Enzyme Supplementation: Good or Bad?

Are enzyme supplements good or bad? Lipski (2020) states that ten percent of 10 year olds, twenty percent of 20 year olds and fifty percent of 50 year olds have enzyme insufficiencies for a multitude of different reasons. Digestive supplements have been used to treat both adults and children with digestive issues (Lipski, 2020). Many different studies have looked at the application of these kinds of supplements for gastrointestinal issues. One review looked at animal, plant based and microbe derived enzymes as novel treatment options for digestive problems (Ianiro et al., 1980). Another review found many experimental studies showing that in pancreatic deficiency the organism is responsible for digestive compensation (Corring, 1980). An article saw that enzyme supplementation could be used clinically in digestive and absorption disorders and that application of enzymes may be beneficial for many conditions associated with poor digestion (Roxas, 2008). A 2014 study compared the use of a gastrointestinal motility enhancing drugs with a full spectrum digestive enzyme complex from a non-animal source for relieving digestive complaints (Quinten et al., 2014). An growth trial and a metabolism trial by Wang et al. (2005) investigated  the effects of dietary enzyme supplementation on performance, nutrient digestibility, intestinal morphology, digestive organ size, and volatile fatty acid profiles in animals. A randomized, double-blind placebo-controlled study found enzyme supplementation to be an effective and safe way to manage disease symptoms (Majeed et al., 2018). However, a systematic review of literature and meta-analysis found no significant difference for efficacy of enzymes (Yaghoobi et al., 2016)

Most research found benefits to using digestive enzyme supplementation and the need for the body to be adaptive to dietary changes.  Corring (1980) believes digestive enzymes adapt to intake. If the body is unable to do that supplementation may be required. Analysis of experimental works showed that this process includes many enzymes (Corring, 1980). They conclude the intestinal step of digestion is the most important in the enzyme breakdown of dietary components. Digestive enzymes are a viable alternative to pharmaceutical drug therapy (Quinen et al., 2014). Several of these works showed that varying combinations of animal, plant, and microbially derived enzymes were effective and showed promising results. Synergistic effects were observed using these combinations of derived enzymes. 

There is a definite clinical application to this research. The effects of enzymes like bromelain were observed and could be directly applied to clinical practice. Further, using enzymes derived from several sources may prove more effective than only from a single source. Moving forward with this research in mind stands to change the clinical practice of enzyme supplementation. 

References

Corring, T. (1980). The adaptation of digestive enzymes to the diet: Its physiological significance. Reproduction, Nutrition, Developpement, 20(4B), 1217–1235. https://doi.org/10.1051/rnd:19800713 https://pubmed.ncbi.nlm.nih.gov/6185981/

Ianiro, G., Pecere, S., Giorgio, V., Gasbarrini, A., & Cammarota, G. (2016). Digestive Enzyme Supplementation in Gastrointestinal Diseases. Current Drug Metabolism, 17(2), 187–193. https://doi.org/10.2174/138920021702160114150137

Lipski, E. (2020). Digestive Wellness (5th ed.). New York: McGraw Hill.

Majeed, M., Majeed, S., Nagabhushanam, K., Arumugam, S., Pande, A., Paschapur, M., & Ali, F. (2018). Evaluation of the Safety and Efficacy of a Multienzyme Complex in Patients with Functional Dyspepsia: A Randomized, Double-Blind, Placebo-Controlled Study. Journal of Medicinal Food, 21(11), 1120–1128. https://doi.org/10.1089/jmf.2017.4172

Quinten, T., Philippart, J.-M., De Beer, T., Vervarcke, S., & Van Den Driessche, M. (2014). Can the supplementation of a digestive enzyme complex offer a solution for common digestive problems? Archives of Public Health, 72(Suppl 1), P7. https://doi.org/10.1186/2049-3258-72-S1-P7

Roxas, M. (2008). The role of enzyme supplementation in digestive disorders. Alternative Medicine Review: A Journal of Clinical Therapeutic, 13(4), 307–314. https://pubmed.ncbi.nlm.nih.gov/19152478/

Wang, Z. R., Qiao, S. Y., Lu, W. Q., & Li, D. F. (2005). Effects of enzyme supplementation on performance, nutrient digestibility, gastrointestinal morphology, and volatile fatty acid profiles in the hindgut of broilers fed wheat-based diets. Poultry Science, 84(6), 875–881. https://doi.org/10.1093/ps/84.6.875

Yaghoobi, M., McNabb-Baltar, J., Bijarchi, R., & Cotton, P. B. (2016). Pancreatic Enzyme Supplements Are Not Effective for Relieving Abdominal Pain in Patients with Chronic Pancreatitis: Meta-Analysis and Systematic Review of Randomized Controlled Trials. Canadian Journal of Gastroenterology & Hepatology, 2016. https://doi.org/10.1155/2016/8541839