Who's Wearing Their Heart on Their Sleeve?

Alissa Marrapodi

September 10, 2010

14 Min Read
Who's Wearing Their Heart on Their Sleeve?

The natural products industry is in the business of repairing one broken heart at a time. Fortunately for manufacturers and formulators in the heart-health business, consumers are conscious of the well-being of their hearts, and they are familiar with heart-healthy products. In fact,75 percent of consumersgeneral population/primary grocery shopperssurveyed by The Natural Marketing Institute (NMI) indicated they used heart-healthy foods/beverages in the past year, and 54 percent are looking to consume more heart-healthy ingredients in their foods/beverages. A total of 54 percent of consumers indicated providing heart-healthy benefits make them more likely to purchase foods/beverages; however, only 19 percent of consumers use dietary supplements for heart health. Apparently, consumers are more likely to purchase fortified foods and beverages versus supplements.
Big names such as Cheerios and Quaker Oats have shined a spotlight on heart health, making ingredients such as plant sterols and fiber everyday familiar ingredients associated with the heart.
I believe ingredients most consumers are more familiar with are not necessarily in the nutraceutical industry, said Jeremy Bartos, ingredients project manager at pTeroPure. They would be something that people eat because its what their parents used to eat. A good example is oatmeal or Cheerios. I believe Quaker Oats has capitalized on this recently in their marketing campaigns.
However, Cheerios and Quaker Oats are not the only thing contributing to increased sales in this sector; the rise in bad hearts is also playing its role.
The popularity and growth of the heart-health market is directly related to the prevalence of the cardiovascular diseases (CVDs) and the aging population, said Joseph Evans, Ph.D., manager, pharmacology with Stratum Nutrition. The American Heart Association estimates nearly 81 million Americans (1 in 3 adults) have one or more types of CVD. Combined with high consumer interest in managing their own health, the heart-health market will continue to offer significant opportunities for growth and the commercialization of new ingredients. Revenues for the total U.S. heart-health ingredient market were valued around $563 million in 2008, and they are projected to exceed $1 billion by 2012 and $2 billion by 2015.
Laura Troha, marketing manager, Cognis Nutrition & Health, added: The number of Americans concerned about cholesterol has doubled since 2001.The reasons vary, but are mainly based on the aging of Baby Boomers along with increased awareness due to media reports and education on health risks. Heart-related concerns remain the number one consumer issue, according to marketing data.
One issue the market may face is its size. Its a giant with a large beating heart that is comprised of several factors related to the cardiovascular system. Think about it: blood pressure, cholesterol, cardiovascular disease (CVD), circulation, stroke the list goes on and on. Its size works for and against it; but, if you look at the numbers, it appears to working more for than against.

The heart-health market certainly is huge, from both a prevalence and economic perspective, Evans continued. The broadness of the market does present certain challenges, but at the end of the day, works to our advantage, as it increases our opportunity for innovation. There simply are a lot of competing products in many segments across a wide range of applications. However, the data we have reviewed tells us the consumer is willing to continue to purchase innovative products containing ingredients with heart-health benefits. The key to the successful commercialization of an ingredient within one or more of the heart-health segments is to build the opportunity on solid science, show the consumer how the ingredient offers a solution toward the support of heart health, and to focus on ingredients compatible with a wide range of applications.
Bartos attributed several factors to the markets growth, including the aging Baby Boomer population; the Internet; and the economic downturn, which led consumers to seek out less expensive alternative options such as nutraceuticals. The heart-health market has really surged over the past 10 years, largely due to the aging of the Baby Boomer generation, he said. The Baby Boomers are the first generation that really stressed education and knowledge, and they are putting it to good use to research new ways to maintain their health as they get older.
However, it may be difficult to access how consumers make their purchases. Are they familiar with heart-healthy ingredients? Or, do consumers buy as a result of a specific condition? Matt Phillips, president of Cyvex Nutrition, said consumers are familiar with both aspects, citing ingredients such as berries and oats, and Cheerios heart-health symbol as a condition-specific association. Consumers increasingly understand the health conditions associated with ingredients, he said. In general, the industry is moving more toward a condition-specific focus versus the ingredient. Conditions are becoming easier for consumers to understand and, in the process, removing the uncertainty about an ingredients benefit. Its also easier for the ingredient supplier to focus on conditions in order to develop a framework for investing in scientific research to support the ingredient.
Vincent Hackel, president and CEO of JBSL-USA Inc., agreed, stating, We think it is from condition-specific awareness. People think, I should lower my blood pressure or reduce my cholesterol, etc. They go out and find products that they feel will address these issues.
Christian Artaria, marketing director and head of functional food development at Indena, said the market is best viewed from two points of view: One where they are addressing a preventive market with a consumer base looking for supplements to maintain or maximize heart health, and the other where consumers know they have a problem, such as high blood pressure or high cholesterol, and are looking for natural supplements to provide part of the solution.
But, as in many sectors of the natural products market, antioxidants is a familiar term to many consumers. Generally, consumers recognize antioxidants. Whether they know what that word means is another story; theyve just been told enough times that antioxidants are good for them, said Steve Kupina, M.S., director of technical sales, Polyphenolics.

