The digestive-health supplement market is becoming a mega category.
Claire Barnes, Technical Advisor, ADM Protexin, Doral, FL, www.bio-kult.com
Ramona Billingslea, Marketing Manager, Betsy’s Health Foods, Houston, TX, www.betsyhealth.com
Kurt Cameron, CMO, Diem, Ann Arbor, MI, www.diemdirectllc.com
Mark Drucker, MD, Advisor, Sun Chlorella, Torrance, CA, www.sunchlorellausa.com
Amanda Edwards, Store Manager, Mount of Olives Health Food, Panama City, FL, www.mountofolives.com
Traci Kantowski, Communications Director, Global Prebiotic Association, Spring, TX, www.prebioticassociation.org
Jay Levy, Director of Sales, Wakunaga of America, Mission Viejo, CA, www.kyolic.com
Dan Lifton, CEO, Quality of Life Labs, Purchase, NY, www.qualityoflife.net
Jason Mitchell, ND, CEO, Probulin, Topeka, KS, www.probulin.com
Ross Pelton, RPh, CCN, Science Director, Essential Formulas, Farmers Branch, TX, www.essentialformulas.com
Marge Roman, Manager, Stay Healthy!, Las Vegas, NV, www.stayhealthylasvegas.com
Scott Sensenbrenner, CEO, Enzymedica, Sarasota, FL, www.enzymedica.com
John Zapfel, CEO, Nature’s Sources, Niles, IL, www.naturessources.com
Reportedly 60 million Americans suffer with heartburn and another 4 million with frequent constipation—digestive unhealth is rampant. According to a 2020 ITC Insights Survey conducted by the Global Prebiotic Association (GPA), digestive complaints were listed in the top half of all health concerns.
Fortunately for consumers, science is learning more about the human microbiome. In fact, we now know that 70 to 80 percent of the immune system resides in the gut, which makes the microbiome critical to both gut health and immunity, two areas that have been challenged during the pandemic.
This challenge has given manufacturers and retailers an opportunity to rise to the occasion by offering a range of products for gut-health, mood, digestive health and immunity, which have a good deal of overlap due to what we’re learning about the gut-brain axis. Based on what we already know about the impact of stress, pollution, food chemicals and more, there’s no better time than the present to be able to help consumers address those needs, deficiencies and challenges with dietary supplements.
Today, we have “biotics” aplenty—prebiotics, probiotics, synbiotics and post-biotics—and so it can get a little confusing for consumers and retailers alike. That being said, consumers do seem to be embracing prebiotics regardless, as that same survey found that 81 percent of consumers have awareness of prebiotics, and, according to the GPA, that number is on the rise.
Natural products and diets for digestion have become more sophisticated and specialized—from diamine oxidase (DAO) to low-FODMAP (fermentable oligo, di-, mono-saccharides and polyols) fiber and everything in between, and this makes it vital for retailers and brands to break it down for consumers, translating the arcana of FAOs to the basics of the digestive health ABCs.
Here, a panel of industry experts helps explain.
VR: What is the state of the market for digestive health products right now?
Sensenbrenner: I think it has never been better, and for a lot of different reasons. For one, consumers are becoming much more aware of the importance of their digestive system. And, especially due to the pandemic, people are realizing that a lot of your immune health begins in your gut and digestive system. So, taking better care of that, whether it’s how you eat or supplement, is critical in today’s world.
Cameron: The state of the category is strong, with a projected 75 percent growth over the next five years. Data suggest the global market for digestive health products will reach 58 billion by 2025.
Pelton: Strong and continuing to grow. In 2020, when much of the world’s economy was shut down due to the COVID-19 pandemic, sales of Dr. Ohhira’s Probiotics remained very strong. This is evidence that many people recognize the importance of maintaining a healthy microbiome and strong immune system.
Mitchell: The overall category is down (14 percent) from 2018, yet Probulin’s volume increased by 25 percent over those same two years. Of course, that decline in the category could, in part, be related to the challenges associated with COVID. While 88 percent of the category sales are dominated by the top 15 brands, 11 of these 15 brands are on a decline while Probulin is not only one of four brands still showing growth but it is still the fastest growing. This is according to SPINS data pull 52-week period ending at the end of 2020.
