Baby Boomers are thinking hard about protecting their cardiovascular health naturally, and suppliers and manufacturers are working to simplify their needs.

By now, most people are aware that cardiovascular diseases are the No. 1 cause of death in the United States.So it should come as no surprise that the state of the market for heart-healthy ingredients, supplements and functional foods remains one of the top conditionspecific best sellers, according to Dean Mosca, president of Proprietary Nutritionals Inc. (PNI, Kearny, NJ).

“We continue to field a wide variety of steady inquiries into our Sytrinol formula for a host of supplement and functional food products. This interest and activity has really not let up,” said Mosca. “Further, since we launched Benexia chia seed, a whole grain with the highest non-marine omega-3 content, we have worked with companies that were keenly interested in Benexia’s heart-health benefits, both from its omega-3 content and its fiber content.” 

David Peters, director of sales and marketing with Biovelop AB (Kimstad, Sweden), offered that the market for heart health functional ingredients is, very positive currently with a diverse selection of international food and drink manufacturers searching out natural ingredients that provide them with access to the FDA- and EFSA-approved heart health claims.

“At the recent SupplySide West and Health Ingredients Europe shows, we have seen a huge amount of interest for our recently-launched oat beta glucan ingredient called PromOat, highlighting this strong demand for natural, cleanlabel ingredients which help to tackle the ever-increasing problems of cardiovascular disease and obesity, yet do not require consumers to radically alter their diets,” said Peters.

Tom Morse, co-founder of Telos Ceuticals, LLC (Walled Lake, MI), supplier of Carogac™, a nutritional ingredient for functional foods, added that the proliferation of studies on some ingredients, such as omega-3s, has helped boost consumer confidence in this category.
“FDA’s reviewing phytosterols to possibly expand health claims is another example,” he said. “Suppliers have introduced many products that support heart health, and manufacturers are always looking for something new to sell in a popular category.” 

Along with fish oils, the market is growing for other heart health ingredients such as CoQ10 and Pycnogenol®, said Frank Assumma, director of marketing with Natural Health Science Inc. (NHS, Hoboken, NJ), supplier of Pycnogenol. “In general, suppliers and manufacturers are in sync with demand, but the manufacturers need to do a better job of simplifying the customer’s needs with combination heart health products, like combining Pycnogenol, CoQ10 and fish oil into one product.There has not been much innovation in the last few years in these areas.” 

Meanwhile, Bob Capelli, vice president of sales and marketing with Cyanotech Corporation (Kailua-Kona, HI), gave the industry credit for its efforts thus far. “So far from everything I’ve seen, the supply industry is doing a good job keeping up with demand and marketing companies are starting to do a better job of getting the word out about their heart-healthy ingredients,” he added.

State of Heart Health Science 

In terms of quality science, the bar has been raised: peer reviewed, crossover trials that show distinct action and benefit are the most desirable, said Mosca.“In addition, if you can show clear mechanism of action, this is highly attractive to formulators and marketers who will be able to provide more compelling reasons to consumers to purchase their supplements over those that do not have such science.” 

There is a trend toward prevention of health conditions rather than improving or even “treating” existing heart health problems. “This development is more evident in Europe, but also has been gaining increasing momentum in the United States,” noted Dr. Frank Schonlau, director of scientific communications with Horphag Research (Geneva, Switzerland), manufacturer of Pycnogenol. “The issue boils down to the essential point of what can be communicated on a product label when it is on the shelves. Some people in the industry argue that ‘you can’t make healthy people healthier’—it is certainly easier to conduct a trial that shows an active nutritional ingredient lowers blood pressure in hypertensive patients.Such studies are of lesser value, as ‘treatment’ of diseases is taboo. The target for the future is ‘risk reduction.’” 

The idea of “risk reduction” should be to determine the threats of high blood pressure and other cardiovascular dangers, and help customers “maintain already healthy levels” through supplementation, added Assumma. “The many studies on Pycnogenol demonstrate its ability to maintain healthy blood lipid profiles and healthy blood pressure which is critical to ‘risk reduction.’”

