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Our bodies are created to take care of themselves. But Science has given us the ability to help our bodies along. When things break down, Science gives us medicine. When we think we are not getting enough nutrients, Science gives us supplements.
The global dietary supplement market size was an estimated US$115 million in 2018 with an expected CAGR of 7.8%. In Singapore, dietary supplements saw a 4% current value growth in 2017, reaching S$357 million. Over the forecast period, they are predicted to record a value CAGR of 3% to reach S$404 million in 2022.
Apart from traditional supplements like vitamins and minerals, people are taking other types of supplements as well. Enzymes are among them. They have become so popular that global sales are expected to reach US$1.6 billion by 2025.
Enzymes are naturally occurring catalysts that help to speed up chemical reactions in our bodies, sometimes making the reaction millions of times faster. Made of protein, they bind to molecules or substrates and alter them, either breaking them down into smaller pieces that are more easily absorbed in the body or producing new molecules.
There are thousands of enzymes maintaining almost every function in our body including respiration; digestion; metabolism; DNA replication; and liver, muscle and nerve function. In fact, enzymes are known to catalyse over 5,000 biochemical reaction types in the cells throughout our bodies.
However, enzymes can be quite sensitive. They work best under very specific conditions – around body temperatures of 37°C, and specific pH ranges such as 7.5 pH in the intestines and 2 pH in the stomach. When conditions are not ideal, enzymes change shape and cannot bind to molecules to do their work.
Since enzymes are so amazing, it seems reasonable to want more of them. If our bodies cannot produce enough enzymes, then perhaps we should consider supplements. Of course, the efficacy of supplements in general and enzymes in particular has not been unequivocally confirmed. Given how sensitive enzymes are to heat and pH levels, those consumed are likely to be broken down and digested before they can do their good work. Even if the enzymes can survive the stomach acid, there is not enough evidence that they can survive long enough to enter the bloodstream to get to the cells that need them.
It would seem that enzyme supplements may be a waste of time and money. But the verdict is not out yet because there are some that seem to be effective. Enzyme therapy, for example, has been found to be useful in treating enzyme-deficiency diseases that are often genetic in origin. Digestive enzymes have been prescribed for pancreatic disease, chronic inflammatory bowel disease and cystic fibrosis.
There are other enzyme supplements that are non-prescriptive that may work as well. These are largely digestive enzymes that break down food into energy and nutrients, and alleviate symptoms of poor digestion. Lactase is one of them. It works within the digestive tract breaking down lactose, the natural sugar found in dairy products, for those who are lactose-intolerant. Amylase, a natural enzyme that breaks down some of the complex sugars in foods help reduce gas and bloating caused by beans and certain vegetables.
The point, then, is that enzyme supplements work but only under certain circumstances. Because there are so many different enzymes, each working on different functions, enzyme supplements have to be selected carefully for people to benefit from the right activity. Most enzyme supplements are digestive enzymes meaning they aid digestion, breaking down the food properly; and alleviate gastrointestinal symptoms after eating. They come in three main types, each corresponding to a natural enzyme: proteases only work on digesting proteins; lipases for digesting fats; and amylases for digesting carbohydrates.
In addition, enzyme supplements have to be consumed with care. Unlike vitamins that can be taken on their own, enzymes are catalysts. They need something to bind to in order to work. So, enzyme supplements have to be taken with food. In many cases, not just any food but specific ones as well. For example, lactase supplements have to be eaten with dairy products and amylase supplements with legumes and vegetables to be effective.
There are some studies that point to the health benefits of digestive enzymes but the studies are small, and the evidence limited and, at times, conflicting. These are some of the findings though more data is needed for the results to be conclusive.
Those who are lactose-intolerant can benefit from enzyme supplements. In several clinical studies with over 100 adults and children who were lactose-intolerant, lactase supplements increased lactose digestion and improved symptoms like cramping, nausea, pain, diarrhea, bloating and gas.
In another clinical study, over 80 people with increased protein intake experienced increased protein absorption and improved blood fat levels when they took fungal proteases supplements.
Those with age-related enzyme deficiency may also see an increase in enzyme production with digestive enzyme supplements.
A digestive enzyme called pancrelipase may alleviate some symptoms of irritable bowel syndrome (IBS). In a pilot study in 2011 involving 69 patients, those who were given pancrelipase saw significant improvement compared to those given placebos. Several preliminary studies also suggest that bromelain may help colitis or bowel inflammation.
Digestive enzymes have been found to help bloating from beans. In addition, a 2015 study found that an acid-resistant lipase, the enzyme that helps dissolve fats, reduced the feeling of fullness after a fatty meal.
There is not enough evidence to prove that digestive enzymes can boost immunity, fight inflammation, alleviate arthritis, treat cancer or improve health in general.
Enzyme supplements are largely safe. Digestive enzymes may, however, interact with antacids and certain diabetes medicine, and cause stomach pains, gas and diarrhea. Those on blood-thinners or have anti-platelet activity should know that enzyme supplements such as bromelain may increase the risk of bleeding. For the most part, enzyme supplements may be considered harmless.