Natural products and consumer s behaviour

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1 Natural products and consumer s behaviour 11.1 Interest in natural products and alternative medicines Factors affecting consumer s behaviour Consumers reasons for using food supplements Food supplement users characteristics and health habits Herbal food supplements consumer s profile

2 11.1 Interest in natural products and alternative medicines

3 Herbal food supplements Definition The European Union (EU) Directive on Food Supplements (2002/46/EC) defines dietary supplements (which include HFS) as: foodstuffs the purpose of which is to supplement the normal diet and which are concentrated sources of nutrients or other substances with a nutritional or physiological effect, alone or in combination, marketed in dose form, namely forms such as capsules, pastilles, tablets, pills and other similar forms, sachets of powder, ampoules of liquids, drop dispensing bottles and other similar forms of liquids and powders designed to be taken in measured small quantities.

4 Herbal food supplements Definition In the category of HFS might be placed: plants as a whole, divided or crushed (simple or combined teas, sold as bulk or doses); liquid extracts (tinctures), juices, energizing drinks, syrups, oils (fat oils or essential oils); powders and granules (in small packages or encapsulated); tablets (filmed or non-filmed); capsules (soft or hard); drinkable ampoule; jelly, pasta, bonbons or bars, etc.

5 Interest in herbal food supplements at global level in the last 10 years food supplements market registered a constant increasing; the biggest food supplements manufacturer at worldwide level is China, with an annually increase of sales of about 10% over 10 years; in China were registered 3000 food supplements manufacturers and about 559 brands of food supplements available for sale; according to the performed studies it was found suprisingly that in generall the Chinese consumers prefer imported food supplements (Redfern Associates, 2010); in USA 50% of adults use food supplements, of which 61% are women of about 60 years old (old persons who used food supplements based on calcium); men prefer food supplements with vitamin D; in Canada, use prevalence peaked in women over 50 years and increasing of food supplements use tends to be positively correlated with socio-economic status much higher of this country (Vatanparast et al., 2010); the international herb supplement market is projected to reach $93 billion by 2015 (Dennis, 2013).

6 11.2. Factors affecting consumer s behaviour

7 Consumption of herbal food supplements in Romania Drivers of consumption are: attractive presentation; spectacular health claims; accessible price (between 5 to 30 euros/product); the new lifestyle of the people; high tech access resulted in an increased appetence for HFS consumption.

8 Consumption of herbal food supplements in Romania Categories of consumers are: not only the specific categories of consumers (to whom food supplements are generally addressed and recommended); but also young people, children and teenagers are attracted by advertising, IT applications and business opportunities (multi-level distribution system).

9 Consumption of herbal food supplements in Romania Categories of HFS found on the market are: the traditional HFS known by the Romanian population (Mentha piperita, Tilia europea, Hypericum perforatum, Matricaria recutita, Calendula officinalis); the new categories of products differentiated by: matrix and presentation form, advertising and promotion but also as composition (many of HFS are obtained by processing of exotic species that are coming from other continents, such as South America, North America, Asia or Australia).

10 Consumption of herbal food supplements in Romania Average consumption of HFS per capita: value between euros/year, less than the West European average (25 euros/capita/year) (Bio Integra 2011, PMR S Report 2010). Top 10 of most food supplements sold include: digestive disorder herbal remedies (such as Liv 52 or Biotics); products addressed to several common disorders (such as Artrostop).

11 Consumption of herbal food supplements in Romania A recent study published in the journal PLOS ONE showed that: HFS are the most popular food supplements in Europe, where most of the consumers use them to complement their diet and to maintain their health; 22% of the Romanian respondents declared that they use HFS to treat the fever or other minor health problems, which means their perception about natural products is more linked to traditional herbal medicine products (THMP) than to dietary supplements; compared to other Central European countries, Romanian consumers prefer the solid matrices, such as tablets and capsules as dose forms.

12 11.3. Consumers reasons for using food supplements

13 Consumer s attitude regarding natural products From a food science perspective, it is dificult to define a food product that is natural. What are the meanings on the label of foods for (usual examples): Natural: the food does not contain added color, artificial flavors, and synthetic substances. Organic: food which is produced using environmentally and animal friendly farming methods on organic farms. These procedures are legally defined and any food sold as 'organic' must be strictly regulated. Conventional: food that is produced following a standard model (can be used pesticides, fertilizers, etc.). Traditional: those eaten by people over the longer course of civilization and which have supported health cultivated, produced, and harvested from the earth and out of nature foods which are wholly unaltered and organic, and contain the highest levels of nutrition or are nutrient-dense GMO-free: different definitions; any product not falling under the scope of GMOlabelling (i.e. below 0.9%) is GMO-free whereas others consider that a 0 tolerance approach (i.e. below the detection limit) should apply to GMO-free products. Functional food: deliver additional or enhanced benefits over and above their basic nutritional value and these benefits are proved scientifically.

