Ever since she gave birth to her fourth child in 2003, Michelle Celona, a 43-year-old part-time teacher in Philadelphia, had suffered from annoying bouts of constipation. Figuring it was the stress of carting three children around or the result of something that had changed in her body after pregnancy, she learned to live with it.
Marketing Fortified Food to Those Leery of DrugsBy MELANIE WARNER
But when the Dannon Company asked Ms. Celona in June if she wanted to participate in a two-week trial for Activia, a new fortified yogurt that the company said could help speed up what nutritionists delicately refer to as intestinal transit time, she jumped at the chance.
"I was skeptical that it would work," she said. "But if it's something I already like, then that's much better than popping a pill."
Dannon, the American division of the French company Group Danone, is counting on finding more people like Ms. Celona, who contend the yogurt worked as promised. The company expects to spend $60 million next year aiming at the 70 million Americans who suffer from digestive problems.
With health problems like diabetes, high blood pressure, arthritis and digestive disorders all on the rise, a growing number of food marketers are selling what the food industry calls functional foods, which promise a host of health benefits, from cholesterol reduction to immunity improvements to easing of intestinal problems.
Marketing solutions to health problems has traditionally been the realm of drug companies, but that is starting to change. As the baby boom generation ages and Americans become increasingly concerned about their health, packaged food companies see a big marketing opportunity. Television, radio and print commercials scheduled for February for Activia yogurt, which contains specific beneficial bacteria that work in the colon along with the body's own bacteria, will feature women talking about their irregularity problems. Activia will be available in supermarkets in mid-January.
Elations, a new flavored beverage from a company run by a team of former Procter & Gamble executives, promises "joint flexibility" and contains the nutritional supplements glucosamine, which is believed to play a role in cartilage formation and repair, and chondroitin, a natural component of cartilage that is thought to help with elasticity.
Next month, PepsiCo will start selling a new version of its Tropicana orange juice containing three grams of fiber per serving (in the form of starch in which molecules have been rearranged to resist digestion). It will join several brands of Tropicana that are already enhanced with various vitamins and minerals and that profess to benefit the heart and the immune system and to make children's bones strong.
In making such assertions, companies are dodging Food and Drug Administration regulations that require a rigorous approval process for health claims. Marketers are not required to get agency approval for claims that talk about the body's "normal, healthy structures and functions," only for references to specific diseases or health conditions.
As a result, Dannon's marketing promises that Activia will help "regulate your digestive system," but the word "constipation" is not used.
Ads and packaging for Elations will refer to "joint flexibility" and "ease of movement," not arthritis.
Most major food and beverage companies say they are working on functional food projects, though some are taking a wait-and-see approach.
At an investor meeting a little over a year ago, the chief executive of Coca-Cola, E. Neville Isdell, said carbonated soft drinks would be "carriers of health and wellness benefits." But the company has yet to market any such products.
How big is the functional foods market? According to some reports, it could be huge. A study by Gerard Anderson, a professor of health policy and management at the Johns Hopkins University Bloomberg School of Public Health, found that 48.4 percent of all Americans in 2002 suffered from at least one chronic health condition, from hypertension to asthma to heart disease, up from 44.7 percent in 1996.
Marketing surveys also show that more Americans are interested in natural solutions to health issues.
"People are getting nervous about pharmaceuticals," said Faith Popcorn, who runs BrainReserve, a marketing company. "If it's food, people trust it more. And people are also so happy to hear that something they love to eat is also good for them."
Ms. Popcorn cites the Vioxx situation - in which millions of pain sufferers were told that the anti-inflammatory drugs they were taking might increase their risk of heart attacks - and the high price of drugs as factors spurring consumers to seek out drug-free remedies.
According to a BrainReserve survey in 2004, 65 percent of people said they were using diet to treat an illness, whether through a low-fat regimen, a diet of organic food or a higher intake of certain kinds of food.
While many scientists promote the healing powers of a diet based on whole grains and lots of fruits and vegetables, some are skeptical of the idea that specific conditions should be treated through packaged food products.
Alice H. Lichtenstein, a senior scientist at the nutrition research center at Tufts University, says she believes that people who may be in need of additional nutrients, cholesterol-lowering plant sterols or extra fiber should get them through a multivitamin or pill-based supplement.
