Mastering the Mental Wellness Market

When it comes to sectors boosted by COVID-19, cognitive health is a no-brainer. “There is a huge market for consumers looking to boost their brainpower by improving memory, focus, and overall cognitive health,” says Bluebonnet Nutrition’s Trisha Sugarek MacDonald, Sr. Director of R&D, noting that SPINS data indicates a nearly $32 million market for products associated with cognitive health. The statistics provided by Sugarek MacDonald, combined with statistics from FMCG Gurus, show a growing market:

72% of consumers are looking for benefits to memory
59% want to maintain healthy brain function
56% report feelings of stress (1)
55% need help concentrating
53% have difficulty sleeping (1)

Fast Fact!

In the year 2000, the average attention span was 12 seconds. When reassessed in 2015, the average attention span had shortened to 8.25 seconds, according to Statistic Brain Research Institute.And COVID-19 seems to be heightening such concerns for many. “COVID has ushered in a heightened sense of anxiety, stress, and insomnia,” says Jolie Root, Senior Nutritionist and Educator at Carlson Laboratories. “Fear, isolation, and grief are part of every family reality now, and families are looking for ways to mitigate the COVID-related health challenges, whether they are physical—such as immune function—or mental, such as COVID brain fog. The condition brings with it symptoms that can include memory loss, confusion, difficulty focusing, dizziness, and trouble finding everyday words.”

Even those who have not been sick with COVID have suffered mentally, Root notes: “COVID has brought higher levels of stress and emotional challenges related to the sense of isolation, financial challenges, working while parenting and homeschooling children. Top searches online are immune health—but mental health is near the top. Consumers want help for their stress, mood challenges, and to get a good night’s sleep.”

Stacey Daigle, Director of Inside Sales & Marketing, NutriScience Innovations, sees this market as the second focus of the pandemic: “At the onset of COVID, consumers focused solely on staying physically healthy. They stayed home and started taking more immune health ingredients, as shown by the dramatic increase in sales of Elderberry, Magnesium, vitamin C, etc. As time went on, stress levels increased. The constant barrage of bad news combined with less interaction with peers made people feel lonely, tired, and stressed. Increased stress levels and social isolation brought Emotional Wellbeing front and center for many consumers. This growing focus has driven the demand for products to support cognitive and emotional health such as Ashwagandha for stress, anxiety, and sleep-related conditions, and L-Theanine for cognitive focus, stress, and sleep. NutriScience has seen an increase in sales of these ingredients since COVID set in last March.”

Also noting the trend, Braxton Wright, Sales Manager at Chemi Nutra, says: “The cognitive health space has been strong for the past few years and we expect it to weather the COVID pandemic rather well. We feel consumers are looking for products that provide more than just caffeine/stimulants and actually provide real benefits for mental health, this is why we have seen strong growth during the significant pull back of the economy.”

Getting down to the numbers, Lauren Clardy, VP Branded Ingredients, AIDP, references data from NBJ: “The mood and stress category was already growing significantly before the pandemic. It climbed 15.2% in 2018 and an estimated 8.1% in 2019. Now, with anxiety and depression on the rise, NBJ expects this market to grow another 14.6% this year, to snag $967 million in sales.”

When it comes to existing supplement users, Shoji Matsukawa, VP at Mitsubishi Gas Chemical, says that the numbers are in this market’s favor. “According to a survey conducted by Council for Responsible Nutrition and Ipsos earlier this year, 43% of dietary supplement users have changed their supplement routines since the start of the pandemic.” He explains: “The reasons why they changed their routines—whether adding new supplements, taking the same supplements more regularly, or increasing doses—were mostly related to stress management. This includes overall immune health, mental health, and sleep support.”

Also driving demand: “Aging populations are taking additional measures to maintain cognitive health, and video gaming has seen a gigantic surge in numbers, so brain support supplements could be seeing better growth than in previous years,” reports Balchem Marketing Manager Tom Druke. “It helps that cognitive products may have immune benefits as well, Druke notes. “Supplementing with zinc is well known to help the immune system, but it also helps neurons within the hippocampus to communicate effectively, supporting the brain’s learning and memory center.”

