Along with conveying diet and lifestyle changes to a growing memory and cognition base, retailers lean on suppliers for the tools to help customers make the best decisions.

In a report by the Centers for Disease Control and Prevention (CDC) 1, more than 16 million people in the United States are living with cognitive impairment and this number has been rapidly increasing over the past decade. Gerald R. Cysewski, PhD, chief science officer of Nutrex Hawaii, Inc., cited figures showing that by 2025, the number of people age 65 or older with Alzheimer’s disease (AD), a major cause of dementia, will increase by 40 percent to an estimated 7. 1 million people.

Yet concern over maintaining our mental faculties is not reserved just for the elderly. A current estimate by the Family Caregiver Alliance2 is that between 13.3 and 16.1 million Americans age 18 and over are afflicted with common brain disorders and cognitive impairment from various causes.

“Consumers generally believe that memory and brain support products are only beneficial for those in the 55 and older category. However, studies show that memory decline starts at the age of 27,” said Tuan Pham, director of California-based Tangut. “In fact, by 55 and older, it may be a little too late to reverse this process. It is definitely beneficial to start a better nutritional regimen by age 55, but it would be much more effective to start this process earlier.”

A Growing Market

Starkie Sowers, director of education with Clark’s Nutrition & Natural Foods Market based in Riverside, CA, offered a unique view of the memory & cognition category’s expanding consumer base. The three-store chain carries a diverse brain health category—more than 200 products—as each store serves a wide variety of shoppers.

“Both Riverside and Loma Linda serve blue- and white-collar communities, but Loma Linda is more vegetarian. Then you have Rancho Mirage, which is filled with retirees between October and May. For each store, you have different types of customers with their own unique needs,” said Sowers. “First, you have 18- to 25-year-olds looking for a mister or missus, going to school and studying (Riverside and Loma Linda). Then, across all three stores, you have the 30- to 50- year-olds who are trading their health for wealth—memory is business and they need to stay sharp, but life stress is taking its toll. Finally, particularly in Rancho Mirage, you have those 55 and older looking to trade back their wealth for their health. You’ll have hourly conversations with customers seeking memory support. It’s up to us to find out the best type for each customer.”

It is an equally important category at Down to Earth Organic & Natural, a five-store chain headquartered in Kailua, HI, that carries at least 40 UC SKUs (not counting DHA/omega-3s, which are very important in cognition and memory support, according to Wellness Department Manager Carmela Wolf) out of approximately 4,200. “We can round up to one percent, which does not sound like a lot, but it actually is an important category with prominent placement,” she said.

The store stocks heavily, especially as the Baby Boomer population over 60 continues to grow, but also to help its overall consumer base. “Not only are Boomers and other seniors looking for memory support, but so are younger professionals and students,” said Wolf. “Unfortunately modern day stress coupled with poor diets and lifestyle can limit anyone's brain function.”

Diet & Lifestyle

As we age, we lose brain cells. This is a normal part of life, and happens to us all, even if we do not face AD or other dementias, noted Thomas B. Shea, PhD, on the board of advisors at Sevo Nutraceuticals and a professor at the University of Massachusetts Lowell. “But unlike most of the cells in our body, brain cells are intended to last for our entire lifetime. Brain cells can’t heal as easily as skin cells, for example. While there is a limited degree of regeneration in the brain, there is not enough to overcome normal age-related loss,” he said, adding that we also fall into routines and can easily neglect exercising our brains.

Gene Bruno, MS, MHS, director of category management with Twinlab Corporation in New York, concurred, noting research that suggests that we can help maintain healthy memory and cognitive function as we age by staying intellectually engaged, maintaining cardiovascular physical activity and minimizing chronic stressors.3

And while poor nutrition also favors loss of cognitive function, optimal nutrition can reduce or delay it. “It is important to maintain a brain-healthy diet that is high in poly- and mono-unsaturated fatty acids (as found in fish and olive oil, vitamin E and polyphenols and antioxidants3,” said Bruno. “Conversely, avoidance of these healthy lifestyle practices is likely to exacerbate memory and cognitive function issues.”