14 Consumer s attitude regarding natural products 2011 Food & Health Survey: Consumer Attitudes Toward Food Safety, Nutrition & Health The 2011 Food & Health Survey: Consumer Attitudes Toward Food Safety, Nutrition & Health, commissioned by the International Food Information Council Foundation, is the sixth annual national quantitative study designed to gain insights from Americans on important food safety, nutrition, and health-related topics. PRICE APPROACHES TASTE AS TOP INFLUENCER FOR AMERICANS WHEN PURCHASING FOODS & BEVERAGES YET, IN A DOWN ECONOMY, HEALTH IS STILL IMPORTANT TO TWO-THIRDS OF AMERICANS _Food_Safety_Nutrition_Health

15 Consumer s attitude regarding natural products This Survey offers the important voice and insights of the consumer for health professionals, government officials, educators, and other interested individuals who seek to improve the lives of Americans. The following are key findings from the 2011 Survey. Overall Health Status; Weight Management; Calories and Energy Balance; Physical Activity; Food Technology & Sustainability; Fortified Foods & Foods with Added Benefits; Dietary Fats; Carbohydrates and Sugars; Low-Calorie Sweeteners; Protein; Sodium; Caffeine; Food Colors; Food Safety; Growing Interest in Imported Foods; Information Sources and Influences; Food Labeling; Purchasing Influences; Restaurants & Eating Occasions.

16 11.4. Food supplement users characteristics and health habits

17 Study cases, statistical and correlation data U.S.A. Who are supplement consumers? (Council for Responsible Nutrition) (January, 2014) (

18 Study cases, statistical and correlation data WHO takes dietary supplements? 68% of U.S. adults reported taking dietary supplements.

19 Study cases, statistical and correlation data Supplement consumers are more likely to engage in healthy habits When it comes to making lifestyles choices, those who take dietary supplements are more likely to engage in other healthy habits than non-supplement users.

20 Study cases, statistical and correlation data WHAT types of supplements do they take? Vitamins and minerals are the most popular category among U.S. adult supplement users with 97% of supplement users taking them. 97% Vitamins and minerals 46% Specialty supplements 28% Herbals and botanicals 24% Sports nutrition & weight management

21 Study cases, statistical and correlation data TOP 5 SUPPLEMENTS WITHIN EACH CATEGORY Multivitamin 77% Omega 3/Fish oil 28% Green tea 9% Protein bars 12% Vitamin D 29% Fiber 10% Garlic 8% Whey protein powders 7% Calcium 26% Probiotics 9% Cranberry 7% Energy drinks/gels 7% Vitamin C 24% CoQ10 9% Echinacea 6% Hydration drinks/gels 4% Vitamin B/B complex 20% Glucosamine 8% Ginko Biloba 4% Five supplements tied 3%

22 Study cases, statistical and correlation data WHERE do they store their supplements? Tip: Store your supplements in a cool, dry place, out of the reach of children, and in a location that is convenient so that you will remember to take them. TOP FIVE PLACES WHERE SUPPLEMENT USERS KEEP THEIR SUPPLEMENTS Kitchen Bedroom Bathroom 40% in cabinet 13% night table 20% in cabinet 21% kitchen counter 8% bathroom counter

23 Study cases, statistical and correlation data Where do they buy supplements? Tip: Look for nationally recognized brands or store brands from a trusted retailer. TOP 5 PLACES SUPPLEMENT USERS PURCHASED SUPPLEMENTS FROM Mass Merchandisers 48% Drug Stores/Pharmacies 39% Supermarkets 24% Warehouse Club 23% Specialty Vitamin Retailer/Chain Health Food Store 14%

24 Study cases, statistical and correlation data WHEN did they start taking supplements? Tip: Supplementing can be appropriate for each life stage. Talk with your doctor or other healthcare practitioner about what dietary supplement regimen is right for you. AT WHAT AGE SUPPLEMENT USERS STARTED TAKING SUPPLEMENTS Adulthood 73% Childhood 12% Adolescence 11% Pregnancy 8%

