What dietary nutrients can be low, affecting pancreatic elastase?

From the Guidelines

Deficiencies in fat-soluble vitamins (A, D, E, and K), zinc, protein, essential fatty acids, antioxidants, B vitamins, and magnesium can affect pancreatic elastase levels and should be addressed through a balanced diet or supplementation to support pancreatic function and enzyme production. Several nutrients in the diet can impact pancreatic elastase production, particularly those involved in pancreatic function and enzyme production.

Key Nutrients

• Fat-soluble vitamins (A, D, E, and K) require proper fat digestion and absorption, which depends on pancreatic enzymes 1.
• Zinc deficiency plays a crucial role in pancreatic enzyme synthesis and secretion 1.
• Protein malnutrition can affect elastase production since enzymes themselves are proteins 1.
• Essential fatty acids, particularly omega-3 fatty acids, help reduce pancreatic inflammation and support proper enzyme function 1.
• Antioxidants like selenium and vitamins C and E protect the pancreas from oxidative damage 1.
• B vitamins, especially B12, are necessary for proper cell function including pancreatic cells 1.
• Magnesium deficiency may impair pancreatic enzyme secretion 1. These nutrient deficiencies often occur together in conditions like malabsorption syndromes, chronic pancreatitis, cystic fibrosis, or celiac disease, which can further compromise pancreatic function in a cyclical manner 1.

Management

Addressing these nutritional deficiencies through a balanced diet or supplementation may help support pancreatic function and elastase production, ultimately improving morbidity, mortality, and quality of life outcomes 1.

From the Research

Nutrients in Diet Affecting Pancreatic Elastase

• The exclusion of meat from the diet for a 1-month period results in significant changes in pancreatic secretion with a selective decrease of elastase-1 output 2.
• Extreme changes in diet, such as a nearly fat-free diet with low cholesterol content, a high-fat diet with low cholesterol, a high-cholesterol diet deriving from meat, and a high-cholesterol diet deriving from eggs, do not significantly impact fecal enzyme concentration/activity 3.
• A diet low in fat and cholesterol may not significantly influence pancreatic exocrine function, as measured by fecal elastase 1 and chymotrypsin activity in stool 3.
• Malnutrition, including deficiencies in fat-soluble vitamins, can occur in individuals with severe pancreatic exocrine insufficiency (PEI) 4, 5.
• The fecal elastase-1 test can be used to evaluate pancreatic exocrine function and screen for PEI in patients with symptoms suggestive of pancreatic disease or established diagnoses of pancreatic disease 6.

Specific Nutrients and Pancreatic Elastase

• Fat intake: a high-fat diet does not significantly impact fecal enzyme concentration/activity 3.
• Cholesterol intake: a high-cholesterol diet deriving from meat or eggs does not significantly impact fecal enzyme concentration/activity 3.
• Protein intake: the exclusion of meat from the diet results in a selective decrease of elastase-1 output 2.
• Fat-soluble vitamins: deficiencies in these vitamins can occur in individuals with severe PEI 4, 5.