Now following the decline in brick-and-mortar sales due to COVID-19, online sales have definitely increased, and Probulin has been hyper-focused on expanding its online digital footprint. This changing environment forces brands to reach the consumer in new ways. It is important to mention that our online focus is done in such a way to still support our brick-and-mortar retailers, as they are our heart and soul.
Zapfel: As witnessed by the massive use of, and advertisements for, antacids and acid blockers, digestive problems are at an all-time high. The publicity of a natural alternative to over-the-counter and prescription drugs for digestive issues hit mainstream media several years ago with a TV commercial for Activia featuring Jamie Lee Curtis. The popularity of natural alternative digestive aid products has grown exponentially ever since.
VR: Has the pandemic caused consumers to buy more digestive health products and has it caused out-of-stocks in this specific category?
Zapfel: Based on me being a consumer, plus looking at our company data, I have seen a dramatic increase in the sales of digestive health products. The pandemic, in my opinion, has increased the desire of people to be healthier through nutrition, exercise and also mental health. This desire has increased the quality of foods purchased plus nutritional supplements, as people want to take charge of their own health.
Billingslea: Because of the increased stress, which can cause issues with digestive health, we definitely saw an increase in consumers wanting digestive health support. At one point last year, our most popular digestive enzyme was out of stock for some time, but this was a supply issue from the manufacturer, as was the case with so many raw materials with all the disruptions in the supply chain the pandemic caused.
Mitchell: Probiotics are among the top choices in the arsenal. Time will tell if the past year will alter how they use probiotics, these events may create a desire to be more consistent about taking daily immune support.
Cameron: COVID-19-related supply chain disruptions and manufacturing slow-downs have affected just about everyone in every sector. Sales of our digestive health products have indeed been climbing and, due to COVID-19, we have had difficulty keeping up with demand. Though this is not all bad—it’s forced us to take a long-range look and develop long-term strategies to ensure stability in supply.
VR: For manufacturers and retailers, what digestive-health product questions do you get the most?
Barnes: The biggest questions we get are: “How do probiotics survive the stomach acid?” “Is it safe to take probiotics long-term?” “Are there any side effects from taking probiotics?” and “What’s the best time of day to take a probiotic?”
The first is an important question for consumers to ask a probiotic manufacturer as to how the probiotics get through the stomach acid in order to have their effect further down the digestive tract.
A cryoprotective coating is applied to Bio-Kult’s individual probiotic strains during a freeze drying process (lyophilization), which [helps] protect the bacteria from the acidity of the stomach and while on the shelf. This process puts the bacteria into a dormant state, and they then become reactivated when they meet certain moisture and temperature conditions in the GI (gastrointestinal) tract. An independent laboratory has carried out in vitro trials testing our strains, at a low pH mimicking the stomach for two hours, and no significant loss in the viability of the organisms was seen.
As to the safety of probiotics, the majority of clinical trials using probiotics have taken place over a number of weeks or months, however one particular study using probiotics daily in children took place over an 18-month study period and was followed-up after four years. Bio-Kult probiotics have been formulated to, and are considered safe to, be taken long-term.
Regarding side effects, probiotics are not associated with significant side-effects. However, some people may experience a [temporary] change in bowel movements such as loose stools or constipation or other symptoms such as bloating, gurgling or mild cramps when first introducing probiotics.
Best time of day? Some studies suggest that taking a probiotic 30 minutes before or with a meal will enhance the viability of the bacteria compared to taking it 30 minutes after, due to the buffering effect of food against the low pH of the stomach. Some research also indicates that survival of the bacteria may be enhanced by taking probiotics with foods containing fat.
Billingslea: There is almost an even split on questions between acid reflux issues and constipation/diarrhea issues, with the former perhaps slightly more popular, in part because people don’t necessarily want to discuss elimination.
Lifton: While we do get the occasional question about “How many CFUs do you have in your probiotic formula?” the “My probiotic is bigger than your probiotic” zaniness of the last decade seems to be slowly becoming less of a confusion point among consumers.
