Community Pharmacy

Prospects and Emerging Trends in the Supplements Market

Increasing numbers of people are taking a proactive approach to their health and the wellbeing trend is sweeping the nation.

Keeping up with consumers or even getting a bit ahead of their desires is the name of the game. In the ever-changing and extremely fickle vitamins, minerals and supplements (VMS) category, it is even more vital to stay on pace or ahead of the curve with those visiting their local pharmacy, many of whom are demanding the next greatest product from this category to allow them to maintain a healthy lifestyle.

Consumer demands for the next best thing from the VMS category always has put a burden on manufacturers to keep the new product pipeline going, and for pharmacies to have a sizeable selection of products that meet as many needs as possible.

Globally, the over the counter (OTC) drugs and dietary supplements market is driven by improvement in lifestyle and ageing of baby boomers, rise in consumer awareness related to preventative healthcare, and proliferation of distribution channels. In addition, increase in trend of self-directed consumers and self-medication for the treatment of primary health conditions have fueled the market growth. However, stringent regulations by FDA and other governing bodies related to the safety and efficacy of OTC medications have delayed the approval restricting the market growth.

Locally, according to Euromonitor International’s report, ‘Vitamins in Ireland’ published in November 2018, vitamins sales are expected to continue growing as consumers increasingly look towards preventative measures over cures. A growing number of consumers are expected to monitor their health through blood tests, which will result in greater awareness of vitamin and other deficiencies.

The report highlights some key facts:

  • Vitamins retail current value sales grow by 2% to reach 16 million in 2018
  • With higher disposable incomes, consumers can afford to supplement their diets with vitamins
  • Vitamin D leads growth in 2018, with retail current value sales rising by 5%
  • Vitamins is expected to post a retail value CAGR of 1% at constant 2018 prices over the forecast period, with sales reaching 17 million in 2023

Prospects

Vitamins sales are expected to continue growing as consumers increasingly look towards preventative measures over cures. A growing number of consumers are expected to monitor their health through blood tests, which will result in greater awareness of vitamin and other deficiencies. While many fitness conscious consumers monitor macronutrient levels (ie fat, protein, carbohydrates), there is expected to be a gradual shift towards focusing on micronutrients also, which will benefit the area. However, there is also likely to be stronger demand for multi functionality products that contain both vitamins and other supplements that complement each another.

Vitamin D is set to drive sales growth over the forecast period. Awareness of the importance of supplementation due to limited sunshine is increasing. It is strongly recommended that consumers supplement their diets with vitamin D, particularly babies and small children in winter time. Ireland’s weather is not likely to improve considerably. The country’s geographical position provides long hours of daylight in summer but short periods of daylight in wintertime. With Ireland also having a moderate climate where it rains a lot, sunshine is not relatively common sometimes even in summer. This will continue to be the case, thus fuelling demand for vitamin D over the forecast period.

Competition in vitamins could become more intense following the acquisition of health giant Merck by Procter & Gamble in April 2018. Prior to this move, Procter & Gamble divested part of its beauty and personal care line to Coty, with the company now well positioned to grow its presence within consumer health in Ireland and abroad. The experience that P&G has from its beauty and personal care lines indicates that the company is likely to aggressively market the consumer health care brands it gained through the Merck acquisition.

There has also been considerable investment by several brand to get their product endorsed by brand ambassadors.

Emerging Trends

Decisions in purchasing

Consumers purchase VMS for reasons often driven by their age. The rise in health technology is starting to show effect as younger consumers are turning to VMS to self-treat symptoms or meet certain fitness requirements. Older generations are often using VMS to avoid sickness and the development of chronic health conditions.

Demographic segmentation

Whilst male VMS represents the smallest segment of the market, it has been experiencing the fastest growth. The majority of products targeted at men have a clear focus on sports nutrition, while products for the everyday male consumer are less represented, presenting an opportunity for businesses. Similarly, there is potential to capitalise on the growing demand for sports related supplements for older generations, targeting against muscle wastage and maintaining healthy joints and for active females.

Fun and innovative formats

New product development has led to an increase in innovative delivery formats, including powders, chews, transdermal creams and sprays, helping the brand stand out and broaden the category to include children and teenagers. Powder based VMS products, which consumers can add to their food or drink to improve its nutritional content, are often perceived to be more ‘natural’, and as such are a key focus area for many brands. Own label brands however remain heavily focused on launching conventional pill methods which are regularly seen to be the most convenient format.

Powder based VMS products which consumers can add to their food or drink to improve its nutritional content, are often perceived to be more ‘natural’, and as such are a key focus area for many brands.

