in their diets to improve their health and well-being as they get older.

This fits with the do it yourself health trend described by A. Elizabeth Sloan in her Third Biannual Report on the top 10 trends. In this report, she cites Food Marketing Institute/ Prevention data that estimates do it yourself health as a $42-billion supermarket retail opportunity. She points out that more health-conscious shoppers are looking for positive benefits from fortified foods rather than for the negative food components to avoid.

There are many ways to define our aging population. In general, mature consumers can be segmented into aging boomers who are now over age 50, the older Americans who are 65+ years and the elderly who are 85+ years. These groups are in different stages of aging and have different interests, needs and resources.

Major health concerns
Much is yet to be learned about the valuable health-promoting components in foods and botanicals. However, there is a growing body of knowledge on the expanded role of foods and active compounds in health promotion. The challenge for product developers and marketers of functional foods is twofold: solid science as a platform on which to build products and a clear understanding of consumer needs and expectations.

Since a thorough discussion of all the potential functional foods is impossible here, well only review foods and ingredients that have the potential to address the leading chronic diseases and health concerns of the mature consumer.

Cardiovascular disease
Cardiovascular disease (CVD) is the leading cause of death for older Americans. Dietary fat and fiber modifications can help control some of the associated risk factors. Recent research has shown that the DASH diet (Dietary Approaches to Stop Hypertension) which is rich in fruits and vegetables (therefore, higher in fiber), low in saturated and total fat and cholesterol, and includes lowfat dairy products is effective in lowering lipid levels.

The recommended ratio of saturated, monounsaturated and polyunsaturated fatty acids in a heart-healthy diet is being fine-tuned. Recent research points to cardioprotective capabilities of omega-3 fatty acids from plant and marine sources. Soy oil contains 54% polyunsaturated fatty acids and is rich in linoleic acid, a short-chain omega-3, as well as vitamin E, and has only 16% saturated fat. Longer omega-3 fatty acids, from marine sources (fish or algae), are docosahexaenoic acid (DHA) and eicosopentaenoic acid (EPA).

Sufficient evidence of the long-chain omega-3s potential to lower the risk of CVD led to the approval of a qualified health claim for products that contain them. As an alternative to marine oils, OmegaTech, Inc., Boulder, CO, markets DHA-rich algal products, both as feed to alter food composition, such as eggs, and as food-grade GRAS ingredients for direct fortification.

Antioxidants combat free radicals that may lead to cellular damage. Some theorize that a high antioxidant intake can reduce the risk of atherosclerosis. Research efforts have aimed to link clinical and epidemiological data with the presence or absence of antioxidant compounds in individual foods and diets.

Blueberries, grapes and many other fruits and other common foods, such as tea, honey and chocolate, have a high phenolic content. Recent literature on whey protein states that it supports antioxidant functions and has potential to lower the risk of atherosclerosis. Even palm oil now is being refined to retain natural carotenoids and vitamin E from the original crude oil and is marketed as red palm oil. Product designers can find antioxidant compounds, from natural mixed carotenoids to vitamin E, for supplementation. For a more detailed discussion of antioxidants, see Abstract on Antioxidants in the May 2001 issue of Food Product Design.

Soys role in promoting cardiovascular health grows. Research has shown soy to be hypocholesterolemic by lowering LDL cholesterol and triglycerides, while slightly increasing HDL cholesterol. Soy protein has earned its own health claim that acknowledges its capability to prevent heart disease: 25 grams of soy protein a day, as part of a diet low in saturated fat and cholesterol, may reduce the risk of heart disease. A serving of [this food] provides [an amount equal to or greater than 6.25 grams per reference amount customarily consumed] grams of soy protein.

Besides soy protein, soy offers isoflavones (genistin, daidzin and glycitin) and phytosterols (beta-sitosterol, capesterol and stigmasterol), additional factors that may help reduce heart-disease risk. Studies show that isoflavones have a positive effect on artery elasticity. Genistein exhibits anticlotting properties by inhibiting platelet aggregation as well as inhibiting smooth-muscle proliferation, one of the primary cell types in plaque. The phytosterols have demonstrated cholesterol-lowering properties.

