The world is getting older, and with that comes a heightened interest in healthy ageing. According to the World Health Organization, the proportion of the world's population over 60 years old will nearly double from 12% to 22% between 2015 and 2050¹. As a result, academia has shown increased interest in conducting research into how we can explain the negative health effects associated with ageing, and consequently stay as healthy as possible for as long as possible. One of the findings which has emerged is that the degree of inflammation present throughout the body is one of the most important components of healthy ageing. Academics have coined this phenomenon inflammaging.

Inflammaging refers to the chronic low-grade inflammation that we all develop as we age. Although everyone will be affected by inflammaging to some degree, the degree of inflammation has been shown to vary substantially. Furthermore, this chronic inflammation has been identified as a key risk factor for a whole host of diseases. While the exact mechanisms behind chronic inflammation are complex and not yet fully understood, the extent to which we experience inflammaging is known to be influenced by a combination of genetic factors, lifestyle choices, environmental exposures, and crucially, our diet².

Diets are known to worsen as we age. Nutrition deficiencies are commonly observed in the elderly population due to a mix of physical, sensory, mental, and social impairments³. As a result, much of the elderly population turns to supplements. This is evidenced by the over 60s age bracket recording the highest usage rate of supplements across countries. 74% of US consumers over the age of 60 report taking at least one supplement daily and 54% reported taking multiple supplements⁴.

At the same time, awareness of inflammaging and chronic inflammation is spreading from academia into the mainstream, as mentions of inflammaging are beginning to crop up throughout social media (Figure 1). Not only will this make the younger generation more aware of inflammaging, but it ties in with the broader wellness and self-care trends evident amongst gen-Z and millennial consumers. The younger generations are becoming more proactive than ever in taking charge of their health and well-being, such as by seeking out products that offer preventive benefits beyond merely addressing symptoms.

This combination of an older generation who are used to taking supplements with a proactive, health-conscious, younger generation, makes for a very positive growth outlook  for the inflammation segment of the OTC inflammation market. Supplements indicated for inflammation is a segment which has traditionally been dominated by products containing primarily turmeric extract. However, this consumer demographic shift due to an increased awareness of inflammaging, coupled with a growing body of literature on the benefits of other active ingredients, presents an opportunity for new products to shape the future of the market.

Inflammation is more significant than we thought

Inflammation is a natural process that our bodies undergo in response to injury or infection. It plays a vital role in our immune system's defence mechanism, helping to eliminate harmful pathogens and initiate the healing process.

During inflammation, injured or infected cells release signalling molecules, such as cytokines, which attract immune cells to the affected site. Immune cells then carry out various functions, including engulfing and destroying damaged cells and pathogens, releasing enzymes and reactive oxygen species, and promoting tissue repair. This process can lead to characteristic signs of inflammation, such as swelling, redness, heat, and pain⁵.

Once the immune cells have completed their task and eliminated the threat, the body signals to stop inflammation. This is a crucial step to prevent the depletion of our body's resources. The body's ability to effectively start and stop inflammation after accomplishing its purpose is what is referred to as acute inflammation. Acute inflammation is defined as a short-term, localised immune response that occurs in direct response to injury or infection. It is a beneficial process for our overall health and helps restore normal tissue function.

Chronic inflammation is a different story. It is an ongoing, long-term inflammatory response that persists even in the absence of injury or infection. Unlike acute inflammation, which is temporary, chronic inflammation can last for extended periods, ranging from months to years. Symptoms of chronic inflammation are varied, but commonly include full-body pain, chronic fatigue, depression, and gastrointestinal complications⁵.

Recent research has shown that chronic inflammation is a major contributor to the development of various chronic conditions. It is particularly relevant for cardiovascular diseases, where it can cause the formation of plaques in blood vessels that can rupture and lead to heart attacks or strokes⁶. Additionally, the immune system is closely linked to metabolism, and inflammation in tissues such as fat, brain, liver, and pancreas has been found to be a contributing factor to various metabolic diseases such as Type 2 diabetes⁷. Figure 2 shows a non-exhaustive list of major conditions which have been shown to be influenced by chronic inflammation.

Inflammation supplements for all

As the population continues to age, the issue of inflammaging becomes increasingly prevalent⁹. Encouraging research has shown that inflammation can be effectively controlled through healthy diet¹⁰. At the same time, diets have been shown to worsen as people age⁹. This is where the role of supplements becomes crucial. By incorporating high-quality supplements into their daily routine, older individuals can reduce chances of inflammaging, chronic inflammation, and promote their overall well-being. As previously mentioned, the older age groups are the largest consumers of supplements, and their rate of supplement use is expected to continue to increase⁴.

At the same time, newfound understanding of inflammaging and its effects should also resonate with younger consumers who are increasingly interested in health, wellness, and anti-ageing. We can therefore also anticipate a growing demand for inflammation supplements, taken as preventative measures, among this age group.

Concurrently, the evidence body demonstrating the effectiveness of dietary supplements in controlling inflammation is growing⁹, which will resonate with both consumers and healthcare professionals. Healthcare professionals becoming more likely to recommend supplements to their patients could increase consumer demand across all demographics.

Sector & Segment estimates the US market for inflammation supplements have grown at a CAGR of approximately 6.3% since 2010. Due to the aforementioned ageing population, coupled with increased interest around inflammaging, disease prevention, and supplement use, we expect this market to outstrip its old growth rate, growing at a rate of 10.2% CAGR until 2033.  

The landscape so far

Amazon.com provides a good lens through which to analyse the US inflammation supplement market, as a survey by Trust Transparency showed that 55% of US consumers purchased their supplements online, of which the vast majority were purchased through Amazon¹¹. Online supplement sales have also been the fastest growing sector for supplement sales throughout the last decade, which was further accelerated by the COVID-19 pandemic.

