Improving cardiovascular health naturally

IMPROVING CARDIOVASCULAR HEALTH NATURALLYTHEMATIC SERIES N°1

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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

GLOBAL URBANIZATION EVOLUTION3

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.

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STATE OF THE MARKET

rising selfcaremarket

BEHAVIORALRISK FACTORS

METABOLICFACTORSFOR CVD

CONSUMERDRIVERS

@Web Research for self-medication

Healthcareprofessional

recommendation

DiabetesObesity

Sedentarylifestyle

Richer, processed food

High bloodpressure

Raised blood lipids

Family/hereditary awareness

Increased consumption of dietary suppplements

Faster, morestressfull life

Increased interest for natural solutions

Urbanization Globalization

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

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.

THE MARCH OF CARDIOVASCULAR DISEASE

• 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.

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ADULTS INOVERWEIGHT 52014

39% 58.6% 61.3%GLOBAL EUROPE AMERICAS

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ADULTS INOBESE 2014

13% 23% 26.8%GLOBAL EUROPE AMERICAS

ADULTS INHYPERTENSIVE 2014

22% 23.2% 18.2%GLOBAL EUROPE AMERICAS

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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 over-nutrition 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 URBAN HEALTH DILEMMA

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.

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.

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 80-89mmHg8. 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.

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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.

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.

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.

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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.

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.

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.

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.

• 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.

• 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.

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

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.

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raw material concentrationextractionhigh flavanolcocoa extract

drying powderformulation

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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.

NATUREX: A NATURAL SOLUTIONS PROVIDER

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.

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

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

B. Channel 2: sold in pharmacies for health-conscious consumers

C. Channel 3: sold in drugstores and natural food stores for wellness-seeking consumers

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.

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

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17.5 31%million this represents

of all deaths globally

people die fromCVD every year

1billionpeople are diagnosedwith hypertension

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

66% 2050 increasing manyhealth risk factorsof the world’s population by

will be living in

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75% americans were usingsome sort of dietary supplement in 2014

morethan

2billionoverweightadults worldwide

40%of the world’s populationhave a cardiovascular

death risk

garlic hawthornoliveleaf

red riceyeast

Nature’s arsenalagainst CVD:

23%flavanols increase blood vessels elasticity by

CocoActiv, EFSA 13.5 Health Claim

1717.60 M$1554.40 M€2015:

USA WESTERNEUROPE 528.80 M$

478.60 M€2015:

HERBAL PRODUCT SALES FORCARDIOVASCULAR CATEGORY

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KEY INFORMATION AT A GLANCE

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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 préhypertension, un concept utile?, 2008, available at: http://www.medicalforum.ch/docs/smf/archiv/fr/2008/2008-03/2008-03-253.pdf

9 Euromonitor international, Consumer health: Euromonitor from trade sources / international statistics

10 IPSOS, Dietary Supplement Research, 2014

Design & supervision: Havas Worldwide Paris / writing: Mensquare / pictures: Shutterstock. Non-contractual pictures and illustrations.

For more information, please contact : Email: [email protected]: +33 (0)4 90 23 96 89 | Fax: +33 (0)4 90 23 73 40Naturex SA - 250 rue Pierre Bayle - BP 81218 84911 AVIGNON cedex 9 - FRANCEwww.naturex.com

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Your Natural Selfcare team.

FROM NATURE TO YOU