Although seven in 10 (69%) U.S. adults are actively working to improve their physical health and half (52%) are trying to incorporate wellness goals/concerns into their daily routines—per Packaged Facts “2011 Consumer Insights Study1”—new mega trends toward “naturally functional/inherent goodness,” heightened FDA, FTC and EU claim scrutiny and concern over the effectiveness and safety of some supplements (even among core users) are re-setting market priorities and product criteria for good.
 
According to the Hartman Group’s “2010 Reimagining Health & Nutrition Study2,” ethnographically, supplement use appears to be waning—especially among core users; but all is not lost yet2. While core users report limiting the number of supplements they take daily due to pervasive doubts about bioavailability, a belief that nutrients in food are best and concern over the long-term effects of supplementation on digestion, they continue to use them—rather than over-the-counter (OTC) and Rx medications—to treat/manage health conditions.
 
Although consumers are using food as a preventative, proactive way to deal with health conditions, it’s not simply about a shift to food and natural nutrients. According to Hartman, “once it’s too late,” food becomes relegated to a secondary wellness tool, although it is still considered essential to treating the issue longer term2.
 
A New Attitude
 
Several years of a tough economy and the U.S. healthcare crisis have finally forced consumers to embrace healthy/preventative behaviors as a necessary cost-saving measure longer term—a new and powerful motivator3. SymphonyIRI (IRI) reports that 81% of  shoppers are making a “strong/some effort” to save on medical expenses by staying healthy3.
 
Even if the economy improves, 88% of adults plan to visit doctors less and self-treat more4. A new need among do-it-yourselfers to have the right healthcare product on hand will also help ensure steady sales5. MD-alternative products (e.g., Plan B One Step contraceptives) were among the best-selling new healthcare products last year per SymphonyIRI5. Consumers have also cut back on spa visits, so products that deliver professional results at home are in high demand5.
 
Fear of side effects, FDA recalls/warnings and high prices prompted eight in 10 (82%) shoppers to try and limit their use of traditional over-the-counter (OTC) medications; one-quarter replaced Rx prescriptions with OTCs in 20103,4,6.
 
More than one-quarter (26%) of adults successfully used a natural alternative remedy in 2010; 55% have not but are interested in doing so7. IRI reports interest in natural/alternative remedies index 171 vs. traditional OTCs7.
 
Homeopathic sales reached $960 million in 2010; homeopathic supplements $130 million, according to the Nutrition Business Journal (NBJ)8. Laxatives, sleep aids, ear, cough/cold and children’s remedies are among the fastest growing categories9.
 
Traditional Chinese medicine service revenue soared over $5 billion in 2010, supplements $430 million; Ayurvedic services $160 million and supplements $30 million8.
 
Consumers are also looking for more multiple-use products5. More than three-quarters (76%) of last year’s best-selling new non-food healthcare products claimed improved effectiveness—73% new technology, 52% a superior process, 31% new/unique formula, 28% convenience/ portability, 19% natural/organic, 14% added nutrients and 11% aromatherapy/therapeutic5. Long-lasting and faster-relief were important to three-quarters of adults4. 
 
Clean labels are increasingly important across food, supplement and OTC products. In OTC, which includes supplements, purity/healthfulness is a key selection factor for 42%; lack of chemicals/irritants 31%7. Packaged Facts reports “natural,” “no gluten,” “vegetarian,” “no preservatives” and “no artificial colors/flavors” were the top package tags/claims on vitamins/minerals supplements last year10.
 
Hartman reports that 52% of adults made a deliberate effort to avoid preservatives last year; 47% artificial flavors; 44% colors/dyes2. In 2010, 44% avoided aspartame/saccharin, 32% sucralose, 22% natural sweeteners other than sugar and 14% stevia2,11.
 
FMI found only 6% of shoppers to be very comfortable with food and/or ingredients from China or Southeast Asia. Meanwhile, 71% are “very/extremely” concerned with products from China; 51% Southeast Asia12,13. Whenever possible, data show products should state “Made in the USA14.”
 
In 2010, health/beauty products racked up $1.5 billion in convenience store sales15, while practitioner supplement sales reached more than $2 billion8.
 
Think small. Health-driven items positioned at checkout lanes represent another virtually untapped opportunity. Moreover, retailers, especially chain drug stores, are driving traffic and creating differentiation with niche brands. Gold Bond, Zicam, Dulcolax, Icy Hot, Physicians Formula and Airborne were all on the top 20 list of niche brands in food, drug and mass merchandisers in 201016.
 
Lastly, third party endorsements (e.g., MD, pharmacists and third party certified claims) are back in vogue17. In addition, Non-GMO verified food sales hit $472 million in 2010, up 25%.
 
Supplement Strategies
 
Sales of dietary supplements reached more than $28 billion in 2010, up 4% over 2009 per NBJ18; 63% regularly took a dietary supplement10.
 
In FDMx and convenience stores, excluding Wal-Mart (FDMxC), vitamins/ supplements were the 9th fastest growing category in unit sales in 2010; beverages topped the list (see Figure 1)19. “Vitamins” were #1 in the healthcare category; weight control/nutritional liquids/powders were also top performers19.
 

Multivitamins remain the most popular supplement followed by calcium, omega 3, vitamin C and D10. Vitamins/minerals ($12 billion) represent the largest sector; vitamin D was the star performer in 2010, at $550 million18. 
 
Fiber, calcium, vitamin D, protein, omega 3s and antioxidants top the list of ingredients adults tried to get more of in 20102 (see Figure 2).
 

The new dietary guidelines raised concern that Americans aren’t getting enough potassium20. The “Gallup 2010 Study of Nutrient Knowledge & Composition” reports that 25% of adults made a “strong effort” to increase their potassium in 2010; 25% iron21. Magnesium, the fastest growing mineral supplement in the U.S., is now the 3rd most popular ingredient in new heart-healthy foods/drinks globally, according to Innova22.
 
With FTC/FDA and the European Union challenging probiotic immunity claims, consumers have refocused attention on vitamin C, fiber/whole grains and superfruits for immune-boosting support23 (see Figure 3).
 

Interest in eye health has refocused interest on vitamin A/beta-carotene. Bausch & Lomb’s PreserVision supplement sales hit $47 million, a rise of 8% in unit sales in the mass market24.
 
With sales well past $5 billion, specialty supplements remain the fastest growing sector, up 6% in 201018. Hartman reports that use of specialty supplements has doubled since 2000 to 37% in 20102. Fish oils, glucosamine/chondroitin, probiotics and CoQ1010 remain the largest segments25.
 
Sports nutrition supplements led sales growth at 9%16. Sports/energy/weight loss, cold/flu/immune, heart, bone, joint, diabetes and anti-cancer remain the largest condition-specific supplement catetgories26.
 
Energy/stamina, immune health, health/wellness and digestive/liver were the most active categories for North American new dietary supplements, according to Innova (see Figure 4)22. Globally, energy/stamina, immune health, general health/wellness and digestive/ liver topped the list22. Pet supplements are projected to grow from $1.2 billion to $1.7 billion by 2014; 63% of households have at least one pet27.
 
 
Chronic, moderate ailments represent an emerging opportunity. In fact, SymphonyIRI estimates the annual market potential for OTC products, including supplements for muscle/joint pain at more than $8 billion, heartburn/indigestion well over $9 billion and insomnia/sleeplessness at more than $5 billion3 (see Figure 5).
 
Despite strong ties to nature, sales in the $5-billion herb/botanical sector are flat18. More important, Hartman reports the use of herbals among core supplement users fell from 70% in 2000 to 45% in 20102. Four in 10 shoppers consider residues (e.g., pesticides, etc.) a “very serious health hazard”12.
 
Gallup reports 42% of adults made a “strong effort” to consume an herb/botanical in 2010—26% more garlic, 22% green tea/EGCG, 12% flaxseed, 12% cinnamon, 7% ginseng and 6% oregano21.
 
With the #1 reason for taking supplements still to supplement, not supplant a healthy diet, marketers need to stick to their roots as well as focus on key treatment areas. Targeting frequent supplement users is best (e.g., 74% believe they need more nutrients as they age vs. 62% of infrequent users)10.
 
Group Therapy
 
Demographic segments continue to offer new opportunities. While the number of adults who use supplements proportionately increases with age—64% aged 60-64; 74% aged 75+—Baby Boomers are the largest cohort at 51 million (see Figure 6)10. Boomers are at the most likely age for a first heart attack, to be diagnosed with diabetes and to suffer the first signs of muscle loss28,29.
 
In 2010, more than 31 million Gen Xers, 31 million seniors and 14 million Millennials used supplements; 64% of women and 49% of men10. The largest gains were among those aged 55-59, up 9.5% and 30-44, up 4%10. Among those 18-24, the number of users remained flat, but the number of supplements taken per person rose dramatically10.
 
Use of functional foods declines with age: 79% of Millennials bought a functional food/drink vs. 45% for those over 6530. Stress, tiredness/lack of energy, sleep, headaches and back/neck pain are the issues Gen Y is most personally affected by31.
 
SymphonyIRI projects low income households (less than $35K)—45% of U.S. households by 2015—will deliver $115 billion in incremental consumer product goods spending during the next decade, and they have a penchant for health32.
 
In fact, low income households are driving growth in yogurt, salty snacks, cold cereal and other sectors; seven in 10 buy fortified foods, 68% condition-specific items32,33.
 
Whole grain/fiber; low fat, sodium, calories, sugar; fortified, protein-rich; natural/unprocessed and superfruits are the most appealing health food attributes; energy, appearance and immunity are the top condition-specific segments33,34. Campbell Soup Canada’s Nourish (pictured above), with a full serving of three food groups, is designed to provide a complete meal at a low price point.
 
Healthy private label foods are also on fire; sales of store brands with calcium claims topped $1 billion in 200934. “Omega 3s,” “lowers cholesterol” and “gluten/GMO-free” are other fast-growing private label claims.
 
Try targeting workers, as they buy more cold/flu/immunity, weight, stress and energy products than non-workers (e.g., laborers vs. management)29.
 
Work on creating more multi-function products (i.e., obese people have more sleep problems; half of diabetics also have arthritis; the immune system ages early in those with arthritis, etc.)29. Performance-minded adults are three times more likely to buy foods/beverage to improve appearance29.
 
Race is a strong new motivator. Blacks have a much higher risk of stroke/heart attack and diabetes; Mexican Americans have the highest incidence of high cholesterol28. Asians are the top supplement users10. Digestive issues, weight management and antioxidants have high appeal to Blacks; weight loss, energy and mental remedies to Hispanics30,31.
 
Sarcopenia, mild cognitive impairment and peripheral arterial disease—which affect 8-12 million consumers, mostly age 50+—are hot items according to the National Institute of Aging. Watch for the organization’s new National Health and Aging Trends Study, which discusses the impact of age-related changes on functional ability.
 
Lastly, with one in eight children already afflicted with two or more risk factors for heart disease and pediatricians monitoring kids’ blood lipids, blood pressure, weight and calcium levels, there will be more market opportunities to come28. Sales of children’s foods hit $10 billion in 2010; $4 billion has some better-for-you element; Packaged Facts predicts growth of 40% from 2010 through 201535.   
 
Nutrients Naturally
 
The recent focus on natural functionality and inherent nutrition is beginning to shift interest away from traditionally fortified foods and supplements, especially among “core” supplement users36,37. 
 
Maintaining health by eating foods that are naturally high in specific nutrients is fast becoming the desired way for consumers to get their nutrition36. In 2010, one-third (32%) of consumers made a “strong effort” to eat foods/drinks “naturally-rich in nutrients;” 28% “naturally-rich in antioxidants” vs. 19% fortified foods with nutrients21. 
 
While 65% of adults are still making a “strong/some effort” to eat more fortified foods, those making “no effort” rose 7% from 2009 to 2010 to 35%; those making “some effort” fell 6% to 46%21.
 
Sloan Trends’ TrendSense model confirms that carotenoids, anthocyanins and resveratrol are the latest phytochemicals to reach mainstream status; flavonoids and polyphenols remain strong mass market opportunities38. In 2010, 26% of shoppers were aware of the health benefits of polyphenols/resveratrol; 24% flavonoids1.
 
In the year ended July 2011, half of shoppers bought cranberry juice, dark chocolate or almonds for their superfood status; 43% green tea, 25% pomegranate juice and 21% Greek yogurt (see Figure 7)39.
 
In beverages, exotic superfruits gave way to more traditional flavors in 2010. Lemon and orange ousted pomegranate and acai from the “top 5” flavors, mango fell 10 slots and tea inched back above green tea. Natural is the #1 need/interest state for new beverage developers for 201140.
 
Spices, pulses (e.g., chick pea, peas, beans, etc.) and nuts/seeds are among the new superfoods. A teaspoon of ground cinnamon or cloves has more antioxidant activity than an 8-oz. glass of pomegranate juice or a half-cup of blueberries41. Look for American superfruits to steal the show.
 
Products claiming  “all-natural” took the highest share (12%) of all CPG products sales with wellness claims in 201142. Packaged Facts reports U.S. retail sales of natural and organic foods/drinks reached $39 billion in 2010, a growth of 9%43. In 2011, 38% of food shoppers are buying organic; quite a bit more (58%) are purchasing pre-packaged foods marked “all-natural,” not organic43. Natural is far more appealing compared to organic at retail44 (see Figure 8).
 
Hartman believes consumers connect “organic” to what happens to food at its origin (i.e., the farm, the plant, the animal); “natural” with “what happens after it leaves the origin,” (i.e., in terms of production and processing). The absence of herbicides, synthetic fertilizers, hormones, antibiotics and GMOs are more strongly linked to organic foods; no artificial flavors, colors or preservatives to natural, which might help to explain natural’s continued growth in the current chemical-phobic environment45. Globally, no additives/preservatives are the top new food/drink better-for-you claims; #3 in the U.S. behind natural and organic22.
 
A Functional Future
 
U.S. sales of functional foods and beverages reached $39 billion in 2010, up well over 4%18. Beverages accounted for nearly $24 billion, snacks $3 billion, prepared/packaged foods more than $4 billion, dairy $2 billion and breads/grains almost $7 billion18.
 
Just over half (56%) of adults bought a functional food in the three months ending July 201146; 55% drank a functional drink more than four times/month43. On the food side, 65% of consumers are using food to help them lose weight; 61% to manage a special health condition3.
 
Powerade ION4 topped the list of best-selling new food/beverages last year, with $191 million year-one sales, followed by Chobani Greek Yogurt at $149 million, Wonderful Pistachios at $114 million and glaceau vitamin water zero at $110 million5.
 
One-third of the best-selling new foods/beverages in the U.S. carried a natural/organic claim; 27% added vitamins/nutrition; 27% high fiber/whole grain; 25% lower calorie; 25% lower fat; 12% energy/protein; 11% antioxidants; 10% no trans; and 6% low salt/sodium.
 
Saturated fat now tops the list of “very/extremely important” label information for 59% of food shoppers; trans fat 58%; total fat 56%; salt/sodium 52%; calories 48%; whole grains 47%; chemical additives 47%; artificial sweeteners 47%; high fructose corn syrup 44%; and cholesterol 43%12.
 
Calcium fell out of the top 10 list of the most sought after health claims on food packages12. But antioxidants show little signs of slowing down, with the exception of their link to heart health, suffering from negative American Heart Association publicity38. Sales of foods/drinks with an omega 3 or DHA claim reached $4 billion in 2010; projected to grow 40% between 2010 and 201547.
 
Protein is the new superstar. The International Food Information Council (IFIC) reports 39% of adults are trying to get more protein in 2011; 65% believe protein helps build muscle, 39% helps you feel full, 39% important as you age and 34% helps lose weight11.
 
Most exciting is the newfound importance of consuming a moderate amount of protein—30 grams at each meal or throughout the day—which optimizes protein’s role in muscle building and weight management. With the typical protein distribution of 10 grams at breakfast, 15 grams at lunch and 65 grams at dinner, this would give high protein breakfast foods superstar status48.
 
Mintel reports that when it comes to functional beverages, antioxidants (51%), calcium (59%), added vitamins (50%), omega 3 (44%), green tea/extract (37%), pomegranate (31%), acai (23%) and taurine (13%) are among the most sought out ingredients49. Soy tops the list of protein “look-fors” for 23%; whey 19%; 27% seek out probiotics; 16% prebiotics and 14% plant sterols49.
 
Four in 10 consumers want snacks that provide health benefits beyond basic nutrition, (i.e., extra antioxidants, etc.)50. Protein and low sodium were the two strongest snack attributes in 201050. Snack granola/bars, trail mixes, snack nuts/seeds/corn nuts, sugarless gum, dry fruit snacks and sensible salty snacks are the gainers in the healthy snack market50.
 
Lastly, healthy menu items influenced 31% of diner’s selections in 201051. In fast food restaurants, for example, healthy options in kid’s meals was the #1 “hot” menu item for 2011; gluten-free, smoothies, organic items, snack-sized, lower-sodium, energy drinks, enhanced/flavored water, low calorie/fat, whole grain breads and energy drinks also made the top 2052. 
 
Condition Specific 
 
With the modality for treatment dependent upon the health issue, both supplements and functional foods/beverages face enormous opportunities in the condition-specific segment. While food is used to prevent many health conditions, its reliance drops for treatment2 (see Figure 9).
 
SymphonyIRI reports that 52 million U.S. households have a member afflicted with muscle/joint pain, 51 million high cholesterol, 50 million high blood pressure, 49 million heartburn/indigestion, 23 million diabetes and 17 million osteoporosis4.
 
Digestive/gut health, heart health, energy/alertness, omega 3, vitamin/mineral and immunity were the top new food/beverage positionings in North America for 2010 per Innova22 (see Figure 10). Globally, digestive/gut, vitamin/mineral, energy, omega 3, heart and immunity top the list.  
 
Consumers are now more concerned about risk factors than preventative heart health; risk factor concern has risen dramatically among younger adults. While 68% of Boomers are concerned about cholesterol and 66% high blood pressure, only 46% were worried about heart health; among Millennials 40%, 40% and 35% respectively were concerned per Hartman2.
 
Weight and lowers cholesterol tie for the most desired functional food benefits (64%), followed by digestion 63%, immunity 60%, enhanced metabolism/lower blood pressure 54%, satiety/healthy blood sugar levels 53% and memory 47%30.
 
In 2010, 39% of consumers watched their weight; 28% tried to lose; 13% tried to maintain53. More than half (55%) of dieters made a strong effort to eat more protein, up 5% over three years, while those limiting carbs fell 6% to 33%21.
 
Seven in 10 (69%)  “dieters”  continue to make a strong effort (18%, up 4% last year)-some effort (51%) to eat foods/drinks promoting satiety21. Blood sugar management is another fast emerging weight platform38.
 
Muscle health/muscle tone is a new opportunity as sports nutrition products crossover to mainstream. HealthFocus reports that muscle health/tone made the top 10 list of concerns adults are “extremely/very concerned” about in 201031 (see Figure 11). The most common problems consumers are dealing with are stress, sleep problems and tired/lack of energy31.
 
While sales hit almost $5 billion in 2011, only 15% of consumers intentionally buy gluten-free54. In fact, more than half of those who bought gluten-free products didn’t know they were gluten-free55, indicating that the long-term market stability is likely weak.
 
Of this small number, 46% think gluten-free is “generally healthier;” 36% trendy for weight loss; 24% higher quality (strict process standards); 13% hyperactivity/ autism; 12% gluten allergy/intolerance; and only 8% Celiac disease54.
 
While the incidence of diabetes is exploding, targeting diabetics will likely meet with limited success. About half (46%) of diabetics modified their diet only slightly in 2009; 33% couldn’t maintain the diet or guidelines56. Of the 54% of adults watching their diet, 23% do so for blood sugar, 15% diabetes30.
 
In 2011, beauty and anti-aging made the top 10 list of beverage developers’ “hot list” for new products for the first time40.
 
Globally, functional foods and beverages are projected to reach $130 billion by 201557.
 
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