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.
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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 billirubin (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 hypochloridia or low stomach acid.
What you can 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.