Wright is seeing this trend as well. “AlphaSize Alpha GPC and SerinAid phosphatidylserine (PS) have seen demand grow. We have seen SerinAid growing more significantly, and this could be attributed to its applications for reducing stress and cortisol. Stress has been a huge focus for consumers recently and the dual applications of PS for cognitive enhancement and stress reduction make it an ingredient that has been rightfully keyed in on by consumers and brands.”

At AIDP, Clardy notes growth in everything from cognitive-specific ingredients to vitamins: “AIDP’s sales of our cognitive wellness branded ingredients as well as key vitamins, minerals, and actives addressing the COVID-related categories of brain wellness, memory problems, mental clarity, focus, stress, anxiety, and sleep are growing well into the double digits. We also see a diversification in the age demographics for these products: Younger individuals are taking control of their overall health with supplements and turning to a variety of stress and sleep support options.”

With regards to diversification, Sugarek MacDonald agrees that the sector is growing: “Brain health is not just a concern for aging individuals. It touches the lives of both men and women, young or old, and is among the top five health concerns of consumers aged 18 to 75. The brain health category applies even to children and students developing in a highly competitive academic world and whose parents are committed to supporting their mental performance and academic achievements. Seniors, too, are seeking to prevent the loss of cognitive skills and their mental abilities occurring as a part of the normal aging process. There is also a new emerging class of individuals beyond childhood for health development and seniors for anti-aging, 20-somethings, and Millennials fall into the category of seeking ‘peak cognitive performance' and a better 'quality of life.' This group consists of knowledge seekers and students, making up 40% of the population affected by cognitive dysfunction and loss of acuity due to stress." Sugarek MacDonald points to a 2013 poll by Trending Machine that found Millennials (13 – 34 years) are more likely than seniors over 55 to forget what day it is, where they put their keys, bathe or shower, and bring a lunch. She adds that millennials also reported the highest stress levels when compared to all other generations, according to the American Psychology Association.

Summing all of this up, Clardy says: “The cognition space is expanding. With COVID-19 and the effects of this global pandemic, the brain wellness category has moved to the forefront with consumers. There is accelerated interest in the areas of memory problems, mental clarity, and an inability to focus, as well as with conditions such as anxiety, sleeplessness, and stress, all being lumped into the cognitive category.”

Brain Food

Diet can have a huge impact on cognitive wellbeing—and it doesn’t take much to have an effect. A study from Ohio State University found that saturated fat may hinder the ability to concentrate (1). Performed on 51 women, the subjects ate a meal high in either saturated fat or unsaturated fat and then took a test to measure their attention. One to four weeks later, the process was repeated again, with the opposite meal of the one the women had eaten the first time. The study found that those with leaky gut performed poorly no matter what kind of fat they ate. Annelise Madison, lead author of the study and a graduate student in clinical psychology, shared in a press release what impressed her: “Most prior work looking at the causative effect of the diet has looked over a period of time. And this was just one meal—it’s pretty remarkable that we saw a difference.” She added that the difference could be even greater, if the high-saturated fat meal was compared to a low-fat meal.

More seriously, a study from the American Academy of Neurology suggested that ‘food networks’ may affect dementia risk (2). The study considered 209 people with dementia and 418 people without, and found that while the groups didn’t differ much in terms of the amount of individual foods they ate, the way the foods were grouped differed substantially. Cécilia Samieri, Ph.D., with the University of Bordeaux, explained in a press release: “Processed meats were a ‘hub’ in the food networks of people with dementia. People who developed dementia were more likely to combine highly processed meats such as sausages, cured meats, and patés with starchy foods like potatoes, alcohol, and snacks like cookies and cakes. People without dementia were more likely to accompany meat with more diverse foods, including fruit and vegetables and seafood. This may suggest that the frequency with which processed meat is combined with other unhealthy foods, rather than average quantity, may be important for dementia risk.”

