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Warning Signs

Dietary supplements, along with a healthy diet and exercise, offer the millions with pre-diabetes and metabolic syndrome a chance to reverse their conditions before they develop into disease.


As members of the natural products retail industry, we are always aware of numbers. Sales of dietary supplements, organic products, personal care items, functional food and beverages are all regularly reported, making huge numbers that sometimes soar well into the billions seem commonplace.

While these estimates are valuable in their own right, they tend to overshadow numbers that, while smaller in scale, are in fact much more necessary to be heard, such as these: 54 million Americans aged 21 years and older have pre-diabetes, according to the Centers for Disease Control and Prevention (CDC) , and more than 50 million Americans have metabolic syndrome, according to the American Heart Association, equating to roughly one in four adults—for each condition.

The Risks As a metabolic disorder signifying a higher level of blood glucose than normal but not enough to be categorized as diabetes, pre-diabetes is a critical warning of the very high likelihood of developing type 2 diabetes. The possibility is so much greater that the CDC estimates people with pre-diabetes to be five to 15 times more likely to develop type 2 diabetes than people with normal glucose values.

Also increasing the risk for developing type 2 diabetes is the group of metabolic risk factors known as metabolic syndrome. Closely related to prediabetes, metabolic syndrome, or insulin resistance syndrome, is the result of the body being unable to efficiently use insulin.

One of the challenges that has led to the high incidence of both conditions is that people don’t tend to notice any symptoms, and may in fact have the conditions for several years without noticing anything. While there are two tests people can take to determine whether they have pre-diabetes, such as fasting plasma glucose (FPG) and the 2-h oral glucose tolerance test (OGTT), there are also multiple risk factors for both of these conditions people should know. 

These risk factors include obesity, age over 45, lack of physical activity, positive family history of diabetes, gestational diabetes, the presence of elevated triglyceride and low HDL levels, and hypertension, said Dr. Michael Harris, director of diabetes for Cedars Sinai Medical Group in Los Angeles, and the medical advisor for Granola Gourmet (Santa Clarita, CA). “The existence of a sedentary, fast food, supersized lifestyle has definitely contributed to the high prevalence of both insulin resistance and pre-diabetes,” he said.

Another factor leading to the high incidence of both conditions, according to Guy Devin, national science educator for Source Naturals (Scotts Valley, CA), is how our food is processed. “It’s not that food itself is bad, but rather what we have done to our food supply, like genetically modified food organisms, the addition of high fructose corn syrup and the use of toxic artificial sweeteners,” he said. “This increases inflammation in the body, which then causes a cascading effect within our bodies.” 

While inflammation is designed to kill infections and promote healing, chronic inflammation can produce growth factors and stimulate very serious degenerative disease processes, added Mike Shirota, president/CEO of Mushroom Wisdom (East Rutherford, NJ). Among the conditions stemming from pre-diabetes and metabolic syndrome aside from type 2 diabetes, Shirota mentioned Alzheimer’s, cancer, autism, infertility stroke, heart disease and obesity.

“Alzheimer’s disease has already started to be called ‘type 3 diabetes,’ especially among the practitioners who apply integrative or alternative medicine,” he said. “I personally believe that cancer should be paid much more attention as one of the effects of metabolic syndrome.

It is said that cancer feeds on sugar, and the relationship between a high level of glucose in blood and cancer (especially breast and prostate) has been discussed lately.” State of the Market Though the realization of the large population of people affected by both metabolic syndrome and pre-diabetes can be discouraging, it does show there is potential for this category that, if realized, could present opportunities for exceptional growth.

For Mitch Skop, senior director, new product development, Pharmachem Laboratories (Kearny, NJ), consumers have already started making the connection between a poor diet, weight gain and metabolic syndrome. “We have seen increased interest in our natural products that reduce the absorption of carbohydrates and support healthy blood sugar levels,” he said.

“Worldwide, we have seen an enormous increase in Phase 2 Carb Controller sales as this crisis has reached pandemic levels worldwide.” Donna Noonan, Mushroom Wisdom’s vice president of marketing, has also seen an increase of sales on wellresearched products, but also noted that one of the hurdles that will need to be overcome to generate more sales is the fact that this topic is not appealing to many.

