Know-how and Know-why Nutrients may be Less Bioaccessible and Less Bioavailable due to Proton Pump Inhibitor - Food Interactions and Incompatibilities Involving Metal-Aquo Complexes

Abstract

Peptide bonds of proteins and acetal bonds of carbohydrates are both hydrolyzed enzymatically and non-enzymatically in an acidic environment. A major problem of raising gastric pH permanently is impaired non-enzymatic as well as acid catalyzed cleavage of peptide and glycosidic bonds, i.e. malfunction of proteolysis and hydrolysis of di-, oligo-, and polysaccharides. In the modified gastric environment, drugs and nutritional components may be differently soluble, differently dissociated, and/or differently hydrolyzed, and therefore have modified absorption and bioavailability profiles. The topic is of major public health importance due to high prevalence of gastrointestinal pathologies and number of PPI prescriptions worldwide, estimated to some 120 million annually [3,4]. Multiple factors have an impact on bioavailability of drugs, i.e. [5] • The drug's profile related to solubility and dissolution, i.e. o Dissociation degree o Hydrogen bond building

Nutrigenomics-Associated Impacts of Nutrients on Genes and Enzymes With Special Consideration of Aromatase

“…These xenobiotics have rather low pK a values. Their absorption by passive diffusion therefore needs acidic pH conditions for absorption from the upper GI tube and treatments with antacids such as PPIs are likely to inhibit the quantitative absorption of NSAIDs or benzodiazepines and result in clearly lower anti-inflammatory effects (32).…”

“…Absorption of such oligo-elements follows the rules of solubility of aqua-complexes which is in turn dramatically depending on pH. The example of iron aqua-complexes shows that at pH conditions encountered at the jejuno-duodenal junction, where pH raises steeply, iron becomes less soluble as a result of a sequence of deprotonations of its aquacomplexes from a 3-or 2-fold positively charged to an uncharged insoluble complex in both cases of ferric iron and ferrous iron: (32,(47)(48)(49).…”

“…The repeated supply of smaller amounts of oligoelements is more likely to lead to an efficient absorption and distribution than with high loading doses. Copper and cobalt but not manganese and zinc aquo-complexes suffer as well from partial loss when pH conditions are unfavorable for absorption (32,(47)(48)(49).…”

Essentials of Bioaccessibility and Bioavailability for Applied Nutritional Practices

“…This difference does not exist in adults aged 60-83. Contraceptives in women aged 20-39 increase plasma levels of copper and ceruloplasmin, but not its absorption [2][3][4][5][6][7].…”