Improving cardiovascular health naturally

IMPROVING CARDIOVASCULAR HEALTH NATURALLY THEMATIC SERIES N째1

OVERVIEW

THE UPWARD MARCH OF CARDIOVASCULAR DISEASE 17.5 million people die from cardiovascular disease annually – 31% of all deaths globally1.

The sad reality, and the good news, is that most of these deaths could be prevented.

Quietly fed by a slow-burning mix of behavioral, environmental, genetic and ethnic risk factors, cardiovascular disease can take decades to raise its head. The seeds of cardiovascular disease are planted from early on in life, facilitated by urbanization and globalization.

With aging populations growing in most OECD countries, and earlier onset in emerging economies, cardiovascular disease will continue its upward march.

There is room and a need for more action.

DIRECT/INDIRECT

MEDICAL COSTS: US CVD ($US BILLIONS)2 1093.9 $

444.2 $

690.3 $

THE URBANIZATION CONTRADICTION While planned and well-managed urbanization contributes to improvements in overall prosperity, increased life expectancy, lower infant mortality and wider access to education and health care, there are downsides.

Urbanization has also played a pivotal role in the transformation of lifestyles and environments. And with that, comes an increase in many non-communicable diseases such as cardiovascular disease and diabetes, which are more prevalent in urban environments.

Two major contributing factors are: • Nutrition transition: from less whole, traditional and homemade food to more quick-to-prepare, processed foods with higher fats and sugars; and higher consumption of meat and dairy.

• Inactivity: urban dwellers often work in factory, office or service settings with longer periods of relative inactivity, together with armchair leisure. Children spend more time on home-based sedentary leisure, with less access to outside activity.

GLOBAL

URBANIZATION EVOLUTION3

54%

2010 2020 2030

66%

30%

1950 2014 2050

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OVERVIEW

GLOBALIZATION AS A VECTOR OF THE URBAN LIFESTYLE Globalization provides roadways for societal change, opening the doors to new models of consumerism and consumption: • Market liberalization enables the implantation of transnational companies and supermarkets, with new and processed food choices, fast foods, improved storage and distribution and cheaper prices.

• Agricultural liberalization and technology change how and which food is produced, is available, and how and where it is sold and at what prices.

• Advertising and targeted marketing of industrially produced food brands, beverages, alcohol and tobacco, along with culture and leisure are broadcast into cities and rural areas alike.

• Geographic mobility can put people into urban settings amidst entrenched lifestyles, with little information to enable healthy decisions.

THE MARCH OF CARDIOVASCULAR DISEASE Urban lifestyles play a major role in the development of health risk factors and the continuing upward march of cardiovascular disease.

Increased interest for natural solutions rising selfcare market

STATE OF THE MARKET

Globalization

Increased consumption of dietary suppplements

Urbanization

Family/hereditary awareness SOCIAL EVOLUTIONS

Healthcare professional recommendation

Richer, processed food BEHAVIORAL RISK FACTORS

CONSUMER DRIVERS Web Research for self-medication

Faster, more stressfull life

@

Sedentary lifestyle

Raised blood lipids Obesity

METABOLIC FACTORS FOR CVD

High blood pressure Diabetes

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OVERVIEW

FOCUS ON MAJOR CARDIOVASCULAR RISK FACTORS EATING INTO ILLNESS Global obesity doubled between 1980 and 2008 and continues to rise.

The globalized route into urbanization results in overnutrition of children and teens through processed, calorie-rich, but nutrient-poor foods. The ensuing issues of overweight and obesity set young lives on a road to the onset of cardiovascular disease. In the United States over the last 30 years, childhood obesity has doubled and teen obesity quadrupled 4.

For today’s adults, this translates into nearly 2 billion overweight worldwide, of which over half a billion are obese6. A nutritional lifestyle that has endowed nearly 40% of the world’s population with a cardiovascular disease risk factor, additionally contributing to the onset of diabetes and hypercholesterolemia.

THE SILENT KILLER From 1980 to 2008, the number of people diagnosed with hypertension rose from 600 million to 1 billion.

And in 2013, hypertension-related complications resulted in over 9 million deaths7.

Hypertension is particularly insidious as there are often no symptoms. Some 25-30% of the adult population, suffer from undiagnosed pre-hypertension – blood pressure of between 120-139mmHg over 8089mmHg8. This makes prevention and early treatment both urgent and possible.

While some progress has been made in developed countries thanks to anti-tobacco campaigns and heightened awareness of the dangers of a high-sodium diet and stress, hypertension remains widespread and is on the rise in emerging economies. More prevalent among men in developed countries, hypertension is spread almost equally between men and women the emerging regions.

Maintaining arterial elasticity is vital for optimal blood flow and is a major factor in preventing and reducing hypertension.

