The cardio health and nutrition category is still pumping strong. The outlook for this supplement sector for 2024 is exciting, and here’s why.
An iconic anthem from Bruce Springsteen proclaims that “everybody has a hungry heart,” and although he was referring to love, it’s true: everybody does have a hungry heart, for nutrition and nutraceuticals.
Stats and market research paint a compelling portrait of where the cardio-support supplement market stands at the top of 2024.
A 2019, the American Heart Association (AHA) report listed heart disease as the leading cause of death in the U.S. “Recently, we have also seen an increase in concern regarding blood clotting as people are linking COVID-19 and the risk of blood clots,” said Vincent Hackel, CEO and President of JBSL-USA (Walnut Creek, CA).
Izaskun Monsalve, senior manager, women’s health, Kerry (Ireland), provided several compelling data points. According to FMCG Gurus, 82 percent consumers recognize the link between good heart health and good overall health, while Kerry’s own research finds that 65 percent of consumers plan to improve their heart health.
“Gen X and older adults see cardiovascular health support as the No. 1 benefit of functional foods, beverages and supplements,” she said. “In 2020-21, 25 percent of supplements and 33 percent of functional food and beverage products launched globally in this category carried a heart-health benefit.”
Focusing on heart health, for millions, is serious, as heart disease is the leading cause of death for men and women in the U.S., according to the U.S. Office of Diseases Prevention and Health Promotion.
According to 2023 data from FMCG Gurus, 30 percent of global proactive health consumers say they want to improve their heart health, pointed out Simo Echchafai, senior vice president, health and human nutrition North America, Aker BioMarine, Norway. That data further shows that these consumers are taking a holistic approach to well-being, looking to fundamentally change diets and lifestyles and one part of that is seeking out products with multiple health claims that are backed by science.
Clarisse Geraci, product manager, Gnosis by Lesaffre Corp., France, observed that the market has expanded to include younger adults. “While cardiovascular health was once a concern only for the aging population, younger consumers are now starkly aware that their lifestyle can greatly impact the potential for impaired cardiovascular health. This may become a concern for younger consumers as they begin to start having their own families and want to be sure they remain healthy and active for all of life’s precious moments,” she said.
Equal Opportunity Concern
“Heart disease was once considered a ‘man’s disease,’ but recent data from The Lancet women and cardiovascular disease Commission confirms otherwise,” commented Geraci. Key points she shared are:
• 35 percent of all deaths in women worldwide are caused by cardiovascular disease
• 275 million women were diagnosed with cardiovascular disease in 2019
• 8.9 million women died from cardiovascular disease in 2019.
“Further,” she emphasized, “the report states that cardiovascular disease among women is understudied, under-diagnosed, under-recognized, and undertreated and women are under-represented in clinical trials.”
Maria Schouvieller, product line manager Minnesota-based Cargill, pointed out that Centers for Disease Control and Prevention (CDC) data shows that more than 60 million women in the U.S. live with some form of heart disease, which can affect women at any age. About one in every five female deaths can be attributed to heart disease, yet only about half of U.S. women recognize that it is their number-one killer.
“It’s not just women, however, who are impacted by the disease,” she said. “Heart disease is also the leading cause of death for men, responsible for about one in every four male deaths, according to CDC data.”
While Schouvieller mentioned high cholesterol as a key factor in heart disease, another is endothelial dysfunction, as described by Deshanie Rai, PhD, vice president global scientific & regulatory affairs, New Jersey-based OmniActive. “It is well-established that a putative mechanism resulting in cardiovascular disease is damage to the vascular endothelium, which releases anti-atherosclerotic molecules, most notably nitric oxide. Therefore, endothelial function can be measured as a biomarker of heart health.”
Geraci added that currently, the market is not necessary creating gender-specific cardio formulas but “we are seeing are more men’s and women’s formulas, like multis, being expanded to include more heart-healthy ingredients. And those multis are not just targeting seniors, but also younger demographics.”
Playing With Heart
Athletes and individuals who workout intensely, routinely, are also a ripe market for cardiovascular support supplements.
