Enzymes and supplemental biotics are growing, morphing and playing off each other.
Many of your patients/clients know about probiotics and enzymes for digestive complaints and regularity. But yet many still look at these products as short-term tools, not quite understanding that they should be consumed regularly and long-term like multivitamins, especially as they get older.
Now that people are romping around, out of confinement, going back to work, and getting back to a sense of pre-COVID normalcy, supplement use has not yet subsided, as the concept of supporting health and balance remains rather firm. This is the basis for encouraging long-term use of enzymes and probiotics—or “enzy-biotics.”
Céline Torres-Moon, Protocol For Life Balance, Illinois, observed, “This year we are on pace to increase sales and this category (enzymes and probiotics) is growing in popularity. We are seeing a lot of specialized probiotics in the market to a targeted demographic or issue. Information on the microbiome has also piqued interest the past few years with more prebiotics as well.”
That stated, Torres-Moon is quick to assert that practitioners should keep in mind that not all patients understand well or clearly what enzymes, prebiotics and probiotics are and how they work for long-term benefit and wellness gains. “It seems that a lot of consumers use probiotics punctually as a therapeutic agent when they are facing a temporary challenge,” she stated. “However, we know that these products should be taken over a long period of time to have a lasting health impact and that a combination pre and probiotic will give optimal results.”
Isabella Adisubrata, R&D assistant, ChildLife Clinicals, California also sees that the enzyme and probiotic category has grown steadily in the past five years, primarily due to an increase in consumer awareness regarding the key benefits.
As to who is buying enzymes and probiotics, Danielle Baumgart, president, Priority One Nutritional Supplements Inc., Washington, said, “Millennials are far greater purchasers of probiotics and enzymes than the older generations. Baby Boomers and Generation X may well need probiotics to help them with digestive difficulties that occur as they age. On the other hand, Millennials are interested in an overall healthier lifestyle. Their digestive systems might function without problems, but they show a great interest in functional foods and following food trends.”
AnnAlisa Behling, ND, medical director, Nature’s Path Medical: Swartz Creek and St. Clair Shores, related that most patients have the same common complaints of GI (gastrointestinal) “distress,” bloating, gas, burping, reflux, constipation and/or diarrhea—“any one of these and all of these can be reasons to suggest they supplement with digestive enzymes, probiotics and prebiotics. But then add in food sensitivities, intolerances, allergies or enzyme insufficiency (pancreatic insufficiency), and aging (less enzyme production with age) to the mix and most people could use one of the above if not all.”
There is interesting research emanating from institutions showing new areas of growth for the -biotic world, notably synbiotics and psychobiotics.
For example, there’s tremendous research activity occurring in the synbiotic sector—so much so that experts have updated guidelines to create a consensus report published in the journal Nature in 2020. The definition for synbiotics is “a mixture comprising live microorganisms and substrate(s) selectively utilized by host microorganisms that confers a health benefit on the host.” According to the authors, the new consensus will serve as the “definitive reference” for synbiotic development and resulting consumer education. This was composed because, according to consensus panel chair Kelly Swanson, “Synbiotics are starting to gain traction in the marketplace, but there’s a lot of confusion around the term, even among scientists.”
“In synergistic synbiotics, the substrate would support probiotic survival,” stated co-author Hannah Holscher. “For example, providing an energy source for the probiotic or changing the microbiome to support the survival of the probiotic.”
Psychobiotics are probiotics with emerging research demonstrating their impact on mood and mental health via the gut-brain axis. Researchers in one study, published in Gastroenterology Clinics of North America in 2017, defined a psychobiotic as a “bacterium which when administered in adequate amounts can have a positive mental health benefit.” Researchers in a review published in 2016 in the journal Trends in Neurosciences explained that this class of beneficial bacteria “exert anxiolytic and antidepressant effects characterized by changes in emotional, cognitive, systemic and neural indices. Bacteria-brain communication channels through which psychobiotics exert effects include the enteric nervous system and the immune system.”
These authors added that the psychophysiological effects of psychobiotics can be grouped into three distinct categories: Psychological effects on emotional and cognitive processes; systemic effects on the HPA axis and the glucocorticoid stress response; and inflammation which is often characterized by abnormal cytokine concentrations.
The idea of consuming probiotics to support emotional and mental wellness may seem unusual but the field of psychobiotics is rapidly growing. Researchers in a review published in Nutrients in 2019 summarized, “Indeed, although probiotic bacteria will be concentrated after ingestion, mainly in the intestinal epithelium (where they provide the host with essential nutrients and modulation of the immune system), they may also produce neuroactive substances which act on the brain-gut axis.”
Torres-Moon pointed to an emerging category of supplements—postbiotics, which are preparations of inanimate microorganisms and/or their components that provide health benefits to the host. “One of the key advantages of postbiotics is that these products are not required to maintain a determined live bacteria count,” she explained.
Authors of a review published in International Journal of Molecular Sciences in 2019 asserted that “postbiotics can include many different constituents including metabolites, short-chain fatty acids (SCFAs), microbial cell fractions, functional proteins, extracellular polysaccharides (EPS), cell lysates, teichoic acid, peptidoglycan-derived muropeptides and pili-type structures.”