The Ingredients

There is no shortage of efficacious and researched ingredients for heart health, but a few ingredients really tug at the heart, e.g., a red wine lovers dreamresveratrol and grape seed extract (GSE)and plant sterols. In its 2009 U.S. Heart Health Ingredients Market report, Frost & Sullivan highlighted four ingredients, including phytosterols, omega-3s, beta-glucans and soy protein. Cocoa is also drawing some attention, as its been shown to decrease cholesterol,1 and decrease blood pressure, improve the health of blood vessels and increase the number of circulating angiogenic cells in patients with coronary artery disease (CAD).2 Coenzyme Q10 (CoQ10) is extremely popular in the management of a healthy heart. More doctors are recommending it, contributing to industry projections of a global rise that will exceed $133.3 million by the year 2015, according to Global Industry Analysts (GIA).
Several companies see the hearty benefits of resveratrol, and are making the most of its antioxidant properties. Cyvex coupled 5-percent trans-resveratrol with Euro black currant in its full-spectrum grape extract, BioVin Advanced. This ingredient has capitalized on the trans-resveratrol craze, and we have customers evaluating this ingredient for bioabsorption and other properties, Phillips said. Black currants cyanidin-3-glucosides are being evaluated positively for specific health benefits, and our market projections lead us to believe this is an up-and-coming ingredient.
Polyphenolics also offers a GSEMegaNatural®-BPwhich is focused on pre-hypertension blood pressure. Two human clinical studies have demonstrated consumption of special GSE with a special process may help in reducing blood pressure in elevated pre-hypertension to normal range, Kupina said.
A 2009 study randomized subjects into three groups(a) placebo, (b) 150 mg/d of GSE and (c) 300 mg/d of GSEand treated them for four weeks.3 Serum lipids and blood glucose were measured at the beginning of the study and at the end. Both the systolic and diastolic blood pressures were lowered after treatment with GSE as compared with placebo, suggesting GSE could be used as a nutraceutical in a lifestyle modification program for patients with the metabolic syndrome. There were no significant changes in serum lipids or blood glucose values.
Additionally, Leucoselect® Phytosome, a GSE from Indena with a high content of smaller-sized oligomeric procyanidins (OPCs), which are crucial for therapeutic activity, has been supported in four clinical trials. These studies have shown how Leucoselect Phytosome can improve the plasma oxidative status in healthy volunteers in different conditions,4 minimize the postprandial oxidative stress and enhance the resistance to oxidative modification of low-density lipoprotein (LDL),5 and reduce LDL and susceptibility to oxidative stress in heavy smokers.6 Artaria said. In in vivo studies we have shown anti-atherosclerosis activity 7,8 and cardiovascular protective activity.9
Pterostilbene is like resveratrol, as its a natural stilbenoid found in small berries such as blueberries and grapes. Both resveratrol and pterostilbene are phytoalexins, i.e., chemicals that are part of the plants defense system, and are produced when the plant is under attack by pathogens, such as bacteria or fungi, but there are some differences between he two. The main difference between pterostilbene and resveratrol is pterostilbene contains two methoxy groups and one hydroxyl group, while resveratrol has three hydroxyl groups, Bartos said. The two methoxy groups cause pterostilbene to be more lipophilic (oil soluble) than resveratrol, which increases oral adsorption and gives it a higher potential for cellular uptake.10,11
Pterostilbene is still relatively uncommon in the heart-health market; it gets most of the press for the anti-aging market because it is a relative of resveratrol, Bartos said. We are obviously hoping to change this with our clinical study on the effect of pterostilbene on lowering cholesterol and blood pressure.


