27/07/2016. For internal training purposes only.

Transcription

1 27/07/2016 Overview of how the digestive system works and how we can assist its actions and ease some symptoms. Covers the effect of dietary choices and lifestyle on its function and the actions of the Comfort Zone Digestive Complex along with other products which can be added to build a programme of digestive support. For internal training purposes only. 1

2 Mouth food is mechanically broken down into smaller pieces but also mixed with saliva which contains enzymes to start the chemical breakdown or digestion of the food. Main digestion takes place in the acidic environment of the stomach by gastric juices and stomach acid. Digestion is completed in the small intestine by pancreatic enzymes, bile, brush border enzymes and action by the gut microbiome. Colon - site for removing excess water from the waste material and excreting it via the rectum 2

3 3

4 The secretion and inhibition of digestive fluids is controlled by hormones such as gastrin, secretin and cholecystokinin. Gastrin Released from gastric mucosa of the stomach Stimulates production and release of gastric juice & hydrochloric acid Gastric juice contains proteases and lipases and intrinsic factor Doctors may prescribe medication to suppress gastric juice production in cases of peptic ulcers, gastric reflux and reflux oesophagitis (inflammation of the food pipe). Please seek professional help if you wish to combine supplements with these medications. Individuals should seek medical advice before altering any medications or using digestive aids alongside medicines. Secretin Produced and secreted by duodenum and small intestines Secretin stimulates production of bile in the liver and release of bile stored in the gallbladder Stimulates secretion of pancreatic juice. Cholecystokinin (CCK) 4

5 produced by the walls of the duodenum... And is stimulated by presence of food, particularly fats CCK Stimulates the gallbladder to discharge bile And stimulates secretion of pancreatic juice from pancreas CCK can also suppress appetite by sending messages via Vegas Nerve to the brain to reduce food intake CCK release can be stimulated by whey protein 4

6 Saliva keeps the food moist while chewing. Saliva contains salivary amylase and lipase, which starts the digestion of carbohydrates and fats Saliva also contains an antibacterial enzyme to keep oral microbial levels in check. 5

7 Stomach The hormone Gastrin stimulates the production of stomach acid which is hydrochloric acid with an acidity level of around ph2 which is a strong acid. Goblet cells of the gastric mucosa produce a mucous layer to protect it from damage. But why do we need this acid? 1. defence mechanism against bacteria and other pathogenic organisms which can enter on the food or via the mouth...these potentially harmful microbes have to pass through the stomach in order to reach the warm, moist, nutrient-supplied digestive tract which would be an ideal environment for organisms to thrive! Strong stomach acid provide excellent barrier, killing microbes. 2. Protein digestion is initiated by stomach acid - it breaks up long protein chains but good levels of stomach acid are required in order for pepsinogen in the gastric juice to convert into the gastric protease enzyme pepsin and further the digestion of proteins. Stomach acid influences the secretion of Intrinsic Factor, a protein secreted by the gastric mucosa which is essential for the absorption of Vitamin B12. Intrinsic factor secretion and therefore B12 absorption are reduced during periods of low stomach acid for example, due to regular antacid use or low stomach acid due to stress or 6

8 nutrient deficiencies. Rennin coagulates the milk protein casein and that delays its release from the stomach so Pepsin has time to start digesting it. 6

9 Accessory Organs feeding into the Duodenum Partially digested food leaves the stomach as chime & enters the duodenum. The accessory organs of the liver, gallbladder and pancreas support digestion. These organs are not part of the digestive tract but essential to its function. At this point, the chyme leaving the stomach is strongly acidic. Bile & pancreatic juice are strongly alkaline and this helps to reduce the strong acidic nature of the chyme as it enters the small intestine. The liver is responsible for the production of bile, a thick liquid concentrated to twenty times the strength and then stored in the gallbladder. Bile is secreted when food is detected in the duodenum and it s responsible for emulsifying fats in order to make them disperse in water. This aids their absorption at the brush border of the small intestine. Bile also aids the absorption of fat soluble vitamins and fatty botanical components by the same emulsification process. The Pancreas produces and secretes pancreatic enzymes to further digest the proteins, fats and carbohydrates. Pancreatic enzymes have anti-inflammatory action too 7