Echchafai agreed, proclaiming, “There is no question that active nutrition and heart health go hand in hand.”
In a study published in Frontiers in Cardiovascular Medicine (Nystoriak/Bhatnagar, 2018), the authors explain that those who are physically active have lower blood pressure and “a more favorable lipoprotein profile.” Previous studies have shown that routine physical activity increases production of nitric oxide. And they write, “Exercise has also been found to have beneficial effects on the heart. Acutely, exercise increases cardiac output and blood pressure, but individuals adapted to exercise show lower resting heart rate and cardiac hypertrophy.”
Geraci opined, “In the realm of sports supplements and active nutrition, incorporating a heart-healthy ingredient makes complete sense. The connection between a robust cardiovascular system and physical performance is clear. A well-functioning heart ensures efficient oxygen delivery to muscles and supports endurance and stamina which is key for athletes. As athletes continually seek to maximize their capabilities, prioritizing heart health is simply foundational, is simply a necessity.”
MenaQ7 Vitamin K2 as MK-7 has been proven to improve arterial flexibility, reduce inflammation and oxidative stress in human cells, and lower oxidative stress in human smooth muscle cells and increase ATP production, according to Geraci. Further, she noted, vitamin K2 as MK-7 also has demonstrated benefits to enhance cardiac output and support muscle health, such as increasing V02max as K2-supplemented athletes showed cardiac output rose by 12 percent vs. placebo.
According to Hackel, brands can position heart health products to support optimal cardiovascular function, which is necessary to efficiently deliver oxygen and nutrients to the muscles during physical activity. “Improved cardiovascular function may enhance endurance and overall athletic performance,” he said.
When formulating products that help improve workout performance, “keep in mind that many gym-goers also want to protect and promote cardiometabolic health,” said Annie Eng, CEO of HP Ingredients, Florida.
Monsalve observed a growing interest in heart-health products with multiple functionality, such as post-workout protein, and hydration, in plant-based beverages. According to Innova Marketing Insights 2022, the fastest-growing heart health category has been dairy and alt-dairy milks in terms of global launches, averaging 28 percent growth annually between 2016 and 2020. Supplements also remain very popular in this space, with one in five supplement launches featuring a heart health claim in 2021—an increase of 50 percent from 2020.
Caroline Schroeder, marketing communications manager, Lycored (New Jersey), also sees robust growth in the functional beverage market. By 2027 the U.S. functional beverage market is expected to reach $62 billion (currently it is at $50 billion). She said, “While we’ll likely still see capsules/tablets and gummies available, beverages more easily fit within a consumer’s lifestyle and routine. Combining the efficacy of a nutraceutical or nutrient complex with the convenience of a beverage could be a game changer for the heart-health segment.”
Geraci sees sachets that deliver quick dispersion for immediate consumption as a growth area. “Delivering health-enhancing compounds in a format that allows for immediate dispersion in a beverage of choice provides the user with the greatest flexibility, which is key to ensuring good habits are kept over time,” she commented. As an example, she cited the launch of MenaQ7 Matrix, a technology from Gnosis that provides vitamin K2 protection in complex formulations, including minerals, and is also a dispersible powder, “making it a perfect fit in heart-healthy formulations in these types of beverages,” she described.
Overall, observed Schouvieller, there is heightened interest in functional beverages featuring health-supportive ingredients as consumers are increasingly seeking out what she called “beverages with a benefit.” Therefore, developing drinks with a heart-health focus could represent an opportunity space for some brands. “Cargill’s plant sterols are easy to use in beverage formulations and could be a good choice for brands interested in developing a heart-conscious beverage,” she said.
Hackel agreed, adding that launching a heart health supplement in the form of a beverage could provide advantages over a tablet or capsule as the beverage can appeal to a wider demographic, including those who are pill averse.
“There is no shortage of options when it comes to innovation in heart health, and we are seeing that liquid formats are on the rise,” said Echchafai. Aker BioMarine has been working on Superba Krill oil emulsions in the form of smoothies as well as coffee-flavored beverages that she noted would work well for the heart health category. “We are seeing that the liquid formats allow us to get a higher, concentrated dosages of krill oil than other formats, with a solid taste profile.”