Pterostilbene has several studies backing its beneficial effects on cholesterol,12,13 as well as other roles in heart health and other ailments. Pterostilbene got a decent amount of press back in 2004 when the first paper on its cholesterol-lowering benefits was published, Bartos continued. Both Time and Parade featured it in their end-of-the-year medical summaries and the BBC made a big enough deal about it that the sale of blueberries rose 185 percent in the United Kingdom in the first half of 2005. But with no commercially viable source for pure pterostilbene at the time, the buzz faded. pTeroPure is planning on regenerating the buzz with the launch of the pTeroPure Pterostilbene ingredient line and the results from the ongoing cholesterol-lowering clinical study, to be completed early next year.
Another fruit-forward approach to heart health is the cranberry, which is high in flavonoids, popular for fighting off CVD. Cranberry juice cocktail has been linked to improvements in endothelial function, and one study published in the beginning of 2010 evaluated the relative effects of extracts of cranberry juice compared to apple, cocoa, red wine and green tea.14 Procyanidin-rich extracts of cranberry juice triggered morphological changes in endothelial cells with reorganization of the actin cytoskeleton and increased immunostaining for phosphotyrosine residues. These actions were independent of antioxidant activity, according to researchers at Queen Mary University of London. And, there was an inverse correlation with an increased expression of a key endothelial transcription factor (Kruppel-like factor 2 [KLF2]), with a broad range of anti-atherosclerotic actions.
Pharmachem markets an ingredient Sytrinolderived from the peels of citrus fruits, with polymethoxylated flavones (PMFs) as one of the main active ingredients. Tangeretin and nobiletin are two of the most common bioflavonoids in citrus fruits. In a 2007 study, 270 mg/d of citrus flavonoids plus 30 mg/d of tocotrienols for four and 12 weeks in hypercholesterolemic men and women aged 19 to 65 years of age significantly improved cardiovascular parameters compared to placebo in all groups. Significant reductions were shown in total cholesterol (20 percent to 30 percent), LDL (19 percent to 27 percent), apolipoprotein B (21 percent) and triglycerides (24 percent to 34 percent).15
Moving away from the fruit family, plant sterols, as stated above, are well-known in the heart-health category. Cognis offers Heart Choice® natural plant sterols and sterol esters. In 2007, Cognis Heart Choice plant sterol ester capsules were effective in improving lipid profiles among hypercholesterolemic subjects in a free-living setting at the minimum dosage recommended by FDA.16 Additionally, consuming of a plant sterol esters-enriched spread consistently lower blood cholesterol concentrations, and was safe to use over a long period of time.17
Along the same lines, Stratum Nutrition developed ARTINIA (Chitin-glucan), which is a novel vegetarian fiber ingredient derived from Aspergillus niger that supports healthy arteries. In rodents fed a high-fat diet to induce oxidative stress, hyperlipidemia and arterial plaque formation, ARTINIA significantly reduced oxidative stress and triglycerides, and blocked the development of aortic plaque by approximately 95 percent.18 A separate study concluded regular consumption of chitin glucan was efficient in preventing the development of atherosclerosis, with a 97-percent decrease in the atheromatous plaque, thanks to a significant improvement of the antioxidant status.19
JBSL-USA Inc. offers nattokinaseNSK-SD® a serine protease derived from the traditional Japanese fermented soybean food natto, which, when taken at 100 mg/d has been clinically proven to offer a wide range of benefits that contribute to cardio health, including: significant profibrinolytic and antihypertensive effects,20 and reduced systolic and diastolic blood pressure in a randomized, double blind placebo-controlled trial.21
The heart-health market is beating fast and continuing to grow and grab consumer attention. Research is helping to make its case stronger and boost the use of heart-healthy nutraceuticals in fortified foods and beverages. This exciting market is sure to see a lot of changes and steady growth.