10 Small Intestine Having been further digested in the duodenum, the food now passes along the small intestine which is about 7metres in length. The surface area on the inner lining is greatly improved by finger-like projections called villi....which in turn have microvilli on their surface. This provides a larger surface area for the absorption of digested foods, vitamins and minerals and to give you some idea of the sort of area we are talking about it translates to something around the size of a tennis court. As the main function of the lower small intestines is absorption of fully digested food, damage to the gut mucosa and inflammation will impact on that function. An extreme example of that would be coeliac disease where there is partial or severe atrophy of the villi due to an allergic reaction to gluten. 8

11 Small Intestine Brush border enzymes are made by the cells lining the duodenum and small intestines and they complete the breakdown of proteins and carbs so they can be absorbed i.e. so the proteins are now amino acids and the carbs and sugars (like maltose, sucrose and Lactose) are now Glucose, fructose and galactose. Fully digested foods are absorbed into the blood stream or lymph system and transported to the liver which is responsible for filtering out toxins before the nutrient-rich blood is sent to the heart to be pumped around the body. 9

12 Bowel the waste material from the digestive process consists of undigested fibre, bacteria, sloughed off mucosal cells and bile pigments. Excess water is removed and the resulting compact material is called faeces & passes out of the body via the rectum 10

13 Factors which can influence transit time of food Diets high in fibre will move faster through the system as fibre bulks up the stools and improves peristalsis which is the muscular movement along this digestive tract which moves in waves to move the food along. Bile softens the stools and aids their transit, as does sufficient fluid intake Water is also the base for the digestive juices secreted by the digestive tract and the accessory organs. Poor fluid intake can therefore lead to a reduction in digestive juices and the enzymes they contain. This can result in digestive insufficiency as well as increased risk of constipation. Being unable to digest food effectively means more partially digested foods for pathogenic organisms to feed on, producing harmful compounds and toxins which can cause a variety of digestive disturbances. The gut flora are able to assist the removal of pathogenic bacteria by producing lactic acid & reducing the acidity in the gut which pushes the acid-intolerant pathogens to keep moving down the tract and out of the body with the faeces. Eating large meals can also pose issues for the body as it needs to produce more enzymes in order to breakdown the larger meal. If that meal is high in fat and protein particularly meat, then it will slow down the digestive transit too. If transit times are too slow bile can be reabsorbed which is not desirable. Bile emulsifies fats for better absorption but it is also a method of removing cholesterol and waste products to be excreted with the faeces. If bile is reabsorbed, so are those toxins and that gives the liver extra work. 11

14 There is a connection between the digestive system and the brain via the vagus nerve. One of its responsibilities is keeping the digestive tract in working order, contracting the muscles of the stomach and intestines to help process food, and sending back information about what is being digested to the brain. The gut microbiome communicates via the vagus nerve in order to maintain homeostasis. It is therefore important not to forget gut bacteria when thinking of the health of the whole body as well as the digestive tract. In fact studies have shown that our gut microbiome can affect behavior, mood and anxiety levels. iome-gutbrain_axis_from_bowel_to_behavior/links/09e4150cb743c5053d pdf 12

15 What changes that homeostasis? 13

16 Stress and eating on the go are major culprits as we don t tend to chew our food properly when rushing through a meal In addition the body responds to stress by diverting energy away from the digestive system into the fight or flight response, leaving us with reduced digestive capabilities. Stress also uses up some key nutrients like B vitamins, zinc & magnesium which support the digestive system and the production of digestive enzymes. Poor food choices are common with the ease of processed, pre-packed foods but they do not have the same nutritional value to the body and they can be a risk to high intake of saturated and hydrogenated fats, salt and sugar. Smoking contributes to a number of digestive disorders including heartburn and gastroesophagial reflux disease (or GERD) as cigarette smoke weakens the sphincter muscle which connects the oesophagus with the stomach. This allows the acidic contents to squirt up into the oesophagus which is not protected by mucous secretions like the stomach and the gut so persistent issues can cause inflammation i.e. oesophagitis. Cigarette smoke also increases the risk for certain diseases like pancreatitis and gallstones. Genetic Enzyme deficiencies may be a problem e.g. impaired Lactase production will reduce your ability to deal with lactose in milk products. 14

