Opportunities in Nutritional Management: Food and drinks to aid disease recovery

Opportunities in Nutritional Management
Executive summary 10
Nutritional management: a growth area 10
Disease and patient targets 11
Key product and ingredient developments 12
Marketing issues and strategy 13
Chapter 1 Nutritional management: a growth area 16
Summary 16
Introduction 17
A note about this report 17
Nutrition’s increasingly accepted role in managing disease 17
Where does "functional foods" end "nutritional management" start? 18
Opportunities exist for both food and clinical nutrition companies 19
Defining nutritional management 21
A growing nutritional management audience 25
Prevalence rates for key disease areas are increasing 25
Government and healthcare policies also encourage a greater focus on nutrition 26
Attractive outcomes will promote future growth 27
Marketing approaches will need updating 29
Food companies will need to operate differently 29
Developing expertise in clinical trials will be crucial 30
Top-down marketing approaches and influencing KOLs is necessary 30
Healthcare marketing expertise will be required 31
Building new sales channels is likely to be a complicated task 31
Accounting for channel complexities 32
Future Outlook 33
Chapter 2 Disease and patient targets 36
Summary 36
Disease and therapy selection criteria 36
Disease and therapy areas 37
Market potential 38
A note on modeling techniques used 38
Further analysis potential 40
Overall prevalence rates and sufferer numbers 40
Hypertension offers the largest consumer audience to target 40
CVD is the second largest disease area by the number of sufferers 41
Of the other higher growth areas osteoporosis has significantly more sufferers 41
In the other low growth areas, three diseases have significant population numbers 41
France: prevalence rates and sufferer numbers 43
Germany: prevalence rates and sufferer numbers 44
Italy: prevalence rates and sufferer numbers 45
The Netherlands: prevalence rates and sufferer numbers 46
Spain: prevalence rates and sufferer numbers 47
Sweden: prevalence rates and sufferer numbers 48
UK: prevalence rates and sufferer numbers 49
US: prevalence rates and sufferer numbers 50
Conclusions 51
Chapter 3 Key product and ingredient developments 54
Summary 54
Introduction 54
Research into the area of nutritional management is in its early days 54
A note on the diseases covered 56
Nutritional intervention in Crohn’s disease 57
Latest research on nutrition on Crohn’s disease 57
The effects of exclusion diets on Crohn’s disease 57
A role for antioxidants managing Crohn’s? 58
A need to overcome malnutrition associated with Crohn’s 58
Potential product opportunities in Crohn’s 59
Nutritional intervention in diabetes 59
Latest research on nutrition in diabetes 59
Effects of dried sweetened cranberries (with added fiber) on diabetes 59
Effects of safflower oil and conjugated linoleic acid on diabetes 60
Effects of antioxidants in black tea on diabetes 60
Potential product opportunities in diabetes 61
Nutritional intervention in food allergies 62
Latest research on nutrition on food allergies 62
Effects of synbiotics on food allergies (non-human study) 62
Nutritional intervention in heart disease/CVD 62
Latest research on nutrition on heart disease/CVD 62
Contrary to some recent research, vitamin supplementation may help 62
Potential product opportunities in heart disease/CVD 63
Nutritional intervention in HIV/AIDS 63
Latest research on nutrition on HIV/AIDS 63
Effects of beta-carotene and vitamin A on HIV/AIDS 64
Effects of zinc on HIV/AIDS 64
Effects of selenium on HIV/AIDS 65
Effects of probiotics on HIV/AIDS 65
Potential product opportunities in HIV/AIDS 66
Nutritional intervention in hypertension 66
Latest research on nutrition on hypertension 66
Effects of wholegrains, especially bran, on hypertension 66
Effects of flavonoids on hypertension (non-human study) 67
Potential product opportunities in hypertension 68
Nutritional intervention in IBS 68
Latest research on nutrition on IBS 68
Effects of synbiotics on IBS 68
Nutritional intervention in malnutrition 69
Latest research on nutrition on malnutrition 69
Malnutrition is a major problem and one that is beginning to be tackled 69
Effects of combined testosterone and nutritional supplement on malnutrition 70
Potential product opportunities in malnutrition 70
Nutritional intervention in osteoporosis 71
Latest research on nutrition on osteoporosis 71
Effects of vitamin D and calcium on osteoporosis 71
Is vitamin D more important than calcium? 71
Effects of dietary versus supplemental calcium on osteoporosis 72
Effects of carotenoids on osteoporosis 73
Effects of vegetarian diets on bone density 73
Potential product opportunities in osteoporosis 74
Nutritional intervention in wound healing 75
Latest research on nutrition on wound healing 75
Poor nutritional status can delay the healing process 75
Nutrients required for wound healing and their roles 75
Potential product opportunities in wound healing 77
Will competition come from retail products? 77