References are on the next page...

References for "Who's Wearing Thier Heart on Their Sleeve?"

1.       Lei Jia et al. Short-term effect of cocoa product consumption on lipid profile: a meta-analysis of randomized controlled trials Am J Clin Nutr. May 26, 2010

2.       Christian Heiss et al. Improvement of Endothelial Function With Dietary Flavanols Is Associated With Mobilization of Circulating Angiogenic Cells in Patients With Coronary Artery Disease J Am Coll Cardiol, 2010; 56:218-224

3.       Brahmesh Sivaprakasapillai et al. Effect of grape seed extract on blood pressure in subjects with the metabolic syndrome Metabolism. 2009 Dec;58(12):1743-6

4.       Nuttal S.L. et al. An evaluation of the antioxidant activity of a standardized grape seed extract, Leucoselect J. Clin. Pharm. Ther. 1998;23(5):385-9

5.       Natella F et al Grape Seed Proanthocyanidins Prevent Plasma Postprandial Oxidative Stress in Humans J. Agric. Food Chem., 2002, 50 (26), pp 77207725

6.        Vigna G.B. et al. Effect of a standardized grape seed extract on low-density lipoprotein susceptibility to oxidation in heavy smokers Metabolism 2003;52(10):1250-57

7.       Ursini F, Sevanian A. Wine polyphenols and optimal nutrition Ann N Y Acad Sci. 2002 May;957:200-9.

8.       Ursini F. et al. Optimization of nutrition: polyphenols and vascular protection Nutr Rev. 1999 Aug;57(8):241-9.

9.       Facino RM, et al. Diet enriched with procyanidins enhances antioxidant activity and reduces myocardial post-ischaemic damage in rats Life Sci. 1999;64(8):627-42.

10.   S. Hougee, et al. Selective COX-2 inhibition by a Pterocarpus marsupium extract characterized by pterostilbene, and its activity in healthy human volunteers Planta Med. 71, 387 (2005)

11.   M. Cichocki, et al. Pterostilbene is equally potent as resveratrol in inhibiting 12-O-tetradecanoylphorbol-13-acetate activated NFkappaB, AP-1, COX-2, and iNOS in mouse epidermis Mol. Nutr. Food Res. 2008;52,S62

12.   Mizuno CS et al. Design, synthesis, biological evaluation and docking studies of pterostilbene analogs inside PPARalpha Bioorg Med Chem. 20081;16(7):3800-8

13.   Zhiqiang Pan et al. Identification of molecular pathways affected by pterostilbene, a natural dimethylether analog of resveratrol BMC Med Genomics. 2008;1:7.

14.   Paul W. Caton et al. Regulation of Vascular Endothelial Function by Procyanidin-Rich Foods and Beverages J Agric Food Chem. Published online on Jan. 28, 2010.

15.   James M. Roza, CN; Zheng Xian-Liu, PhD; Najla Guthrie Effect Of Citrus Flavonoids And Tocotrienols On Serum Cholesterol Levels In Hypercholesterolemic Subjects Altern Ther Health Med. 2007;13(6):44-48

16.   Robert V Acuff et al. The lipid lowering effect of plant sterol ester capsules in hypercholesterolemic subjects Lipids in Health and Disease 2007, 6:11

17.   H F J Hendriks et al. Safety of long-term consumption of plant sterol esters-enriched spread Eur  J Clin Nutr. 2003;57, 681692

18.   Arlet Berecochea-Lopez et al. Fungal Chitin-Glucan from Aspergillus niger Efficiently Reduces Aortic Fatty Streak Accumulation in the High-Fat Fed Hamster, an Animal Model of Nutritionally Induced Atherosclerosis J. Agric. Food Chem. 2009, 57, 10931098

19.   Audrey Deschamps et al. Managing oxidative stress with a vegetal ingredient, chitin-glucan Agro FOOD. July/August 2009; 20(4):12

20.   Connie Ng et al. Oral Bioavailability of Nattokinase (NSK-SD®)

21.   Kim JY et al. Effects of nattokinase on blood pressure: a randomized, controlled trial Hypertens Res. 2008 Aug;31(8):1583-8

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