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Enzymes Play an Important Role in Digestion: Digestive enzymes break down foods into the nutrients that fuel your body.

When you eat a delicious meal, you might not think about what's happening to the food as it goes into your stomach--but the minute you start eating, a collection of digestive enzymes goes to work They break down the food and beverages you consume so your body can absorb the nutrients from your meal.

"Without the necessary enzymes, the food you eat isn't broken down completely, which can lead to nutrient deficiencies, weight loss, malnutrition, diarrhea, abdominal pain, bloating, and gas," explains registered dietitian Colleen D. Webb, MS, RDN, a dietitian at the Jill Roberts Center for Inflammatory Bowel Disease at Weill Cornell.

Amylase, Protease, and Lipase

The most well-known digestive enzymes are amylase, protease, and lipase. These are responsible for the bulk of carbohydrate, protein, and fat digestion, respectively. But these digestive enzymes also work with other enzymes in the complex process of digestion.

Amylase is produced by the salivary glands and pancreas. It's responsible for breaking down starches into simpler sugars, such as maltose. These sugars, plus other sugars such as sucrose (table sugar) and lactose (milk sugar), require further digestion by another set of enzymes called "brush border" enzymes, Webb says.

Your intestinal lining contains tiny microvilli, which are brush-like protrusions that stick out from cells along the intestinal wall. The brush border enzymes in the microvilli complete the last phase of digestion before the sugars are absorbed into the body. Brush border enzymes include lactase (which breaks down lactose), sucrase (which breaks down sucrose), and maltase (which breaks down maltose).

Any enzyme that helps break down protein is a protease. The digestive enzyme pepsin begins protein digestion in the stomach, but Webb notes that most protein digestion happens in the small intestine, thanks to other proteases, including trypsin and chymotrypsin, that are secreted by the pancreas.

Fat (lipid) digestion also begins in the stomach. It starts with gastric lipase before it enters the small intestine, where it is further broken down by a variety of pancreatic lipases before it undergoes a complicated absorption process.

Causes of Enzyme Deficiencies

Despite digestive enzymes' importance for healthy digestion, you may not have a particular enzyme, or you may have poor production of one or more digestive enzymes. Problems with your pancreas, such as pancreatitis or cystic fibrosis, can affect the production of certain enzymes. Celiac disease, an intolerance to gluten-containing grains such as wheat and barley, may cause damage to the brush border in the intestine if the disease is not treated.

Other potential causes of low enzyme production include:

I Chronic stress

* Low-grade inflammation

* Aging

* Low stomach acid.

However, not all enzyme deficiencies are serious.

"Many people are familiar with lactose intolerance," Webb explains. "Lactose intolerance occurs when people are deficient in lactase. As a result, lactose travels to the large intestine, where it is fermented by bacteria and causes gas, bloating, and diarrhea."

To find out if you lack any digestive enzymes, your doctor can order blood, urine, stool, or breath tests to identify various deficiencies. Symptoms, past medical history, and food sensitivities can also help healthcare providers determine if you're deficient in certain enzymes.

Enzyme Supplements

If you are low in a particular enzyme or you are missing an enzyme, you may improve your digestion by taking digestive enzymes in supplement form.

"I frequently recommend over-the-counter, comprehensive digestive enzymes for my patients with small intestinal bacterial overgrowth, Crohn's disease of the small intestine, irritable bowel syndrome, and complaints of abdominal bloating or gas," Webb says. "These supplements provide you with enzymes that are lacking, and they also give you some enzymes that are not produced in the human body that also aid in digestion."

Before taking digestive enzymes, Webb recommends checking with your healthcare provider.

Supplements aren't regulated by the U.S. Food and Drug Administration (FDA), which means their quality, potency, and purity may vary. Look for digestive enzymes that have been certified by third-party certification organizations. For example, enzyme supplements certified by the Good Manufacturing Practice (GMP) means they are produced and controlled according to strict standards.

WHAT YOU SHOULD KNOW

* Digestive enzyme supplements should be taken, if at all, on a short-term basis. Lactose intolerance and similar conditions may be better managed by long-term diet changes rather than long-term supplement consumption.

* Consuming too many processed foods and foods that contain environmental toxins may impair enzyme production. Eating more fresh fruits and vegetables may help preserve your enzyme health.

* Chronic stress may be the most common cause of low enzymes. When your body is in the" fight-or-flight" mode associated with stress, digestion isn't a high priority, so enzyme production can suffer.
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Title Annotation:MEDICAL NUTRITION
Publication:Women's Nutrition Connection
Date:Jan 1, 2018
Words:767
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