Download - Enzymes and autism: Gut health, diet, and nutritional balance Devin Houston, PhD Autism One May 2012
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Enzymes and autism:
Gut health, diet, and
nutritional balance
Devin Houston, PhDAutism OneMay 2012
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Autism and the Gut
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Autism and Digestion
Decreased carb, starch digestion and transport
Fewer short-chain fatty acids produced
GI problems correlated with behavioral problems
Inefficient breakdown of food proteins
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Food Intolerance or Allergy?
• Usually dose related
• Often due to body’s reaction to food protein
• Symptoms involve mainly digestive system
• More people have food intolerances than allergies
Allergy
Food Intolerance
• Occurs quickly with even tiny bits of food
• Occurs every time
• Involves immune system, histamine release
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Causes of Food Intolerance
• Absence of enzyme needed to digest food
• Irritable bowel syndrome
• Food poisoning
• Sensitivity to food additives
• Recurring stress or psychological factors
• Celiac disease
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Food Intolerances in Autism
Wheat (gluten) Dairy (casein)
Polyphenols
Peptides
Deficient removal of sugar groups?
Histamine release?
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Starch and sugar intolerance
Dairy (sugars)
Lactose intolerance due to lactase enzyme deficiency
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Autism diets
• Gluten-free casein-free (GFCF)
• Specific carbohydrate diet (SCD)
• Body Ecology Diet (BED)
• Low oxalate diet (LOD)
• Gut and psychology syndrome diet (GAPS)
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Enzyme Supplements
• Complement restrictive diets.
• Work in stomach, start digestion earlier.
• Enzyme often achieve same goals as diets with less cost, more convenience and with faster results.
• Anecdotal improvements similar with enzymes and diet, indicating similar mechanism of action.
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Digestion of Proteins
Large Proteins Small peptides
Amino acidsEnzyme
Enzyme
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Starch Digestion
Complex carbohydrateGlycosidic bond
Glucose
Enzyme
Enzyme
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Triglyceride fat digestion
Lipase enzyme
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What Are Enzymes?
• Special proteins catalyze chemical reactions
• Unchanged during reaction
• Specific for single reaction
• Thousands of enzymes used in living systems• Metabolic – in cells, not replaced by oral supps• Digestive – Breakdown proteins, carbs, fats• Pancreatic (animal-based)• Plant-based (fruits, fungi, bacteria)
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Digestive Enzymes
• Break down whole foods into absorbable form
• Found in saliva, stomach, pancreas and intestine
• Produced by probiotic bacteria in colon
• Both pancreatic and plant-based enzymes available in oral form
• Plant-derived enzymes are acid-stable; can work in stomach AND GI tract
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How do enzymes help?
Break down proteins differently, more thoroughly Prevent production of exorphin and other peptides Requires optimal blend of protease and peptidase enzymes Function in stomach, no peptide absorption occurs
Break down starches, prevent gas and bloating
May mimic enzymes produced by probiotics
Modify polyphenolic compounds
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Understanding the Stomach
• “Safe” place for foods
• Keeps food for 2 – 5 hours
• Minimal food breakdown
• Supplemental enzymes shift digestion to stomach
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Enzyme Supplements
• Can address enzyme “deficiency”
• Shifts digestion from gut to stomach, a “safer” place to break down problem foods
• Are very safe, no toxicity at any dose
• Can provide benefits to anyone
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Structure determines Function
• Just like letters make up words, amino acids make up proteins.
• Function dependent on composition and sequence of amino acids.
• Change the structure, change the function.
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Structure determines Function
MOTHER
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Food Intolerances in Autism
Wheat (gluten) Dairy (casein)Peptides
CasomorphinGliadomorphinSoy morphins
OPIATE ACTIONS
EXORPHIN PEPTIDES
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DPP IV: Dipeptidyl Peptidase IV
• Only known enzyme to breakdown exorphins
• Produced by cells lining the GI tract
• Found in commercially available protease enzyme blends (Houston, DB; 1999)
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tyr-pro-phe-pro-glu-pro-ile
(1) Pepsin (2) Elastase
Bovine casein molecule
CASOMORPHIN
x-x-x-x-x-x-x-x- -x-x-x-x-x-x-x-x
“Normal” digestion of caseinin stomach and duodenum
Incomplete digestion of food proteins produces bioactive exorphin peptides
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DPP IV
X-pro-X-pro -X-pro-X
DPP IV effect on exorphins
X = any amino acid
Rule 1: Unblocked N-terminus (left side)
Rule 2: Proline must be next-to-last amino acid on N-terminus
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phe-pro-
(1) Pepsin
Bovine Casein
DPP IV
Casein amino acid sequence affected by DPP IV in stomach
x-x-x-x- -x-x-x-xtyr-pro- glu-pro- ile
No casomorphin formed!
X
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Bovine Casein
Protease 4.5 Protease 6.0
pro-glu-pro-ile-x-x-x-xx-x-x-x-tyr-pro-phe-
Using multiple proteases to prevent peptide formation
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Multiple proteases necessary for
complete protein breakdown
• Relying on DPP IV alone not sufficient
• Add other proteases with different peptide bond preferences to insure complete breakdown
• Studies of similar enzyme cocktails used in celiac trials, possible FDA approved treatment in future
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Carbohydrase enzymes for starches and carbs
• Studies indicate some children with autism may be low in disaccharidases
• Bacteria and yeast prefer to feed on undigested carbs in gut
• Cause of bloating, gas, loose stools when not broken down sufficiently
• Amylase, glucoamylase, lactase
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Enzymes for Polyphenolic Foods
• Highly colored fruits & veggies: good nutrition but not tolerated by some
• Raw veggies may be hard on GI tract
• Enzymes such as xylanase, cellulase, glucanase can help solubilize fiber
• Prevent “flushing” effect seen with certain foods and wines?
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Enzyme Dosing
•Experimentation encouraged, no toxicity, safe dosing
•Try taking enzymes at beginning of meal
•Base dosing on size of meal, not body weight or age
•May be taken with most medications or other supplements
•Effective with first dose for digestive results
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Avoid This Product!Supplement FactsServing Size:
3 CapsulesServings Per Container: 40
“Super-Duper” enzyme blend 505mgVegetal Analog of Pancreatin 286 mgAcid Stable Protease 12 mgAmylase
52 mgAmyloglocosidase 12 mgCellulase
5 mgLactase
5 mgCellulase
5 mgHemicellulase
3 mgLipase
125 mg*Daily Value not established
Values listed are based on serving size, be sure to check
Milligram units are useless for enzymes
Make sure “proprietary blends” are listed on label
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Better ProductSupplement FactsServing Size:
1 CapsuleServings Per Container: 120
Peptidase50,000 HUT
Xylanase 16,000 XUProtease 800 65,000 HUTAmylase
12,000 DUProtease 6.0 25,000 HUTGlucoamylase 25 AGULactase
1,500 ALUAlpha-galactosidase 200 GalUBeta-glucanase 30 BGULipase
200 FIP*Daily Value not established
Activity units guarantee active product
No “Proprietary Blend” hiding ingredients