KEYWORDS
Metabolic Health
Cardiometabolic Health
Lactobacillus plantarum
Science-backed
Cardiovascular Health
Skin
Metabolic
Joint
Immunity
Abstract
Metabolic health risk factors are among the leading causes of global mortality and continue to remain a disease burden on worldwide health organisations. As such, there is a significant unmet need in cardiometabolic health that we need to address – and fast. There are plenty of clinical trials exploring scientific advancements to assist global health organisations in managing these underlying conditions with therapeutic innovations, which are natural and often easier for the body to handle.
This article discusses how scientific research and clinical trials in cardiometabolic health can assist health brands and retailers to develop innovative solutions that are able to bridge the gap to help consumers live much longer and more importantly, healthier lives.
Article
It’s been widely reported that only 6.8% of U.S. adults have achieved optimal cardiometabolic health (1). While ultra-processed foods (UPFs), lack of exercise and unhealthy habits are often a major obstacle in achieving this goal, there are other risk factors at play. Sometimes, these are simply down to genetics. Research from the British Heart Foundation states that global heart and circulatory disease prevalence affects 48 million people in North America, 48 million in Latin America, 100 million in Europe, 98 million in Africa and the Middle East, and a staggering 340 million in Asia and Australasia (2). The question we need to ask is how health brands in association with global health organisations can support consumers to achieve improved cardiometabolic health.
The unmet need in clinical research
Metabolic or cardiometabolic health is, by definition, a ‘catch-all’ term that we associate with the body being able to adequately respond to nutrients that are in turn able to reduce our risk of metabolic diseases such as obesity, type 2 diabetes, heart disease, stroke and non-alcoholic fatty liver disease. The way the human body converts food into energy differs significantly from individual to individual. It takes into consideration cultural influences, environmental factors, and our genetics. For example, researchers still don’t have all the answers as to why some women experience gestational diabetes during pregnancy, while others do not. According to Diabetes UK, it affects at least 4 to 5 in 100 women during pregnancy (3). So far, research has ascertained that this could be down to overweight or obesity, increased maternal age, having a family history of diabetes, or having a South Asian, Black or African Caribbean or Middle Eastern background. Yet sometimes, it’s simply hormonal changes within the body.
In a new PLOS ONE study published in March 2024 from the University of Washington, researchers found that when female adolescents experienced puberty earlier in life compared to those of the same age, they were at a higher risk of experiencing cardiometabolic health issues in their adult lives, based on a sample of 655 women (4). In another study published in the Journal of American Heart Association, young adults were also the topic of exploration. Those who reported higher stress during their teenage years through to adulthood were more likely to be at an increased risk of high blood pressure and obesity than their peers who reported less stress. The study measured how stress patterns over time had a causal effect on fat distribution, vascular health and obesity to determine the results (5).
Elsewhere, a current Danish clinical study is recruiting volunteers to study the link between the JAK2 genetic mutation and myeloproliferative neoplasm (MPN) – a group of rare conditions said to affect the bone marrow, resulting in the body producing more red or white blood cells and platelets (6). Being at risk of MPN could lead to cardiovascular disease, so an early diagnosis could mean individuals receive additional monitoring and treatment to prevent the condition causing heart complications in later life.
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The consequences of preliminary research
However, there are times when research is published far too early, or where there is too little evidence to back up wider claims. This can often lead to more harm being done than good, particularly if it’s captured by national media outlets. Controversy surrounding recent preliminary research that stated that people were more likely to die from cardiovascular disease if they restricted their eating across an 8-hour time window has been met with mixed reviews from scientists in the industry.
This particular study, which was carried out as part of an analysis of over 20,000 U.S. adults, was presented at the American Heart Association’s Epidemiology and Prevention Lifestyle and Cardiometabolic Scientific Sessions in March 2024 (7). As a non-peer-reviewed study, the results only identified preliminary findings, however the headline sparked debate amongst those in the industry, saying that it is not yet possible to understand the link between the two (8, 9). There are simply too many parameters to consider, such as if those following the time-restricted diet tended to be older and at a higher cardiovascular risk than those who were otherwise healthy and fit.
