This is the first in a three-part series on the importance of proper digestion. In this installment, we will take a closer look at the digestive system, its role in maintaining your health, and the importance of digestive enzymes. In the next issue, we will look at a common condition called dysbiosis, which occurs when there is an imbalance in your intestinal bacteria and can lead to conditions such as constipation, candidiasis, and irritable bowel syndrome. The third part of the series will examine a condition called leaky gut syndrome, which is to blame for many skin condition and food allergies and sensitivities.

We have all heard the saying, “You are what you eat.” Taken at face value, this statement can be somewhat misleading. A more accurate statement would be, “You are what you absorb.” Healthy food choices are very important, but those nutritious foods won’t do you much good at all if your digestive system is not functioning properly. In fact, most of us have dysfunctional digestive systems and don’t even know it.

Even if nutrition is a high priority for you and you spend considerable time and effort (and money) eating nutrient-rich, organic produce and free-range meats and taking daily vitamins, you may not be absorbing the nutrients that your body desperately needs to stay healthy. To better understand the dynamics of this frustrating set of circumstances how to address it, we must first take a closer look at the digestive process so that we can develop an appreciation for the importance of nurturing this delicate system.

Let’s begin by identifying the key components of the digestive system. The digestive system consists of two components: a chemical component and a mechanical component. The chemical component consists of digestive enzymes and gastric juices produced by the mechanical components. Enzymes are the catalysts of life. They are responsible for essentially every metabolic function and process in your body. Enzymes make things happen. Although there are thousands of enzymes for the numerous metabolic processes that take place in our bodies, for the purpose of this discussion we will be talking about digestive enzymes in particular. The utilization of food for energy is directly dependent upon the action and interaction of these types of enzymes.

As important as enzymes are, their existence would not be possible without the presence of other key factors. Enzymes are made up from amino acids, which we obtain from the protein we eat. Co-factors must also be present for enzymes to work properly. These cofactors are called micronutrients. These are your vitamins and minerals. A deficiency in just some of these cofactors can be enough to inhibit the digestion and absorption process. So you can why it would be important for you supplement with a good multivitamin if you are not eating the recommended five to seven servings of vegetables and fruits per day.

This is a good time to distinguish between digestion, absorption, and assimilation – terms that we will be using frequently throughout this discussion. Digestion refers to the process of breaking down food items into smaller components, with the help of gastric juices and enzymes, such as amino acids and micronutrients (vitamins and minerals) so that they can then be absorbed into your bloodstream and then assimilated into your cells and tissues and then metabolized or converted into energy.

Now let’s take a look at this process from the point at which food enters your mouth. Actually, in the moments before food enters your mouth, your brain is already preparing your digestive system for what is about to happen. Upon the first sight, smell, or even thought of food, your brain signals special glands in your mouth to begin releasing salivary amylase (pytalin), which is useful in breaking down starches. The infamous scientist Pavlov demonstrated this phenomenon when his dogs began to salivate at the sound of a dinner bell. Because the digestion of starches is somewhat more challenging for the human digestive system than that of protein and fat (herbivores have considerably longer digestive tracts than those of carnivores and omnivores), this is your body’s way of getting a head start.

Once the food enters your mouth and you begin to chew, the paratoid glands behind your ears are stimulated to release hormones that in turn stimulate the thymus gland to produce T-cells. These T-cells represent the first line of defense in your immune system. They help your body to deal with any harmful bacteria present in the food that has just entered your system. Chewing and liquefying your food thoroughly before you begin to swallow is absolutely essential to the digestive process. There is a saying among holistic nutritionists: “drink your foods and chew your liquids.” This saying emphasizes the importance of this crucial phase in the digestive process.

As you begin to swallow the food, the next phase of the digestive process known as peristalsis begins. This is the mechanical component of the digestive process that pushes the food down through your gastrointestinal tract is triggered at the moment the food enters your esophagus — the tube that runs from your mouth to your stomach. At the bottom of your esophagus, there is a valve called cardiac or esophageal sphincter, which separates the esophagus from the stomach. This is also the part of the body associated with gastrointestinal esophageal reflux disorder — acid reflux or GERD — when the gastric juices fail to completely break down fats and proteins in your stomach and are forced back up your esophagus past your esophageal sphincter. This can be caused by either eating too much at once (particularly fatty foods) or, as is more often the case, having insufficient stomach acid and enzymes to break down the fats and proteins in your stomach. Incidentally, GERD is the number one cause of esophageal cancer.