Mitchell: When buying a probiotic, consumers are typically looking for a product that works and is affordable. There is a myth that exists when discussing probiotics that the higher the billion count the better the product is. The thought is that if 50 billion is good then 100 billion is better. The truth is that is absolutely not true that more is better. In fact, research has revealed that taking more than 10 to 20 billion CFUs per day will not necessarily yield any better results. At Probulin, we focus on delivering the correct amount of surviving probiotic cultures (10-20 billion CFUs per day) using our MAKTrek 3-D delivery system.
VR: What are the main drivers of digestive un-health today—poor diet, medications, stress, ingredients in food, or other factors?
Edwards: In my personal opinion, not of Mount of Olives Health Foods, our food has been [tinkered with] through DNA changes (GMO [genetically modified organism] foods), excess toxicity (pesticides), and unnatural growing methods (excess fertilizers which leak into our waterways and create toxic water).
I personally believe that medications are harsh on the liver and create a sluggish liver and imbalances in enzymes, which, long term, negatively affect every system in the body. Stress impacts individuals differently. Many people also suffer from hormone imbalance, which do affect the gut. I personally feel that the amount of additives in foods is criminal. Food dyes are known to encourage focus problems in kids and adults. I also believe that the toxicity of our air and water negatively affects our microbiome.
Sensenbrenner: I think that the biggest thing, it all goes back to your diet, the modern diet. We’ve become this fast-paced society that really doesn’t have a lot of time for eating healthy. Our society used to be about locally grown food. You would sit down with your family, each and every night, and eat a complete meal with vegetables and locally grown and homemade food.
Today, we’re fast-paced, and we don’t have a lot of time for cooking, or even eating at all for that matter, and this has really forced the emergence of prepared foods that have inactive enzymes because of the way they’re processed. And a lot of the issues that our consumers are dealing with do relate to a lack of enzymes in their diet.
VR: While more options for consumers can be beneficial, is it a challenge to clearly communicate the USPs of today’s digestive health products?
Lifton: People have more options today than just “Have some Swedish bitters and call me in the morning.” And thankfully Tums is not the only option that people have. There are smart formulas with cutting-edge ingredients that good manufacturers have been putting together, and that’s fine. It’s only not fine when these space-age ingredients are added because they sound sexy—not a good enough reason, and not an ethical reason to add them.
Billingslea: I have to give credit for this answer to my long-time sales staff member, Lisa Ryan. New products targeted to special diets, like keto or low-FODMAP, don’t necessarily make it onto our shelves because we already have products that meet these needs, just without the marketing angle. What we do is work to educate our customers on just what the products we already have can accomplish for them, including supporting some of these specialty diets.
Pelton: We need to continue to educate people about the importance of a diversity of fiber, and about the fact that digestive health is largely regulated by postbiotic metabolites. In addition, there’s a new understanding about how vitamin D regulates the microbiome and, since vitamin D deficiency is a global epidemic, this contributes to dysbiosis and all other health problems.
Barnes: It certainly can become confusing for consumers to comprehend all the advice that is out there concerning digestive health, much of which can often be contradictory.
For example, while many different diets are promoted as being beneficial to digestive health, it should be understood that making drastic changes to an individual’s diet will have an impact on their gut microbiota. Certain diets, such as low-FODMAP, will considerably limit the food source for many gut bacteria and should ideally only be undertaken for a limited time, while aiming to rebalance the gut microbiota.
Consumers are becoming increasingly more knowledgeable and educated. Being able to explain the mechanism of action of digestive health products and diets in a way consumers can understand should be most helpful in communicating USPs while also expanding the consumer’s knowledge.
VR: In a similar vein, we have prebiotics, probiotics, synbiotics and post-biotics. How do we help consumers navigate this?
Sensenbrenner: So, enzymes break down foods mechanically, then probiotics create the beneficial bacteria so that your body can extract nutrients further. How do we help consumers understand that? It definitely goes back to education, to help consumers understand why they need an enzyme versus a probiotic or both.
