What do your liver, gallbladder and pancreas all have in common? They help digest fat!

Fats are one of the major food groups needed for proper nutrition, along with protein and carbohydrates. When you eat food, your digestive system must break down the nutrients in the food by converting them to smaller molecules that your cells, organs, and tissues use for hundreds of metabolic functions. Enzymes made in different parts of your digestive tract act on these smaller molecules to finalize this process.

The steps of digestion

Salivary amylase is released in the mouth through chewing. This is the first enzyme your food will come into contact with, and it begins the digestion process. Lingual lipase is also produced in the mouth, which begins to emulsify any fat.

Once the food reaches the stomach, the parietal cells release acids (like hydrochloric acid), pepsin, and gastric amylase and lipase to help degrade food into chyme (these acids also turn off the salivary amylase and allow gastric amylase to take over).

The chyme is then moved into the duodenum or the upper part of the small intestine. This is the main site for the absorption of nutrients and the digestion of fat! This acidic chyme triggers the release of the hormone secretin that regulates pH in the small intestine and stimulates the liver to make bile. (If you are low in hydrochloric acid, secretin will not be stimulated.)

This in turn signals the pancreas to release hormones, bile, bicarbonate (which changes the acidity of the chyme from acid to alkaline) and various enzymes, including lipase—the main fat enzyme that we will talk about in this article!

If you have sufficient enzyme activity, this cascade works well, but as you can see, there can be problems in any one of these steps.

Have you ever experienced bloating or cramping after meals? Or have loose, greasy foul-smelling stool, very dry skin, gallbladder pain, hormone imbalances or a deficiency in the fat-soluble vitamins A, D, E or K? Have you had your gallbladder removed, or do you just feel a little unsettled after eating fatty foods? Whatever the reason, you may be experiencing a problem in digesting and absorbing fat.

What causes fat malabsorption?

• The liver cannot produce enough bile

• The quality of the bile is sluggish—the gall bladder cannot release sticky bile readily

• The lack of pancreatic enzymes—specifically lipase

The fat enzyme: Lipase

Lipase is the major enzyme that breaks down dietary fats into smaller molecules called fatty acids and glycerol. This is done when lipase hydrolyzes lipids, the ester bonds in triglycerides. Hydrolysis is the breakdown of fat by the addition of water. Since all cell membranes and other structures are made of lipids, it is important to have adequate amounts of healthy fats in the diet. Fat also helps produce important hormones. But just as important as eating enough fats, and the right kind of fats, is ensuring that you are properly digesting the fats you eat. When fat is not broken down correctly, the fat may coat food particles and interfere with the breakdown of proteins and carbohydrates.

 

The role of bile in fat digestion

When the food you eat reaches the stomach, the cells in your stomach make a small amount of lipase, called gastric lipase. This enzyme works mostly on butterfat and does not require bile. Once the food moves to the small intestines, bile that was made by the liver and stored in the gallbladder is released by the gallbladder to help emulsify the remaining fat. This signals the pancreas to release pancreatic lipase, which finishes the job. Bile contains water, electrolytes and other organic molecules, including the bile acids, cholesterol, fats and bilirubin (the waste product produced by the breakdown of old red blood cells). The liver uses cholesterol to produce two main bile acids, called cholic acid and chenodeoxycholic acid. When these two bile acids combine with the amino acids glycine and taurine, they form bile salts. Bile salts contain a fat-soluble portion and a water-soluble portion, so they act as a detergent that causes the big molecules of fat to break down into much smaller molecules. This allows the lipase enzyme to access and break down the smaller fat molecules into fatty acids and monoglycerides.

 

It is common in people who do not eat enough fat to have bile that does not get activated often. This can cause the liver to not make enough bile, because eating fat stimulates the production of bile. This can also cause the bile in the gallbladder to become stagnant, because it is not being emptied enough. This is when people may develop gallstones or pain in the gall bladder. Another thing that can cause gallstones is an overconsumption of hydrogenated fats and processed vegetable oils.

 

If this happens, the gallbladder may have to be completely removed. Then the whole bile process becomes less efficient. The liver will still produce bile, but it will continuously leak bile into the small intestine, and there will not be enough stored bile to digest fats effectively. The fat particles remain large and cannot combine readily with the pancreatic lipase. This is why fat malabsorption is common in people without a gall bladder.

 

Why is Lipase important?

• Fats must be digested properly before absorption, because fat is not water-soluble, and the end products of fat digestion are carried in water substances like blood and lymph. Without lipase, the fats cannot be split into fatty acids and glycerol.

• Lipase digests fat-soluble vitamins.

• Lipase-deficient people may have issues with high cholesterol and high triglycerides. Some triglycerides are needed in the body for energy, but high levels are often thought to be a risk for heart disease.

• Lipase requires chloride as a coenzyme. Lipase-deficient people have a tendency towards hypochlorhydria or low stomach acid.

 

What can you do?

• Ensure you are producing enough hydrochloric acid (HCL), which is the trigger for the liver to produce bile. Natural ways to stimulate HCL production include taking a tablespoon of apple cider vinegar or lemon juice in the morning or before a meal. You can also take supplemental betaine-HCL.

• Ensure you have healthy bile flow. If you do not, or you have had your gall bladder removed, you can try supplementing with ox bile to help this step along.