Plant stanol/sterol esters GRAS-affirmed ingredients used in margarines and other fat-containing foods, such as salad dressing block cholesterol absorption. Clinical studies show that regular use of margarine produced a 7% to 14% reduction in total/LDL cholesterol with an intake of approximately 1 gram per day is needed. Products containing stanols or sterols can use a health claim that stipulates the amount needed per day as well as the amount in a serving of the food, similar in wording to the soy protein health claim.

One of the newest entrants on the list of functional foods for CVD is citrus fruit and juice. At the 2001 IFT Symposium, Citrus Impact on Cardiovascular Disease, held in New Orleans, LA, researchers examined studies that support citrus cardiovascular benefits. Frank Speizer, M.D., Harvard Medical School, Boston, reported evidence that nutrients in orange juice, specifically potassium, folic acid and vitamin C, may provide CVD protection.

Studies have suggested protective roles for each of these nutrients, and orange juice is a major source of all three, Speizer said. These findings add important supportive evidence that daily consumption of citrus fruits can reduce the risks of cardiovascular disease.

Dietary fiber, especially soluble fiber, has long been recognized as a factor in lowering CVD risk. Beta-glucans, found in abundance in oats and barley, are responsible for this effect, and oat products can carry the claim: Diets low in saturated fat and cholesterol that include soluble fiber from whole oats may reduce the risk of heart disease.
As part of its FutureCeuticals line, VanDrunen Farms, Momence, IL, recently introduced a USDA-developed soluble fiber, high beta-glucan oat-bran hydocolloid. While being marketed as a fat replacer, it meets the requirements for an oat fiber label health claim.

A number of other dietary fibers also claim to be heart healthy. Inulin, produced from chicory root, has water-soluble dietary fiber properties that could help lower CVD risk by lowering serum lipids and triglycerides. A new introduction from Nutrinova, Somerset, NJ, is made from the fruit of the carob tree. It is 80% insoluble dietary fiber characterized by its high content of lignin, polyphenols, tannin and pinitol. A clinical study using 15 grams per day showed cholesterol-lowering potential in humans possibly due its antioxidant activity and the presence of lignin, which has a high affinity for bile acids.

Larex Inc., White Bear Lake, MN, extracts a water-soluble hemicellulose, arabinogalatan, from unused portions of larch trees, to create a GRAS ingredient that has shown significant reduction in serum cholesterol, according to research conducted at the University of Minnesota, Minneapolis-St. Paul.

Cancer
Despite many years of research, neither the etiology nor a cure for cancer has been found. However, studies have demonstrated that dietary factors can promote or protect against cancer. A number of the foods/ingredients that may mitigate cardiovascular disease also may play a role in functional foods for cancer treatment and prevention.
In vitro and animal studies, plus epidemiological data, indicate that soy isoflavones can contribute to the fight against some types of cancer (breast, uterine, colon, lung, prostate and leukemia). It appears that genistein interferes with enzymes involved in controlling cell growth and regulation, and inhibits angiogenesis, which would interfere with tumor growth. It may also increase the effectiveness of cancer treatment drugs.

Much of what was said about antioxidants for cardiovascular disease applies to cancer as well. However, there are some additional compounds that are effective for specific tumors. Studies show lycopene, found in tomatoes, is effective in reducing prostate cancer cell growth by approximately 20%. Lutein, an antioxidant found in fruits, vegetables and egg yolks, also reduced prostate cancer cell growth by 25%, while a combination of lutein and lycopene reduced the growth by 32%. Lutein and zeaxanthin also are attributed with lowering breast cancer risk. According to a recent study, almonds provide antioxidants and phytochemicals that may play a role in preventing colon and other cancers.