Could functional foods encroach on nutritional management? 77
Are any functional foods currently targeting this area? 78
Functional foods are not currently targeting nutritional management 78
But some products might be suitable for targeting nutritional management 80
Might regulation actually encourage competition? 81
In the future functional foods will have better substantiated claims 81
Conclusions 82
Chapter 4 Marketing issues and strategy 86
Summary 86
Introduction 87
A need to establish the Nutritional Management space 87
Top-down marketing strategies 88
Influencing the key opinion leaders is crucial 88
Who are the KOLs? 89
Marketing should be aligned with a top-down approach 90
Targeting KOLs means undertaking pharmaceutical style research 90
Consumer perceptions and needs 91
Consumers’ needs are often overlooked 91
Patients’ needs are similar to everyday consumers’ 91
Better tasting products can improve patient outcomes 92
Snacking may actually be beneficial for many hospital patients 92
Aligning propositions with consumer needs 93
A greater focus on sufferers’ needs is required 93
Great scope for further research into nutritional management preferences exists 94
Branded food items may well have a role to play 94
Channel issues 95
Education will be key in targeting hospital channels 95
Residential care is also a major channel to address 96
Conclusions 97
Chapter 5 Conclusions 100
A need to promote the role of nutritional management 100
The key targets for nutritional management 101
Hypertension, cardiovascular disease, osteoporosis and diabetes are major targets 101
Quickly filling gaps in marketing competencies will be crucial 103
Upfront integration of research, marketing strategy and product design will be key 104
Appendix 106
References 106
Index 111
List of Figures
Figure 1.1: Defining the nutritional management space 19
Figure 1.2: Examples of products that offer nutritional management: Abbott Nutrition’s Glucerna range and Nestlé Nutrition’s Boost range. 20
Figure 1.3: The European legal framework defining the nutritional management space 24
Figure 2.4: Disease prevalence 2008 (% total population), growth in sufferer numbers (CAGR 2008-2013) and forecast suffers number 2013 (actual) 42
Figure 3.5: New potential areas of product innovation to help provide nutritional management of Crohn’s disease 59
Figure 3.6: New potential areas of product innovation to help provide nutritional management of diabetes 61
Figure 3.7: New potential areas of product innovation to help provide nutritional management of heart and cardiovascular disease 63
Figure 3.8: New potential areas of product innovation to help provide nutritional management of HIV/AIDS 66
Figure 3.9: New potential areas of product innovation to help provide nutritional management of hypertension 68
Figure 3.10: New potential areas of product innovation to help provide nutritional management of food allergies 70
Figure 3.11: New potential areas of product innovation to help provide nutritional management of osteoporosis 74
Figure 3.12: New potential areas of product innovation to help provide nutritional management of wound healing 77
Figure 4.13: Top-down marketing strategy: aligning targeting of opinion leaders with product uptake and consumer reach in Nutritional Management 90
Figure 5.14: Overall assessment of nutritional management potential by selected disease 102
List of Tables
Table 1.1: Number of sufferers by major nutritional management disease, 2008-2013 25
Table 2.2: Disease prevalence 2008 (% total population), growth in sufferer numbers (CAGR 2008-2013) and forecast suffers number 2013 (actual) 42
Table 2.3: Core nutritional management disease prevalence in France, 2008-2013 43
Table 2.4: Core nutritional management disease prevalence in Germany, 2008-2013 44
Table 2.5: Core nutritional management disease prevalence in Italy, 2008-2013 45
Table 2.6: Core nutritional management disease prevalence in the Netherlands, 2008-2013 46
Table 2.7: Core nutritional management disease prevalence in Spain, 2008-2013 47
Table 2.8: Core nutritional management disease prevalence in Sweden, 2008-2013 48
Table 2.9: Core nutritional management disease prevalence in the UK, 2008-2013 49
Table 2.10: Core nutritional management disease prevalence in the US, 2008-2013 50
Table 3.11: Area of potential benefits of specific ingredients by disease area as indicated by recent research, 2009 55
Table 3.12: Number of product launches in the last year making indirect nutritional management function claims versus number making explicit nutrient claims, major West European countries and the US, July 2008 – July 2009 79
Table 3.13: Number of nutritional management function claims by claim area, number of and as a percentage of all products launched, major West European countries and the US, July 2008 – July 2009 80
Table 3.14: Number of nutrient content claims, by type, major West European countries and the US, July 2008 – July 2009 81
Table 4.15: Percentage of people aged 65 or more living in old age institutions, major West European countries and the US 96