ENZYMES: SUPPORTING DIGESTION IN AUTISM SPECTRUM DISORDERS

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ENZYMES SUPPORTING DIGESTION IN AUTISM SPECTRUM
DISORDERS
AUTISM ONE CONFERENCE Chicago, IL May 2006
Devin B. Houston, Ph.D. President Houston
Nutraceuticals, Inc
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SPEAKER CREDENTIALS

• Ph.D. in Biochemistry (South Alabama, 1987)
• Enzyme research since 1982
• NIH-funded research at Virginia and St. Louis
  medical schools
• Enzyme product development at Natl Enzyme
• Inventor of enzyme product supplements

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FULL DISCLOSURE STATEMENTS
Dr. Houston is owner of a company that sells
enzyme products. Any product mentioned is not
considered as a treatment or cure for autism.
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ENZYME FACTS

• Enzymes used in food industry for decades
• Used as digestive supplement for over 60 years
• FDA status Generally Regarded As Safe (GRAS)
• No fungal spores or allergens in products
• Anti-inflammatory properties in animal studies
• Target of action only in gut
• Eventually broken down as any other food protein
• Minimal or no effect on pancreatic enzyme
  secretion with normal dosing

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WHAT ARE ENZYMES?

• Catalytic Proteins (Energizer Bunny!)
• Specific Enzyme for each Chemical Reaction
• Thousands of different enzymes, most not useful
  orally
• Pancreatic enzymes OR plant enzymes?
• Dietary enzymes are SAFE

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Protease Enzyme
Protein Substrate
Enzymes keep working as long as substrate is
available and conditions are favorable for enzyme
function.
Amino acids
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THERE ARE MANY DIFFERENT TYPES OF ENZYMES

• Metabolic Enzymes
• Over 4000 involved in synthesis, detoxification,
  movement, and cellular regulation
• Usually found within cells
• Not active orally
• Digestive Enzymes
• Involved in food degradative processes
• Found primarily in pancreas and GI tract

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Pancreatic Vs. Plant-Derived Enzymes
(Digestive Enzymes)

• Animal-based - Enzymes extracted from pig and cow
  pancreas (Viokase, Creon, Pancreatin)
• Function in narrow pH range
• Must be enteric coated
• Work only in intestinal tract, produce exorphin
  peptides
• Plant-based - Isolated from papaya, pineapple,
  and fungi
• Function in broad pH range
• Similar function as pancreatic, but different
  structure
• Work in stomach and intestinal tract
• Classified as dietary supplements (no
  prescription needed)

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DIGESTIVE ENZYMES WORK ONLY ON PROTEINS, CARBS,
AND TRIGLYCERIDES

• Proteases - Break down large proteins into
  peptides, which in turn are degraded to amino
  acids Pepsin, trypsin, chymotrypsin,
  peptidase, elastase, papain , bromelain, ficin,
  actinidin.
• Carbohydrases - Complex carbohydrates degraded to
  simple sugars Amylase, lactase, glucoamylase,
  cellulase, sucrase, maltase, galactosidase,
  glucanase, xylanase.
• Lipases - Triglycerides broken down to
  short-chain fatty acids Lipase.

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THE PROBLEM

• The behavior, health, and mood of many
  individuals are apparently affected by certain
  foods.
• These effects, or intolerances, are especially
  evident in many children with autism spectrum
  disorders.
• In many of these children, enzyme supplementation
  may help reduce the intolerances to foods such as
  wheat, dairy, soy, etc.

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THE ANSWER?

• Better digestion of food, especially proteins,
  may bring relief from some intolerances.
• Increased breakdown of protein, carbohydrates,
  and fats should provide better availability of
  amino acids, sugars, and short-chain fatty acids
  for metabolic needs.
• Supplemental plant-based enzymes are intended to
  enhance and support normal digestion, as well as
  decreasing certain peptides implicated in certain
  ASD behaviors.

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The Answer?

• Enzymes may allow a broader range of food choices
  which can then allow better nutrition and health.
• Enzymes are NOT designed to allow non-nutritive
  foods to become nutritious.

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FOOD INTOLERANCES ARE DIFFERENT FROM FOOD
ALLERGIES

• Respiratory type allergies are potentially
  life-threatening conditions, and no supplement
  will allow ingestion of such offending foods.
• Many benign food allergies may be caused by
  incomplete breakdown of proteins.