And then you’ve got confusion between probiotics and prebiotics. And a lot of the emerging science is really showing that prebiotics, in many cases, are more beneficial than probiotics because they help the body to produce more good bacteria than would have been there without them.
But I think that we, as companies and retailers, need to almost “Sesame Street” the explanation between the mechanical process of enzymes versus the biological aspects of probiotics.
Levy: Now that probiotics are found in everything from pizza to beer, much of the public has learned about the potential health benefits of living microbes. The new microbiome supplements, however, may require a little more educational support. It could be something as simple as a glossary handout or poster to explain the various terms.
Prebiotics are the dietary fiber that nourish probiotics. Essentially, they’re fertilizer for good bacteria. High-fiber foods, such as whole grains, bananas, green onions, garlic, soybeans and artichokes contain prebiotics. However, most people don’t eat enough of them to realize their benefits. Research backs the benefits of prebiotics, including healthy weight management, supporting regular bowel movements and improving the bioavailability of minerals.
Synbiotics are products that contain both probiotics and prebiotics. The “syn” comes from the synergy of both working together. These innovative products optimize benefits to support overall wellness.
Prebiotics and probiotics are better together. When paired with probiotics, prebiotics have been shown to improve the survival of probiotics as they pass through the digestive tract and help them thrive when they reach the gut.
Barnes: Put simply, prebiotics feed the gut bacteria, probiotics are live microorganisms that help balance the gut microbiota, and post-biotics are the by-products of the gut bacteria when fermenting fiber, which appear to help regulate the gut microbiome as well as having beneficial functions on the host.
VR: What are the biggest trends you see in natural products for digestive health today?
Billingslea: I’m glad to see more and more recognition of the importance of gut health to other areas of the body, such as the brain and heart. I think probiotics will continue to expand and grow in popularity. I feel this trend is more likely to last than diet trends, which tend to rise in popularity and then fade.
Mitchell: Consumers are now starting to see probiotics as one of the essential supplements that should be taken daily to help maintain digestive health and immune function. The old thinking was that probiotics were only appropriate when things in the digestive system were out of balance.
The growth is in large part due to more consumers adding it to their routine and experiencing meaningful benefits, as well as researchers continuing to reveal additional applications. At Probulin, we even have topical probiotic products to support skin health and the skin microbiome. I firmly believe that a probiotic could eventually become an essential nutrient with an assigned RDI (recommended daily intake) value. At least I hope that that happens. Research certainly supports the use of probiotics and how important they are.
Roman: I think the trend is leaning toward products to fix digestive issues rather than Band-Aid the problems. Companies seem to be producing more condition-specific formulas for special diets and food sensitivities.
Cameron: I believe that—rightfully so—the low-FODMAP movement will overcome the “anti-gluten” movement relatively quickly, especially with organizations like Monash introducing certification and education programs and services like Epicured offering low-FODMAP meal subscriptions. Specialty fibers and even traditional fibers like psyllium will continue to see large gains.
Drucker: Consumers that are interested in digestive health are becoming more discerning in the products they choose. They are looking for healthier foods and nutritional products that are less processed and based upon whole foods.
Barnes: Many more individuals are wising up to the trend of maintaining wellness for digestive health. Instead of waiting until they have symptoms of poor digestive health, they are seeking out products that may prevent digestive conditions and support their gut health.
Sensenbrenner: It’s all about the human microbiome. With the human microbiome, it’s very similar to when humankind first started considering exploring space. We only understand a small part of it, right? And less than 1 percent is what we understand of the microbiome’s impact on the human body. So, I think, for the coming decades, that’s probably one of the biggest trends that we’re going to see, which is really trying to understand and explore the human microbiome.
VR: For manufacturers, in a few paragraphs please spotlight one or two products or proprietary ingredients you are most excited about and why? For non-manufacturers, what do you believe consumers are most interested in, digestive health-wise?
Levy: Our new innovative synbiotic, Kyo-Dophilus Pro+, is formulated to balance the GI system and promote digestive health for general well-being. It includes our clinically studied proprietary blend of human strain Lactobacillus gasseri KS-13, Bifidobacterium bifidum G9-1 and Bifidobacterium longum MM-2 that we call The Friendly Trio.