17 Antacids and some other medications are designed to suppress digestive secretions and may be necessary in certain circumstances but this action still has a negative effect on digestion as well as impacting on the numbers of our beneficial gut flora. Antibiotics also affect our gut flora numbers, as does stress. Whatever the cause, poor digestion of food can increase the risk of food allergies. We have mentioned 2 of them already so in the case of coeliac disease where there is an allergic reaction to gliadin in gluten which breaks down the villi or food intolerances as is the case with lactose intolerance caused by insufficient production of lactase enzyme needed to digest the lactose

18 Many of those vital enzymes decrease with age as the cells of the intestinal walls, the stomach and the accessory organs become less effective at producing them. Nutritional deficiencies also affect the functioning of the cells and the accessory organs which in turn impacts on the body resulting in gastrointestinal issues and disorders. Using digestive enzymes to replace those declining endogenous enzymes may help to replenish nutrient levels due to better breakdown of foods & restore optimal nutritional status which may be linked to various ailments. 15

19 GERD Gastroesophageal Reflux Disorder 16

20 The results can lead to indigestion, constipation, haemorrhoids, diarrhoea, flatulence and bloating. As each stage of digestion is compromised it affects the stages that follow and leaves the digestive system open to bacterial, yeast and parasitic infection and the bacterial imbalance of dysbiosis. This can weaken the lining of the digestive tract and making it more prone to leaky gut and makes us vulnerable to food intolerance and allergies. Medical interventions like antibiotics and antacids impact the gut flora and gut lining further and can lead to an oversensitive immune response. All this can result in inflammation and a downward spiral in not only gut health but overall health due to the poor absorption of nutrients, a leaky gut and local and systemic inflammation. 17

21 We may need to address some ailment symptoms and take supplements to help the body get back on track. Focus on the person s needs at this time and remember that as their needs and symptoms change, so should their supplement programme. Supplements are there to SUPPLEMENT AND SUPPORT a healthy diet and lifestyle not REPLACE it! 18

22 - but digestive issues have been on the rise and this needs to be addressed. 19

23 Remember our definition? Digestion is a process of mechanical and chemical breakdown of foods into molecules that can be absorbed and utilised by the body......for example, protein breaks down into amino acids which may be used to make enzymes, hormones, neurotransmitters or they may be built back up into the more complex proteins to make muscle or tissues of the body. The system has to work as a whole like a team. If one part malfunctions, the whole process is impaired. 20

24 Any underlying nutritional deficiency will impact on digestion in the same way it affects other systems of the body like stress response & energy levels. Our primary source of these will be our diet and a diet that is nutrient-dense should also provide fibre, fatty acids, plant compounds etc. Eat regularly and regulate blood sugars A good multivitamin with minerals provides key nutrients in helpful levels, supplementing the diet...and ensuring a regular supply of the trace nutrients as well. Find one that suits your age & activity level and addresses your lifestyle or ailment needs and look out for the additional compounds which add extra potency or antioxidant activity to the product. Support your body by addressing any lifestyle issues which are demanding on your nutritional intake e.g. stress will gobble up quite a lot of magnesium, B5, vitamin C, and carotenoids in order to support adrenal function but it will also negatively impact your digestive processes. During stress your fight or flight response diverts energy from digestion and instead mobilises stored sugars... which is necessary during an acute bout of stress but we don t want that long term. 21