In more positive news, a study published in Alzheimer’s and Dementia found that the Mediterranean diet may support higher cognitive function (3). Researchers with the National Eye Institute examined the effects of nine components of the Mediterranean diet on cognition, and found that participants with the greatest adherence to the Mediterranean diet had the lowest risk of cognitive impairment. Fish and vegetable consumption appeared to have the greatest protective effect. One major finding: The benefits were the same for those who have the ApoE gene, which puts people at high risk for Alzheimer’s disease.

This may be useful information for your customers: Even if they can’t adhere to the ideal diet at all times, taking steps such as avoid high-fat comfort foods before high-stress or cognitively demanding events can help. Choosing to eat more diverse foods may also be more actionable than cutting out processed meats altogether.

Supplement Spotlight

There are plenty of ingredients that customers may find useful and can discuss with their healthcare provider. Among those suggested by our experts:

Bacopa. Abey Thomas, Head of Global Marketing at Natural Remedies, notes the consumer interest in this herb. “We’ve observed an increase in demand for our ingredient BacoMind, a clinically tested extract of Bacopa monnieri used to support learning and memory in the elderly and in children.”

Clardy agreed, noting that this demand extends to herbs in general. “Consumers are seeking help from botanicals for relief from stress, sleep, and anxiety, and to help them remain focused and calm. In 2020, NBJ projects herbs and botanicals will see an 18.5% increase in sales, up from an industry-leading 8.6% in 2019.” Clardy points to bacopa and holy basil—also known as tulsi—as two herbs often used within Ayurvedic tradition that have been shown to support cognition, memory, and stress relief. AIDP distributes branded ingredients BacoMind and holy basil branded as OciBest.

CBD/Hemp. A new study from the University College London suggests that it can help improve blood flow to the hippocampus, an area of the brain associated with memory and emotion (2). The study was small—it was only performed on 15 young adults—but Dr. Michael Bloomfield, lead author of the study, said in a press release that “This supports the view that CBD has region-specific blood flow effects in the human brain, which has previously been disputed. If replicated, these results could lead to further research across a range of conditions characterized by changes in how the brain processes memories.”

It also helps support the ECS. “The endocannabinoid system (ECS) is a powerful body system that modulates all physiological functions and maintains a range of functions throughout the body,” explains Clardy. “New research is continuing to expand our knowledge of the ECS in pain, stress, anxiety, insomnia, focus, and other neurological conditions.” She points to hemp as a useful modulator for the ECS: “Hemp is the most abundant natural source of dietary phytocannabinoids that can maintain the balance and tone of the ECS.” AIDP has partnered with Verdant Oasis; Clardy notes regulatory reasons for this: “Due to the absence of regulations from the FDA and USDA, the hemp CBD market has been operating in a grey area of uncertainty that is not conducive for conducting a long-term successful business. Every aspect of the hemp market continues to be troubled by a lack of legal clarity. Verdant has recognized these challenges and has conducted itself to the letter of the law to eliminate risk—while focusing on the safety, legality, and efficacy of their products.”

Choline. “Choline is gaining more attention this year, especially for its role in cognitive health,” says Cole. “As more research is published, we continue to see the importance of choline for cognitive development, memory, and focus. While choline intake during pregnancy and early life is often focused on cognitive development whereas memory support may appeal to the elderly, it is evident choline is important throughout all stages of life for many aspects of cognitive health.”

Sugarek MacDonald told WholeFoods that Citicoline is essential for the synthesis of the phospholipid phosphatidylcholine, which makes up approximately 30% of brain tissue, lining cell membranes to determine what is allowed in and out of the cell. She specifically discussed Cognizin, a branded form of water-soluble citicoline in Bluebonnet’s BrainPower formula. “Tested for efficacy, Cognizin helps enhance communication between neurons, maintain healthy acetylcholine levels, protect neural structures, and support healthy brain activity and energy,” Sugarek MacDonald explains. “Clinical research indicates that citicoline supports mitochondria's health, the powerhouses within cells that produce the brain’s energy. Healthy mitochondrial function results in higher ATP levels—the body’s main energy storage molecule—in brain cells. Furthermore, Cognizin aids in neural communication by protecting neural structures against free-radical damage and facilitating information transmission through healthy cell membranes. Lastly, citicoline is often called a "brain nutrient" because it increases levels of several important neurotransmitters, including acetylcholine, an important brain chemical that regulates cognitive function. Cognizin has also been shown to support the activity of nerves that respond to acetylcholine, helping to raise activity levels in the brain's learning and communication circuits.”

