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Digestion is the process by which the body breaks down food into absorbable nutrients. The body absorbs and assimilates everything that we ingest. Digestion includes physical actions such as chewing and peristalsis (involuntary contraction and dilation of muscles to force forward movement), as well as the chemical actions of enzymes, bile and acids.

An enzyme is a protein that acts as a catalyst in a biological reaction. It binds itself to a substance and converts it into another substance. Enzymes are very specific in their functions, which is why there are different enzymes for different biological reactions. In the case of digestion, distinct forms of food require specific enzymes. Food is digested in three areas of the body: the mouth, the stomach and the intestines.

On This Page
The Mouth
The Stomach
The Intestines
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The Mouth
Beginning in the mouth with chewing, food is physically broken up into small pieces to facilitate the beginning of complete digestion. Chewing thoroughly is an important step because smaller pieces offer more surface area for contact with the digestive enzymes and acids in the stomach and are therefore more easily digested. Chewing also stimulates the release of hormones that control appetite. The longer you chew, the less likely you are to overeat.

Only one digestive enzyme, amylase (for starch), is present in the mouth. However, food is normally not in the mouth long enough to permit complete digestion and little nutrient absorption takes place in the mouth.

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The Stomach
 The primary function of the stomach is to break large proteins into smaller peptides and peptones. The acidic environment in the stomach (1.5 to 7.0 pH) is home to the enzyme pepsin, used to digest proteins. Pepsin breaks up proteins into smaller peptides of varying lengths. Other enzymes such as gelatinase (for gelatin) digest specific proteins.  

Amylase (for starch) is inactivated, or destroyed, when stomach pH falls below 6.5.1 Before this happens however, up to 50% of starches may be partially broken down. Some fat is emulsified (broken up into smaller pieces) in the stomach by bile acids, and the enzyme lipase, to aid digestion in the small intestine. At the average stomach pH of 2.0, however, most fat is formed into large globules that pass unchanged into the small intestine. Small amounts of sucrose (table sugar) may be broken apart into glucose and fructose by acid hydrolysis from the bile acids in the stomach.

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The Intestines
Virtually all absorption of nutrients (macronutrients such as carbohydrates and fats and micronutrients such as vitamins and minerals) occurs in the intestines. Absorption of nutrients is, in fact, the primary function of the small intestine. Most carbohydrates, for instance, are absorbed in the small intestine. The pancreatic enzymes secreted into the small intestine also contain amylase which breaks down starches into a disaccharide (a complex carbohydrate) called maltose.2 In the intestines, enzymes such as maltase and lactase break disaccharides into single sugars, such as glucose. When adults and older children do not have enough lactase to digest lactose (the sugar in milk) lactose intolerance results and milk cannot be completely digested.

When food leaves the stomach, digestion is completed in the small intestine with the help of the enzymes secreted by the pancreas (lipase, amylase, protease, maltase, trypsin and chymotrypsin). The pH of food mass increases from about 2.0 to 6.5 (still slightly acidic), as it passes from the stomach through the small intestine to the colon. Very few nutrients, except water, is absorbed by the large intestine (colon).