25 We have already noted that a multiple is the best way to support the programme with zinc being key to the production of digestive enzymes and stomach acid and supports the function of the liver and pancreas. A multiple also support the gut mucosa with carotenoids, vitamin A & C and there are numerous nutrients involved in the support of the immune activity in the gut. Solgar has a big range of well-formulated multiples to choose from with most of them suitable for vegans and vegetarians and free from common allergens. The digestive system needs to breakdown the foods correctly at each point in the digestive process so this is our next step. By using digestive enzymes or supporting the accessory organs and tissues of the digestive tract, we are ensuring complete digestion of the foods we eat and laying excellent foundations for the rest of the programme. This will buy the body some time to use the multivitamin nutrients to address any deficiencies and get back on track. Probiotics are vital to the gut environment they keep pathogens at bay by competitive inhibition (fighting for space to adhere to the gut mucosa) but they also provide an environment which is hostile to pathogens by altering the acidity levels to suit the situation. Certain probiotics synthesise nutrients like biotin which help gut mucosal repair. Some, like Probi Lp299v can have a modulating effect on inflammation and disproportionate immune response to any partially digested 22

26 foods leaking across the gut wall. These are foundational supplements but you may need at some point to consider gut healing if the issues have been chronic. If the problems have lead to gut dysbiosis then some form of antibacterial or antifungal product should be considered. Adapt this basic foundation to suit an individual s specific situation but these are key areas of concern. 22

27 23

28 Here we see our blend of digestive enzymes amylases, proteases and lipases but also Cellulase, an enzyme we are not capable of producing but which helps us to breakdown cellulose in vegetables. Also, at the top we see an unusual enzyme, not commonly seen in digestive products, called alpha galactosidase. This helps the digestion of beans and pulses and raw vegetables which are so often the cause of flatulence and bloating after eating. Comfort Zone provides a full range of digestive capability and would be the digestive enzyme of choice. In addition to the enzyme activity we have the botanical Comfort blend of cumin, chamomile, anise, fennel and ginger. 24

29 Cumin has been used to alleviate cramps but it has also been found to reduce the activity of a couple of bacterial enzymes which have potentially harmful effects: Beta-glucoronidase which releases toxins that have been bound up for removal Mucinase which breaks down mucin, the protective compounds coating the gut mucosa. The result is that the gut mucosa would now be exposed to harmful compounds which could lead to damage. The bacteria producing these enzymes can over-proliferate when there s excess undigested food present - more reasons to ensure proper digestion. Ginger s support of digestive function is well known and broad-acting and includes anti-inflammatory, anti-nausea, stimulation of bile, supporting peristalsis and support of mucosal membranes. If the food has more time in the stomach, gastric digestion can be improved before emptying into the duodenum for the next stage and ginger may help with that. Chamomile was traditionally used for intestinal irritation, ulcers and spasms but it 25

30 can also calm inflammation in the gut. Anise helps alleviate flatulence and protect the gastric mucosa from damage. Research suggests fennel stimulates production of certain digestive enzymes (trypsin, lipase and amylase). And also helps reduce gut spasm so it may be supportive for irritable bowel. So all in all a great botanical support for the digestive enzymes in the Comfort Zone Digestive Complex. 25

31 26

32 Betaine Hydrochloride will provide the acidic environment in which the gastric juices work best as well as providing that initial breakdown of proteins. The addition of Pepsin provides the next step to continuing the protein digestion and this is important for 2 main reasons 1st. it ensures the completion of each stage of protein digestion ready for the next. 2nd. most allergens are derived from poorly digested proteins or excessive consumption so complete digestion of proteins may reduce the risk of future allergies. The acidic environment also gives some protection against pathogenic microbes which enter with food. Botanical Digestive Complex is not a digestive enzyme but a range of botanicals with broad support for the digestive system by stimulating digestive secretions including bile but also providing anti-spasmodic & calminative support and helping to reduce indigestion and bloating so this product is more about support of the existing functions than taking over and providing the enzymes. Both approaches have their benefits. Feedback to date on the Botanical Digestive has been supporting its use for reflux and IBS. Probi Lp299v will support the action of the existing gut flora but also has ability to strengthen the gut mucosa as a selective permeable membrane i.e. it keeps out 27