From vitamins to herbal extracts to plant sterols, there is a spate of quality, science-backed ingredients for brands to create effective and appealing heart-support products.
Adequate vitamin K2 intake has been shown to positively influence the cardiovascular system, yet populations are deficient in this vital nutrient due to diet and commonly prescribed medications, according to Geraci. There is a strong focus on the role of arterial stiffness impacting cardiovascular health, as well as the discovery of the vitamin K-dependent protein Matrix Gla Protein (MGP), the most potent modulator of vascular calcification known, she said. However, the body needs enoughc vitamin K2 to activate it.
New research has built upon the groundbreaking three-year MenaQ7 study showing a nutritional dose of 180 mcg of vitamin K2 as MK-7 (MenaQ7) taken daily inhibited age-related arterial stiffening and also promoted vascular elasticity. A one-year follow-up study of men and women also showed supplementation with 180 mcg of MenaQ7 stops the increase in cfPWV, a marker for arterial stiffness.
Most recently, said Geraci, a secondary analysis looked at the effect of MK7 supplementation on vascular stiffness in women who were pre-, peri- and post-menopausal, as a follow up to the findings of the one-year study. The authors state that these results confirm hormonal changes affect the vasculature and that post-menopausal women have increased vascular stiffness reflected by functional vascular damage.
NSK-SD nattokinase derived from natto and has 20 human studies showing its benefits for cardiovascular health, according to Hackel. “The human studies have shown NSK-SD to effectively degrade harmful blood clots, help manage blood pressure and platelet and blood cell aggregation, and improve blood flow. He explained, “The mechanism of action of NSK-SD is mainly attributed to its ability to directly and indirectly degrade fibrin, which is the main component of a blood clot. A recent human study showed nattokinase to improve blood flow by more quickly increasing temperature of hands after being placed in an ice water bath.”
In research, curcumin, said Rai, has been shown to be cardioprotective through enhancing antioxidative and anti-inflammatory pathways; therefore, it can be a simple approach to help support endothelial function.
She pointed out that until recently, no known studies have assessed whether long-term curcumin supplementation can improve endothelial function in healthy populations. OmniActive Health Technologies studied whether daily supplementation with its proprietary curcumin extract, Curcuwin, could favorably influence heart health. Healthy adults who supplemented with OmniActive’s curcumin extract at 200 mg oral curcuminoids/day for eight weeks exhibited a meaningful improvement in endothelial function. She commented that based on this study “oral curcumin supplementation may present a simple lifestyle strategy for brands and consumers looking to support heart health.”
An article about heart-health product formulations would not be complete without mention of the essential omega-3 fatty acids DHA and EPA, with a robust foundation of scientific support showing cardiovascular benefits.
Kerry’s Eupoly Omega-3 is backed by clinical studies showing its support for heart health, with high availability of EPA and DHA fatty acids and a shelf life of eight months at room temperature, according to Monsalve. The fish-burp normally associated with omega-3 EFAs is going by the wayside, as manufacturing technologies are overcoming this unappealing aspect. “Deodorization and stabilization technology prevents off-tastes usually associated with omega-3 fatty acids. This makes Eupoly ideal for use in functional foods, beverages, gummies and supplements, and its kosher and halal certifications ensure its acceptability to a wide range of consumers,” she said. Kerry also provides a vegan, algae-based format, Eupoly DHA.
Superba Krill oil from Aker BioMarine, is a natural phospholipid complex of omega-3 and choline. According to Echchafai, Superba Krill oil raises the omega-3 index level in the body, as shown in several studies. An Omega-3 Index of 8 percent or above is the optimal range, widely demonstrated to be optimal for healthy heart function. Furthermore, krill oil does not increase LDL. It can lower triglyceride levels in the blood, helping to contribute to healthy cholesterol levels. A major double blind, randomized, placebo-controlled trial with more than 500 participants showed that krill oil significantly reduced fasting triglycerides by 33.5 percent from baseline after 26 weeks (placebo corrected 12.7 percent).