In addition, suppliers and manufacturers are interested in research that shows a correlation between a nutritional ingredient and a health condition, noted Morse. “For example, we are particularly interested in such studies as the ones linking higher plasma lycopene concentrations with a lower risk of cardiovascular disease because our product, Carogac, has 76 times more lycopene than tomatoes, or those studies linking low carotenoid levels with atherosclosis because Carogac is such a comprehensive, bio-accessible source of carotenoids.” 

Developments in the past year include more companies introducing different forms of ingredients so they can be used in various applications, Morse added.

“To use Carogac as an example, the forms include freeze-dried powder, puree and frozen puree. This allows for use in a variety of types of consumer products such as dietary supplements, foods, beverages and personal care products,” he said. “Being water-soluble, bio-available and flavor-neutral make it easy to integrate into foods, beverages and supplements.” 

Capelli noted that manufacturers of dietary supplements want to see solid science in the form of human clinical trials.“The gold standard is a trial that is placebo- controlled and double-blind,” he said, offering that there have been some excellent studies coming out over the last year or two on both ingredients that Cyanotech produces—spirulina and astaxanthin— showing benefits for heart health. “In fact, a review paper on the health benefits of spirulina with a major focus on cardiovascular benefits written by Cyanotech staff just appeared a few months ago in a peerreviewed journal in Europe.” 

Category Trends 

Combining whole-grain ingredients with other heart-healthy ingredients such as polymethoxylated flavones, CoQ10 and vitamin E, in formulas that address heart health, is one trend noticed by PNI’s Mosca. There’s also more interest in these nutraceutical combinations for functional foods and beverages, and interest in omega-3s is at an all-time high, he added.

Peters agreed, noting that PromOat’s functional versatility gives manufacturers the ability to think and create in an innovative fashion. “No longer restricted to the types of products traditionally associated with oats, they can now bring the benefits of oats to a much wider market and in many different formats,” he said.

After a downward trend toward ingredient commoditization, in recent years, ingredients backed by some form of brand protection and science have steadily grown in popularity, offered Telos Ceuticals’ Morse. “There is always a desire for a novel ingredient, particularly in established categories. Many finished products utilize a variety of compounds in one package, which, of course, impacts the cost to produce and the price to the consumer,” he said.However, there may not always be enough of an ingredient to have the optimum benefit if the expense of the ingredients makes the finished product potentially cost prohibitive. “That is an aspect of product development manufacturers wrestle with all the time, which is why we have had such a positive response to the array of components naturally found in Carogac,” Morse explained. “It is a more cost effective way to get high levels of expensive components such as lycopene.” 

Studying Healthy Hearts 

Studies on lowering the risks for cardiovascular health problems are dramatically more demanding as healthy people are investigated, noted Horphag Research’s Schonlau. He added that suitable parameters well established and accepted by health professionals and authorities need to be identified.

“Moreover, such risk-reduction factors will not respond to the same extent as, for example, the systolic blood pressure in hypertensive individuals would,” he explained. “In order to carry out a study with normo-tensive individuals with the goal of demonstrating a significant decrease of healthy blood pressure levels, the number of study participants needs to be much larger to make the statistics work. This inflates the costs involved.” 

For example, Pycnogenol has been examined in a double-blind, placebo-controlled study in which 200 perimenopausal women with healthy blood pressure levels were studied over a six month treatment period. With such a large number of participants, Pycnogenol demonstrated statistically significant decreases in both systolic and diastolic blood pressure as compared to the placebo. “The exact numbers were quite low (the systolic blood pressure in women decreased by 3mmHg), but due to the large number of participants, the figure turned out to be significant,” said Schonlau. “This effect of Pycnogenol certainly does represent a valuable risk reduction contribution, as menopausal women are known to suffer increased cardiovascular health problems.” 