25 Study cases, statistical and correlation data WHY do they take supplements? Depending on your age, gender and lifestyle, reasons for supplementing can differ. Remember that dietary supplements are not intended to treat, diagnose, mitigate, prevent, cure, or cure diseases. % OF SUPPLEMENT USERS WHO AGREED WITH THE FOLLOWING STATEMENTS TOP REASONS OVERALL GENDER AGE MEN WOMEN Overall healthy/ 54% 51% 56% 50% 55% 57% wellness benefits To fill nutrient gaps 36% 33% 39% 38% 32% 39% in my diet Heart health 32% 36% 28% 19% 31% 42% Healthy aging 29% 27% 32% 15% 31% 40% Immune health 29% 29% 29% 34% 29% 25% Energy 29% 31% 27% 31% 33% 23% Bone health 29% 20% 36% 17% 31% 36% Help reduce the risk 22% 26% 19% 18% 25% 24% of illness Joint health 21% 23% 20% 13% 21% 28%

26 Study cases, statistical and correlation data

27 Study cases, statistical and correlation data EUROPE Usage of Plant Food Supplements across Six European Countries: Findings from the PlantLIBRA Consumer Survey ( ) Authors: Alicia Garcia-Alvarez, Bernadette Egan, Simone de Klein, Lorena Dima, Franco M. Maggi, Merja Isoniemi, Lourdes Ribas-Barba, Monique M. Raats, Eva Melanie Meissner, Mihaela Badea, Flavia Bruno, Maija Salmenhaara, Raimon Milà-Villarroel, Viktoria Knaze, Charo Hodgkins, Angela Marculescu, Liisa Uusitalo, Patrizia Restani, Lluís Serra-Majem. Published: March 18, 2014, DOI: /journal.pone

28 Study cases, statistical and correlation data Objective: to provide an overview of the characteristics and usage patterns of PFS consumers in six European countries. Design: data on PFS usage were collected in a cross-sectional, retrospective survey of PFS consumers using a bespoke frequency of PFS usage questionnaire. Subjects/setting: a total sample of 2359 adult PFS consumers from Finland, Germany, Italy, Romania, Spain and the United Kingdom. Data analyses: descriptive analyses were conducted, with all data stratified by gender, age, and country; absolute frequencies, percentages and 95% confidence intervals are reported.

29 Results: Study cases, statistical and correlation data Overall, an estimated 18.8% of screened survey respondents used at least one PFS. Characteristics of PFS consumers included being older, well-educated, never having smoked and self-reporting health status as good or very good. Across countries, 491 different botanicals were identified in the PFS products used, with Ginkgo biloba (Ginkgo), Oenothera biennis (Evening primrose) and Cynara scolymus (Artichoke) being most frequently reported; the most popular dose forms were capsules and pills/tablets. Most consumers used one product and half of all users took single-botanical products. Some results varied across countries. Conclusions: The PlantLIBRA consumer survey is unique in reporting on usage patterns of PFS consumers in six European countries. The survey highlights the complexity of measuring the intake of such products, particularly at pan-european level. Incorporating measures of the intake of botanicals in national dietary surveys would provide much-needed data for comprehensive risk and benefit assessments at the European level.

30 Study cases, statistical and correlation data EUROPE Central and Eastern European Countries FOOD SUPPLEMENTS IN CENTRAL AND EASTERN EUROPEAN COUNTRIES, A. Stoimenova, Faculty of Pharmacy, Department of Social Pharmacy, Medical University Sofia, Acta Medica Bulgarica, Vol. XXXVII, 2010, No. 1 cmb.medun.acad.bg:8080/jspui/bitstream/10861/299/1/stoimenova- A_acta-medica-1-10.pdf

31 Study cases, statistical and correlation data AIM: to outline the main tendencies in the development of food supplements markets in Central and Eastern European countries as one of the most dynamic segments of the EU food supplements market. MATERIALS AND METHODS: - publications on food supplements; - sales reports, published by marketing companies; - publications on food supplements found in Scopus database; - product brochures and catalogues.

32 Study cases, statistical and correlation data RESULTS: food supplements market is very dynamic, but still below pharmaceutical market by volume and value; both over-the-counter (OTC) pharmaceutical segment and food supplements segment show a positive trend; good performance of vitamins and food supplements result of the drivers affecting the industry; the drivers are: regulation (different from market to market), product innovations (consumers taste and preferences can change very quickly), consumer knowledge and needs; dynamic markets of Lithuania, Hungary, Czech Republic, Estonia and Latvia (spenders in food supplements per capita); fastest growing market are Russia and Ukraine; in Southeastern Europe the biggest markets are Romania, Bulgaria and Croatia; the biggest sales in Eastern Europe recorded multivitamin food supplements, followed by combinations, minerals, probiotic supplements, calcium supplements, child-specific vitamins and minerals.