When research that has not yet been verified gets significant media coverage, there’s little those in the industry can do other than ensure consumers are given an opposing perspective. As such, scientific evidence is powerful in today’s consumer-driven health world. According to research by FMCG Gurus, product efficacy and proven claims are the ‘most important consumer purchase motivators’ when buying functional foods with prebiotics and probiotics (10). So, when consumers are looking for a metabolic health supplement that can promote healthy ageing, digestive health or heart health, there’s a reason why peer-reviewed, scientifically backed claims always win.
The New Era of Probiotics
Probiotics have long been associated with improvements in overall gut health. These live organisms react to the environment in our gut and can help promote resilience and help normalise gut microbiota that has potentially been disturbed by antibiotics or other such stressors, including diet, everyday stress from work or life, and lifestyle choices (smoking, processed food, lack of exercise). However, their mechanisms of action are often complex and differ from strain to strain, therefore their interactions can be that of a metabolic, microbiological, physiological, endocrinological, neurological or immunological nature (11). This now means that probiotic use now goes beyond gut health – and consumers are just beginning to realise how beneficial they can be in other areas of health.
LP LDL is one such probiotic strain that’s been scientifically proven to support cardiometabolic health. Denmark-based ProBiotix Health plc has been instrumental in showcasing that Lactobacillus plantarum, identified as LPLDL by the life sciences company, can positively impact on multiple cardiometabolic health biomarkers, including total, LDL and HDL cholesterol, Apolipoprotein B, triglycerides and blood pressure.
The strain’s mechanism of action utilises the gut-liver axis to support cardiometabolic health due to its bile salt hydrolase enzymatic activity in the small intestine, thereby reducing bile salt reabsorption into the liver. This leads to an increase in blood cholesterol uptake by the liver as it is required to synthesise cholesterol into new bile salts to replenish and restore the bile acid pool, where finally blood cholesterol levels are reduced.
In a 2022 peer-reviewed study published in the Journal of Functional Foods, and carried out independently by the University of Roehampton, it was found that Lactobacillus plantarum LPLDL can significantly reduce LDL cholesterol levels – a key biomarker associated with increased coronary heart disease (CHD) risk (12). The placebo-controlled, double-blind study was part of a six-week human intervention, aimed at investigating the effect of LPLDL in male and female adults with hypercholesterolemia (high cholesterol), aged between 30 and 65 years.
Volunteers were randomly assigned to either consume 4x109 CFU per day of LPLDL, or a placebo, both in identical DR capsules. Each group was assessed at week three and six, with those on the patented probiotic strain showing statistically significant results versus the placebo as early as the third week. The results of the study highlighted that after taking LPLDL daily for six weeks, it could reduce total cholesterol by 36%, LDL by 28%, non-HDL cholesterol by 17% and apolipoprotein B by 28%.
In a secondary study by the University of Roehampton and presented at Probiota in early 2024 (13), the probiotic strain was combined with plant sterols and stanols (PSS) in a double-blind, placebo-controlled, parallel study to investigate the impact on blood lipid profiles of 26 hypercholesterolaemic adults with coeliac disease, aged 35 to 70. After nine weeks, the investigation found that participants had significantly reduced total cholesterol, LDL-C and ApoB, which are key atherosclerosis risk biomarkers. This signifies that the combination of LPLDL and PSS is proven to be an effective, safe and well-tolerated approach to improving blood lipid profiles.
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From innovative science to solutions
Health brands can therefore easily use innovative ingredients like probiotics to help reduce the heart health burden on global health authorities through scientific advancements. While traditional capsule formats remain popular, more unique consumption methods, such as techniques like gummies and oral disintegration technology, are on the rise in the dietary supplement market. These innovative delivery methods are becoming increasingly favoured primarily since they appeal to all consumer types, offering convenience and enhancing user experience.
Specifically, when it comes to formulations of an oral disintegration powder, it requires a great deal of scientific expertise, especially when taste and mouthfeel are top of the agenda. When we use probiotics, these requirements are magnified due to their unstable nature. For example, they are fragile to moisture (including heat moisture) and exposure to the elements may cause the product to be destabilised and compromise the end formulation. As such, dedicated formulation and manufacturing expertise for probiotics is paramount in achieving a high quality oral dispersible powder.
Oral dispersion technology is being used to support cardiometabolic health too. For example, Vitamin B as a sublingual or oral melt under the tongue can have a functional approach to help with absorption into the bloodstream. Probiotic strains, such as LPLDL,are also proving to be a hit with consumers. LPLDL features a unique dosing technology, for instance, one that melts instantly on the tongue without the addition of water, that enables health brands to deliver the formulation in a novel way, while delivering superior organoleptic properties. The result is a highly innovative and convenient heart health product, which has been scientifically validated for efficacy.