The Lifestyle Effect

Increasingly hectic lifestyles and busy work schedules mean we are a current population who eats out more often, with this in turn often leading to over-indulgence in meals which are often unbalanced in terms of nutrition.

Alternatively there are many who just don’t have the time to eat adequately. There is also an adverse effect on health and wellbeing with tiredness and stress being two of the more pressing concerns.

Nutrients that are of concern include:

Vitamin D: Studies by scientists at University College Cork report one in 8 Irish people have vitamin D deficiency. Bones can become frail and soft if they are lacking in vitamin D. Severe cases of vitamin D deficiency can cause rickets in children and osteomalacia in adults. Vitamin D deficiency has been linked to other health issues such as cancer, asthma, depression, Alzheimer’s, type-II diabetes, high blood pressure and such autoimmune diseases as multiple sclerosis, type-I diabetes and Crohn’s.

From October to early March, people should rely on getting their vitamin D from certain foods and vitamin supplements.

Iron: one in 10 women are anaemic, yet many have no idea, even though their iron levels might be so low that their body’s producing less red blood cells, meaning they have full-blown iron-deficiency anaemia.This can have a significant impact, as iron is essential in the production of red blood cells, which are responsible for carrying oxygen around the body, keeping various tissues and organs in working order.

But while the symptoms, including tiredness, shortness of breath, palpitations and a rapid heart rate, headaches, paleness, hair loss and brittle nails, can have a significant effect, they’re often ignored, or dismissed as an inevitable side-effect to hectic, modern lifestyles.

Haemochromatosis affects around one in 200 people across Europe, but it’s particularly prevalent in Ireland, affecting one in 83 people.

Those with haemochromatosis take in too much iron, leading to an overload which can result in symptoms such as tiredness, depression, joint and abdominal pain and loss of sex drive. Haemochromatosis can only be developed if both parents are carriers of the gene.

As part of its awareness drive the HSE has said that research indicates early diagnosis should see the manageable condition being no barrier to a normal life.

The element iron is required for the body to produce hemoglobin in red blood cells to transport oxygen around the body.

Those with haemochromatosis have a mutation in this function in that they keep taking in too much iron after this process.As public awareness of the condition is low, symptoms (which include fatigue, depression, joint and abdominal pain and loss of sex drive) are often confused with other health issues.

Magnesium: The average healthy adult requires around 270-400mg of magnesium per day, but research has shown that three-quarters aren’t getting a good enough fix. In fact, magnesium deficiency is one of the most common nutritional deficiencies in adults today, and this is associated with an increased risk of conditions such as diabetes, poor absorption, chronic diarrhoea, coeliac disease and ‘hungry bone syndrome’. Experts have even dubbed it the ‘invisible deficiency’, because it is so often overlooked.

Studies have shown that when magnesium levels are too low, it’s harder to stay asleep. Magnesium also has a role in hormonal regulation and may also help blood sugar balance which can help with mood issues such as depression and anxiety.

Selenium: up to half of adults and teenagers do not meet the recommended intake. This nutrient doesn’t get the same ‘buzz’ as vitamins C and D or calcium. It is needed in much smaller quantities than many other nutrients, but there are many ways selenium benefits the body, playing a role in reproductive health, thyroid function, DNA synthesis, and it’s also an antioxidant. Women and men need 55 mcg per day of selenium, which is considered a trace element. (Women who are pregnant or breastfeeding need 60 and 70 mcg, respectively.) Most people do get adequate amounts in their diet, though those who smoke, drink alcohol, or take birth control pills may run low in the mineral.

Folic acid: Current guidelines state that all women thinking of having a baby should have a folic acid supplement, as should any pregnant woman up to week 12 of her pregnancy. Folic acid can help to prevent neural tube defects. Pregnant and breastfeeding women are also at risk of vitamin D deficiency and should take a daily supplement containing 10 micrograms – a point pharmacy teams could raise with expectant mothers.

Fish oil supplements should be pregnancy-specific to avoid high doses of vitamin A, and breastfeeding women should continue with vitamin D and fish oil supplementation.

Ageing population

Nutritional issues play a key role in a wide range of age-related diseases and debility. The potential for good nutrition and physical activity programmes to improve health outcomes in later years are so far under-exploited, yet are urgently called for, as the Irish population ages.

Within the next 40 years, approximately one in four Irish people will be over 65 years of age compared with less than one in nine currently.

Without the implementation of strategies to address nutritional issues affecting this age group, such a demographic shift will pose enormous challenges for Irish society and its healthcare system.

