Innovating in human health: Booming HMO market opens window for adult nutrition

22 Jun 2023 --- Human Milk Oligosaccharides (HMOs) are a growing ingredient in infant nutrition, and according to experts’ forecast, they might be entering adult nutrition next. Regulatory approval differs geographically, although more and more countries are looking into the compound for various nutrition and health solutions. 

Nutrition Insight speaks with Chr. Hansen, FrieslandCampina Ingredients and Morinaga Milk about the present and future of HMOs.

Jesper Sig Mathiasen, senior VP of the HMO business unit at Chr. Hansen, tells us that in the past years, the understanding of the benefits of human breast milk has changed dramatically, and HMOs play a significant role in this change. 

“Human milk is not only a food providing nutrients, such as fats, protein, carbohydrates and vitamins, but it is so much more. It’s a complex system that contains a large number of bioactives that support the infant’s immune system, act as anti-infectives or even promote cognitive development.”

“HMOs and their benefits for human health are being more widely researched, meaning their benefits are becoming better understood by the scientific community. Still, there is much to be uncovered regarding the functionality of HMOs, so we anticipate extensive scientific research in that field in the coming years,” says Sophie Nicolas, marketing manager of early life nutrition at FrieslandCampina Ingredients.

Human breast milk is a complex system that contains a large number of bioactives that support the infant’s immune system.Innovating in infant nutrition 
Mathisen argues that HMOs are probably the most significant innovation in recent years, with increasing penetration into new infant formula and infant nutrition products.

“The first HMO approved and used was 2’FL (2'-Fucosyllactose) in 2016. In 2022, we saw mixes with 5 HMOs being launched. Innovation will continue with more HMOs in complex formula compositions for infants who cannot be breastfed.”

“Probiotics human-residential bifidobacteria (HRB) such as Bifidobacterium longum, B. breve, and B. infantis are popular ingredients that have been incorporated into infant formula to help establish a bifidobacteria-dominant gut microbiota in early life,” says Chyn Boon Wong, assistant manager, marketing and scientific affairs at Morinaga Milk.

“Some of these have also been paired with the prebiotic HMOs, FOS, or GOS as synbiotics in infant formula.”

She explains that amid supply-chains uncertainty, infant formula brands are trying to innovate and move toward more sustainable packaging options. 

“In the short term, brands have already started to transition to alternative formats such as dissolvable milk tablets, ‘easy cube’ pouch format and our Morinaga ‘Hagukumi liquid milk’ in a thin and compact aluminum pouch, minimizing bulky tinned packaging and reducing waste.”

Moving on to adults
Nicolas adds that at the same time, consumers looking for concrete health benefits are becoming more aware of the value HMOs can bring. As a result, demand for these ingredients is growing fast. 

“In fact, 35% of new infant milk formula (IMF) product launches now contain at least one HMO, up from 25% in 2021. An emerging trend is the uptake of HMOs outside the IMF sector – we see a lot of interest in and potential for applications for children and adults too.”

Nicolas says that HMOs are used almost exclusively in infant nutrition up to three years old, in powder or Ready-to-Drink formats. 

“However, we have started seeing HMOs in applications targeting young children (over three years old), such as flavored ambient ready-to-drink products, particularly in the APAC region. This means more product formats for children containing HMOs could also emerge shortly, such as yogurt drinks, gummies, capsules and stick packs.”

She notes that besides young children, HMOs may also enter the adult nutrition segment in formats such as supplements.

“Colonizing the gut”Bifidobacteria are the first colonizers of the infant’s gut that play a crucial role in gut microbiota development, details Boon Wong.
Bifidobacteria are the first colonizers of the infant’s gut that play a crucial role in gut microbiota development and immune system training, details Boon Wong.

She continues to explain how breastfeeding is associated with higher levels of Bifidobacterium species, but only those of human-residential bifidobacteria (HRB) that can utilize HMOs and are compatible with human milk. 

“Human-residential bifidobacteria (HRB) is recognized as the natural inhabitant of the human gut that has coevolved with the human host during the evolutionary process and retain certain genetic elements and metabolic capability including HMO utilization and lysozyme tolerance that make them more competitive in the infant’s gut.” 

Probiotic strains
Boon Wong exemplifies strains of HRB probiotics, including B. longum BB536, B. breve M-16V, and B. infantis M-63, “which have been shown to possess clinical benefits in improving bifidobacteria colonization, facilitating immune maturation and preventing NEC and allergies,” she details.

Mathisen from Chr. Hansen adds that HMOs fit well into the high focus on infant health and the establishment of the early microbiome. 

“Serving as prebiotics, HMOs play an important role in supporting a well-balanced bacterial gut flora dominated by certain species such as bifidobacteria.” 

In addition to HMOs, probiotics, or even synbiotics – the combination of the two – are leading ingredients being intensively studied and increasingly added into infant nutrition products.

“Infant formula players are adding more HMO mixes and dosages to bring IF closer to breast milk, such as Chr. Hansen’s MyOli 5 HMO mix. More and more countries approve the use of various HMOs at higher concentrations. The MyOli 5 HMO mix by Chr. Hansen has just been approved in the EU at the highest concentration levels, closer to the natural concentrations,” details Mathiasen. 

“We are seeing continued higher activity in research on various potential health effects of HMOs for applications outside infant nutrition. For example, you can see dietary supplements for children or adults with specific health indications on the market. Guided by new scientific findings, there are many more possibilities for HMOs in the future that we can’t even guess today.”

HMO approval for use in IMF is increasing, says FrieslandCampina Ingredients.Future for HMOs
Chr. Hansen says that the scientific evidence on HMOs is growing and indicates that HMOs directly affect health. 

“New data shows that HMOs contribute to the gut and immune system development, which Chr. Hansen recently presented at a webinar. An improved understanding of the direct effects of HMOs, prebiotic function and synbiotics have great potential to support health performance,” reveals Mathisen.

Nicolas at FrieslandCampina Ingredients argues that while trying to formulate infant nutrition products closer to the composition of breast milk isn’t new, progress is still being made. 

“Historically, galacto-oligosaccharides (GOS) have been used to bridge the gap between IMF and human milk through their proven positive influence on infant gut microbiota composition. 

“However, diversity of oligosaccharide structures is needed to enhance the nutritional value of the IMF further. Combining GOS and HMOs could play a role here by increasing the volume and variety of oligosaccharide structures, helping to close this gap,” she argues.

Changes in early-life nutrition market dynamics are also playing in favor of HMOs.

“HMO approval for use in IMF is increasing. However, key markets such as China are not yet authorized to use them, despite their huge potential and the significant value they would provide for all suppliers in this region. Approval for HMOs is expected to occur in China in 2024. HMOs are also awaiting approval in countries such as Japan and Indonesia,” notes Nicolas.

The infant nutrition segment will see a more microbiome-oriented focus with an emphasis on exploring the best combination of prebiotics and probiotics to provide the best support to early life gut microbiome development and health in later life, according to Morinaga Milk.

“In particular, research on human-residential bifidobacteria will continue to be a highlight where incorporation of these breastmilk-selected probiotics is seen to possess the potential to establish a healthy gut microbiota as those in the breastfed infant gut,” concludes Boon Wong.

By Beatrice Wihlander