Along with diverse probiotic bacteria strains, Pro+ Synbiotic includes the prebiotic BioEcolians, which specifically stimulates the growth of the lactobacilli and bifidobacteria bacteria. This alpha-glucan oligosaccharide is composed of short glucose chains linked by glycosidic bonds α1-2 and α1-6, obtained from sugars by completely controlled enzymatic process. Studies demonstrate that 81 percent of BioEcolians prebiotic reach the gut where it can be used by the bacteria. The prebiotic promotes the growth of beneficial bacteria in the bowel while limiting the growth of pathogenic strains, strengthens the intestinal barrier and helps regulate innate immunity.
Adding an effective prebiotic like BioEcolians to our nine clinically studied probiotic strains creates a revolutionary solution to conveniently improve both the user’s digestive health and their immune response in one synbiotic formula.
Sensenbrenner: One of our newest products is our Heartburn Soothe product, which is a product that literally works in seconds. It was developed in partnership with the Roskamp Institute, and it was a multi-year project. They helped us develop what I believe is the best product on the planet for helping consumers to naturally relieve the symptoms of occasional heartburn. It features a proprietary blend of alginic acid, prickly pear cactus, betaine and calcium carbonate to provide immediate relief and reduce pH levels to a comfortable range.
The second is our kiwi product called Kiwi Regularity. I’m excited about that product too, because that came out of a partnership with a family in New Zealand. They’re the original kiwi producers, and they’ve got a very special kiwi that’s beneficial for relieving constipation. Constipation is an area that’s often overlooked, yet millions of people are suffering from it. Our product is a very gentle formula but, when you take it, it helps to normalize your body so that you’re not dealing with that discomfort of constipation.
And then, of course, there’s our Digest Gold product, which is the No.1 complete meal digestive product, which continues to be a product that excites me.
Cameron: We are most excited about diamine oxidase (DAO) and xylose isomerase (XI). DAO is the primary histamine-degrading enzyme, and it works just as lactase works for those who are lactose intolerant. XI does the same for fructose. These are attractive to consumers because they are simple, safe and effective enzymes that provide tangible, “experiential” benefits within minutes.
Lifton: Featuring GutGard, artichoke and ginger, our Peptisol product is geared to occasional indigestion and heartburn, plus it promotes daily regularity. Human clinical trials have found that artichoke leaf extract and GutGard, a proprietary extract of licorice root, both relieve abdominal discomfort, bloating and fullness that come with occasional indigestion, while ginger has been shown to gently soothe nausea. And the artichoke extract helps with regular elimination.
Deodorex works from the inside out, helping to reduce body odors where they originate by decreasing levels of these chemicals in the intestines and blood. Deodorex features Champex—a patented proprietary extract of champignon mushroom. Champex has been shown to: reduce body odors by up to 60 percent; inhibit the chemical that causes bad breath; purify the blood of ammonia; maintain normal uric acid levels; and support the health of the kidneys.
ProbioPure features the probiotic Morinaga BB536, which provides help for occasional constipation, diarrhea, abdominal discomfort, gas and bloating. BB536 is one of the world’s most researched and effective probiotic strains. Human clinical trials have shown that BB536 provides: a natural defense against episodic digestive upsets, including occasional constipation and diarrhea, abdominal discomfort, gas and bloating; improves the body’s ratio of beneficial bacteria; and decreases ammonia and putrefactive products in the digestive tract.
Barnes: Bio-Kult Advanced Multi-strain formulation is a unique probiotic supplement containing 14 different strains. Bio-Kult Mind contains the highly researched strain Bacillus subtilis PXN 21, grape and wild blueberry extracts (Memophenol) and zinc. Zinc contributes to normal cognitive function, the protection of cells from oxidative stress and the normal function of the immune system.