The role of dietary fiber and resistant starch in a healthy colon is related to a number of factors: increased transit time, increased stool bulk, fermentation to butyric acid, dilution of potential carcinogens and prebiotic activity. Specific types of dietary fiber associated with promoting a healthy colon include wheat bran, inulin, arabinogalatan and resistant starch.

Honeys and inulins prebiotic activity has been associated with intestinal health. Of course, dairy products with live cultures provide probiotics that also promote a healthy colon by crowding out harmful bacteria. In addition, milk sphingolipids are being investigated for suppression of colon carcinogenesis.

Vision
Primary vision problems for mature consumers are cataracts and age-related macular degeneration (AMD). New research indicates that dietary factors may play a role in preventing or slowing down the progression of these ailments.

A few years ago, lutein was identified as an antioxidant for preventing AMD. It works in combination with zeaxanthin, which is found in the same foods as lutein dark green, leafy vegetables, as well as Brussels sprouts, green beans, sweet corn, summer squash, avocado and egg yolks. Purified lutein and zeaxanthin supplements are available. Lutein derived from marigold flowers, first introduced by Kemin Foods, L.C., Des Moines, IA, was affirmed as GRAS this year.
In foods, egg yolk and maize have the highest concentration of lutein and zeaxanthin. The presence of some dietary fat aids antioxidant absorption, so lutein and zeaxanthin are readily absorbed from egg yolks according to Donald McNamara, Ph.D., executive director of the American Egg Boards Egg Nutrition Center, Washington, DC.

Another product that aids eye function is DHA oil. A clinical study has demonstrated that intake of long-chain omega-3 fatty acids (EPA and DHA) is inversely associated with AMD. Designer eggs with increased vitamin E, omega-3 fatty acid and carotenoids, created by altering the feed of the laying hen, hold promise as a source of multiple substances to thwart the vision problems of older Americans. Studies indicate that designer eggs can help improve plasma levels of these nutrients without adversely affecting lipid levels.

Successful development
The heterogeneity of the mature consumer population and the myriad of health concerns experienced throughout the senior years make it difficult to define the ideal functional food. Mary Ellen Camire, Ph.D., chair of the committee on functional food for the Council of Agricultural Science and Technology, Ames, IA, and researcher from the University of Maine in Bar Harbor, says the consumer wants an all-purpose convenience food to take care of everything. Find synergy and build within a food all that they need, she says. Orange juice with added calcium and folic acid is a good example.

Barbara Gollman, M.S., R.D., a spokesperson for the American Dietetic Association, Chicago, believes functional foods can play a beneficial role by providing health-promoting substances people are not able to get from their diets. However, she notes, there have been a few cases of people who have overindulged by using supplements and functional foods. We need to caution people to be careful and we need stronger labeling laws.

Specific needs Gollman cites for functional-food development include calcium, probiotics, glucosamine or other substances for joint diseases, vitamin B12 and fiber. Both Camire and Gollman agree taste is important, as is price, to the mature consumer.

To ensure success when designing a new functional food, address the following questions first:
What are the target populations nutritional needs?
How does this product address those needs?
How does it fit in their total diet?
Do you want to help fill a gap, or totally fill a nutritional need?
What are the ingredient characteristics?
What is the most appropriate vehicle for delivering the functional component? Is this a product the target audience will consume in adequate quantities? Is there a potential for overdosing?
Next, confirm the quality of the ingredient as well as its bioavailabity and efficacy in the food or beverage product. Last, but certainly not least, be sure the taste, convenience and price meet consumers expectations.

Angela M. Miraglio is a registered dietitian and Fellow of the American Dietetic Association from Des Plaines, IL. She has extensive experience in trade communications, public and consumer affairs and technical communications, as well as product development and nutritional assessment. Her firm, AMM Food & Nutrition Consulting, provides food and nutrition communications and technical support services to food and beverage companies, and trade and professional associations. She can be reached via e-mail at [email protected].

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