They added that research suggests that postbiotics may have direct and clinically relevant immunomodulatory effects and evidence has been published showing effective use of postbiotics in healthy individuals to improve overall health and relieve mild symptoms of GI distress.
“The health effects of pre/probiotics are extensive, and we are still in the infancy of our understanding of the interplay between our commensal flora and the different tissues these beneficial bacteria are interacting with,” observed Torres-Moon. “From the skin to the gut, a complex network of biodiverse resident micro-organisms create local ecosystems that have direct or indirect impacts on host health from regulating immunity and brain chemistry to metabolic health.”
She added that discovering how the interaction between host and probiotics impacts health is a very active field of research; however, due to the complexity of the subject, randomized clinical trials assessing the long-term effects of probiotic supplementation on health have not always had expected results. While some studies using specific strains have shown clear benefits for short-term immune support, GI health, and women’s health, results of studies on brain health and metabolic health have been more heterogeneous.
Beyond gut health, said Adisubrata, some probiotics, such as Streptococcus salivarius BLIS K12, may also provide support to the ear, nose and throat health. Probiotics may also help boost the immune system, and some have been found to promote the production of the body’s natural antibodies. “In children, some probiotics have been linked to respiratory health and were proven to reduce the risk of respiratory illnesses, and studies found that certain probiotics (Lactobacillus reuteri) can also help with colicky infants,” she said.
Baumgart cited a recent Harvard Health Publishing article about the many non-digestive benefits of probiotics. For example, she offered, one strain may fight against cavity-causing organisms in the mouth, while another has been linked to prevention and fighting of bacterial vaginosis (BV). “BV is an important issue that must be treated due to pregnancy-related issues, and possible link to pelvic inflammatory disease. Another interesting research category is eczema in children, many physicians have found success in treating this painful skin condition with pre and probiotics.
According to Kathy McIntee, vice president, Patient One MediNutritionals, New York, a new study published in Physiology & Behavior in 2021 examined the role of Saccharomyces boulardii, a probiotic yeast, in mechanisms of gut dysbiosis. This is meaningful to patients/clients who have undergone antibiotic therapy, as antibiotic intake is known to lead to gut inflammation and dysbiosis; gut dysbiosis has a role in neuroinflammation, oxidative stress and cognitive decline. This study showed that S. boulardii reduced gut dysbiosis linked to neuroinflammation and oxidative stress by protecting hippocampal neurons.
Enzymes are also being researched. Last year, a new relationship between enzymes and gut microbes was identified. In their 2020 paper published in eLife, researchers were investigating how certain gut bacteria metabolize the hormone dopamine and they found a new class of enzymes that not only disassemble certain neurotransmitters but also facilitate digestion of hardier foods such as nuts, liberating the nutrients for bioassimilation.
Japanese mycologists have created a method for extracting protease, amylase and lipase enzymes from fungi which work throughout the entire digestive system and have been tested to be free of mycotoxins, according to Dr. Behling. Extracts of these enzymes are dried into powders and put into capsules. She added that proteolytic enzymes can support reduction of pain and inflammation as well as breakdown fibers and fibrin making them helpful for lung issues, cardiovascular support, inflammatory control, infections, as well as promoting healthy aging.
Enzymes are well documented as anti-inflammatory agents, said Baumgart, so they are beneficial in cases of sports injury. “Enzymes can help speed up healing time, minimize bruising and breakdown scar tissue formations,” she explained.
Protocol For Life Balance offers what Torres-Moon described as a “robust” line of enzymes and pre- and probiotic products; a total of 18 products, this category represents more than 10 percent of the company’s entire line of supplements. Its two prebiotics are Acacia Powder, which is rooted in traditional herbalism and Prebiotic XOS, which exerts a selective bifidogenic effect at only 1.55 g per serving. Protocol For Life Balance’s probiotic products, she noted, contain well-characterized strains that are clinically validated. “We offer 10 different probiotic products in different potencies and with different applications,” she said. Protocol For Life Balance also makes several enzyme products for digestive health, as well as for immune/respiratory and cardiovascular health.
“After a careful assessment of their patients’ needs, practitioners can recommend our supplements knowing that they will receive active probiotics with strains that are verified using the RiboPrinter Microbial Characterization System,” Torres-Moon stated. “We also perform rigorous stability testing to ensure that the bacterial count of our probiotics is at least at the level indicated on the label at the end of shelf life of our product.”
ChildLife Clinicals’ Oral Care Probiotics provides 33 mg (2 billion CFU) probiotics in a proprietary blend of Streptococcus salivarius BLIS K12 and Lactobacillus plantarum UALp-05 per tablet to supply beneficial bacteria to the oral cavity and support ear, nose and throat health, delivered in a natural berry-flavored chewable tablet. “Practitioners can recommend them for oral and respiratory health support and to restore a healthy quantity of beneficial bacteria in the oral cavity,” said Adisubrata.
