[Heart Health] Vol. 17 No. 10 October 2012 Still Beating Strong By Steve Myers, Senior Editor A great deal is asked of the heart, both abstractly and physically. A mere pump, the heart helps push nutrient- and oxygen-rich blood throughout the body and performs this primary task faithfully and rhythmically for decades. It is the very definition of a loyal worker. However, its efficiency, consistency and longevity rely on a healthy cardiovascular system, and this is where people can run into problems over time. Aside from some genetically linked structural and functional issues, the heart is a happy, healthy pumper as long as the blood is flowing freely throughout the body's network of veins and arteries. Any number of situations along this vascular journey can reduce blood flow to the heart and result in heart damage or death. Unfortunately, such problems are common. Heart disease is the leading cause of death in the United States, despite a recent decline in heart-related deaths—cardiovascular disease (CVD) death rates declined 31 percent from 1998 to 2008.1 Still, about every 25 seconds, someone has a coronary event, and one person dies of a coronary event each minute, according to the American Heart Association (AHA). To put the disease prevalence in simple prospective, AHA has reported more than one in three adults has some form of CVD. The problem isn't just American. "CVD kills more people worldwide than any other disease," said Stephen Moon, CEO, Provexis and Science in Sport. "Indeed, experts estimate that by the year 2020, nearly 40 percent of all deaths worldwide will be due to CVD, more than twice the percentage of deaths from cancer." The reason why heart disease is so prevalent is the same reason why the heart health product market is huge and still expanding. Dietary and lifestyle choices are the root of most CVD. AHA said 80 percent of heart disease and stroke is preventable. A healthy diet, consistent exercise and smoking cessation are among the top ways to prevent heart problems or improve risk factors such as hypertension, high cholesterol, high blood sugar and excess body weight. Consumers are motivated by quality of life, but also spring into action when conventional treatment becomes a financial burden. "About 37 percent or nearly 125 million Americans have heart diseases," added Bryan See, regional product manager, Carotech Inc., citing AHA sources. "In the same report, health care cost for heart disease will rise from US$273 billion to US$818 billion in conjunction with the increase of heart disease cases to 41 percent by 2030." The good news, he assured, is that both drugs and supplements can help consumers fight certain heart diseases. "Those concerned with the side effects associated with pharmaceuticals, such as statin drugs for cholesterol, are looking for alternative medicines such as heart-health supplements like fish oil, phytosterols, tocotrienols, CoQ10, etc." "The heart health market is estimated to grow by approximately 20 percent per year for the next several years," noted Heather Thompson, global marketing, communications, Stratum Nutrition. "Several factors are responsible for this growth: an aging population that demands a higher quality of life in their senior years; growing consumer awareness of heart health indicators; and the consumer trend toward maintaining a healthy lifestyle in order to minimize illness onset." www.naturalproductsinsider.com Page 1 [Heart Health] Vol. 17 No. 10 October 2012 Pam Stauffer, marketing manager, Cargill, reported the United States makes up the largest single heart health food and drinks market, capturing around two-thirds of the overall sector ($6.8 billion in 2009) and is forecast to reach $10.5 billion by 2015. "The high prevalence of CVD and associated risk factors, such as hypertension, has created a consumer base willing to use food and drink products that are specifically designed to aid heart health," she said. " According to [the Natural Marketing Institute], nearly three-in-four consumers report usage of heart-healthy foods and beverages. This trend has remained stable since 2005." The consumer base for natural heart health products tends to be older, and this demographic may be poised to contribute some big growth to the sector. "The demographic of the elderly/baby boomers is increasing," See noted. William Loh, vice president of marketing, Cargill, agreed consumer perception and focus on cardiovascular health increases with age, and the aging U.S. population will drive preference toward foods that promote cardiovascular health. Moon confirmed the aging U.S. population is definitely contributing to an increase in sales of heart- healthy food, beverages and dietary supplements. "Indeed, more consumers are turning to functional products to help them stay healthy as they grow older." As heart product companies jockey to gain a profitable share of the increased number of consumers seeking help, the market is getting a boost from public health efforts to increase awareness. "Governments, health professionals and the health-oriented media have consistently pressed the message on the importance of cardiovascular health, leading to increased consumer awareness of the consequences of CVD," Moon said. "This awareness is one of the primary factors driving market growth." The depth of the awareness of heart health may be the next necessary focal point. "Many in the public fail to realize the interconnectedness of seemingly unrelated symptoms, such as elevated blood glucose levels, continuous high blood pressure or abdominal tissue accumulation, with future CVD," said Paul Dijkstra, CEO, InterHealth USA. He explained while awareness is the first step in supporting a healthy heart, consumers need to understand it takes a multifaceted approach to supporting heart health. "A combination of weight reduction, healthy diet, moderate and regular exercise, and science-backed dietary supplements and functional food and beverages may help maintain heart health." Looking back, Dijkstra sees a heart-health category that has undergone somewhat of a revolutionary process during the past decade. "There is an interrelated triage of consumer interest, product activity and manufacturer intent," he said. "Along with the increased interest and awareness on the consumer and professional sides about the importance of supplementation—using nutraceuticals as well as functional foods and beverages—for maintaining a healthy cardiovascular system, manufacturers have significantly increased their research activities developing new compounds and new product forms much to the liking of consumers. This has lead to an increase in category growth." Moon said more than half of Americans use supplements on a daily basis, according to the Centers for Disease Control and Prevention (CDC). "The United States is one of the key global markets for dietary supplements," he noted. "In terms of sub-segments, heart health is one of the most lucrative areas, with many consumers taking supplements to keep their hearts healthy." That said, he www.naturalproductsinsider.com Page 2 [Heart Health] Vol. 17 No. 10 October 2012 acknowledged fortified foods and beverages, which are easy to incorporate into daily life, are also growing in favor with health-conscious U.S. consumers. "Everyday products that feature naturally derived ingredients with proven health benefits are particularly popular," he said. "Some examples include spreads fortified with plant sterols, breads with high levels of fiber and beta-glucans and ready -to-drink beverages formulated with naturally derived, scientifically substantiated ingredients such as Fruitflow." Citing convenience as a key differentiator for busy consumers, he predicted "healthy shot" products will continue to grow in popularity. DSM, one of Provexis’ commercial partners, has used Fruitflow, a whole tomato extract designed to improve blood flow, in such a product to help prevent deep vein thrombosis on long-haul flights, according to Moon. Thompson reported today’s consumers are actively seeking “convenient” supplementation, which most view to be in the form of food and beverages, whenever possible, rather than taking pills. "This trend has fueled innovation within the industry, and resulted in wide varieties of delivery methods," she noted. "We continually work in our application labs to test viability of new applications in supplement, food and beverage, whether that be a chewable, baked good, snack, drink sachet, gum or other 'convenient' new ways to supplement our heart-healthy fiber." "Some heart-health shoppers love the convenience of dietary supplements, while others seek food and beverage alternatives," Stauffer said, noting this dichotomy can be positive for those businesses, like Cargill, that work with both dietary supplement manufacturers, and food and beverage manufacturers. "Products made with CoroWise® plant sterols range from dietary supplements such as Cardio Chews®, to many foods and beverages such as Smart Balance® Heart Right® milk and Corazonas™ chips and oatmeal squares." Count Dijkstra among those seeing food and beverage applications as a key heart-health growth category, as he noted there is continuing product activity for heart-health food and beverages. Still, versatility might be the important characteristic in this dynamic health segment. "Market success for heart-health nutraceutical ingredients lies strongly in its application for dietary supplement, food and beverage markets," he reasoned. In the growing market of natural heart-health