Although still under-detected and undertreated, malnutrition has been recognised by

Governments across Europe, including Ireland, as an urgent public health issue that needs to be addressed, although a national action plan

Supplements, such as a daily multivitamin, can provide an effective strategy for maintaining health, supporting nutrient intakes, plugging dietary gaps and helping to address the nutritional challenges associated with ageing.

Due to weaker digestive systems in older age, it is difficult for the human body to absorb the required nutrients from food. Among the geriatric population, loss of appetite and the weakening of bones are common issues. In many cases, the diet does not contain sufficient calories or the essential nutrients that the body needs.

With the growing interest in healthy ageing, B vitamins, fish oils and zinc have all been shown in randomised clinical trials to support cognitive function, while vitamin D is recommended across the board for the over-65s.

Managing the Category

There is a plethora of conflicting information about the advantages and benefits to be had of certain supplements over others, in addition to a variation in the quality of products with the same ingredients.

Ultimately, the decision will come down to what is seen as convenient and best suited for the purchaser. What is deemed an important quality by one customer may be an entirely different issue for another.

Pharmacists should highlight products that have some research behind them and are manufactured with high quality control. It may also be beneficial to purchase from companies that are investing in promotional campaigns that could draw more customers into pharmacy, as well as companies that offer in-store support material and training for pharmacy staff.

It is always important that a customer walks away from their pharmacy feeling like all their specific health needs were met. More often than not they will come away from the experience with more knowledge through the education given to them during their visit. Therefore pharmacists and their staff should provide customers with clear advice and guidance on the variety of products available.

When it comes to stock, keep in mind that there will always be the need for the basic vitamin and mineral essentials such as calcium, vitamins B, C and D and magnesium.

Consumption Safety

New guidelines on how many vitamins and mineral supplements can be safely consumed were published in June of last year by Ireland’s food regulator, alongside warnings about the dangers of over consumption.

The new report from the Food Safety Authority of Ireland’s (FSAI) Scientific Committee outlines the process that the burgeoning food supplement industry can use to establish maximum safe levels for 21 of the 30 vitamins and minerals permitted in food supplements in Ireland.

The report sets out tolerable upper intake levels of these nutrients for the population of Ireland which can be used by the food supplement industry as a guide to ensure that the daily dose provided by supplements containing vitamins and minerals is safe when placed on the Irish market.

Whilst the setting of maximum safe levels of vitamins and minerals in food supplements is provided for in EU law, the precise levels have not been established yet. The FSAI will be working with the food supplement industry to establish guidance for the marketing of safe vitamin and mineral supplements in Ireland.

Dr Pamela Byrne, CEO, FSAI states that under food law, all food supplements marketed in Ireland for the first time must be notified to the FSAI. The number of food supplements notified to the FSAI as being on the Irish market has been increasing year on year and it is incumbent on the food supplement industry to take on board this new guidance, reformulate their products accordingly and provide labels that are easy for consumers to understand.

“The numbers of food supplements that have been notified to us has risen from 700 in 2007 to over 2,500 in 2017 – an increase of over 300%. Of those notified, the number of products that require more detailed examination to assess if they pose a risk to consumer safety is also continuing to rise, with over 95% of food supplements requiring this due to high vitamin or mineral content. We are concerned about the growing number of these products and, in particular, the safety of vulnerable groups of the population in Ireland including children, pregnant women and older people. This comprehensive report enables us to provide robust advice and guidance to the industry on the levels of nutrients for their products by age and gender groupings.

“Our advice for the general public regarding taking food supplements is that it is not necessary to take food supplements to maintain a healthy lifestyle. The FSAI recommends a well-balanced diet with plenty of fruit and vegetables and, plenty of exercise. The only food supplements that the FSAI recommends are 400µg folic acid per day for women who are sexually active and a 5µg vitamin D3 only supplement per day for all infants from birth to 12 months”, added Dr Byrne.

People in Ireland are becoming more aware of the importance of a varied and balanced diet for good health which is positive; however, some are using food supplements in their diet and there can be a mistaken belief that ‘more is better’,” says Professor Albert Flynn, Chairman of the FSAI Scientific Committee.

“There can be adverse health effects when people take too much of some vitamins or minerals.

“This is particularly true when it comes to children and adolescents who may be taking the same amounts of vitamins and minerals from food supplements as adults, despite having different needs and smaller body sizes. We know from recent surveys of dietary practices in Ireland that most people are getting more than enough vitamins and minerals from their diet alone,” he added.

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