Curcumin. This ever-popular turmeric extract is known as an all-around useful supplement—and it has a place in the cognitive health realm, too. America’s Finest, Inc. sells a Memory Health product that combines Sabinsa’s Curcumin C3 Complex with bacopa and L-Dopa to support the repair of neurons, maintain healthy mood and mental alertness, and fight off free radicals, their website says.

Another winning combo: Aqua Biome sells Fish Oil + Meriva Curcumin, Indena’s branded curcumin Phytosome, to support joint health, brain function, and a healthy inflammatory response.

Ginkgo biloba. This one is specifically a brain nutrient; a blog from Global Healing’s Founder Dr. Edward Group calls it a nootropic, explaining that it “may enhance brain function by improving memory and the processing of information… Ginkgo is also an antioxidant. Its effects include improving blood flow to the brain and promoting normal stress hormone levels in healthy people” (3). Dr. Group notes that people use it to stimulate mental performance and focus, and to stay calm.

L-Theanine. L-theanine is often used to promote calm, and Daigle suggests it may have overall cognitive benefits as well. “Suntheanine L-theanine is a fast-acting, gentle, calming ingredient that also promotes focus and better-quality sleep. Although Suntheanine has been in the market for many years, we’re seeing renewed interest in Suntheanine due to its cognitive effects. It is a patented ingredient with over 200 scientific, clinical and safety studies. Suntheanine helps to increase Alpha brain waves, which are associated with a relaxed mental state. It increases focus and memory capabilities while helping to reduce stress.”

Magnesium. We all know the importance of magnesium—and the numbers show that consumers do too. “Magnesium is experiencing strong growth in its role for sleep along with melatonin,” Clardy says, citing NBJ. “Magnesium sales in 2019 were estimated to be $1.1 billion in the U.S., the same as calcium. More impressively, magnesium is predicted to grow by 11% in 2020, as sleep and calm become a priority for consumers.” AIDP’s Magtein, magnesium-l-threonate, is the subject of a new trial that demonstrated “significant improvements in memory, learning, and recall,” Clardy says, noting that “an additional pilot study has shown significant benefits to attention and executive functioning in adults with attention deficit disorder.”

Omega-3s. These fatty acids are credited with a variety of health benefits, and Root says that cognitive health is no exception: “The science continues to build momentum on the benefits of the omega-3s EPA, DPA, and DHA, with increasing attention being paid to relevant dosing and achievement of target blood levels as represented by RBC membrane omega-3 levels in texts such as the HSOmega-3 Index.” She also points to a paper published in the Journal of Psychiatric Research titled The landscape of cognitive function in recovered COVID-19 patients, which found a connection between persistent cognitive impairments in recovered COVID patients and elevated inflammatory markers such as TNFa and CRP. While more research would need to be conducted, Root notes, “This would suggest attention must be paid to balancing the inflammatory response with modulators such as the aforementioned omega-3s and other nutrients like vitamin D, curcumin, ginger, and boswellin.”

Another option here: NOW Foods’ Ultra Omega-3, with a ratio of EPA to DHA intended to support cognitive health. Their website notes that the enteric coating and odor control should help those who have trouble tolerating fish oils.

PQQ (Pyrroloquinoline quinone). “PQQ is both an antioxidant and antioxidant regenerator naturally found in a wide range of foods, such as vegetables, fruits, dairy, meat, and breastmilk,” says Katherine Cole, R&D Manager, ChildLife Nutrition. “PQQ's antioxidant properties help protect the nervous system from oxidative damage. Studies have found that PQQ promotes mitochondrial production and function, which is important to cognitive health.”