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EXORPHIN PEPTIDES

• Derived from proteins casein, gluten, soy, blood
• Produced normally from sequential action of
  pepsin and elastase enzymes, if casein/gluten
  present
• Interact with opiate receptors in gut, and
  possibly brain, producing opiate-like effects
  such as decreased gut motility and less
  sensitivity to pain
• These opiate interactions appear to be different
  in those with ASD

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EXORPHIN PEPTIDES

• Decreased levels of exorphin peptides often have
  beneficial effects on stereotypical ASD behavior
• Peptide levels may be decreased by restricting
  intake of dairy, wheat, and soy proteins, OR
• Use of proteolytic enzymes to alter and enhance
  breakdown of same proteins without producing
  specific exorphin peptides.

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DIPEPTIDYL PEPTIDASE IV

• Only known enzyme to break down casomorphin
• Present in cells lining GI tract
• DPP IV activity detected in several fungal enzyme
  blends (Houston, Natl Enzyme, 1998)
• Very specific (and limited) in function

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ENZYMATIC FORMATION OF CASOMORPHIN FROM CASEIN
Casein
X-X-X-X-tyr-pro-phe-pro-glu-pro-ile-X-X-X-X
(1) Pepsin
(2) Elastase
tyr-pro-phe-pro-glu-pro-ile
Casomorphin
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CASOMORPHIN FROM CASEIN BLOCKED BY DPP IV
Casein
X-X-X-X-tyr-pro-phe-pro-glu-pro-ile-X-X-X-X
(1) Pepsin
(2) Elastase
DPP IV In Stomach
tyr-pro-phe-pro-glu-pro-ile
Casomorphin
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DIETARY ISSUES ARE IMPORTANT IN AUTISM

• Gut Inflammation (leaky gut) reduced enzymes?
• Dietary restrictions can be helpful (GFCF, SCD)
  but may hinder nutritional status
• Increased immune system problems
• Food allergies more prevalent

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THE GLUTEN-FREE/CASEIN-FREE DIET (GFCF)

• GFCF diet found to be helpful in eliminating many
  ASD behaviors and digestive problems.
• Requires elimination of wheat, dairy, soy, and
  often many other foods.
• Often requires lifestyle change for whole family.
• Foods expensive, hard to find in some areas.
• Much of what the diet does can also be
  accomplished using appropriate enzymes.
• The GFCF Diet is a shotgun while enzymes are more
  like a laser.

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ENZYMES AND THE GFCF DIET

• Enzymes may be used with or without GFCF diet,
  those on diet often find additional benefits with
  enzymes.
• Enzymes help break down ALL food proteins, not
  just casein and gluten.
• In many cases, enzymes can be a suitable
  alternative to the GFCF diet.
• Most find that enzymes allow GFCF diet to be less
  stressful part of the family lifestyle and
  real-world situations.

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INDICATIONS FOR ADDING ENZYMES TO GFCF DIET

• Increased intolerance to other foods
• Decrease in nutritional status on diet
• Stools not consistent in appearance
• Lack of weight gain or height increase
• Appearance of undigested food in stools

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CHALLENGING THE GFCF DIET

• If possible, use enzymes consistently for one
  month prior to challenge.
• Challenge on weekend, when possible reactions can
  be monitored.
• Initial food challenges should be small, and
  dont spare the enzymes. If the first attempt is
  not successful, try again after 2 - 3 months.
• Not all foods may be added back to diet.
• Effective doses will vary between individuals

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REASONS TO TRY ENZYMES

• Most results obvious within one month
• Inexpensive relative to other choices
• No special preparation needed
• No toxicity issues, FDA says is safe (GRAS)
• No interference with therapies or meds
• Enzymes may be a better fit for your family
  situation than restrictive diets
• Running out of foods for your child

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ENZYME DOSING TIPS

• Some experimentation needed to find optimal
  dosing.
• For optimal benefits, enzymes should be taken at
  the beginning of a meal.
• Enzymes are dosed by amount of food eaten, not
  age or body weight.
• May be taken with other medications or
  supplements with no interaction occurring.
• Enzymes are effective with first dose, no
  critical level needed for efficacy

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ARE ENZYMES WORKING?

• Withdrawal symptoms during first 3 weeks
• More emotional
• Emotional support needed as awareness increases
• Should taper off within 7 -10 days, if doesnt,
  decrease the enzyme dose.
• Better digestive function
• Child may show more interest in other foods
• Reduced cravings for carbs
• Weight gain in thin children

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Dr. Devin Houston, PhD President Houston
Nutraceuticals, Inc email devin.houston_at_houston
ni.com phone [phone] website
www.houstonni.com