The next phase of the process occurs in your stomach — the body’s blender. This is where the digestion of proteins and fats begins. The stomach produces pepsin and hydrochloric acid (HCL) to break down proteins and to kill any harmful microbes present in the food items. As we get older, we gradually lose our ability to produce HCL. This condition — known as hypochlorhydria — can also occur in people who are chronically stressed out. This condition is also linked with vitamin B12 deficiencies, which is why many older people receive regular B12 shots from their doctors. Hypochlorhydria is most effectively addressed by supplementing with betaine HCL and vitamin B12. A less potent alternative to a betaine HCL supplement may be apple cider vinegar, but not in the presence of candidiasis (to be discussed in more detail in Part II of this series).

The stomach is also where lipase is released to begin the process of breaking down the fats. Because these gastric juices are extremely caustic and powerful (HCL would burn through clothing and skin if spilled on us), the lining of the stomach is covered by a layer of protective mucosa. If there is an overproduction of stomach acid, as with chronic stress or the use of certain drugs, this helpful mucosa is broken down and ulcers begin to form. Ulcers can also be caused by a bacterium called h. pylori.

While the typical response by individuals suffering from stomach ulcers is to neutralize the stomach acid with over-the-counter and prescription antacids, these drugs also inhibit the proper digestion of proteins. This is a good example of using a band-aid to address the symptoms instead of addressing the cause. In this case, the possible causes would be chronic stress, poor diet (including trans fats), or overeating. Both acid reflux disorder and stomach ulcers may often be addressed by simply supplementing with digestive enzymes or herbs to control the h. pylori. Another effective remedy for this ulcers and stomach burn is deglycyrrihized licorice or DGL. Licorice stimulates the production of protective mucous in the stomach and is very effective if taken in the form of a chewable tablet 20 to 30 minutes prior to eating. Although licorice may elevate blood pressure in most individuals, the deglycyrrihized form does not have this side effect.

Food generally stays in the stomach for two to four hours. However, this transit time can be longer with higher fat or higher fiber foods and shorter with lower fat or lower fiber foods. Chronic stress and enzyme insufficiencies may also lengthen this transit time. While most nutrients are not really absorbed into the bloodstream until they get into the small intestines, some substances, such as alcohol and water and certain salts, are absorbed directly into the bloodstream from the stomach.

The next stop in this journey is the small intestine. This is where the digestion of proteins and fats are completed. Carbohydrates are also broken down here by enzymes such as sucrase, lactase, and amylase. The small intestine is 15 to 20 feet long and, like the stomach, is lined with mucosa. It is a relatively well-known fact that if spread flat, the small intestine would cover a surface the size of a tennis court.

In addition to the protective mucosa, the walls of the small intestine are covered by villi — small finger-like folds that are in turn covered by millions of microvilli. The villi and microvilli, collectively known as the brush border, have three basic functions: producing digestive enzymes,; absorbing nutrients; and keeping toxins and pollutants from entering the bloodstream. This brush border lining repairs and replaces itself every three to five days. If the lining is breached or partially destroyed by microbes, drugs, alcohol, and processed foods (especially gluten-containing foods), it becomes more permeable and nutrient absorption is compromised and toxins are allowed to enter the bloodstream. This condition is known as Intestinal Permeability Syndrome or leaky gut, and we will take a much closer look at this condition later in Part Three of this series.

The small intestine or the gut is also inhabited by billions of bacteria, collectively referred to as your gut flora. These beneficial bacteria are essential for the production of enzymes and some vitamins, such as A, B, and K and also help to keep the more harmful bacteria in check. We will take a closer look at the importance of maintaining a healthy gut flora in the next issue.

