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PubMed1993

Adaptation of lactose maldigesters to continued milk intakes.

Twenty-five lactose-maldigesting and lactose-intolerant African Americans, ranging in age from 13 to 39 y, were given gradually increasing amounts of lactose in milk over a period of time until the maximum lactose dose tolerated was determined. Seventeen (77%) of the 22 subjects who completed the study tolerated > or = 12 g lactose and 5 (23%) tolerated < 12 g. Breath-hydrogen tests done on each subject with the maximum dose of lactose tolerated showed that only four (18%) had a breath-hydrogen concentration < 5 ppm above fasting concentration. This study suggests that the majority of African-American young adults who claim intolerance to moderate amounts of milk can ultimately adapt and tolerate > or = 12 g lactose in milk (the equivalent of 8 oz of full-lactose milk) with minimal or no discomfort if milk is ingested in gradually increasing amounts. The mechanism of adaptation is assumed to be an increased tolerance to colonic lactose-fermentation products.

Adaptation, Physiological↗
PubMed1976

Utilization of a low-lactose milk.

This study was undertaken to determine if a milk containing prehydrolyzed lactose, yet affording full nutritional benefits, could be ingested by a milk intolerant (MI) population without the symptoms of lactose intolerance. MI was defined by the failure of serum glucose to rise greater than 20 mg/100 ml after ingestion of 50 gm of lactose as well as by subjective and objective symptoms and signs after consumption of both 12.5 gm of lactose in water and 250 ml of skim milk. Lactose tolerance (LT) was evidenced by both lack of symptoms and a concomitant rise in serum glucose of greater than 20 mg/100 ml after ingestion of 50 gm lactose in water. A series of four, two hr tolerance tests were given to 12 MI patients and 12 LT controls. The following solutions were employed: 12.5 gm lactose, 250 ml skim milk. 250 ml low-lactose skim milk, and 6 gm glucose plus 6 gm galactose. In the MI group, significant differences were apparent between the tolerance test utilizing skim milk and that using low-lactose skim milk; no such differences were observed in the LT group. These observations indicate that in the MI population the lactose in skim milk was poorly absorbed or tolerated, but after hydrolysis the low-lactose skim milk was well tolerated. A MI individual then, appears able to absorb the monosaccharides of the prehydrolyzed milk and can, furthermore, tolerate the low-lactose skim milk without suffering from symptoms normally associated with lactose intolerance.

Animals↗
PubMedDate not supplied

[Nutritional status and breath hydrogen test with lactose and lactulose in Terena Indian children].

OBJECTIVE: To evaluate the nutritional status, absorption and tolerance of lactose and the occurrence of small-bowel bacterial overgrowth. METHODS: A cross-sectional study including all 264 Terena Indian children younger than 10 years from two tribes (Limão Verde and Córrego Seco) in Mato Grosso do Sul. The nutritional status was assessed based upon weight and height, using NCHS data as reference. The breath hydrogen test after an oral lactose (18 g) administration was used for evaluation of lactose absorption and tolerance. The occurrence of bacterial overgrowth was evaluated using the breath hydrogen test after the administration of lactulose (5 g). RESULTS: The median z scores of weight-for-age, weight-for-height and height-for-age were, respectively, in infants under 1 year (n=34): -0.66, +0.60 and -0.85. Between 1 and 5 years (n=111), the values were: -0.50, +0.28 and -1.17. Between 5 and 10 years (n=119), these anthropometric values were, respectively: -0.09, +0.50 and -0.60. Deficient lactose absorption or malabsorption was verified only after the fourth year of age in 89.3% of the 197 evaluated children. Lactose intolerance was found in 37.1% of them. Small-bowel overgrowth was detected in 11.5% of the Terena Indian children (n=252). CONCLUSIONS: The prevalence of recent malnutrition was low, but the median height-for-age was lower than the NCHS reference. The prevalence of ontogenetic lactase deficiency was high. Bacterial overgrowth may be considered as evidence of the occurrence of nonsymptomatic environmental enteropathy in Terena Indian children.

English Abstract↗
PubMed1974

Public health and genetic constitution of the San ("Bushmen"): carbohydrate metabolism and acetylator status of the Kung of Tsumkwe in the North-western Kalahari.

Intolerance to lactose owing to deficiency of lactase is particularly prevalent among non-Caucasian peoples. Special caution is therefore needed in offering them milk supplements. