Cardiovascular health at heart of well-being despite claim roadblocks

15 Oct 2020 --- A holistic view is necessary to understand the cardiovascular sector, which has a broad reach allowing it to address concerns from bone health to COVID-19. 

However, regulatory differences between regions like the US and UK can create major difficulties in making health claims. Industry players speak to NutritionInsight about the new forces shaping this space and the trends that lie ahead.

“Cardiovascular health is a broader, more positive construct than just the absence of clinically evident disease. Recently, it has become evident that there is a substantial overlap between the components of cardiovascular health and general health, related to physical, mental and social functioning,” says Lorena Carboni, scientific and communication specialist at Gnosis by Lesaffre.

This relationship also goes the other way, with factors like sleep quality, digestive health, inflammation and immunity all having positive and negative effects on the heart. 

Notably, cardiovascular diseases (CVD) are the leading cause of death globally, estimated to take 17.9 million lives each year, says Efrat Kat, vice-president of global sales of Solabia-Algatech Nutrition.

This group of disorders includes coronary, cerebrovascular, peripheral and congenital heart diseases. 

Laetitia Petrussa, product manager at IFF Health, adds that the cardiovascular system carries oxygen, nutrients, electrolytes, and hormones throughout the body to all the other organ systems.

“Interruptions, blockage or lack of oxygen will impair the function of other organs. Even small deficiencies over a prolonged time can be detrimental,” she stresses. 

Intersection with other areas
Besides being a key element to overall wellness, there are also intersections between heart health and other specific concerns. 

Elise Kaiser, vice-president of sales, Americas, NattoPharma, highlights the overlap with bone health. Both areas are predicated on how the body utilizes calcium.

“If someone has enough vitamin K2, proteins in the body are activated to ensure that calcium is directed to the bones. This is while simultaneously stopping it from depositing in other parts of the body, namely the arteries and soft tissues where it can do harm,” she details. 

Cardiovascular health has also entered the COVID-19 conversation. Petrussa points out that the pandemic is shining a light on the impact of cardiovascular conditions on disease susceptibility, leading to heart health being increasingly viewed as a piece in the holistic health puzzle.The consumption of dietary supplements without performing healthy changes in lifestyle would have only a limited effect.

Pre-existing cardiovascular diseases seem to be linked with worse outcomes and increased risk of death in patients with COVID-19, adds Kat. 

She explains that COVID-19 itself can induce myocardial injury, arrhythmia, acute coronary syndrome and venous thromboembolism.

“COVID-19 and its vascular complications highlight the importance of maintaining healthy circulation,” adds Dominik Mattern, Kappa Bioscience’s vice-president of marketing. 

Earlier this month, a study funded by the company positioned vitamin K metabolism as the “potential missing link” between lung damage and thromboembolism – two of the most serious outcomes observed in COVID-19 patients. 

“EFSA will not budge”
Despite the research backing some ingredients in the heart health space, claims can still be quite the challenge. 

Kaiser details that US companies can create cardio-supporting products that feature MenaQ7 vitamin K2 as MK-7 with structure function claims approved by the Food and Drug Administration (FDA). However, the European Food Safety Authority (EFSA) has different restrictions. 

“EFSA continues to require a higher level of evidence than many regulatory agencies. Although we felt we had a substantial and sufficient body of evidence in hand, NattoPharma applied for and was denied an EFSA health claim for MenaQ7 and maintenance of the elastic properties of the arteries,” she details.

The main conclusion from EFSA was that MenaQ7 was sufficiently characterized. Still, a cause-and-effect relationship has not been fully demonstrated between the consumption of MenaQ7 and maintenance of the arteries’ elastic properties.

“Although population, in vivo and human studies have clearly linked vitamin K2 consumption to improved arterial health, no health claim is likely to be awarded under EFSA’s current purview. We have been working for years presenting our substantial body of evidence to the regulatory authorities, yet it seems no matter how much we put out there, EFSA will not budge,” says Kaiser.NattoPharma’s study of healthy postmenopausal women shows that those taking 180 μg daily of MenaQ7 for three years had more flexible arteries than a placebo group. 

Moves toward prevention
There is also a need to educate consumers about the importance of heart health. Kat explains that consumers should adopt a healthy lifestyle and take a holistic approach.

The consumption of dietary supplements without performing healthy changes in lifestyle, such as quitting smoking, reducing alcohol consumption and eating a healthy and balanced diet, would have only a limited effect.

“There is also a need to educate potential customers that the best way to fight CVD is by prevention. Prevention can be achieved by reducing behavioral risk factors,” Kat says. 

Petrussa agrees that the focus for food supplements should be on prevention. This includes keeping the heart and blood vessels healthy, even before a rise in blood pressure or blood cholesterol occurs.

“A few ingredients focus on maintaining a healthy vascular endothelial function. The endothelium has increasingly been recognized as a smart barrier and a key regulator of blood flow in both small and large blood vessels. Deregulation of the endothelial function is often seen as an early sign of atherosclerosis and precursor of CVD,” she details. 

Adopting a heart-healthy lifestyle at younger ages
In an encouraging move for prevention, Petrussa also observes that consumers are starting to think about their heart health at an earlier stage.

“One of the biggest changes we’ve seen in the last ten years is that the consumer for cardio-support products is skewing younger,” adds Kaiser.

Where cardiovascular health was once a concern for older shoppers exclusively, she now sees more shoppers in their late 20s and early 30s actively seeking supplements that support heart health.

Convenience reigns
Another trend proliferating in the heart health space is innovative delivery formats. Mattern observes a growing desire for more convenient products. For example, elderly people may have swallowing difficulties, where Millennials seek out fun and taste-driven formats. 

“Gummies present advantages in terms of consumer-friendliness, and demand is growing steadily globally. Sugar-free, vegan and organic options are available to match modern lifestyle choices. Kappa Bioscience has developed several turnkey gummy solutions, including one targeting cardiovascular health,” he states.

Meanwhile, Petrussa flags the rise of polypills, which are pills containing a combination of several ingredients commonly taken together to treat heart disease and high blood pressure. These arrive in a convenient “one-a-day” form.

Polypills often use fixed-dose combinations of cholesterol- and blood pressure-lowering drugs and aspirin for an additional effect.Consumers are seeking innovative delivery formats and natural ingredients.

Naturality demands on the rise
Other themes that have now become mainstays across the broader nutrition industry are having an impact on the cardiovascular space. Notably, naturality is becoming even more important to consumers. 

According to Innova Market Insights, NPD with natural claims has seen a CAGR increase of 5 percent over the past three years (2017-2019), growing at around 8 percent annually compared to the past year. Interestingly, 65 percent of global consumers say that they perceive “natural” food and drinks to be healthier.

“We expect to see a rise in strategic natural extract blends, working on even more aspects of cardiovascular protection, and leveraging these complementary actions to support cardiovascular health in a more convenient and more cost-effective way,” says Petrussa. 

Kat adds that consumers are willing to spend more money on clean label supplements. “Increasing awareness of harmful chemicals used in supplements is pushing consumers toward heart health supplements made with ingredients sourced from reliable suppliers.”

She concludes that clean labels cut through the clutter of too much data and represent valuable information, enabling consumers to feel that they have more control over their well-being.

By Katherine Durrell