Memophenol is a patented formula that combines bioavailable flavonoids French grapes (Vitis vinifera) and Canadian wild blueberry (Vaccinium angustifolium) extracts. Research has indicated that Memophenol is highly bioavailable, can improve neurogenesis (the formation of new brain cells), can improve neuronal connections, and has improved learning and memory in human clinical trials.
Mitchell: Probulin’s newest product, Total Care Immune, supercharges that connection by adding 100 mg of Eldermune (equivalent to 4,225 mg of whole elderberry) to a specially formulated blend of 10 probiotic strains. It’s all encapsulated, with pre- and postbiotics, in Probulin’s MAKTrek 3D delivery system, so they survive the journey.
Drucker: Sun Chlorella is a whole food supplement that is ideal for digestive health. It is a fresh-water algae that is packed with vitamins, minerals, antioxidants, fiber and chlorophyll. It is an ideal whole food for digestive health. It cleans the digestive system and nourishes the gut bacteria that make up the gut microbiome.
VR: For manufacturers, what tools (shelf-talkers, etc.) and value-adds do you offer retailers to help them differentiate and sell products in this category?
Sensenbrenner: The digestive category is one of the few categories that literally impacts the entire population because everyone digests food. And digestive issues involve children, involve men, involve women and all different age groups. And yet, the majority of the population does not realize that the best solutions for digestive health are actually found within retail stores.
At Enzymedica, we provide signage, such as large posters and signs, and we will even custom-print signs for retailers to help them hang in their storefront windows, which will help retailers advertise to consumers as they’re driving by their store.
If you’re suffering from a food intolerance, stop in Jane’s Health Food Hut; we’ve got the answers. And that’s a great thing that retailers can do. Use the front of your store to help consumers understand that you’ve got the answers and increase your traffic as a result of that. You can use the digestive category as a key cornerstone to driving that traffic. And then, as they come into the store, make sure that your digestive products are located in a prominent location so that they can immediately see them. It could be an end-cap dedicated to digestive health or one of the main-aisle sections for those consumers who walk into the store, who may be new to the store, looking for digestive solutions.
Cameron: After starting out with a consumer-direct and physician-direct model, we are just now entering the retail channel. We’ve developed shelf-talkers, end caps, and small sample tubes of some items that can be positioned point-of-purchase. We’ve also developed both print and digital informational pieces specific to the channel, which retailers can share with their customers.
VR: What predictions do you have for the future of the digestive health category?
Zapfel: Probiotics in various forms—drinks, yogurt and supplements still top the list. Prebiotics, fiber, etcetera, are making strides but have a way to go to become mainstream.
Digestive enzymes supplements are making the most strides in the last couple of years to become mainstream and along with probiotics are the greatest one-two punch available for digestive health.
Cameron: It’s just going to keep growing, based on the data available and our own experience in the field. I do believe we will see some culling of the vast probiotics offerings, with more specialization and specificity in application. I think we’ll see more innovation in the ingredient sector, both drilling down into probiotics with more specificity as well as a move away from probiotics toward other compounds that address the complexity of GI and digestive health.
Sensenbrenner: I think that the digestive category is consistently stable, and, as the population just naturally continues to increase, the marketplace becomes larger and larger. Because so many people are dealing with digestive issues, it is a category that is worth the investment for companies like Enzymedica, so we can really expand human discovery as we’re searching nature for its best solutions, and that’s really what Enzymedica does best.
Lifton: My “gut” tells me that the category of supplements for digestive health will only continue to grow. Why? Because medication use shows no sign of dramatic drops, stress is unavoidable and our food supply will, for the foreseeable future at least, continue to be dominated by chemical-laden fast, packaged and canned foods.
Fortunately, digestive health science, research and product development relating to dietary supplements also keep growing, and so we’re very happy to continue expanding our line of innovative research-backed digestive health products for consumers.
Barnes: Research is now heading to areas beyond digestive health and immune health, which are the categories that have dominated the probiotic space since the beginning of this market. The market is moving toward a ‘wellness’ positioning rather than remaining just in supporting digestive conditions. Weight control, mood/depression, oral health, fertility (both male and female), skin (including anti-aging/wrinkles), energy/endurance and sleep are all areas being worked on for the future of this category. VR