The pancreas is also instrumental in the digestive process. Its role is to produce digestive enzymes and a hormone known as insulin. When food passes from the stomach to the small intestine through the duodenum, the pancreas secretes bicarbonates that neutralize the acidity of the chyme so it won’t harm the gut. It then secretes specific enzymes that digest fats, carbohydrates, and proteins. These enzymes are categorized as lipase, amylase, and protease. Lipase breaks fats into fatty acids and glycerol. Amylase breaks complex carbohydrates down into simple sugars. And protease breaks the links between amino acids from protein. Once broken down, these nutrients can be absorbed into the bloodstream through the gut lining. Insufficient secretion of pancreatic enzymes can lead to nutritional deficiencies.

The production of the hormones insulin and glucagon comprise the endocrine function of the pancreas. Insulin and glucagons are essential to regulating blood sugar levels. When blood sugar gets to high, the pancreas secretes insulin, which signals the cells to burn glucose for energy and store any excess as glycogen and fat. This function may be compromised, resulting in blood sugar imbalances, if one repeatedly consumes too many refined carbohydrates or simple sugars. In this case, the pancreas produces too much insulin and you become hypoglycemic. Eventually, the pancreas can lose the ability to produce enough insulin, which can lead to diabetes. However, by eating adequate protein and fat with less refined carbohydrates, the hormone glucagons is able to do its job by mobilizing stored body fat for energy along with any available glucose. So as you can see, the key is to eat a more balanced diet that includes all of the macronutrients.

The liver also plays a vital role in the digestive process. In addition to being the body’s fuel filter, the liver produces bile to emulsify or break down fats. Bile, which is made in the liver and then stored in the gall bladder, is a soap-like substance made of bile salts, cholesterol, and lecithin. It makes fats more water- soluble so that the enzymes can make them small enough for the cells to use. The liver is also responsible for the processing of virtually all of the essential nutrients. The liver is also the storage place for glycogen, essential fats and fat-soluble vitamins, such as vitamins A, D, E, and K. These nutrients are necessary for the production of cholesterol and hormones such as testosterone and estrogen. In fact, liver dysfunction is much more often to blame for increased blood cholesterol levels (since the liver produces over 70% of the cholesterol in your body).

Perhaps the most challenging job for the liver is to neutralize and detoxify toxins and pollutants, including alcohol and drugs. Because our bodies are constantly bombarded by food-born and environmental toxins, the liver often becomes overburdened and its ability to detoxify these substances becomes compromised. The liver can lose as much as 70% of its capability and show no signs of dysfunction. Whatever toxins the liver cannot neutralize are stored in the liver or in tissues throughout the body. This is why it is important to detoxify the liver once or twice a year under the guidance of a nutritional consultant or other qualified health care practitioner.

As the holding tank for bile, the gall bladder is an often overlooked and under-appreciated organ. Between meals, the gall bladder actually concentrates bile. When bile becomes too concentrated, as with the over-consumption of trans fats and refined carbohydrates, gallstones may form. Gall bladder disease is directly related to diet. Unfortunately, the most common method of treating gall bladder problems is to remove the organ. This is especially disconcerting considering the vital role of this organ and the fact that stones can often be purged and gall bladder function restored to normal by doing a liver-gall bladder flush with the help of specific nutritional supplements and colon hydrotherapy.

The last stage of the digestive process occurs in the large intestine or colon. Approximately three to five in length, the colon is where water, bacteria, and fiber go after all nutrients have been absorbed in the small intestine. The main function of the colon is to absorb the water and any remaining nutrients from the chyme and form remaining wastes into stool. Two and half gallons of water pass through the colon each day, two thirds of which come from bodily fluids. If the chyme passes through the colon too quickly, water is not absorbed and diarrhea results. If the colon is too sluggish from either poor diet or dehydration, the stool becomes too dry and constipation occurs. About two-thirds of stool is composed of water and undigested fiber and food. The remaining third is composed of living and dead bacteria. In fact, the colon contains trillions of bacteria. As with the beneficial bacteria in the small intestine, these probiotics play a key role in killing disease-causing microbes and producing enzymes and essential vitamins. Again, we will take a closer look at these bacteria in the next issue.

When the stool is well formed, it gets pushed down into the rectum where it is held until there is sufficient volume to have a bowel movement. This bowel movement is part voluntary and part involuntary. The urge to purge occurs when the internal sphincter relaxes. The external sphincter does not open until you consciously allow it to do so. Many people ignore this urge or intentionally wait until its convenient. This can cause the water in the stool to be absorbed back into the body, leading to hardened stools, constipation and even hemorrhoids.