Excessive weight and elevated blood sugar are dietary consequences also associated with mild cognitive and memory impairment, according to Dallas Clouatre, PhD, consultant for research and development with California-based Jarrow Formulas, Inc. “The American penchant for consuming refined carbohydrates and simple sugars is considered by many researchers as major contributors to mental decline with age. For instance, high, but not moderate, caloric intake is associated with mild cognitive impairment.4”

Further, a September 2012 study5 noted obesity accelerates cognitive decline and AD progression. “Participants who were both obese and metabolically abnormal showed a 22.5 percent faster decline in memory and thinking skills than participants of normal weight and no metabolic abnormality,” said Tangut’s Pham.

Wolf and the Down to Earth team believe that selling local, fresh, organic and all-vegetarian products arms the community with tools to be healthier. And through its outreach program, the store offers a variety of free seminars and health talks so they can learn the diet and lifestyle lessons to use those tools to their maximum benefit.

“Down to Earth provides free vegetarian cooking classes and nutritional seminars in its stores, and in the community at local hospitals and schools almost since we started in 1977. This year we also began offering intense cooking workshops for a fee, where customers receive hands-on training,” said Wolf, offering examples that include gluten-free and raw food workshops that are conducted in three-sessions and special workshops for children. “We also participate in health fairs and other events to help educate island communities about the importance of living a healthy, vegetarian lifestyle.”

Providing a Story

Retailers Wolf and Sowers both understand that properly advising their customers is about more than simply directing them to a product.

“Customers are always looking for a story. They’re trying to decipher science and how it applies to their bodies and the products we offer,” said Sowers, noting that Clark’s Nutrition offers Life Extension magazine in its stores, and commends the publication for doing a good job talking in specifics about how ingredients work. “We also utilize Aisle 7 in our stores, which puts the data and science in front of the customer, but you still need soft information.”

“Understanding the differences of how each supplement can support healthy brain function really allows us to help customers find the right fit for them,” said Wolf. “Knowing our products through training, usually from suppliers, is key.”

A supplier of Down to Earth’s is a local supplement provider, Nutrex Hawaii. At the heart of the company’s offerings is its BioAstin Hawaiian Astaxanthin.

“Retailers need to be knowledgeable about the products they sell and we provide as much educational material as possible. We try to continually educate retailers on the most current research on the benefits of spirulina and astaxanthin,” said Nutrex’s Cysewski, noting that since 2005, 21 scientific studies (invivo and in-vitro animal studies, in-vitro studies with human cells, and two studies involving human subjects) have been published on potential benefits of astaxanthin of brain health. “In a recent study conducted at Toboku University in Japan, researchers found that the level of phospholipid hydroperoxides, which abnormally accumulate in patients with dementia, could be reduced by consumption of astaxanthin over a 12-week period. These researchers suggest that astaxanthin may contribute to the prevention of dementia.”

In 2009, Nutrex Hawaii launched OmegaAstin, an all-vegetarian form of omega-3, 6 and 9 that also contains Bioastin Hawaiian Astaxanthin, which specifically targets brain and cardiovascular health.

Staple Strengths

According to Clark Nutrition’s Sowers, Gingko biloba, which is documented to increase circulatory blood flow in the body, especially blood flow to brain tissue, is the core single-nutrient at the top of his staff’s list for “customers seeking to be a little sharper.”

Gingko is also the chief botanical in American Health’s More Than A Multiple with Brain Essentials’ neurosupportive complex. According to Susan Hazels Mitmesser, PhD, nutrition research with the New York-based company, the product goes the extra step to provide targeted support for those seeking added brain support while also receiving all the benefits of a broad spectrum multivitamin supplement.