Fruit extracts are a natural for heart-healthy products. HP Ingredients’ Bergamonte Polyphenolic Fraction (Citrus bergamia Risso) is a patented standardized extract which has unique profile of flavanoids such as neoeriocitrin, neohesperidin, naringin, brutelidin and melitidin. In a 2022 study BPF at doses of 10 mg/kg were consumed for 30 consecutive days and was shown to support protection of serum LDL cholesterol (LDL-C) and triglycerides when subjects consumed a hyperlipidemic diet. This effect was accompanied by significant reductions of malondialdehyde (MDA) and glutathione peroxidase serum levels, two biomarkers of oxidative stress. “This latter action shows strong antioxidant ability of BPF,” Eng commented. Additionally, BPF activity increased HDL-C levels.”
Kerry’s Capros, for cardiovascular support. is rich in vitamin C and derived from the edible fresh fruits of the ayurvedic ingredient amla (Phyllanthus emblica), described Monsalve. “Studies on Capros describe its ability to support endothelial function, support a healthy lipid profile, maintain healthy cholesterol levels and support healthy blood flow,” she said, “And because it is rich in polyphenols, it exhibits exceptionally high antioxidant activity.”
Lycored offers Cardiomato, a phytosterol complex and tomato extract that has been scientifically shown to support a healthy circulatory system, and Lycomato, which supports healthy circulation and overall cardiovascular wellness, noted Schroeder. “Cardiomato is a combination of our proprietary phytosterol complex and our patented standardized tomato extract to help foster improved cardiovascular wellness over time,” she said.” This nutrient complex can help maintain a healthy circulatory system and protect low-density lipoproteins (LDL) from oxidation.”
Plant sterols are also known to be helpful in managing cholesterol. According to Kristen Dammann, senior scientist – regulatory and nutrition, Cargill, numerous studies have shown that intake of plant sterols (approximately 1-3 grams per day) can reduce low-density lipoprotein (LDL) cholesterol; the FDA (U.S. Food ad Drug Administration) has authorized a health claim describing the relationship between plant sterol consumption and the reduced risk of heart disease. The model claim states: “Diets low in saturated fat and cholesterol that include 2 g per day of plant sterols eaten with meals or snacks may reduce the risk of heart disease. A serving of [name of food] supplies [x] g of plant sterols.”
Dammann noted that Cargill’s CoroWise plant sterols include options that are water and oil-dispersible and suitable for a wide range of foods, beverages and supplements.
Chile-based Nutrartis has launched Cardiosmile, a plant sterol supplement in a liquid sachet format, in the U.S. market. The water-dispersible plant sterols are formulated to serve as a convenient way to support cardiovascular health which can be added to water, foods and beverages. “Cardiosmile’s clinical effectiveness lies in its unique ability to markedly reduce cholesterol absorption,” said Gonzalo Vega, chief business officer and technical director at Nutrartis. “By furnishing a convenient, readily used form of plant sterols, Cardiosmile supports heart and metabolic health on a systemic level, facilitating the maintenance of healthy cholesterol levels.”
Each serving of Cardiosmile contains 1.4 grams of beta-sitosterol, and two grams of total plant sterols. Nutrartis sources its sterols from pine trees, and guarantees that the supplement is vegan, contains no preservatives, is non-GMO (genetically modified organism), gluten-, sugar-, sodium- and lactose-free.
The old way of looking at heart health as an “old person’s concern” is disappearing, as fitness-oriented younger adults are keen on keeping their hearts pumping strong. Brands that include them with efficacious formulas will be right on the pulse of this growing category. NIE
For More Information:
Aker BioMarine, www.akerbiomarine.com
Gnosis by Lesaffre, www.gnosisbylesaffre.com, www.menaQ7.com
HP Ingredients, www.hpingredients.com
JBSL, USA, www.jbsl-net.com/english
OmniActive Health Technologies, www.omniactives.com