Obstacles to Overcome 

The natural supplement industry is always at odds with the drug industry; the drug companies’ power and wealth of resources in promoting the “magic pill” answer to cardiovascular health of statins is massive. Capelli said regardless of the drug companies’ strength, more consumers are gravitating toward natural alternatives to forego the side effects that invariably come with prescription drugs. “The old adage ‘an apple a day keeps the doctor away’ is moving more toward ‘a handful of supplements a day keeps the drug companies at bay,’ and is helping keep consumers out of coronary units around the world,” he said.

Another impediment is that conventionally trained health care workers have traditionally had little understanding about heart disease prevention beyond “don’t smoke and lose weight,” noted Morse. “They are not trained in nutrition and are often skeptical of anything that is not regulated the way drugs are,” he said. “This lack of knowledge has often meant they did not utilize tools in the nutritional arsenal, to the detriment of their patients. As medical costs rise, the body of supplement science grows and medical schools expand their scope to include nutrition, this is likely to change.And with the ready availability of information via the internet, consumers are taking more control of their own health.”

Risk-Lowering Nutrients

Overall, a heart-healthy diet includes fiber, whole grains, lean protein and antioxidant-rich fruits and vegetables, said Mosca, president of PNI. Equally important, he added, is what it does not include: highfat, fried and processed foods.“And diet in-and-of itself is only part of the equation. Consumers must strive to be physically fit and to ensure they have as little visceral fat (tummy) as possible.” 

Beyond diet, supplementation can play a key role in supporting the structure and function of the heart muscle and the cardiovascular system.

Of interest to PNI are polymethoxylated flavones (PMFs), a group of compounds derived from the peels of citrus fruits, and the main active ingredients in Sytrinol. The two most common are tangeretin and nobiletin, which are extremely potent bioflavonoids. More than 25 years of documented research provides evidence that these particular bioflavonoids deliver heart health benefits.

Nobiletin and tangeretin help lower levels of LDL by preventing the manufacture of its building blocks: apolipoprotein B and triglycerides. Apolipoprotein B is considered the primary building block, making up almost 90 per cent of LDL cholesterol.Interestingly, triglycerides, the main kind of fat in the body, are one of the key contributors to the formation of apolipoprotein B. 

Sytrinol is also made up of palm tocotrienols, which, like tocopherols, are members of the vitamin E family and are extracted from the fruit of the palm tree. Like vitamin E, palm tocotrienols control anti-inflammatory responses and degrade HMG-CoA reductase, a key enzyme in the body used by the liver to produce cholesterol.
Besides reducing cholesterol, palm tocotrienols have also been shown to inhibit arterial plaque formation and reduce blood platelet aggregation (clumping).

Palm tocotrienols are also powerful antioxidants, known to possess antioxidant potential far greater than that shown by vitamin E itself. In human studies, it was observed that alpha tocotrienols decreased the oxidation of LDL. This action is important as raised LDL is a risk factor in cardiovascular disease.The antioxidant properties of tocotrienols can minimize the damage caused by these compounds while protecting cell membranes.

Further, fiber and whole grains are imperative in a heart-healthy diet. As more people become aware that they need to increase fiber intake, the industry is responding with launches of fortified/ enhanced convenience foods that help provide significant amounts of whole grain fiber.

Chia seed and its omega-3 alpha linoleic acid (ALA) have been studied for impact and influence on cardiovascular health. ALA reduces risk of fatal cardiac ischemic condition.A dosage-response relationship was identified between ALA consumption and reduction of fatal cardiac ischemic conditions in women in the Nurses’ Health Study. Similar effects were found in men in the Health Professionals’ Study, wherein a one percent increase in ALA intake was associated with a 40 percent decrease in relative risk of fatal AMI.

A larger intake of ALA fatty acid has been shown to decrease cardiovascular mortality. In one study, men in the highest quintile of ALA intake (expressed as percentage of energy) showed a reduction of 40 percent in the cardiovascular mortality rate.Similar effects were found in another study: men in the highest quintile of ALA intake had 25 percent less mortality in cardiovascular conditions.