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Liver health nutraceuticals: Countering a modern age concern

With the increase in global obesity and metabolic syndrome prevalence, liver health will inevitably become one of the great concerns of the modern age and a major nutraceuticals interest. Non-alcoholic fatty liver disease (NAFLD) is a growing medical issue devoid of pharmaceutical solutions. Intake of processed food and medication, along with occurrence of diabetes and obesity are all rising. Despite clear consumers’ attention, most nutraceutical products available are repetitive commodities, and almost none are aimed at children. In Pharmalinea’s experience so far in 2019 and especially at Vitafoods Europe, business development professionals are increasingly inquiring about the indication and available solutions. In this review we summarise the scale of the issue and the market opportunity.

1 – Indication

NAFLD is known as excessive lipid accumulation in the liver, usually coinciding with oxidative stress and inflammation. Fat accumulation happens because of abnormal hepatic metabolism of fatty acids, in the absence of significant alcohol intake, viral infection, or any other specific aetiology of liver disease.

This disease is becoming a major concern worldwide. It affects a staggering 25% of the global population notably both adults and children. In some countries the prevalence of NAFLD is up to 30% and is one of the most common causes of liver disease, possibly leading to severe outcomes such as cirrhosis, liver failure and transplantation.

NAFLD patients usually don’t show symptoms and the condition is often diagnosed by chance, making it difficult to predict. Currently no direct treatment exists - patients are required to lose weight and follow strict diet.

Early identification is important and supplementation with liver-protective ingredients may be a suitable option to counter the early start of NAFLD.

2 – Nutritional & nutraceutical solutions

Several studies have demonstrated nutraceuticals interest in preventing liver disease. Among the many ingredients screened, those shown as most effective were vitamin D and vitamin E at high concentrations, omega-3 fatty acids, choline, SAMe, and various polyphenols. All these molecules present interest in liver protection through their direct or indirect anti-inflammatory or antioxidative properties.

3 – Market Status

With increasing awareness of the liver-gut axis, consumer interest for liver health is continuously growing. Web searches for 'liver supplement' have risen by 33% in the past five years. Despite increasing consumer attention, there is a clear lack of quality nutraceutical solutions on the market today.

Most of the available products are commodity herbals, relying on bibliographical data rather than clinical proof, with unknown bioavailability. For example, many solutions addressing liver problems contain milk thistle extract, while its major active component, silybin, has poor bioavailability. Other times, manufacturers simply mix together different herbals commonly associated to liver health, disregarding clinical substantiation, control over which part of the plant should be used or possible interaction between the substances. Products are often positioned as 'detox' or 'liver cleanse', misleading consumers as no ingredient can technically detoxify the liver. In the flood of 'me-too' products, there are hardly any solutions available for children, even though they are equally as affected by the issue as adults, and the situation is unlikely to ameliorate. Products targeting children are always a challenge as they must be in child-friendly form and possess excellent organoleptics, which is essential for adherence.

Conclusion

The demand for effective, clinically-substantiated and adapted solutions is meant to grow, since obesity, diabetes, toxins and medication intakes are projected only to rise. Such products development is particularly tough, requiring expertise in ingredients bioavailability and stability in user-friendly forms. Companies should seize the opportunity and launch a product in time to achieve an advantageous position, getting ahead of competitors, yet not rushing development or risking mistakes that might damage brand image.

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