Can Enzymes Make the Meal?

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The study does not discuss the costs of any of the products mentioned.  You could say, “well it doesn’t amount to very much,” we suppose.  But 70% of the nearly 1,900 stories we’ve reviewed fail to adequately discuss cost.  It all adds up.  We think it’s an important item to include in any story about claims for health care interventions.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Not Satisfactory

The story lacks precision in describing the benefits of some products that have actually been studied in human tests (e.g. lactase and Bean-o), but then gives too much detail about products that have only been tested in lab studies. Does anybody care that a pill results in “60% [of] large gluten molecules broken down in a half-hour and 75% at 90 minutes” in a test tube? No. We care what happens inside people’s bodies and whether the products produce actual symptom relief. It’s particularly upsetting that the story concludes with a plug for these test tube benefits, when a few paragraphs earlier we are told that the products have never been tested in human trials.

Does the story adequately explain/quantify the harms of the intervention?

Not Satisfactory

The story makes a half-hearted attempt here. It says that new over-the-counter enzymes are made by fungi and haven’t been tested in humans. And it suggests that anyone with a fungal allergy should “use the products with caution.” It also passes along a company spokespersons’ observation that  “only occasional side effects” are reported by customers taking one of their supplements.

But the company phone line is hardly an accurate tool for assessing possible harms and side effects of these products. And vague warnings about possible allergic reactions don’t qualify as useful information for decision-making. If there are safety concerns with any of these products, the story should have spelled them out more clearly and described what the risks are.

Does the story seem to grasp the quality of the evidence?

Not Satisfactory

There are some notes of caution sprinkled throughout the piece. For example:

“there are not high-quality, well-designed studies” that prove [the products] work in humans

since the enzymes can work slowly, he says he is skeptical the capsules will work fast enough for many patients, who experience symptoms in minutes or hours.

But for every such caveat, it seems, there is a quote from a company spokesperson touting how effective the new products are in lab tests:

Both companies say lab tests show their enzymes do what they are expected to do. For example, says Jeremy Appleton, a naturopathic doctor at Schwabe, proteases are tested to make sure they efficiently break down proteins.

Such tests provide very little assurance as to how the products will perform inside a human stomach or whether they will provide actual symptom relief. The story should have done a better job of communicating this, or, better yet, left out these comments entirely.

The story should also have done a better job explaining what kind of evidence supports the established enzyme products, lactase and Bean-o. The story cites “doctors” and “published human trials” as the evidence that these products work–not good enough for a satisfactory rating.

Does the story commit disease-mongering?

Not Satisfactory

We’ll flag the story for casually throwing around the term “gluten sensitivity,” which the story says can produce “symptoms such as stomach aches, joint pain, fatigue and headaches.” These are generalized complaints that are unlikely to be caused by gluten, and we think this description will help feed the public’s (largely unfounded) fear that gluten is a harmful substance that should be avoided. While some researchers now believe that certain people do experience adverse effects from gluten that are not a result of celiac disease (i.e. “gluten sensitivity”), the number of people affected is most certainly tiny compared to the number of people who think they are sensitive to gluten. The story makes gluten sensitivity sound like a garden variety ailment, when in fact it’s an uncommon and poorly understood phenomenon–if it even exists at all.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story at least gave a nod to Lactase and Beano products, but it doesn’t address other common-sense approaches that may help treat gas and bloating: avoiding the foods that give you trouble, avoiding fat-rich meals, eating smaller meals, etc.