33 Study cases, statistical and correlation data CONCLUSIONS: the food supplement market in Eastern Europe countries is dominated by the market of multivitamin and mineral supplements; the other food supplements are various combination products, vitamin C, vitamin B, tonics and child-specific preparations; plant-based supplements are less used; no knowledge on inclusion of food supplements in different prophylaxis programs; necessity of independent monitoring by non-governmental associations and consumers associations; development of regulated and stable markets of food supplements; consumer and medical specialists education is needed.

34 Study cases, statistical and correlation data EUROPE Romania HERBAL SUPPLEMENTS CONSUMPTION IN ROMANIA FROM THE PERSPECTIVE OF PUBLIC HEALTH AND EDUCATION, M. Stoia and S. Oancea, University Lucian Blaga Sibiu, ACTA MEDICA TRANSILVANICA, vol. II, no. 2, 2013, pag

35 Methods: Study cases, statistical and correlation data analysis and market research of herbal/dietary supplements using different sources of the last 10 years (mainly specialized publications, and press releases); analysis of certain statistical indicators from official bulletins of Ministry of Agriculture and Rural Development, and National Institute of Statistics. The following indicators were taken into account, for a period of 10 years ( ): crop area and production of medicinal and aromatic plants; share of persons with low educational attainment; death rate of chronic diseases; life expectancy of age 65; statistical processing: mathematical extrapolation for trend calculation by linear regression.

36 Study cases, statistical and correlation data RESULTS: most significant growth of herbal food supplements sales in Romania from 65 million Euros in 2008 to 200 million Euros in 2010, reaching an average consumption per capita of 9.5 Euros; herbal/traditional products experienced high growth in 2010 in Romania and this is expected to lead to significant changes in consumption habits and life style, which in turn will lead to increasing demand for more sophisticated herbal products; crop area and total production of medicinal and aromatic plants have significantly increased by 2010, showing a positive trend in harnessing the potential of ethnopharmacology; from the perspective of education, significant improvement occurs in persons with low educational attainment, during the last decade; health indicators (death rate of chronic diseases, and life expectancy at age 65) have also improved in the last decade; significant correlations were found between: % of aged persons with a low educational attainment and death rate of chronic diseases (r=0.98), respectively life expectancy at age 65 (r=-0.89); death rate of chronic diseases and life expectancy at age 65 (r=-0.80); herbal suppliments consumption and % of aged persons with low educational attainment (r=-0.91), respectively death rate of chronic diseases (r=-0.83), and life expectancy at age 65 (r=0.94).

37 Study cases, statistical and correlation data Conclusions: the annual average consumption per capita is lower than in other European countries, but forecasts are optimistic; education, health and life expectancy have improved over the studied period, and follow a positive forecast; significant correlations between herbal supplements consumption, educational attainment and health indicators (r = 0.9).

38 11.5. Herbal food supplements consumer s profile

39 Herbal food supplements consumer s profile The market success may be relatively easy to be explained by: the diversity of products; the nutrition and health claims; the possibility of using them without the medical doctor s recommendation; the target categories of consumers to whom the products are addressed. The average herbal supplement user (research from the National Marketing Institute, 2014): the current supplement user consumes an average of 3.3 pills per day; vitamin/mineral supplement user consumes an average of 4.0 pills per day; the average herbal supplement user downs 5.5 pills per day.

40 Herbal food supplement consumer s profile Categories of consumers are: relatively well educated persons (having quick access to information, using internet and ordering on-line the products); persons having a new lifestyle and fast rate of working, more stressful, that really need dietary supplements, especially vitamins and minerals or energy drinks; young people looking for improving their aspect (body building, slimming products), physical form or sexual activity; elderly with low income, who trust in medicinal plants and natural products benefits; pregnant women or women at menopause, having hormonal deficiencies and increased needs for certain minerals and vitamins; old people threatened by osteoporosis, whose absorption of minerals is problematic or the diet is poor in some necessary nutrients; children with low immunity, different allergies or metabolic deficiencies; consumers of media who wish to be trendy (buying everything that is trendy, including bio products and new formula of dietary supplements or food addressed to specific nutritional needs).

41 CONCLUSIONS lack of the EU official data concerning food supplements (which include HFS); food medicinal product price?; experts in traditional medicine and nutrition, lack information on supplements and herbals; food supplements represent a category of products that lend themselves to sending misleading messages; picture of confidence in natural product that favored their adulteration; products with complex matrices, possible synergies and antagonism actions, unkown effects after interaction with diet and medicinal treatment, so on; free access to them by many distribution channels, including on-line access; on-line trade supervision at European level is a problem.

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