“The thought of blood sugar lowering, lowering blood pressure and reducing insulin resistance usually goes along with the dreaded ‘weight’ issue—these are not fun topics, especially if they hit home for many.” What is helping to make this topic more appealing to the masses, however, is the development of food that is both low glycemic and good tasting.

“Public awareness of low glycemic foods is growing. In just the last year we have seen national advertising campaigns for low glycemic diets and weight loss for diabetics,” said Jeff Cohen, president and granola visionary with Gourmet Granola, which offers energy bars for diabetics. “In 2006 the low glycemic market was only $350 million, but growing 45 percent annually. In 2011 it is expected to be $1.8 billion, according to a Packaged Facts report.” Dietary Supplements … and Pharmaceuticals?

Advertising dollars spent by drug companies have brought their message to the forefront of public awareness and have allowed them to maintain a large segment of health care dollars. While this may potentially spark feelings of contention among advocates of supplements, in regards to metabolic syndrome and prediabetes, it is important not to overlook the necessity of both sides in lowering the impact of these two conditions.

“We do not subscribe to the ‘us versus them’ approach, but fully believe in the pluralistic approach,” said Ulrik Breval-Carlsson, president of Sprunk-Jansen (Petaluma, CA), who cautioned retailers to never encourage people to ditch their cholesterol-lowering drugs in favor of any dietary supplement.

“Instead, retailers, who are specialists in dietary supplement advantages, should ensure their customers have the proper education about how such supplements as [Sprunk-Jansen’s] WEIGHLEVEL, CHOLESTEROL LEVEL and GLUCOSE LEVEL work harmoniously to support a healthy diet and exercise program along with the pharmaceuticals they may be taking.” 

There is, however, good news for proponents of natural alternatives, according to Skop. “Rising drug and health care costs will continue to benefit the natural products industry. With more consumers making the connection between metabolic syndrome and a poor diet, they realize that taking a drug isn’t always the answer,” he said. “An increased focus on improving diet, exercise and use of natural products are other positive trends for our industry.” In influencing more people to start taking preventative measures, Devin recommended retailers “get the word out that nature has the wisdom to heal us on every level. Hippocrates said it well: ‘Let food be your medicine and let medicine be your food.’ If we look at the overall growth of our industry, we are making headway in so many important categories that we are now setting the competition.” 

Making the Difference In furthering the impact of the trio of dietary supplements, healthy diet and exercise, the delivery of simple but compelling information to customers will be an important part of a successful message, as will communicating to those with pre-diabetes and metabolic syndrome that they can do something to reverse the momentum of these conditions.

“Metabolic syndrome can be treated very effectively with proper diet and exercise, and it does not have to lead to diabetes,” assured Frank Assumma, director of marketing at Natural Health Science (Hoboken, NJ), the exclusive distributor of the French maritime pine bark extract Pycnogenol®, which has been shown to benefit people with metabolic syndrome, pre-diabetes and diabetes. “It is important to stress the need to maintain a healthy weight, and to exercise and eat properly.” 

In getting across the importance of supplementation, retailers have a number of avenues to pursue in collecting the information they need to keep both themselves and their staff up-to-date in this category. One which Carol Ketring, store manager for Health Food Center in Oklahoma City, OK, utilizes is the manufacturers themselves. “Nordic Naturals, Natural Factors and Nature’s Plus are among the companies that always have research to back up their products,” she said, adding that many companies also offer staff trainings. 

“In this industry, there are opportunities to learn everyday.” In helping customers gain access to some of the latest information and research, Health Food Center has an extensive resource center where their customers can find books on a variety of health topics. “It’s like a mini Barnes & Noble,” Ketring said. “People can search for a good diet or exercise program, or learn what they can do to keep their blood sugar in balance.”

For retailers who may not have the space to devote to a resource center, Source Natural’s Devin strongly recommended they establish within their supplement section a space where customers who are dealing with managing metabolic inflammation can find the products they need. After all, said Devin, “Each store in our industry is now the greatest source of information, quenching the flames of inflammation, bringing optimum health without side effects. When it comes to lifestyle and wellness prevention, we as an industry can have the farthest reaching effect for our communities.”