• Ensure that your body is making enough lipase. This is the final step in fat digestion. Your doctor can test lipase if you are unsure. It is called the LPS test, and it can detect problems with the pancreas.

• You can also try supplementing with a digestive enzyme that contains lipase, like Enzymedica Digest Gold.

We’ve outlined some of the most common hidden sources of gluten below, so you can avoid these traps and keep your gluten-free diet gluten-free.

 

PROCESSED MEATS

One of gluten’s most popular uses is as a binding agent, and this is how it finds its way into processed meats like meatballs, preformed hamburger patties, sausages and hotdogs. It’s used to hold the meats together, so they maintain their shape and structure. Gluten has also been found in imitation seafood and even processed deli meats.

 

MEAT ALTERNATIVES

Vegetarians and vegans also have to be careful, because meat alternatives like tofu may also contain gluten if they are cooked in a batter that contains wheat. Veggie burgers, veggie sausages and imitation bacon can also contain gluten. Check the label for “seitan,” which is made using wheat gluten.

 

SAUCES

You might think you’re doing yourself a favor by choosing a salad over a sandwich at lunchtime, but gluten might be lurking in your dressing as well. It’s also found in marinades and sauces, including soy sauce, which is often made with wheat. Gravies may also harbor gluten, especially if flour was used in its preparation.

 

FRIED FOODS

Some fried foods may be cooked in a batter containing wheat flour. And even if it’s not, there could still be cross-contamination if they’re cooked in a fryer that previously held gluten-containing foods. So, it’s best to limit your intake of French fries and potato chips as much as possible.

 

SOUPS

Barley contains gluten, so it makes sense that any soups containing barley will also contain gluten. You’ll also want to watch out for soups with noodles, another common source of gluten.

 

MALT BEVERAGES

Unfortunately, most beers, ales and lagers are not gluten-free. They’re made directly from gluten-producing grains, and they’re not distilled, so the gluten is not removed. There are several gluten-free beers coming onto the market now, though, so one of these may be worth trying out. Otherwise, you can stick to wine or hard liquor, both of which are gluten-free.

 

COFFEE

One study suggested that instant coffee was susceptible to gluten cross-contamination.1 If you’d like to avoid this, you may want to stick to ground coffee. You should also choose your coffee creamers carefully, because these can contain gluten as well.

 

MUSTARD

It might surprise you to know that some mustards are made with malt vinegar or wheat flour, which means they may contain gluten. Check the label to ensure that the kind you are buying doesn’t have these ingredients.

 

DESSERTS

Many candies and candy bars include wheat flour – a sure sign of gluten. It may also show up in certain pie and pudding fillings, and even in cheesecake. Some products that use caramel food coloring may also have gluten. If you’re concerned about this, it may be best to avoid these altogether.

 

VITAMINS AND SUPPLEMENTS

Even the most devoutly gluten-free among us rarely think to check their vitamins and supplements for gluten, but they could be hiding there as well. As mentioned above, gluten is a popular binding agent, and it can be used to hold the pills together.

 

You may see “starch” listed on the label, but that doesn’t necessarily mean there is gluten. Starch can come from a variety of sources, including corn, potatoes, and tapioca. What you want to watch out for is wheat starch, as this contains gluten. If the label isn’t clear about whether the supplement has gluten, you can always reach out to the manufacturer to be sure. One example of a high quality, whole food multivitamin without gluten is Enzyme Nutrition™, from Enzymedica.

 

MEDICATIONS

Going hand-in-hand with supplements, many medications also use starch as a filler or binding agent. Read the labels carefully on over-the-counter medications and talk to your doctor if it is a prescription to ensure that you are not inadvertently consuming gluten through your medications.

 

BEAUTY PRODUCTS

Certain beauty products like lipstick and lip balm may contain gluten, and because of their close proximity to your mouth, you could accidentally ingest some. If this is a worry for you, make sure you look for products that are gluten-free. You’ll also want to take a closer look at your toothpaste and mouthwash. Some of these may also contain gluten.

 

What Should I Do?

There’s no rule stating that a gluten-free product must announce that it’s gluten-free, so it’s a good idea to examine the ingredient list if you’re not sure. Look out for mention of grains like wheat, barley, or rye. Then, check for trickier names like seitan, brewer’s yeast, malt vinegar, oats and spelt. These may also contain gluten. Be careful of products that advertise themselves as being “wheat-free.” This is not the same as being gluten-free. Barley and spelt, for example, are both grains that contain gluten, but they are not wheat, so it would be accurate for a label to say that a product containing them is “wheat-free.” However, they are not any better for you than a wheat-containing product if your goal is to avoid gluten. If you’re not sure whether or not a product contains gluten, it’s always a good idea to reach out to the manufacturer. Many companies may list this information on their website. Otherwise, a quick call or email will usually clear up the matter. You might consider taking GlutenEase™ or GlutenEase™ Extra Strength. These products support the breakdown of gluten components in the event that it is accidentally consumed, providing an additional safety net.

 

Sources:

1 Vojdani, A., Tarash, I. (2013, Jan.). Cross-Reaction between Gliadin and Different Food and Tissue Antigens. Food and Nutrition Sciences. 4(1): 20-32

 

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