Seeing One’s Way To Healthy Vision
AAccording to the World Health Organization (WHO), approximately 296 million people suffer from vision impairment around the world, not including blindness. A staggering 82 percent of these cases include people over the age of 50 who are suffering from agerelated conditions, namely age related macular degeneration (AMD), an eye disease causing a loss of central vision leaving only peripheral vision intact.
AMD Alliance International, an organization dedicated to bringing “knowledge, help and hope to individuals and families around the world affected by AMD,” contends that AMD is the leading cause of vision loss in people aged 50 and older in the Western world, and the condition affects over 30 million People worldwide. Still, the organization explained that many people are still unaware of AMD or the need for regular Eye exams to identify AMD in its early stages and prevent vision loss.
Analysts Frost & Sullivan found that the eye ingredients market in 2008 was valued at $138 million, with a compound growth rate of 5.3 percent from 2008 through 2015. While dietary supplements lead the nutritional market for eye health products, statistics and industry professionals maintain that the outlook is not all rosy for the category.
Lacking Knowledge
According to a recent Frost & Sullivan study, supplements accounted for just over 66 percent of the overall eye health market just three years ago. But when broken down as a percentage of total sales of supplements, Euromonitor estimated that eye health products only account for one percent. In other words, eye health supplements are many, but no one is buying them—yet.
Steve Siegel, vice president of Ecuadorian Rainforest, LLC (Belleville, NJ), explained that this disconnection in statistics could be explained by the fact that eye health is generally neglected in American society. “When one considers the extent to which the average consumer goes to take care of their eyes, this is no surprise,” he said. “Most eye exams done by doctors for physicals consist of the outdated ‘cover one eye and read the letters on the poster.’ There is more to eye health than that.”
Perhaps this category remains in its infancy because shoppers aren’t yet aware of the specific nutrients available for eye health. “The concept that eating certain foods such as carrots for eye health has been around for years,” said Christian Artaria, marketing director and head of functional food development at Indena (Milan, Italy), “but the knowledge of how specific ingredients can impact eye health conditions has been a recent phenomenon.”
Ingredients such as lutein and zeaxanthin, though known in the nutritional Supplement world, are still fairly new to most consumers. Trends in lutein, for example, show that people are aware of it, but may not know exactly what it does. Citing a multi-sponsor survey from 2008, Aparna Parikh, marketing manager at DSM
(Parsippany, NJ), explained that trends show a steady increase of awareness of lutein from three percent in 1999 to 30 percent in 2008. Still, only 65 percent of those who were aware of lutein were able to specify eye health as a benefit.Parikh credits some of this awareness as a result of Wyeth Consumer Health’s introduction of Centrum with lutein around 1995, and the AREDS study completed in 2001 (more on this to come).
And while health care practitioners may still employ the examinations Artaria depicted, Parikh contends that the awareness of these ingredients has in fact grown tremendously in the past few years. According to a 2009 survey, she said, knowledge of lutein grew to 97 percent in 2009, while zeaxanthin grew to 71 percent (up from 11 percent in 2007). “We expect this awareness to continue growing as lutein and zeaxanthin continue to gain ground with an increasingly aging population concerned about quality of life,” Parikh added.
According to Artaria, this population is one that is dealing with eye complications beyond AMD in growing numbers.According to the National Eye Institute, he said, more than half of all Americans either have a cataract or have had cataract surgery by the age of 80.
“Educating consumers about these new ingredients and their role for eye health takes time, and awareness is being built,” he said. “Most people become aware of how nutrition may help a particular health condition only after they are found to have a particular problem or witness someone close to them experiencing it.”
Seeing is Believing
Released October 2001, the National Institutes of Health’s AREDS (Age- Related Eye Disease Study) broke ground when researchers found that high levels of antioxidants and zinc significantly reduced the risk of advanced AMD and its associated vision loss. A high risk group of 4,757 participants aged 50-80 years in 11 clinical centers nationwide were given one of four treatments: zinc alone, antioxidants alone, a combination of antioxidants and zinc, and a placebo.
Ultimately, researchers found that people at high risk of developing AMD lowered their risk by about 25 percent when treated with a combination of vitamin C, vitamin E, beta-carotene and zinc. This same group also benefits from these nutrients in the form of a reduced risk of vision loss caused by advanced AMD by about 19 percent.
The industry can look forward to the results of AREDS 2, which are expected to be released in 2013. “In the AREDS Study, we found a combination of vitamins and minerals that effectively slowed the progression of AMD for some people,” said Paul A. Sieving, MD, PhD, director of the National Eye Institute at the National Institutes of Health. “Now, we will conduct this more precisely-targeted study to see if the new combination of nutrients can reduce AMD progression even further.”
While the first study focused on antioxidants and zinc, AREDS 2 will add to the formula lutein and zeaxanthin, in addition to omega-3 fatty acids DHA and EPA. Like its predecessor, AREDS 2 will examine 4,000 participants aged 50 through 85 years with AMD in both eyes or advanced AMD in one eye over the course of five years. “Until we get the results from AREDS 2, we encourage people with AMD to visit their eye care professional to see if they need to take the AREDS vitamin and mineral formulation,” said Sieving. “This alone could save more than 300,000 people from vision loss over the next five years.”
This is certainly good news for the supplement industry, which is often under fire from critics for a lack of scientific support. “We’re seeing a number of products being introduced based on the upcoming results of the AREDS 2.