“In balanced combination, vitamin B12 promotes a healthy nervous system, which is essential to brain health.Ginkgo supports memory and clarity, and is especially helpful with occasional, mild memory problems that we may naturally experience as we age. And turmeric is a vital antioxidant that helps fight the damaging effect of free radicals,” Mitmesser explained, adding that since free radicals can impact healthy cells, supplementing with antioxidants helps provide on-going benefits. “Along with these essential ingredients More Than A Multiple with Brain Essentials delivers whole foodbased nutrition with a broad spectrum of vitamins, minerals, phytonutrients and energy-rich whole food concentrates: advanced benefits for both brain and whole body health in one complex.”

Newer Ingredients

While Tangut’s memory and cognitive product, Memory Fortifier, also features ginkgo, the company differentiated it with the addition of two key ingredients in its natural blend. “Ginkgo increases blood flow to the brain and improves short-term memory, but we also use Cistanche tubulosa, a new ingredient to the U.S. from Tibet, which stimulates nerve growth factor; and Lycium babarum (goji), which reduces neurons apoptosis and increases human antioxidant efficacy,” explained Pham.

“Current products on the market focus mainly on ingredients that are beneficial for short-term memory. Our product also has goji and cistanche, which research has indicated provides long-term benefits for memory,” he continued. “As such, our product is a more complete and balanced product for memory and brain health.”

Memory Fortifier is delivered in a veggie tablet especially convenient for use by the elderly.

Twinlab’s Bruno also highlighted the need to stand out in a market of products that seem to be a variation or reiteration on the same nutraceuticals that have been used for decades. “The market would benefit by the introduction of new nutraceuticals with cognitive benefits that also have human clinical research behind them.That’s why Twinlab introduced BioPQQ Microtabs.”

BioPQQ Microtabs contains 20 mg of pyrroloquinoline quinone (PQQ).Research has shown that PQQ supports the activity and replication of mitochondria, the parts of the cell that are responsible for producing ATP (the body’s energy currency). Clinical research has also found that supplementation with PQQ may help to support healthy cognitive function.6

In 2007, a human double-blind, placebo-controlled clinical trial7 was conducted in Japan using BioPQQ.Seventy-one subjects between the ages of 40 and 70 were supplemented with a placebo, with 20 mg of PQQ daily, or with 20 mg of PQQ along with 300 mg of coenzyme Q10 (CoQ10).The results showed tendencies toward improvements on some cognitive health tests in the PQQ group compared to the placebo group.

Twinlab’s BioPQQ product is exclusively available in a very small microtab, which makes them extremely easy to swallow. In addition, BioPQQ Microtabs are specially formulated to break down very rapidly in the stomach so that they are promptly available for absorption, according to Bruno.

Beyond stimulating mitochondrial activity, PQQ is a shining star on the market due to the strong antioxidant effects it exhibits. “PQQ is considered by some to be the only new vitamin discovered in the past couple of decades or more. It suppresses the excessive generation of a number of radicals, including the extremely harmful peroxynitrite radical,” noted Jarrow Formulas’ Clouatre. “In aging humans, memory, attention and cognition decline with age, at least in part due to oxidative stress. The combination of 20 mg PQQ plus CoQ10 in one clinical trial was sufficient to yield substantial benefits to human test subjects in all three areas.8”

While Jarrow was excited to introduce its own PQQ product as a recent addition to its line that supports key brain functions, it also recently launched MagMind, a new form of magnesium that crosses the bloodbrain barrier. “MagMind is a magnesium L-threonate that increases magnesium levels in the brain more effectively than other forms of magnesium,” said Clouatre. “Emerging research shows that increasing the brain magnesium level supports learning, working memory, as well as short and long-term memory in the young and aged.”

A Personal Experience

As a full service pharmacy and medical equipment supplier, Shawn McKallagat, Rph, owner of Letourneau’s Pharmacy Inc. in Andover, MA, frequently interacts with patients & caretakers who take memory and cognition very seriously and has observed a shift in consumers of these products to a younger population.