One form of PQQ, BioPQQ, has specifically been studied for cognitive health. Matsukawa explains: “In one particular open-label study, BioPQQ has demonstrated positive effects on stress, fatigue, and sleep. Test subjects who took 20mg of BioPQQ daily for eight weeks saw significant improvements in vigor, fatigue, tension, anxiety, anger/hostility, and confusion. Additionally, measures for quality of life, appetite, sleep, and pain also improved considerably among both male and female subjects during this same period of time. The study revealed improvement in drowsiness at awakening, sleep onset, and maintenance, and sleep duration as well, for those taking BioPQQ.” He adds that BioPQQ has received an NDI from the FDA.

Probiotics. As with most parts of the body, the brain is connected to the gut—a blog on Just Thrive’s website notes that the two communicate over the gut-brain axis, and that the microbiome has a “huge influence” on this axis: “When your gut is in healthy balance, it sends positive messages and essential nutrients to your brain, and creates important ‘feel-good’ neurotransmitters like serotonin and GABA,” the blog explains (4). “But when your gut is in dysbiosis, the messages get garbled, and bad bacteria set off system-wide problems,” including inflammation, reduced neurotransmitter production, and high cortisol. A good probiotic can have a big effect—not just on digestive health, but on whole-body health.

Pycnogenol. This French maritime pine bark extract has been shown to have cognitive benefits. Sebastien Bornet, VP Global Sales & Marketing at Horphag Research, explains: “Pycnogenol’s benefits are backed by decades of independent, peer-reviewed research. Pycnogenol’s powerful antioxidant effects and circulatory benefits have been shown to be safe and effective to support brain function for all ages. Most recently ,a 2018 study found Pycnogenol to improve symptoms of Mild Cognitive Impairment, a potential risk factor for dementia and other degenerative cognitive conditions. This research showed that supplementing with Pycnogenol resulted in an 18% improvement of Mini-Mental State Examination scores. Another study published in 2015 found Pycnogenol to help improve overall cognitive function in the workplace, including mental performance, sustained attention, and mood in people aged between 35 and 55.”

In an interview with Richard A. Passwater, Ph.D., Professor Peter Rohdewald, Ph.D., explained that Pycnogenol has been proven in clinical trials to support health memory in the elderly, as well as to support other cognitive tasks such as decision making and dealing with complex problems (5). In one study, the Pycnogenol group outperformed the control group for evaluation of cognitive function deterioration. Benefits have also been observed in students and in healthy professionals, suggesting that it’s a good supplement for customers no matter what their age or profession.

Resveratrol. Resveratrol is often used as part of a healthy aging regimen; it now has a study pointing to cognitive benefits, as well. A clinical study published in Nutrients randomized 125 volunteers to take two capsules containing 75mg of Veri-te resveratrol daily or a placebo for 12 months, followed by the alternate treatment for a further 12 months (6). Dr. Rachel Wong, a lead researcher on the study, said in a press release that for postmenopausal women, “Our observed improvement in overall cognitive performance with resveratrol could potentially reverse cognitive aging by up to 10 years.”

Trend Alert: Gaining the Edge on Gaming

Video games have been gaining in popularity—and during the pandemic, they have exploded, as people turned to games to help them stay connected to loved ones and to keep them occupied. “There has been increased emphasis on the growth of esports this year,” Druke states. “Ingredient suppliers and supplement manufacturers are looking to address the demand for solutions that improve video gaming performance, and much of the opportunity here is within the cognitive space. Gamers must be able to recognize patterns and dynamically adapt to ever-changing conditions, sometimes over the space of several hours at a time. Many minerals have been researched for their cognitive benefits, many of which are able to deliver improved focus and attention, memory, coordinated reaction time, and cognitive energy. By supplementing with magnesium, iron, zinc, and choline, gamers (especially esports professionals) are able to better compete as the minerals help maintain optimal cognitive function.”