The company also offers a Digestive Health product, which is a ready-to-mix, natural, orange-flavored supplemental powder that provides 1,000 mg digestive enzyme blend per 1 scoop (1.4 g). Practitioners can recommend ChildLife Clinicals Digestive Health to support proper digestion, optimize nutrient availability and promote GI health.
According to Baumgart, Priority One Nutritional Supplements’ Proto-Zyme is a proteolytic enzyme tablet designed to support the body’s normal connective tissue repair and synthesis processes, while maintaining a normal inflammatory response.
Priority Zyme is a high-potency formula that contains high amounts of proteolytic enzymes, and each serving includes 5 mg of A-chymotrypsin, a digestive enzyme secreted by the pancreas that breaks down protein in the small intestine. “Proteolytic enzymes support a healthy inflammatory response due to strenuous exercise,” she explained. Priority Zyme provides nutritional support for cellular health.
Priority One’s Gastri-Gest is a combination of plant enzymes that help maintain healthy digestion and intestinal enzyme activity and is targeted for those with occasional indigestion. The enzymes in Gastri-Gest promote absorption in a healthy GI tract. Additionally, Hypo-Gest is Priority One’s most powerful two-phase formula that provides enzymes to maintain healthy digestion and intestinal enzyme activity. Enzymes promote absorption in a healthy GI tract. It is formulated to support healthy digestion in patients seeking small intestinal bacterial balance.
Healthy intestinal lining can produce the disaccharide enzymes necessary for proper digestion of foods that often cause mal-digestive distress. Proper digestion is also dependent upon the body s ability to produce healthy levels of gastric acid, pancreatic and or gallbladder bile. Support for these natural processes in the form of a comprehensive digestive enzyme is imperative during times of temporary digestive distress.
Baumgart related, “By request we have added SIBOZyme with no HCL to our line of exclusive products formulated by Dr. Mona Morstein. And our Pre+Probiotic is a combination of PreticX XOS prebiotic fiber and the shelf-stable probiotic LactoSpore Bacillus coagulans. Finally, our PreticX is a non-GMO (genetically modified organism) xylooligosaccharides (XOS) prebiotic. In clinically validated research, it has been shown to significantly improve the beneficial gut flora of both healthy as well as overweight individuals,” she said.
Patient One’s Saccharomyces boulardii is a non-pathogenic probiotic yeast that supports the immune system and provides a favorable growth environment for the beneficial bacteria that support health and digestive comfort, according to McIntee. “Studies have shown the efficacy and safety of S. boulardii for a number of health conditions in both adults and children. These applications include prevention of antibiotic-related diarrhea, recurrent C. difficile-related diarrhea and colitis, traveler’s diarrhea, acute bacterial and viral diarrhea, inflammatory bowels and irritable bowels.”
Patient One Flora Maintenance is a multi-strain, identity-confirmed probiotic with a potency of 25 billion bacteria per serving at encapsulation. It features 10 compatible, well-researched bacteria (seven found in the small intestine and three found in the large intestine) are combined with a fructo-oligosaccharide (FOS, a prebiotic). The combination of a prebiotic and a probiotic has been clinically proven to promote enhanced effectiveness.
The area of “enzy-biotics” is one that will likely see tremendous growth, combining the actions of enzymes as well as pre-pro-syn-, post- and psychobiotics for health-promoting protocols.
“The field of probiotics research has grown rapidly, with novel tools and clinical trials to provide evidence on the health benefits of strain-specific probiotics,” observed Adisubrata. “For infants, efforts were made to mimic human breastmilk by adding probiotics and prebiotics naturally found in breastmilk to infant formulas. We have also seen new, exciting research on the benefit of probiotics beyond gut health, such as the use of probiotics for beauty and skin care.”
Baumgart characterizes the research being conducted in the life cycle span of enzymes as “fascinating.” Enzymes, she explained, have finite life cycles, but some can have as little as one use, and some into the millions before their life cycle is ended. A new study published in March of 2021 by the team from UWA’s (The University of Western Australia) School of Molecular Sciences and the ARC Centre of Excellence in Plant Energy Biology (PEB), in collaboration with the University of Florida and other U.S. researchers, developed a simple, new metric—Catalytic-Cycles-till-Replacement—that quantifies how many times different enzymes are reused before they are replaced.
“This will be important for the future development of medicines targeted with enzymes and the natural enzyme industrial can potentially identify and use specific enzymes and their replication properties to achieve the same benefits with less raw materials,” she predicted.
Healthy Take Aways
• Millennials are far greater purchasers of probiotics and enzymes than the older generations.
• Bacteria-brain communication channels through which psychobiotics exert effects include the enteric nervous system and the immune system.
• In children, some probiotics have been linked to respiratory health and were proven to reduce the risk of respiratory illnesses.
• Proteolytic enzymes can support reduction of pain and inflammation.
For More Information:
ChildLife Clinicals, https://childlifeclinicals.com
Patient One MediNutritionals, www.patientoneformulas.com
Priority One Nutritional Supplements Inc., www.priorityonevitamins.com
Protocol For Life Balance, www.protocolforlife.com