Natural solutions – are they the future?
Therapeutic innovations or naturally occurring probiotics could therefore support the cardiometabolic health burden we are facing today. Of course, medical interventions will always be required, but when so many consumers are taking their health into their own hands to live a longer and healthier life, innovations in this sector will continue to play a pivotal part in addressing those unmet needs. Especially when 64% of global consumers believe products with natural ingredients are healthier. Therefore, when natural formulations are scientifically backed with no observed side effects, the market opportunity only increases.
References and notes
- O'Hearn M. et al, Trends and Disparities in Cardiometabolic Health Among U.S. Adults, 1999-2018. J Am Coll Cardiol. 2022 Jul 12;80(2):138-151.
doi: 10.1016/j.jacc.2022.04.046. PMID: 35798448; PMCID: PMC10475326. Trends and Disparities in Cardiometabolic Health Among U.S. Adults, 1999-2018 - PubMed (nih.gov) - BHF, CVD Global Factsheet, 2024
- Diabetes UK, https://www.diabetes.org.uk/diabetes-the-basics/gestational-diabetes/causes
- Maria E. Bleil, Bradley M. Appelhans, Steven E. Gregorich, Robert A. Hiatt, Glenn I. Roisman, Cathryn Booth-LaForce. Pubertal timing: A life course pathway linking early life risk to adulthood cardiometabolic health. PLOS ONE, 2024; 19 (3): e0299433 DOI: 10.1371/journal.pone.0299433 https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0299433
- Fangqi Guo, Xinci Chen, Steve Howland, Phoebe Danza, Zhongzheng Niu, W. James Gauderman, Rima Habre, Rob McConnell, Mingzhu Yan, Lora Whitfield, Yanjie Li, Howard N. Hodis, Carrie V. Breton, Theresa M. Bastain, Shohreh F. Farzan. Perceived Stress From Childhood to Adulthood and Cardiometabolic End Points in Young Adulthood: An 18‐Year Prospective Study. Journal of the American Heart Association, 2024; DOI: 10.1161/JAHA.123.030741https://www.ahajournals.org/doi/10.1161/JAHA.123.030741
- Novo Nordisk Foundation, ‘New treatments for cardiometabolic disease to reach patients faster through pilot programme’, December 2023 https://novonordiskfonden.dk/en/news/new-treatments-for-cardiometabolic-disease-to-reach-patients-faster-through-pilot-programme/
- American Heart Association. "8-hour time-restricted eating linked to a 91% higher risk of cardiovascular death." ScienceDaily. ScienceDaily, 20 March 2024. www.sciencedaily.com/releases/2024/03/240320115727.htm
- Science Media Centre ‘Expert reaction to conference abstract about time-restricted eating and cardiovascular death’, March 2024 https://www.sciencemediacentre.org/expert-reaction-to-conference-abstract-about-time-restricted-eating-and-cardiovascular-death/
- TCTMD, ‘Intermittent Fasting Study Sparks Debate Over Increases in CV Mortality’, March 2024. https://www.tctmd.com/news/intermittent-fasting-study-sparks-debate-over-increases-cv-mortality
- FMCG Gurus via Dairy Foods, ‘Consumers want products that are backed up by science’, April 2023. https://www.dairyfoods.com/articles/96333-research-consumers-want-products-that-are-backed-up-by-science
- International Probiotics Association, The Microbiome and Probiotics Interaction, accessed July 2024. https://internationalprobiotics.org/infographics/the-microbiome-probiotics-interaction/
- Keleszade et al (2022) JFF. 89: 104939 104157. https://www.sciencedirect.com/science/article/pii/S1756464622000093
- Costabile A, Buttarazzi I, Kolida S, Quercia S, Baldini J, Swann JR, et al. (2017) An in vivo assessment of the cholesterol-lowering efficacy of Lactobacillus plantarum ECGC 13110402 in normal to mildly hypercholesterolaemic adults. PLoS ONE 12(12): e0187964. February 2024. The cholesterol lowering efficacy of Lactobacillus plantarum ECGC 13110402 in hypercholesterolemic adults: a double-blind, randomized, placebo controlled, pilot human intervention study — University of Roehampton Research Explorer
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