As a nation renowned for its stiff upper lip we're not normally very good at talking about embarrassing subjects. But that seems to be changing when it comes to gut health - an area where over one third of the UK population regularly suffers a disorder. Not surprisingly, manufacturers are cashing in on consumers' desire for wellbeing and their awareness of the benefits of gut friendly bacteria.
According to research group Mintel, the number of new product launches in Europe positioned as pro or prebiotic has risen from 20 in 1997 to 1,915 in 2005. And analysts predict the category will continue to grow, reaching euro 180M by 2010. The biggest category for both pro and prebiotics is dairy, but as technology progresses, the most recent activity has been in the cereal and bakery sectors.
Despite some negative press criticising some of the less well-known products for containing too few bacteria to have any effect, both have been proven to have a positive effect on gut health. Probiotics (live bacteria) add good bacteria to the gut; while prebiotics (non-digestible fibres) actually feed the good bacteria already there. More recently, synbiotics, a mixture of both, have also begun to feature.
Although most commonly added to dairy products because these are at the right temperature to prevent the bacteria becoming active, it is now possible to include probiotics in ambient foods, thanks to some technological developments.
Swedish probiotics producer Medipharm, a subsidiary of Arla Foods, has launched a coated bacteria, Lactobacillus F19, that can resist the damaging conditions in ambient foods and even in ice cream, if the conditions are correct.
Kerstin Holmgren, research and development manager at Medipharm, explains: "One of our customers wanted to put probiotics in cereals. But [standard] freeze-dried bacteria can't be used in cereals because there's too much moisture, which would destroy the bacteria. The shelf-life is also wrong, at up to one year at room temperature." Medipharm found a solution in micro-encapsulation - in this case, protecting the bacteria by surrounding it with vegetable oil. "It still looks like a powder, but it can be added to cereals, infant formula and cereal bars, and is stable at room temperature for up to 12 months," says Holmgren.
Research is also continuing into the effects F19 has on irritable bowel syndrome and chronic fatigue syndrome, and the firm has applied for a patent on its research into the connection between F19 and a reduction in obesity through its effect on the metabolic rate.
Meanwhile, in collaboration with Tetra Pak, Ingredients firm Chr Hansen has developed an in-line pump system for adding probiotics to finished products.
It uses Tetra Pak's Flex Dos system, which allows bacteria to be added to liquids just before they are filled into cartons. "It is a way of adding cultures without contaminating sterile products," explains Margaret O'Connell, Chr Hansen's UK technical manager for dairy and probiotics. The innovation is expected to boost the market for probiotic drinks, as it overcomes restrictions resulting from the delicate nature of probiotics and concerns over contamination.
When it comes to marketing gut health products, O'Connell suggests that probiotics often don't have a specific target audience.
But, she says: "We've looked at our strains [LA-5 and BB-12] in infant formulas and products for the elderly, as well as for people who travel. We've done a lot of work on travellers' diarrhoea (for people who pick up tummy bugs when abroad) and we've shown that by taking our probiotics, you can reduce the time you feel terrible from a few days to one day."
The difficulty, however, is in communicating this to the consumer, says O'Connell. "You can't make a medicinal claim, you can only say 'boosts immune system' or 'improves stability of digestive tract'. And the pending changes to European health claims legislation are only going to make things harder," she adds. "Clinical documentation [to substantiate a claim] will become vital."
Despite this, ingredients supplier Danisco is predicting that probiotic strains will increasingly become tailored towards specific conditions, following the launch of its Restore strain, aimed at restoring the gut's beneficial bacteria after taking antibiotics. Danisco claims that the latest addition to its Howaru probiotics range helps to restore bifidobacteria in the gut to a normal levels within a fortnight of completing a course of antibiotics.
Made to measure solutions
Restore is the first in a line of condition-specific studies by Danisco, as global probiotics business director Scott Bush explains: "Many probiotic suppliers employ a one-strain-does-it-all approach to efficacy. Danisco's screening strategy, utilising in vitro and in vivo models allows selection of the best strain or blend for each condition."
Similarly, when it comes to prebiotics, marketing is often more focused on specific age groups. According to prebiotic producer Orafti, infant formula manufacturers looking to replicate the qualities of breast milk are turning to prebiotics to boost gut health. New on to this market are Infacol Probiotic Drops from Forest Laboratories. The company says its prebiotic ingredient, L. reuteri, has been scientifically proven to inhibit harmful bacteria in the system without affecting the balance of good bacteria.
The most well-known prebiotics are inulin and oligofructose, but according to professor Glenn Gibson from the University of Reading's School of Food Biosciences, a much wider list is now emerging from Japan; including such prebiotics as isomaltooligosaccharides, lactosucrose and polydextrose.
"The advantage of prebiotics over probiotics is that product integrity, viability or stability are not issues, hence they can be added to many food vehicles," says Gibson, who points out that new product developments are "occurring at a rapid pace". Most recent interest has turned to the use of prebiotics in cereals (think tummy-friendly Rice Krispies Multigrain), cereal bars and bread.
And although their benefits have not been as extensively researched as those of probiotics, "the beneficial natures of both approaches are undoubtedly the same", says Gibson.
He also agrees that both can be beneficial to all age groups, stating: "Even a sceptic would admit that the approaches are relatively harmless." However, he adds that some age groups are more prone to intervention than others. "The magnitude of a prebiotic effect is related to starting levels of the target flora population. Examples include the elderly, who are especially prone to gastrointestinal infection, weaning children, formula-fed infants and frequent travellers," he says.
With research continuing and pending legislation increasing the pressure to substantiate any health claims with scientific research, where is the already seemingly crowded market heading? And will consumers be able to keep pace with the science?
According to Holmgren, consumer knowledge in the UK is only at the beginning compared with other countries in the EU (such as Finland). Similarly, Markus Smet, head of marketing and strategy at Naturis, suggests there is still room for probiotics in particular to expand into the cereal market. "Snacking on the go is another untapped area," says Smet, "and the use of prebiotics to reduce fat and sugar is an area that bakery and breakfast still have room to utilise."
So, with inulin readily being incorporated in food as a fat-replacer, are we likely to see gut health claims appearing on tubs of ice cream? Not likely, says O'Connell, as health claims on high fat, sugar and salt foods are likely to be restricted by changes to the regulations.
"Functional ingredients should be added to healthy foods, especially probiotics, where consumers are encouraged to eat them on a daily basis," she says. "You could put probiotics in a chocolate cheesecake, for instance, and your gut would be nice and healthy, but at 1,000 calories a slice, your arteries would be like concrete!" Ultimately, the dosage is the key target, followed by shelf-life, she says.
O'Connell suggests that a probiotic cottage cheese might be the next innovation on the market, while Holmgren believes probiotics added to room temperature liquids will be the next big thing. "But manufacturers are always looking for a longer and longer shelf-life, which makes it harder to add probiotics."
One thing that is agreed is that "the journey from science to consumer is not an easy one", says Christine Nicolay from Orafti, which is continually researching the area of consumer understanding. Ingredients firm DSM Food Specialties is also researching consumer perception of probiotics. It found that while digestive health was viewed as a vital part of overall wellbeing, people remain unsure of the best method to improve gut health, and are wary of functional products that aren't backed up by scientific evidence.
O'Connell agrees that as technology progresses, manufacturers must be wary of confusing the consumer. "It's easy to explain something to one person, but the challenge is in explaining it to 60M people."