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What are digestive enzymes?

Digestive enzymes are active proteins produced by the mouth, stomach, pancreas and small intestine to break down food into nutrients that can be absorbed by the body. Our bodies produce a number of enzymes to help with digestion. They are involved in breaking down proteins, fats, and carbohydrates down into their building compounds which are amino acids, fatty acids and simple sugars respectively.

Issues with Digestive Enzymes

A number of health problems can be linked to nutrient malabsorption due to the lack of digestive enzymes (1). Low enzymatic activity can lead to the slowing of the digestion process and uncomfortable symptoms. A common example is lactose intolerance. A number of adults do not produce enough lactase to break down the dairy sugar lactose. This leads to higher lactose in the digestive tract and more bloating, flatulence and diarrhea. Various health conditions can lead to low levels of digestive enzymes. Examples include cystic fibrosis, chronic pancreatitis (inflammation of the pancreas), and pancreatic cancer.

Health benefits of digestive enzymes

Digestive enzymes can be prescribed or be taken as supplements. Pancreatic enzyme supplementation is the treatment for people suffering from exocrine pancreatic insufficiency (EPI) in chronic pancreatitis, pancreatic cancer, cystic fibrosis or diabetes (2-7). Enzyme supplementation is also used for lactose intolerance. It is estimated that 75% of people worldwide experience a decrease in their ability to break down lactose, especially during adulthood (8).

Digestive enzyme supplements are available for people who do not have clinical illnesses but need some aid in digestion. In a broader sense, if you have any problems with digestion, supplementing with digestive enzymes can help

  • Improve the availability of nutrients that would otherwise have been not absorbed by the body
  • Improve energy levels as a result of more nutrients being available such as sugars
  • Help reduce gas and bloating caused by undigested plant product

Features of Digestive Enzymes

The majority of digestive enzymes for breaking down carbohydrates, lipids and proteins are produced by the pancreas (9). The pancreas produces proteases to break down proteins into amino acids but bacterial and fungal proteases in our gut also aid in digestion. Some supplements contain Papain, another protease, that can be isolated from the papaya fruit (10). Lipases are involved in breaking down fats into simpler fatty acids for absorption. They catalyze the partial or complete hydrolysis of triacylglycerols. They are commonly supplemented for digestive disorders of lipids (11).

The main enzymes involved in breaking down carbohydrates are amylases, diastases, cellulases, xylanases, iand lactases. Not all of these are naturally produced by humans during digestion. Alpha-amylase is the main carbohydrate digestion enzyme produced by us. It is primarily made in the pancreas and salivary glands. Cellulases and xylanases break down complex plant carbohydrates like cellulose and xylan. These are not produced by us but can be produced by our bacterial flora. Cellulase converts cellulose to beta-glucose which is one of the main forms of energy for the body (12). A multi-enzyme formula containing cellulase can lead to improved protein absorption as well as immune support (13). While we are unable to produce xylanase we digest around 72% of the xylan we ingest with the help of our gut flora (14,15). Lactase is usually found in higher levels in infants but decreases with age and can lead to a deficiency later in life. The levels of lactase in complex digestive enzyme supplements are not as high as those required for those suffering from lactose intolerance. The levels are sufficient to aid with digestion. Diastase is a fungal amylase that has a high efficiency compared to bacterial amylases (16). Invertase converts sucrose (common table sugar) into its component parts, glucose and fructose. All of these enzymes together work together to more completely break down the complex carbohydrates our bodies ingest such as grain, nuts, starches, salad leaves, corn etc.

What to look for while buying digestive enzyme supplements?

There are certain things to look for while buying supplements

  • Price – While it might be easy to go for the cheapest product, it is important to know you are getting your bang for your buck. Check to see the units of the enzymes you are getting with your buy to make sure you are getting what you need.
  • Reputation – Make sure the company you are buying from has a good reputation for producing these supplements and that they can be trusted.
  • Multiple enzymes – A multiple enzyme products will give you the most benefit. These will have the enzymes discussed to break down protein, carbohydrates, and fats.
  • Potency – It is important to check the enzyme units included in each pill. This will tell you the dose of enzyme you are taking. Only weak products will not list the dose. The benefit of bacterial and fungal-derived enzymes is that a lower dosage can be very effective and that they have a broader pH range of activity in comparison to animal sources (17).

How to read the units for the digestive enzymes?

The units for enzyme activity are set by the food chemicals codex (FCC) which is a division of the USP (United States Pharmacopeia). This gives you the activity of the enzyme. For example, a cellulase enzyme might be listed as “18 mg (90 FCC CU)”. This would mean that it has 90 units of activity of the cellulase enzyme for breaking down cellulose based on the FCC standards.

Which digestive enzyme supplement would you recommend?

The MapleLife Digestive Enzymes provide a complex mixture of enzymes for the digestion of carbohydrates, proteins, and lipids. The enzymes discussed in this article can all be found in these pills. MapleLife is a highly recommended brand.  They have included high-quality enzymes as shown in the enzyme activity units listed in these pills. They have also made it accessible at a fantastic price.

FAQ

How do I know if I have a problem digesting my food?