HYPERTENSIVE

OVERWEIGHT

ADULTS IN

2014

ADULTS IN

5

2014

6

22% 23.2% 18.2% 39% 58.6% 61.3% GLOBAL

OBESE

ADULTS IN

13% 23% GLOBAL

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EUROPE

EUROPE

AMERICAS

AMERICAS

EUROPE

2014

GLOBAL

THE URBAN HEALTH DILEMMA

6

The dilemma for today’s urbanite is literally “how to have their cake and eat it too”. To strike a balance between enjoyment and excess; between effort and easy living. It’s a unique ‘first-world’ paradigm, but one that is also beginning to apply to urbanized populations in the emerging world.

26.8% AMERICAS

Living in an environment where food is abundant, technology is modifying activity levels, leisure time is increasing and consumerism is invasive, people find it challenging to take charge of their health.

Dietary supplements can help to fill health gaps; supporting improved cardiovascular health within the realities of urban lifestyle.

FOCUS

THE DIETARY SUPPLEMENT LANDSCAPE In 2014, more than 75% of Americans were using some type of dietary supplement.

The urban consumer relies primarily on healthcare professionals for dietary supplement prescriptions, with word of mouth recommendations in second place.

Internet is an important tool for educated consumers to study up on active ingredients, manufacturers and research results, putting more power in their hands.

The result is increasing demand for natural, safe and ethical healthcare products.

HERBAL PRODUCT SALES FOR CARDIOVASCULAR CATEGORY 9

PLAYING BY THE RULES Regulators across the US and Europe are tightening the procedures and definitions around health and nutritional claims. In December 2015, the US FDA elevated the status of the Office of Dietary Supplement Programs to enhance the effectiveness of dietary supplement regulation.

Consumer pressure has seen product labeling evolve to ensure more traceability and transparency.

Suspicious of big business, they are also looking to independent quality and ethical certifications as proof of compliance.

As regulators step up, there is increasingly less scope for unsubstantiated claims on packaging and increased onus for manufacturers to provide for factual ingredient information.

This is especially true in Europe, where the use of health claims on botanical supplement labels is strictly regulated. This creates challenges for both manufacturers – to create meaningful labels that meet regulatory requirements; and consumers – to get a clear picture of the health benefits.

For some manufacturers, this will need to translate into proactive rigor, or risk losing consumer trust and brand reputation.

Even strong brands will retain long-term consumer loyalty, and out-live the fierce competition only through efficient, safe and high-quality products.

USA

1717.60 M$ 2015 : 1554.40 M€

All of which offers unique opportunities for innovative natural products to step up to the global chronic health challenges and prove what is a reality... That nature is full of beauty, surprises and efficient active ingredients.

WESTERN EUROPE

528.80 M$ 2015 : 478.60 M€

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SOLUTIONS

NATURE’S CONTRIBUTION TO CARDIOVASCULAR HEALTH Natural ingredients have come full circle from age-old preventative and curative use in traditional societies and folk medicine, into the households of today’s urbanites.

Olive leaf: The olive is famous for its central place in the Mediterranean diet, with the fruit and the tree rich in health benefits. The olive leaf is packed with choline, polyphenols and flavonoids.

Oleuropein, the main polyphenol, contributes to the prevention of atherogenesis and LDL oxidation and thus, the enhancement of blood flow; as well as relieving hypertension and diabetes.

Modern technology now allows concentrated extraction of these valuable active ingredients and their transformation into effective products to fit with today’s lifestyles, addressing specific health needs and nutrient gaps.

In the domain of cardiovascular health, a number of natural extracts have proven their worth.

• Garlic: A complex botanical which can reduce levels of cholesterol and LDL oxidation, as well as hypertension and the development of atherogenesis.

• Red rice yeast: Part of many traditional Asian diets, it is known to be beneficial in maintaining normal cholesterol levels, and benefits from an EU accredited health claim. Most red rice yeast supplements also contain CoQ10, to offset loss of this enzyme, which has antioxidant properties and is essential for cell growth and maintenance.

• Omega 3: Research has shown that Omega 3 deficiency is a factor for cardiovascular disease.

Sourced from plant (flaxseed, chia…) or animal sources (fish and krill oil…), Omega 3 fatty acids can slow the development of atherosclerosis, and reduce triglycerides and blood pressure.

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Hawthorn: WHO recognizes the value of hawthorn to help cardiovascular function and reduce stress. Well-known in traditional herbal medicine across Europe and the US, its leaves and flowers which are full of flavonoids, enhance coronary blood flow and oxygen utilization, have a hypotensive effect, strengthen heart contractions and rate, and act as a mild heart tonic.

Research and development continues to unlock more of nature’s efficacy in support of cardiovascular health – particularly in the domains of blood circulation and weight management.

SOLUTIONS

NATUREX: A NATURAL SOLUTIONS PROVIDER

INNOVATING CARDIOVASCULAR HEALTH NATURALLY HEALTHY WEIGHT FOR A HEALTHY HEART The urban consumer understands the impact of overweight and obesity on heart health. A US market study showed that improving overall health and preventing cardiovascular disease were important aims, and that consumers are willing to use natural, safe and efficient dietary supplements as part of a healthy eating program10.