An ideal transit time in the colon is between 12 and 24 hours. This should result in two to three bowel movements a day. As infants, we had a bowel movement within 30 minutes after each feeding. This is because our digestive systems were still healthy and the peristalic function was still normal. As we begin eating processed foods, our systems become more and more compromised. To test your transit time, try taking 1,000 milligrams of supplemental charcoal. You can purchase charcoal tablets or capsules in most health food markets. Note exactly when you take the charcoal and count the number of hours between the time you took them and the time you begin to see darkened or black colored stool. You can also perform this test with three to fours beets, looking for a red stool.

Many health problems can arise in the colon as a result of improper diet, resisting the urge to purge, and abuse of drugs or alcohol. In fact, many holistic health practitioners today believe that many serious health problems that plague our country are related to a dysfunctional colon. Arthritis may be caused by toxins building up in the colon and then being reabsorbed back into the bloodstream and eventually being deposited into our connective tissue causing inflammation and pain. Diverticular disease is an irritation of the intestinal lining, which can result from insufficient fiber intake or dehydration. Chronic back pain and even degenerative disk disease may result from an underactive colon, while irritable bowel syndrome is symptomatic of an overactive or spastic colon. Even appendicitis can result from a dysfunctional colon because the appendix it extends just off the beginning of the colon. The appendix contains a great deal of lymphatic tissue and is thought to play a key role in the immune system.

Optimizing Enzyme Performance
Now that you understand how the digestive process works, let’s take a brief look at how we can address some of the more common digestive problems with making better food choices and supplementing with enzymes.

While our bodies produce a significant quantity and spectrum of enzymes to make the digestive process, the foods we eat also contain naturally occurring enzymes to assist in this process. The fact that natural foods contain enzymes to assist in our digestion is evidence of the inherent harmony present in the natural world. We are designed to eat these foods and they are designed to be eaten. This is how life persists.
However, the reason we do not receive the full benefit of these food-borne enzymes is that we tend to overprocess and overcook our foods. When we refine our grains into flours and cereals and then bleach out the nutrients, we destroy the enzymes we need to properly digest the grain. When we pasteurize and homogenize our dairy products, we kill precious digestive enzymes. When we overcook our vegetables, we not only kill vital enzymes, we destroy many of the essential vitamins and minerals found in those foods. Although many of these foods must be cooked in order for them to be edible and palatable, we should be more mindful of how much we cook them.

Meats should be cooked to rare or medium rare and vegetables should be lightly cooked to an al dente (with a slight crunch) consistency. Ideally, we should eat vegetables in their raw state as often as we can. Because grains are somewhat unique in that they are more difficult to digest in their raw form, they should be soaked overnight so that they undergo a fermentation or sprouting process before cooking (see the book Nourishing Traditions, by Sally Fallon for more specific instructions on grain preparation).

To further optimize digestion, supplementation is often necessary. This is because many of us, through the aging process or because of stress and poor diet, produce an insufficient amount of enzymes to get the job done properly. A fairly easy method for determining whether you need to supplement with enzymes is the 90-120 method. Simply stated, if you experience symptoms of indigestion, such as gas or stomach distension, within 90 minutes after eating, you may have an HCL deficiency. If you experience these symptoms 120 minutes or more after eating (assuming you did not experience them before that time), you may have a pancreatic enzyme deficiency.

In the first scenario, you would take a supplement containing betaine HCL and pepsin during your meal. If the symptoms go away, you have identified your deficiency. The dosage will depend on how deficient you are. Begin by taking the minimum dosage the first meal and increase by one or two tablets each meal until you feel a stomach burn, and then back off by one or two.

In the latter scenario, you would take a supplement that contains a broad spectrum of digestive enzymes, including (at the minimum) protease, amylase, and lipase. A better quality supplement will also include cellulase, phytase, lactase, sucrase, and maltase. Unlike HCL supplements, digestive enzyme supplements should be taken just prior to eating. If your problems begin between 90 and 120 minutes, supplement with both HCL and digestive enzymes.

Look for next month’s issue when we take a closer look at your gut flora, how it can become unbalanced, and how to address the issues that arise from this condition.