Heart disease has been a top-of-mind public health issue for many years, and it appears personal experiences by consumers as well as efforts by groups such as the American Heart Association and others have had a positive effect in enhancing consumer knowledge. Many understand the issues surrounding heart health, and, as a result, there are opportunities for food and beverage companies to consider.

“All of the things we are talking about are markets that are poised to tip,” said Elizabeth Sloan, president of Sloan Trends Inc., Escondido, Calif. “Circulation is over the tipping point. The awareness of it is over the edge; it is right up in the top quartile, if you will, of consumer awareness, but (food) manufacturers have not gotten on the bandwagon. A health claim is not an issue. It may be prices, but I’m not sure. Issue may be how to position such a product.”

Market research conducted by Dr. Sloan and her colleagues highlight several key issues related to heart health: circulation, arteriosclerosis or plaque build-up and stroke.

Catherine Adams-Hutt, chief regulatory and science officer for Sloan Trends, said all of the issues are related, but many consumers are starting to view them independently.

Both circulation and stroke have mass market opportunities, according to Dr. Sloan’s TrendSense Model.

“Circulation has the second largest growth rate, according to Datamonitor, behind hypertension,” she said. “It has been around for a while, and there is a new emphasis on stroke with baby boomers getting into the ‘stroke zone.’

“This whole heart disease thing is starting to refocus, and at the cutting edge is circulation, and it is starting to refocus on energy. That surprised us when we did the work. I think a lot of this comes out of the sports world, which actually skews younger.”

Dr. Adams-Hutt thinks the issue of circulation is more marketable than other factors related to heart health.

“It involves preventing a problem with regard to a disease state,” she said. “Better blood flow is healthy; it helps prevent plaque formation.”

Ingredients to improve blood flow

Several ingredients have shown promise in having a beneficial effect on circulation performance. A notable ingredient in this category is cocoa flavanols. In July 2012, Barry Callebaut, Zurich, Switzerland, received a positive opinion from the European Food Standards Agency that states “cocoa flavanols help maintain endothelium-dependent vasodilation, which contributes to normal blood flow.”

The company was able to provide evidence that the intake of 200 mg of cocoa flavanols, provided by 2.5 grams of high-flavanol cocoa powder or 10 grams of high-flavanol dark chocolate, positively influence blood circulation in the human body.

Barry Callebaut is the first company in the European Union to obtain a positive scientific opinion on a health claim on cocoa flavanols. The company has been working on the effort since 2005 and has conducted more than 20 human clinical studies examining various impacts of cocoa flavanols on the human body. For the studies, the company used cocoa powder and chocolate products made through its Acticoa process that results in high-flavanol cocoa products.

Barry Callebaut is waiting to learn if the commission further approves the health claim. If it is approved, the company will have the right to use the claim for five years within E.U. countries. Applications where the ingredient may work best include chocolate beverages, cereal bars and cookies.

But Barry Callebaut is not the only company working in the circulation category. Mars, Inc., Hackettstown, N.J., is considered a pioneer in the field of cocoa flavanols and researching the health benefits of the ingredient. Through the company’s Mars Symbioscience subsidiary, which is based in Germantown, Md., the company focuses on human health and nutrition research. Through the group, the company produces Cocoavia, a cocoa extract supplement designed to maintain healthy circulation.

Mars has been researching cocoa flavanols for more than 20 years. The research led to the development of Cocoapro, a process that allows the company to extract flavanols found in the cocoa bean that may be destroyed during processing.

DSM Nutritional Products, which has an office in Parsippany, N.J., markets FruitFlow, an ingredient that has been shown to contribute to healthy blood flow. The ingredient is a tomato-based concentrate that has been developed in two forms, FruitFlow 1, which is a water-soluble syrup, and FruitFlow 2, which is a sugar-free derivative that is supplied in a powder form. The ingredient performs well in juice-based and water-based beverages as well as dairy applications with a recommended dosage of 3 grams, according to the company. The science behind FruitFlow has qualified it for an E.F.S.A. health claim that states. “FruitFlow helps maintain normal platelet aggregation, which contributes to healthy blood flow.”

Preventing plaque, stroke

In contrast to what she sees as the immediate potential of products tied to improved circultation, which has immediate potential, Dr. Sloan described as just emerging the market for ingredients that may reduce the amount of plaque in arteries.

“It has crossed into the mass market, and is a logical extension of how the baby boomer population is evolving,” she said. “They are moving toward the risk factor side and trying to control things related to their heart.

“With regard to plaque build-up, 52% of men have undesirable levels of plaque. So there is a real issue here. It is something consumers, especially those entering the baby boomer age range, want to try and control.”

Dr. Adams-Hutt said plaque build-up is where a shift occurs in the science.

“It is emerging,” she said. “Oxidation of low density lipoprotein is what is causing some of the plaque formation. The goal is to prevent the oxidation from occurring, and antioxidants may play a role. But this is where the science and the research into the benefits of different anitoxidants is still going on.”

She added that preventing inflammation also may provide a benefit.

“We want to make sure we are moderating inflammatory response, and this may be where omega-3s come in as anti-inflammatories,” she said. “But this is another area where the research is ongoing.”

Dr. Sloan said she was “floored” by the potential size of the markets related to heart health, whether it is related to improving circulation, preventing plaque or reducing the incidence of a stroke.

“There are medications for all of these issues, but consumers would prefer to receive similar health benefits through the foods they eat,” she said.

Dr. Adams-Hutt added that dietary intervention studies have shown decreases in consumer cholesterol levels.

“Drugs will have a larger effect, but it is important to note dietary intervention studies have shown results,” she said.

Both Dr. Sloan and Dr. Adams-Hutt said consumer concern about strokes is starting to shift toward younger adults.

“Stroke is no longer something a distant relative died from,” Dr. Sloan said. “It is something that has affected people who are close to you. In SymphonyIRI data, I have seen the percentage of households reporting heart problems related to stroke. It has reached 26 million people who have had someone in their family who has had an issue related to a stroke.

Dr. Sloan added that the issues related to heart health are straight forward.

“If you look at the market research you can see the interest in cholesterol and blood pressure has really grown in the younger audience, such as millennials and the gen X group,” she said. “They are seeing their parents going through it, and shifting their focus from general heart health to more specific issues.

“I think it is old news to take something general for heart health. We are seeing consumers shift to focusing on risk factors. The numbers by age will speak for themselves. We believe this is helping these markets grow and become more important. Improved circulation and managing plaque are the new, specific preventative measures to take action on.”