33 what shouldn t get through (allergens, pathogens) and it facilitates the transport of what should get through (completely digested foods & nutrients). This all helps to reduce inflammation and modulate the immune response too. Lactase 3500 are chewable wafers of the enzyme which digests lactose, the milk sugar which can cause intolerances in some people. One tablet provides enough lactase to digest the lactose in a ml glass of milk. Artichoke has a history of use supporting digestive function and has been used with indigestion, gastritis and gallbladder issues and to relieve symptoms like flatulence, constipation and intestinal cramps. Caricol is heat treated papaya and there are studies supporting its use in IBS particularly in normalising stool formation. The proteolytic enzymes in Caricol may also have a mild anti-inflammatory soothing action. This product may be particularly helpful for children with digestive issues and toilet problems caused by hard stools. Add it to yoghurt or freeze it and offer it as an iced dessert! 27

34 Zinc is vital for liver and pancreas function & the production of some 200 enzymes as well as for growth and repair of gut tissues. Along with B1 and B6, zinc is needed for the production of HCl. Using organic bound forms of zinc will enhance absorption so choose amino acid chelates, picolinates or citrates for example. My multi-nutrient suggestion would be Earthsource due to its spirulina and chlorella base which is cleansing and deodourising as well as nourishing plus there are several digestive-supporting ingredients like borage and sunflower seed oil, pectin, oat fibre, barleygrass, flaxseed and wheat grass powders, bromelain, chlorophyll and a small amount of plant enzymes Low stomach acid production interferes with intrinsic factor secretion and ultimately B12 absorption. If this is suspected or you have a blood test which shows low B12 levels, try the methylcobalamin sublingual tablets so the B12 absorbs in the mouth and bypasses potential low stomach acid issues. As a reminder - B12 deficiency can lead to fatigue, nervous system problems, low mood, insomnia and elevated homocysteine levels. 28

35 Full Spectrum Curcumin 185x is a patented version of this turmeric extract in a highly absorbable form. Curcumin is well known for its anti-inflammatory, antimicrobial and digestive supporting actions. It is reported to help in cases of excess acid, diarrhoea, pancreatitis, ulcerative colitis and gallstones to name but a few. When stress is the cause of the digestive disturbances, Balance Rhodiola would be an excellent choice as this is a complex which can help with stress and strengthen the body through its adaptogenic properties and adrenal support. It also helps with mood and quality of sleep, which impact on the immune function and digestive response. Theanine may also be helpful - a fast acting amino acid, it can lift mood but primarily keeps you calm, focused and more perceptive. During stress and times of digestive disturbance, people often need support with protein intake while they address their dietary changes and support the gut in its healing process. Whey to Go is pre-digested protein so easy for the body to accept and utilise. It is also enhanced with 1000mg glutamine per serving which helps the healing process. Whey protein and dietary fibre increase production and release of CCK which would enhance bile secretion and pancreatic juices to support digestion further. This powder can be used on its own in water, juice or milk of your choice or made 29

36 into smoothies by adding other beneficial ingredients like green foods. 29

37 We recognised the need to ensure a good diet & complete digestion of our foods, deal with any lifestyle issues which are impacting negatively on our digestion and taking the appropriate supplements to support the outcome. 30

38 We discussed the need for a starting plan with a strong base in dealing with underlying nutritional insufficiencies and supporting it with digestive aids to ensure complete digestion and replenishing probiotics in order to strengthen the gut, modulate immune response & inflammation and to regain homeostasis via the vagus nerve. 31

39 Comfort Zone is a key base product, providing digestive enzymes including lactase but also Alpha Galactosidase for those fibrous plant foods. It also has the Comfort Blend of herbs which soothe and calm. Taken with food it can be used at every meal with dosage depending on the size and composition of the meal. And if you ve been out for dinner and eaten too much or something has left you feeling bloated, try taking 2 with water, even if it s been 2 hours or more since you ate - it may ease the discomfort! 32

40 Thank you for being part of the Solgar elearning programme. 33