"The danger with this is that people will add food to their diet, rather than substitute, and then they'll end up consuming more calories, which would not be good," Dr. Lichtenstein said.
Food companies say many people do not like to take pills and find it easier to get nutrients or supplements in a food or a beverage that they may be consuming anyway.
But getting people with high cholesterol to buy a cholesterol-lowering cereal or those with constipation to eat more yogurt has proven difficult. Over the last 10 years, many attempts to market functional foods have fallen flat.
Marketing experts say Americans crave quick, simple solutions for better health, but they are also wary of big promises that do not ring true.
In 1999, the Kellogg Company devoted extensive resources to Ensemble - a line of cereals, cookies, lasagna, frozen entrees and baked potato chips that contained psyllium, a soluble fiber that has been proved to reduce cholesterol - only to take it off the market nine months later because of poor consumer response.
Similarly, analysts say that Cadbury Schweppes's 7UP Plus, a soda fortified with calcium and vitamin C and marketed as good for bones, has underperformed relative to other recent soda introductions. Several months ago, the company took out the vitamin C and said it would introduce two new flavors.
Lauren Radcliffe, a Cadbury spokeswoman, said that the company remained excited about 7UP Plus and was planning an ad campaign for the first quarter of 2006.
Harvey Hartman, chief executive of the Hartman Group, a Seattle consulting firm, said consumers might be likely to respond to health claims for certain foods or beverages, but soda was not one of them. "Juice, yogurt, cereal, bars, these things make sense," Mr. Hartman said. "They're already perceived as being relatively healthy."
Coca-Cola's Minute Maid brand, for instance, has had strong sales for its Heart Wise orange juice with plant sterols. Sales for Heart Wise are up 39 percent over the last year, versus a decline of 3.5 percent for regular Minute Maid juice, according to Information Resources Inc., a marketing information company.
Juan Carlos Dalto, chief executive of Dannon, said yogurt was an ideal food for health benefits. "Yogurt is already perceived as a health product and most people realize that it already has bacterial cultures," he said. "With Activia, we're just adding a specific strain that offers a specific benefit."
Dannon's bacteria strain, Bifidus regularis, is part of a class of bacteria that already exists in the digestive systems of most healthy people. The company has sponsored four studies showing that among people who are irregular, consumption of one four-ounce container of Activia yogurt a day leads to as much as a 40 percent reduction in the amount of time it takes food to exit the digestive system.
People with constipation or other digestive maladies may have a shortage of beneficial bacteria as a result of improper diet or heavy use of antibiotics, which tend to kill good bacteria along with the bad.
"We are saying that, after two weeks, Activia naturally regulates your digestive system," said Andreas Ostermayer, Dannon's senior vice president for marketing.
Scientists say that healthy bacteria, or probiotics, can be effective in helping to alleviate minor intestinal disorders, but certainly are not a cure-all remedy and may not work for everyone.
The yogurt is already a blockbuster product for Groupe Danone in Europe and Asia. The company says sales of the product, which was introduced in France in 1997, have grown by 24 percent a year from 2000 to 2004 and it is now its fastest-growing product, representing 4.1 percent of Groupe Danone's 2004 sales of $16.2 billion.
Mr. Ostermayer said that Dannon waited to release the product in the United States until the company had done extensive testing and believed it could get the marketing right. The company spent the last two years doing consumer tests and going to medical conferences to educate doctors about the benefits of probiotic bacteria.
The Elations Company is also trying to foster a greater awareness among doctors of its particular ingredients. The company is promoting the findings of a recent arthritis study that was done independently and without involvement from the company. The study, funded by the National Institutes of Health, the government's main vehicle for conducting medical research, showed that glucosamine and chondroitin were effective in treating pain associated with osteoarthritis of the knee.
Mr. Hartman, the Seattle consultant, said that while functional foods had always been a great idea, the category is an enigma.
"It hasn't been nearly as successful as people thought it would be," he said.
But Mr. Hartman added that if a manufacturer could crack the code, getting the product and the marketing right, the opportunity to appeal to the millions of Americans looking to food for health solutions was "huge."
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