“This shift seems to be occurring via customers coming into the store over initial concern for a parent with a likely or confirmed dementia or Alzheimer's diagnosis. We have found that an individual in their late 40s to early 60s who is caring for an aging parent is much more regularly taking the same product they buy for their parents,” he added. “People are becoming much more cognizant of the hereditary link associated with memory impairment and are increasingly willing to address it at an earlier age.”

Letourneau’s has carried natural products and supplements for more than 10 years, but it carries only a select few products that address memory & cognition. To become a core product, it must meet the pharmacy’s top criteria: scientific backing, hands-on supplier support and positive customer testimonials.

“Some customers are very interested in the science behind products and what actually makes them unique within the marketplace, while others prioritize knowing we have many customers who have great results with the item we're recommending,” said McKallagat.

The strongest tool in Letourneau’s arsenal is a partnership with Massachusetts- based Sevo Nutraceuticals and its Perceptiv product, which provides overall antioxidant protection with folic acid and vitamins B12 and E, and boosts energy for brain cells with acetyl-L-carnitine. Over the 20 years of study that the team has conducted on the formulation, there have been seven independent clinical studies. The latest two were presented at AAIC (Alzheimer’s Association International Conference) July 2013 and will be published later in 2013.

“Perceptiv not only provides antioxidant protection and energy, but it also targets a specific metabolic pathway that is critical to maintain brain cell health and function,” said Sevo Nutraceuticals’ Shea. “There are many products on the market without independent clinical studies that demonstrate effectiveness.”

McKallagat noted that Sevo Nutraceuticals offers more support than any other vendor he works with at the pharmacy. “In addition to more formal seminars Sevo hosts that usually include caretakers, end users, physical therapists and physicians, on several occasions they've also made themselves personally available to customers by setting up a table for the day and fielding questions or interest as people come through the store,” he said, noting that the company also actively forwards any new brain health information that is released as it pertains to its product specifically or simply to the subject as a whole.

“We spend time educating all of our retailers on the topic of brain health in general and specifically to the benefits of Perceptiv. Dr. Shea and our team have built and conducted seminars for dozens of our resellers,” said Bernie Prusaczyk, CEO of Sevo Nutraceuticals, adding that the company provides a range of materials to help its reseller partners learn about the formulation and then best communicate to their customers via a wide assortment of materials and programs.

And this kind of support helps retailers like Letourneau’s conquer the biggest challenge of the memory & cognition category. “The biggest challenge is the endless number of supplements and products within it.People become inundated with product information and it ultimately turns into white noise,” said McKallagat.“Sevo Nutraceuticals focuses on distinguishing its product by continually testing Perceptiv and publishing the science behind it. We believe Sevo recognizes this issue as their biggest challenge and they are very active in trying to separate themselves as a truly unique remedy.”

Additionally, the experience of McKallagat and his staff is that end users will see results within one to two months, which customers are able to effectively track with the different memory cognition tests Sevo provides.

References:

1. Www.cdc.gov/aging/pdf/cognitive_impairment/ cogimp_poilicy_final.pdf.

2 www.caregiver.org/caregiver/jsp/ content_node.jsp?nodeid=438.

3 Hedden T, Gabrieli JDE. Insights into the ageing mind: a view from cognitive neuroscience. Nature Reviews Neuroscience. 5:87-96.

4 Geda YE, et al. Caloric intake, aging, and mild cognitive impairment: a population-based study. J Alzheimers Dis. 2013 Jan 1;34(2):501-7.

5 www.naturalnews.com/037044_obesity_cognitive_ decline_Alzheimers.html.

6 Rucker R, Chowanadisai W, Nakano M. Potential Physiological Importance of Pyrroloquinoline Quinone. Altern Med Rev. 2009;14(3):268-277.

7 http://pyrroloquinoline-quinone.com/pqq-info/. 8 Food Style 2009; 13(7):50-3. Medical Consultation and New Remedies 2011. 48(5):1.