WATER is the most important macro nutrient we consume. Over 50% of our body weight is water. Beverages provide just under half of the water we require each day. The rest of the water is from food. Water also aids digestion as part of the food mass in the intestines. Motility, the movement of food in the digestive tract, is more effective if more water is retained in the food. When food reaches the colon, most of the water is reabsorbed.
CARBOHYDRATE digestion occurs primarily in the small intestine. Most carbohydrates are easily digested and 90% to 98% are absorbed.1 Bile acids in the stomach aid in acid hydrolysis to break sucrose down into glucose and fructose. Before the stomach pH falls below 6.5, destroying amylase, up to 50% of starches may be partially broken down, but digestion of most carbohydrates is done in the small intestine.1
FIBER, a complex carbohydrate, makes up the remaining 2% to 10% of unabsorbed carbohydrates. Dietary fiber can be further subdivided into soluble and insoluble fibers.1  Insoluble fibers (such as lignins and cellulose from vegetables, grains and nuts) increase fecal bulk and decrease transit time through the intestines.3 They are partially digested by intestinal bacteria but are not absorbed well. Soluble fibers (such as pectins and gums from fruits, beans and grains) delay stomach emptying, slow the absorption rate of glucose and help to lower the levels of fats and cholesterol in the blood.4  Pectins are neither digested nor absorbed, but gums may be partially digested by intestinal bacteria and absorbed1 providing food for the cells lining the colon.
FATS, (or lipids) such as those found in egg yolks, can be broken into glycerol and fatty acids by stomach acids, but most fat digestion occurs in the small intestine. Bile, secreted by the gall bladder, emulsifies large fat particles and breaks them into a smaller size so that pancreatic and intestinal lipases can digest the fats. The lipase enzymes are responsible for the majority of fat digestion. Fats are 95% to 100% digestible in healthy people.1 Bile salts also facilitate absorption of fatty acids
PROTEIN digestion starts with stomach enzymes (proteases) such as pepsin that break apart specific links in the amino acid chains that comprise proteins. These chains are reduced to much shorter lengths, called peptides and peptones. The partially digested proteins move onto the small intestine where pancreatic protease continues digestion, breaking the peptides and peptones into individual amino acids which are absorbed directly or attached (chelated) to minerals, thus allowing mineral absorption.

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Protein digestibility varies widely 1:
bullet 
From vegetables and fruits: 65% to 85%  
bulletFrom legumes: 78%  
bulletFrom cereals and grains: 76% to 84%  
bulletFrom milk, meat and eggs: 97%
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If protein digestion is incomplete, longer peptide chains of undigested proteins can be absorbed, possibly causing allergic reactions.5 Symptoms of food allergies vary widely and can affect any part of the body.

BACTERIA and PROBIOTICS such as Lactobacillus acidophilus also are important digestive aids and sources of nutrition. Intestinal bacteria synthesize biotin and vitamin K, both essential nutrients.5 Lactobacillus acidophilus and other friendly intestinal bacteria can help the intestines maintain a healthy colon against an onslaught of unhealthy pathogenic bacteria such as E. coli or salmonella, especially in infants.6 These friendly probiotic bacteria also help the digestion of proteins, carbohydrates and fats.6, 7 Probiotics (or “friendly” bacteria) can be found naturally in the body, but the majority are ingested in foods or as supplements.

The digestion of foods and the absorption of nutrients is the first, and most important, step to good health. Our bodies are designed to get the highest possible benefit from food, but digestive aids are sometimes needed. Many of us also supplement our diet to ensure we obtain adequate nutrition. The proper absorption of dietary supplements is just as important as the proper digestion of food, and the two work closely together. 

References:
Guthrie, J.A., Ph.D. Introductory Nutrition, The C.V. Mosby Company, St Louis; 1975.
Pike, R.L., Ph.D. & Brown, M.L., Ph.D., Nutrition: An Integrated Approach, John Wiley & Sons, Inc. New York;1975
Kundsen, K.E.B., et al. Physiological Implications of Wheat and Oat Dietary Fibers in New Developments in Dietary Fiber, 1990; Advances in Experimental Medicine and Biology, 1990;270:135-147.
Anderson, J.W. and Ward, K. High carbohydrate, high fiber diets for Insulin-treated men with diabetes mellitus. American Journal of Clinical Nutrition, 1979;32-2312.
Alpers, D.A. M.D., Clouse, R.E., M.D. & Stenson, W.F., M.D. Manual of Nutritional Therapeutics, Little Brown & Company, 1984.  
Friend, B.A. et al. Nutritional and Therapeutic Aspects of Lactobacilli. Journal of Applied Nutrition, 1984;36(2):125-153. 
Fernandes, C.F., et al. Therapeutic role of dietary Lactobacilli and Lactobacillus fermented dairy products. Fed of Eur Microbiol Rev, 1987;46:343-356.  
 
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