If you have problems with gas or bloating after meals, get full after a few bites of food or feel heavy in your abdomen (like you have food sitting in your stomach), you might have some issues. Other signs to look for would be undigested food in your stool, an oily floating slick in the toilet bowl (indicating undigested fat) and consistently floating stools.

How safe are digestive enzymes?

Digestive enzymes are fairly safe. It is important to only take a pill at a time for your first dose with a meal and monitor changes in your stool and overall digestive comfort.

When should I take digestive enzymes and how much should I take?

Digestive enzymes should be taken with food. At first, one pill with the main meal should be taken and the effects should be seen. There is no need to take them with snacks unless you have major issues.

Are there any precautions?

Very few side effects and allergies have been seen with digestive enzymes but some precaution should be taken just in case. Do not leave these pills in your mouth for a long duration as these contain active enzymes and can lead to gum or cheek irritation.  If you have any diarrhea, abdominal pain/cramps or nausea while taking this product, it might not be right for you. Please consult a doctor or pharmacist. Allergies to these pills are rare but if you have any rash or swelling, please consult a doctor.

Do not take these pills if you are sensitive to wheat, celery, papain, carrot, fennel, cypress pollen, and grass pollen, as well as the plant family that includes ragweed, chrysanthemums, marigolds, daisies and echinacea. If you’re allergic to any of these foods or plant, then you may find that you’re allergic to bromelain and vice versa. Digestive enzymes should only be combined with blood-thinning drugs like warfarin (Coumadin) under a doctor’s supervision.

References

 

  1. Keller, J., & Layer, P. (2005). Human pancreatic exocrine response to nutrients in health and disease. Gut, 54 Suppl 6(suppl 6), vi1-28. https://doi.org/10.1136/gut.2005.065946
  2. Olesen, S.S.; Juel, J.; Graversen, C.; Kolesnikov, Y.; Wilder-Smith, O.H.; Drewes, A.M. Pharmacological pain management in chronic pancreatitis. World J. Gastroenterol., 2013, 19(42), 7292-7301.
  3. Zubarik, R.; Ganguly, E. The rosemont criteria can predict the pain response to pancreatic enzyme supplementation in patients with suspected chronic pancreatitis undergoing endoscopic ultrasound. Gut Liver, 2011, 5(4), 521-526.
  4. Heather, A. Wiera and Robert J. Kuhnb. Pancreatic enzyme sup- plementation. Curr. Opin. Pediatr., 2011, 23, 541-544.
  5. Borowitz, D.; Stevens, C.; Brettman, L.R.; Campion, M.; Chatfield, B.; Cipolli, M.; Liprotamase 726 Study Group. International phase III trial of liprotamase efficacy and safety in pancreatic-insufficient cystic fibrosis patients. J. Cyst. Fibros., 2011, 10(6), 443-452.
  6. Domínguez-Muñoz, J.E. Pancreatic enzyme therapy for pancreatic exocrine insufficiency. Curr. Gastroenterol. Rep., 2007, 9(2), 116- 122.
  7. Imrie, C.W.; Connett, G.; Hall, R.I.; Charnley, R.M. Review arti- cle: enzyme supplementation in cystic fibrosis, chronic pancreatitis, pancreatic and periampullary cancer. Aliment. Pharm. Ther., 2010, 32(Suppl 1), 1-25.
  8. Kanabar, D.; Randhawa, M.; Clayton, P. Improvemento of symptoms in infant colic following reduction of lactose load with lac- tase. J. Hum. Nutr. Dietet., 2001, 14, 359-363.
  9. Roxas, M. The role of enzyme supplementation in digestive disor- ders. Altern. Med. Rev., 2008, 13(4), 307-314.
  10. Smith RG. Enzymatic debriding agents: an evaluation of the medical literature.  Ostomy Wound Manage 2008;54(8):16-34.
  11. Lipase.  In: Sweetman S.  Eds. Martindale, The Complete Drug reference. The Pharmaceutical Press: London; 2009:2362.
  12. Abeles FB. Abscission: role of cellulase. Plant Physiol. 1969;44(3):447-52.
  13. Glade MJ, Kendra D, Kaminski MV Jr. Improvement in protein utilization in nursing-home patients on tube feeding supplemented with an enzyme product derived from Aspergillus niger and bromelain. Nutrition. 2001 Apr;17(4):348-50.
  14. Zhang M, et al. Xylan utilization in human gut commensal bacteria is orchestrated by unique modular organization of polysaccharide-degrading enzymes. Proc Natl Acad Sci. 2014;111(35),E3708-E3717.
  15. Joshi S, Agte V. Digestibility of dietary fiber components in vegetarian men. Plant Foods Hum Nutr. 1995;48(1),39-44.
  16. Sivaramakrishnan  S, Gangadharan D,  Nampoothiri KM, Soccol  CR, Pandey A. Alpha amylase production  by Aspergillus oryzae employing solid-state fermentation. JSIR. 2007;668.
  17. Griffin, S.M.; Alderson, D.; Farndon, J.R. Acid resistant lipase as replacement therapy in chronic pancreatic exocrine insufficiency: a study in dogs. Gut, 1989, 30, 1012-1015.