Enzymes: Breaking It All Down in ASD

Addressing digestive issues can lead to improved digestion for ASD kids... and you.

One can judge the efficacy of a given supplement by the length of time it survives in the market. Parents of children on the autism spectrum are adept at quickly deducing what works for their kids—and if the product does not produce results, it rapidly disappears. Many supplements have come and gone in the dozen or so years since enzymes first hit the autism scene, but enzyme supplements are more popular than ever. The increased use of enzymes as part of dietary programs to support the GI tract indicates they do work, but many parents still do not understand how enzymes help digestion. The lactose factor Replacing or altering metabolic enzymes is difficult and usually requires genetic manipulation. But digestive enzymes (see Enzymes 101), which make up a very tiny fraction of the body’s enzyme load, are different. Enzymes involved in digestion function outside of cells but within the GI tract to break down food proteins, carbohydrates, starches and triglyceride fats. As such, these enzymes can be replaced or supplemented orally with great effectiveness. One example of enzyme supplementation is the use of lactase, an enzyme that breaks down the carbohydrate disaccharide lactose to glucose and galactose, which are simple sugars. Many of us become lactose intolerant after the age of 30, and eating dairy products can be a painful experience if lactase is not available to break down lactose. Symptoms include bloating, gas, cramping, and watery stools—but taking a capsule of lactase enzyme can easily allow one to enjoy cheese and ice cream without the unpleasant side effects of lactose intolerance. Digestion and ASD So how do enzymes help the digestion of those with spectrum disorders? Food intolerance is a condition widely found in those with autism, though it is by no means restricted to autism. The causes of food intolerance are not always known, but in many cases the intolerance occurs due to incomplete breakdown of foods during the digestive process. This is most notable with food proteins, which are composed of amino acids. Think of amino acids as letters, and proteins as words. Just as specific sequences of letters form specific words, specific sequences of amino acids produce different proteins. If you change the “letter,” you change the meaning of the “word.” Digestion is supposed to completely break down proteins to amino acids. However, some proteins are only partially broken down while in the small intestine. The small protein fragments produced from incomplete digestion are called peptides. Peptide production during digestion is actually quite normal, and eventually even peptides are broken down completely way downstream in the gut. However, in some individuals these peptides can produce biological effects, some of which are helpful, while others are problematic. With certain individuals, the effects are observed in both digestive functions and behavioral responses. Loose stools or constipation may occur, and certain behaviors may be exhibited—for example, lack of attention, hyperactivity, or sleep issues. If a pattern of eating certain foods is associated with certain repeatable behaviors, then it may be possible to address these problems through dietary intervention. By understanding how certain foods are processed in the gut during digestion we can then address the underlying problems of food intolerance with the use of appropriate enzyme supplements. Changing the Digestive Landscape The problem for those with food intolerance is that the bulk of protein and carbohydrate digestion is in the same part of the gut that nutrient absorption occurs. Peptides and disaccharides are formed, absorbed, and may enter the systemic circulation through active or passive transport mechanisms found in the gut wall. If gut inflammation is present, these compounds can enter the circulation much easier. Once in the bloodstream, these compounds can pro- duce effects in other parts of the body. Taking supplemental enzymes can greatly change the digestive landscape—however, the enzymes taken orally must be from non-pancreatic sources, as these are not stable to stomach acid. Plant-based enzymes derived from fungal sources are the most common over-the-counter enzyme supplements and are active even in stomach acid. When taken with a meal, the enzymes start the breakdown of foods while the food is still in the stomach. Any food eaten will remain in the stomach from 90 to 180 minutes depending on the type and quantity of food. More importantly, foods and their nutrients are not absorbed from the stomach. This means that a food peptide can be tolerated while it is in the stomach but once it moves into the small intestine the peptide can be absorbed and become active. Therefore, one has a window of opportunity to address a potential food infraction before the infraction produces a resultant behavioral response. Wheat and dairy proteins can be safely broken down while those foods are still in the stomach using the correct combination of proteolytic enzymes. Sufficient enzyme must be dosed such that the enzymes have time to work on the food before the stomach empties. Contrary to popular belief, very little food breakdown occurs in the stomach. Pepsin is the major enzyme in the stomach and its primary purpose is to activate pancreatic enzymes once the food mass empties into the duodenum. So, by adding additional acid-stable enzymes (by oral administration) to the food mass in the stomach, we jump-start the digestive process. Enzymes in Autism  In the case of ingesting a food that is not tolerated, taking enzymes specific for the breakdown of that food may alleviate the intolerance. This function has received quite a bit of notice in the research community. Several research institutions have presented protease enzyme combinations as possible treatments for severe food intolerance such as celiac disease. Using protease enzymes that specifically address the structure of gliadin, a gluten peptide, researchers have demonstrated that gliadin production from gluten is inhibited. Since gliadin is the culprit that causes gut damage and immune problems in those with celiac disease, the effects of eating wheat are negated when these enzymes are used appropriately. While FDA approval is quite some time away, it is still gratifying to see the traditional research community emphasize the importance of plant-based enzymes in dietary problems. As stated earlier, the great majority of enzyme supplements are derived from fungal sources. Aspergillus niger, grown under controlled conditions, is the primary source of enzymes. Varying the growth conditions of the fungi produces different enzymes. Japan is the primary source of enzyme production. The combination of art and science used for centuries in Japanese enzyme production results in purified enzyme proteins without any fungal contamination. Enzymes are most likely the safest dietary supplement available. Studies conducted with humans taking large amounts (up to 10 grams or more) of various enzymes over a period of time showed no ill effects. Enzymes are proteins and any protein has the potential to be allergenic, so one should insure that no sensitivity to enzyme protein exists prior to taking standard doses. Optimizing the Dose Dosing of enzyme products is based on the amount of food eaten, not body weight or age. There are many factors to consider for determining optimal dosing: diet, gut health, environment, etc. Since the safety factor for enzyme dosing is so large, we recommend experimenting with different dosing. You can use the enzyme supplier’s dosing recommendations as a guideline but keep in mind that individuals are different. It is best to start with low amounts and work up to a dose that produces the desired result. One other indication that enzymes are providing help in the autism community is the proliferation of supplement companies now offering enzyme products. Unfortunately, many of these companies have no real experience or expertise in the use of enzymes. Anybody can contact an enzyme manufacturer and become a supplier of enzyme products. However, that does not guarantee a product that will produce results.

Base your choice of enzyme product on the knowledge and expertise shown by the company. Look for a company with actual hands-on experience in characterizing and purifying enzymes. Ideally, the staff should include a doctoral-level scientist with actual laboratory research experience and publications in enzyme biochemistry. They should do their own formulation and relay the information to a reputable, GMP- compliant enzyme manufacturer. Different enzyme combinations can produce very different results so an understanding of how each enzyme works is essential to producing an effective product. Finally, the company should be responsive to any questions you may have concerning their products. A company should want to build a relationship with its customer so providing answers is paramount to establishing trust.

.   .   .   .   .   .   .   .   . Enzymes 101

The body produces an immense amount of enzymes. The vast majority of these enzymes are utilized within cells of every organ to regulate every metabolic pathway. Without enzymes to control the action of chemical reactions, life would not be possible—defects involving enzymes can lead to serious life-threatening conditions. The vast majority of enzymes produced by the body for digestion are found in
the gut, downstream from the stomach. Most of these enzymes are produced by the pancreas, which secretes them into the small intestine as food moves from the stomach into the duodenum (the first section of the small intestine). The majority of other enzymes are produced from cells lining the gut wall. Probiotic bacteria also contribute enzymes to do the finishing work of digestion in the colon.