The study will conclude in 2012 with results anticipated to be published in 2013,” explained Artaria. “AREDS provided scientific validation for many eye doctors who were skeptical of the benefits of supplements for eye health. After the first study was completed in 2001, demand for eye health supplements grew and many manufacturers are anticipating a similar situation based on AREDS 2.”
AREDS Ingredients
Indeed, many manufacturers are tapping into the upcoming AREDS 2 excitement by promoting ingredients for eye health such as lutein, zeaxanthin and omega-3s.
DSM’s portfolio for eye health ingredients includes FloraGLO® lutein and OPTISHARP® zeaxanthin, in addition to ROPUFA® omega-3, in response to recent studies documenting the effects the ingredients in visual performance.
“These studies demonstrate that lutein and zeaxanthin in the macula can act as an optical filter to reduce glare discomfort, reduce glare disability and photostress, improve visibility and image resolution by absorbing scattered blue light, and improve spatial vision by enhancing contrast,” said Parikh, adding that in addition to these benefits, lutein and zeaxanthin boast biological roles including protecting the retinal tissue from the damaging effects of blue light and enhancing neural gap junction communication, allowing for faster visual processing.
Parikh also cited newer research suggesting that omega-3s are associated with a protective role against AMD.
“Omega-3 fatty acids protect against the onset and progression of AMD by modulating the extent of processes involved in the development of AMD such as preventing the formation of new blood vessels in advanced AMD, reducing inflammation and protecting against cell death,” she explained. “Awareness of fish oils/omega-3 is extremely high— nine out of 10 adults are aware of fish oils/omega-3. Consumers are less aware of the role of omega-3 in AMD since the science is still emerging.”
From EPAX AS (Aalesund, Norway) is EPAX 1050TG, an ingredient high in DHA. “The product contains a minimum of 430mg/g of DHA and has been used in many studies related to eye health,” explained Baldur Hjaltason, the company’s business development and sales manager. According to Hjaltason, a recent study showed that omega-3 from marine oils was not ranked in the top seven ingredients consumers can identify as beneficial for eye health. “This shows that consumer education is needed in order to explain the role of DHA in eye health,” he said. “There is very strong science that links consumption of DHA to reduction in AMD.”
Also projected to benefit from positive AREDS 2 findings is OmniActiv Health Technologies (Maharashtra, India), which offers a source of both free lutein and lutein esters, as well as a combination of lutein and zeaxanthin isomers, under its Lutemax® line of ingredients. Lutemax extracts are sourced from premium marigold flowers.
“The company has established a dedicated group of farmers in India that grow marigolds with no use of feedgrade additives and preservatives or pesticides such as ethoxyquin. This vertically integrated process helps to enhance quality, purity and performance of the raw material,” said Hiren Doshi, the company’s vice president.
Once harvested, the marigolds are dehydrated and extracted into oleoresins in dedicated facilities under foodgrade standards. Lutein and a combination of lutein and zeaxanthin isomers are then isolated and purified from the marigold oleoresin using GRAS solvents in OmniActive’s cGMP, HACCP and ISO- 22000 certified facility. “The Lutemax line is based on internationally patented manufacturing technologies that yield lutein, as well as the lutein and zeaxanthin isomer extract found in Lutemax 2020, and deliver enhanced functionality, stability and bioavailability for improved benefit delivery,” Doshi added.
Trend Watch
Still, other trends, mostly in the area of delivery, are boosting the market’s growth potential. “Most of the eye health studies have been done on single ingredients, but now the new focus seems to be on combining one or more of those ingredients to look at eye health in a broader way,” explained Hjaltason, who maintained that the eye health category as a result becomes divided into two parts. “First is eye disease prevention. Consumers are as concerned about preventing eye problems as with cholesterol content and arthritis. This is, of course, less of a concern to them than for diseases like cancer and cardiovascular, but still rather high,” he continued. “The second part is manAging or treating eye diseases. Around a quarter of the US population is interested in managing their eye diseases, and supplements are an attractive choice.”
As more shoppers look for eye health products, suppliers are making sure that ingredients are appropriate for a variety of formats. OmniActiv’s Doshi has noticed an increased interest in incorporating eye health ingredients into functional foods or beverages. “OmniActiv’s Lutemax Free Lutein and Lutemax Lutein Esters provide a comprehensive range of delivery formulations, including forms ideal for beverages—cold water dispersible powders and dry and liquid systems—based on OmniActiv’s patent pending UltraSol platform and liquid micro-emulsions,” he said. “These forms are typically water soluble or water dispersible, stable, food grade, vegetarian and GMO- and allergen-free.”
And while Indena’s Artaria conceded that the most common delivery form has still been through supplements the form of tablets, capsules and soft gels, new delivery forms on the horizon include mouth sprays and eye drops.Supplements have been the most common form, and a majority of the research has been conducted utilizing these forms,” he said, noting that the new delivery forms “seem to occupy niche segments and do not have the breadth of supporting research.”
According to Doshi, these new formats will allow new consumers to actively explore more options in this sometimesforgotten category, and as medical costs continue to rise, consumers’ proactive measures to prevent AMD will become more common. “The growing body of scientific research on the role of these carotenoids like lutein and zeaxanthin isomers in the protection of visual function in the short term, and in prevention of tissue degradation leading to degenerative eye diseases in the long term, will only further propel the popularity of eye health supplements,” he said.