Multiple scientific studies confirm and quantify Svetol’s efficacy in three areas: BMI reduction, fat burning, and very importantly, glucose regulation, which is a common denominator in both obesity and diabetes.

The offer is built on two strategic focuses: achieving natural efficacy while meeting consumer demand and growing the Heart Health category with a new mechanism of action. Success is based on several factors: • Deep knowledge of markets, consumers and health issues • Stable active ingredients, which deliver clinically proven and demonstrable benefits • Bona fide health and authorized nutritional claims, understood by consumers • Good manufacturing practices and compliant suppliers • Clear and complete information on the ‘what’ and ‘how’ of the product • Reliable and experienced partners to get innovative solutions which consumers can connect with.

Aware that a consumer focus approach is key to achieving performance, Naturex provides three marketing angles that relate to specific consumer profiles and purchasing behavior. The idea is to tailor the offering and the packaging to each sales channel and customer type.

A

B

C

HEALTHY ARTERIES FOR A HEALTHY HEART Flavanols are proven to improve endothelial function: the elasticity of blood vessels and subsequent blood flow – thereby contributing to a reduction in hypertension and increased heart function. However, extracting good quality plant-based flavanol in sufficient amounts for nutraceutical supplement applications has been a challenge… until now.

Combining quality sourcing (collaboration with Barry Callebaut Group, the world’s leading manufacturer of cocoa products), technology, extensive scientific data, and an accredited European health claim, high-quality & patented cocoa flavanols are an innovative active ingredient, targeting endothelial function. Endothelial dysfunction is recognized as one of the earliest sign of cardiovascular disorders. raw material

extraction

B. Channel 2: sold in pharmacies for health-conscious consumers C. Channel 3: sold in drugstores and natural food stores for wellness-seeking consumers

High quality and relevant healthcare products for the right people at the right time.

high flavanol cocoa extract

concentration

D PATENTESS E C O PR

EFSA 13.5 drying

A. Channel 1: prescribed by healthcare practitioners to their patients

Stop by Naturex’s booth at Vitafoods Europe 2016 to learn more about cocoa flavanols and cardiovascular risk factors management.

powder formulation

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SUMMARY

KEY INFORMATION AT A GLANCE

17.5 66%

of the world’s population

will be living in

million

urban by areas

2

this represents

31%

people die from CVD every year

of all deaths globally

2050

increasing many health risk factors

40%

billion

of the world’s population

overweight adults worldwide

have a cardiovascular

death risk

1

billion

25 to 30% of adults are diagnosed with pre-hypertension

more than HERBAL PRODUCT SALES FOR CARDIOVASCULAR CATEGORY

75%

people are diagnosed with hypertension

americans were using some sort of dietary supplement in 2014

USA

1717.60 M$ 2015: 1554.40 M€

Nature’s arsenal against CVD:

garlic

red rice yeast

WESTERN EUROPE

528.80 M$ 2015: 478.60 M€

hawthorn

olive leaf

CocoActiv, EFSA 13.5 Health Claim flavanols increase blood vessels elasticity by

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23%

SOURCES 1 World Health Organization, CVD factsheet, 2015, available at: http://www.who.int/mediacentre/factsheets/ fs317/en/ 2 Journal of American College of Cardiology, Worldwide Environment of CVD, 2012, available at: http://content. onlinejacc.org/article.aspx?articleid=1485688 3 Department of Economic and Social Affairs of the United Nations, World Urbanization Prospects, The 2014 Revision, 2014 available at: http://esa.un.org/unpd/wup/ World Health Organization, Commission on social determinants and Health: Globalization, Food and nutrition, 2007, available at: http://www.who.int/social_ determinants/publications/globalization/en/ 4 Centers for disease control and prevention, Childhood obesity facts, 2013, available at: http://www.cdc.gov/ healthyschools/obesity/facts.htm 5 World Health Organization, Global health observatory data, 2015, available at: http://www.who.int/gho/ncd/ risk_factors/overweight/en/index1.html 6 World Health Organization, Obesity and overweight fact sheet, 2015, available at: http://www.who.int/ mediacentre/factsheets/fs311/en/ World Health Organization, Global Health observatory data, 2015, available at: http://www.who.int/gho/ncd/ risk_factors/blood_pressure_prevalence/en/index1.html 7 World Health organization, A global brief on hypertension, 2013 available at: http://www.who.int/ cardiovascular_diseases/publications/global_brief_ hypertension/en/ 8 Forum Med Suisse, La prĂŠhypertension, un concept utile?, 2008, available at: http://www.medicalforum.ch/ docs/smf/archiv/fr/2008/2008-03/2008-03-253.pdf

Design & supervision: Havas Worldwide Paris / writing: Mensquare / pictures: Shutterstock.

Non-contractual pictures and illustrations.

9 Euromonitor international, Consumer health: Euromonitor from trade sources / international statistics 10 IPSOS, Dietary Supplement Research, 2014

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Your Natural Selfcare team.

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