A diverse offering of inflammation supplements are available on Amazon, but the market is largely dominated by turmeric.  In fact, 19 of the 20 best sellers for inflammation all contain curcumin, the active ingredient which gives turmeric its anti-inflammatory effects (the only exception is NutriFlair’s Organic Ceylon Cinnamon Extract). Many of these products go a step further to include ingredients which have been shown to enhance the anti-inflammatory effects of turmeric, such as ginger and black pepper^12,13, further demonstrating the strong association between turmeric and inflammation amongst consumers.

Despite the popularity of turmeric, there are some issues associated with its usage that should be taken into consideration. Firstly, turmeric has been shown to have poor bioavailability¹⁴, which means that the body may not absorb it efficiently (some evidence does show that combining turmeric with black pepper can help improve its absorption). Secondly, turmeric may have potential drug interactions with blood thinning medications, drugs that reduce stomach acid, and diabetes medicine¹⁵. Finally, higher doses of Turmeric have been associated with symptoms such as nausea, diarrhoea, and headache¹⁶. When analysing the consumer reviews of the top turmeric supplements, many consumers echoed these side effects, as well as acid reflux.

Figure 4 shows the current best selling turmeric supplement by BioSchwartz, with over 40,000 sales in the past month (October 2023). It also shows the next three best-selling products positioned for inflammation which do not contain turmeric. Although sales volumes are lower than turmeric for these products, over 1,000 monthly sales for each indicate an opportunity for other active ingredients to carve out a customer base within this segment.

These other active ingredients shown in Figure 4 are also not without shortcomings. Certain forms of cinnamon supplement have been shown to cause liver damage in certain people¹⁷, as well as triggering allergic reactions and gastrointestinal side effects¹⁸. Although there is limited evidence of Oregano extract resulting in any severe side effects, consumer reviews mention that it can similarly cause allergic and gastrointestinal distress. Finally, case reports exist of neem oil causing vomiting, kidney, and brain failure in children¹⁹, as well as having a long-term contraceptive effect in men²⁰.

New Challengers

As the demographic shift continues and inflammaging gains more popularity, we expect important changes in the inflammation supplements market as more players are attracted. Interestingly, the non-turmeric ingredients in Figure 4 were rarely mentioned in health articles talking about inflammaging or chronic inflammation. Instead, the ingredients which are most frequently cited alongside turmeric are Vitamin D, Omega-3, and to a lesser extent Resveratrol (a chemical frequently found in red grapes). Although each of these ingredients comes with its own set of pros and cons, we believe each has a chance to shape the future of the market, given the right approach.

Vitamin D

Vitamin D deficiency has been linked to various inflammatory diseases²¹, and studies have shown its ability to improve inflammatory markers such as MCP-1, IL-6, and IL-8²². With its wide recognition as a beneficial supplement, particularly for bone health and immunity, it may have the broadest market reach among inflammation ingredients. This can be a double-edged sword, as these benefits can overshadow Vitamin D’s anti-inflammatory effects. At the same time, manufacturers should be weary not to overemphasize the anti-inflammatory effects at the cost of other health benefits with higher awareness among consumers. In addition, taking excessive amounts of Vitamin D supplements can lead to harmful effects like nausea, vomiting, poor appetite, and weight loss. Consumers taking Vitamin D also need to be aware of potential drug interactions with statins and corticosteroids²³.

Omega-3

Studies have demonstrated that n-3 PUFAs (Omega-3) can effectively improve levels of inflammatory markers such as CRP, TNF-α, and IL-6 in individuals with various health conditions²⁴. Omega-3 supplements similarly enjoy high consumer awareness, an established demand, and a wide market reach, making them a reliable choice. However, the price of Omega-3 supplements may be a consideration for some consumers. It is also worth noting that some individuals may experience fishy-tasting belching, acne exacerbation, nausea, or diarrhoea²⁵.

Resveratrol

Resveratrol, known for its potent antioxidant properties²⁶, offers a novel ingredient which is strongly associated with inflammation. At the same time, it is important to acknowledge that Resveratrol has limitations in terms of poor solubility and bioavailability, which may impact its effectiveness²⁷. Compared to Omega-3 or Vitamin D, Resveratrol is also less recognised and familiar to consumers.

Other Contenders:

Boswellia, Quercetin, Bromelain, Glutathione, Sulforaphane, and Cayenne Pepper are part of a group of niche ingredients with the potential to alleviate inflammation, among other health benefits such as joint health²⁸, gut health²⁹, and cognitive function³⁰. While they possess anti-inflammatory properties, their successful adoption may require comprehensive consumer education.

Looking to the Future

In summary, the changing landscape of the health and wellness industry indicates exciting future prospects for inflammation supplements. As the ageing population seeks solutions for healthy ageing, and as younger generations become more health-conscious, supplement companies have a unique opportunity to meet evolving consumer needs. Navigating this evolving landscape requires a forward-looking approach, both by considering the changing needs and expectations of consumers, and staying abreast of regulatory developments. Product innovation which maximises both efficacy and brand resonance will be the key to shaping the future of this field.

How we can help

Sector & Segment has extensive experience supporting companies through every stage of launching a new product or campaign. Some of our areas of expertise include:

• Conducting competitive analysis to identify market gaps
• Conducting digital listening and identifying trends in consumer voices
• Translating consumer insights into improving your product offering, pipeline, and positioning
• Concept testing new products or campaigns with consumers and healthcare professionals

For further assistance and information, please don't hesitate to contact us at info@sectorandsegment.com.

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