Thomas agrees, noting that the popularity of video games is unlikely to go away—and that products intended to support gamers are therefore likely to continue popping up. “Cognitive ingredients addressing the needs of e-gamers is a new trend that we’re observing. We believe this trend will continue, as brands look to engage the tech-savvy millennials and the Gen-Z population.”

One new offering in this area: Screen Time Stamina, a formula from Source Naturals intended to support mental focus, energy, and eye health with ingredients including huperzine A, lutein, and ginseng.

Sugarek MacDonald pointed to a study performed specifically for gamers’ cognitive needs. The study was performed on adolescent males, who were given placebo, 250mg Cognizin, or 500mg Cognizin daily for 28 days. Those on Cognizin saw a significant increase in motor speed on a Finger Tap test, and improved attention on Speed Task tests, compared to those on placebo.

Getting Those Zzz’s

A key step those trying to bring their cognitive troubles under control is to get a good night’s sleep. “Inadequate sleep has been associated with heightened emotional reactivity and reduced attention, memory, and executive function,” Root says. She adds that sleep will be vital for the struggle ahead. “Experts in every field warn of the ‘twindemic,’ not just of COVID and the flu, but also of COVID and the growing mental health pandemic.”

Moving Forward

Looking to what’s coming next, Wright suggests improved regulations. “Regulations are not as strict as we would like to see,” he says. “We still see many ingredients in the market that are ‘bootleg’ versions of true high quality and substantiated ingredients on the market. We see this very often with Alpha GPC and brands using synthetic versions that are untested and potentially dangerous. We would love to see more testing for genotoxins in many of these synthetic knockoffs of Phosphatidylserine and Alpha GPC as well as other ingredients in the market. We are working to engage the FDA to be stricter on imported ingredients that lack the safety and quality required. Our goal is to make sure the market is safe for consumers. We would love to see more regulation in the market and will do our best to make sure consumers can purchase without concern.”

Indeed, recently a study was published in Neurology that concluded that OTC cognitive health supplements may contain unapproved drugs—and while CRN pointed out that the researchers went looking for illegal drugs and found them, and that the 10 products they tested are not representative of the entire market, CRN also urged FDA to take “stronger enforcement action against tainted products containing illegal drug ingredients in the marketplace” in a statement responding to the study (7).

Cole agrees that customers are looking for more transparency and honesty in this arena, although he says manufacturers should step up too. “Cognitive health product claims for aging populations has come under fire lately, as it can be challenging to clearly differentiate between normal cognitive decline with age, and disease states. Substantiating claims with studies conducted on healthy populations, and carefully crafting claims that apply to generally healthy populations are ways brands can be mindful of this distinction.”

Wright feels that putting time into claims substantiation won’t go to waste—and that good brands already know that. “Science has also been increasingly important to our customers; it is important to many of our customers to ensure that the ingredients they are utilizing are proven to be effective,” Wright says. “This is a great turn in brand and consumer mentality, we truly enjoy this since we offer ingredients with dozens of clinical studies on the material directly and have pushed for more scientific backing for years.”

Overall, the category has a bright future. “The pandemic has enabled consumers to focus on their overall health, and mental health is one such category that has gained priority in the consumers’ minds,” Thomas says. “Post-pandemic, we believe that this category will overlap with stress and sleep as consumers look for a one-stop solution for these issues.”

Strategies to Grow Your Business

On January 20-21, 2020, WholeFoods Magazine and Trust Transparency Center will host our next virtual event in the #NaturallyInformed series: Mental Wellness: Mastering the Market. This Naturally Informed event will cover a wide range of pressing topics focused on boosting brainpower with strategies such as nootropics and brain hacking, as well as fostering mental wellbeing by enhancing stress resilience, elevating mood, and more. An impressive line-up of world-class experts will provide insights on the latest science and technologies driving development, merchandising and communication strategies for brands and retailers, and the inside scoop on what will drive new opportunities in the market. Register today at www.NaturallyInformed.net. WF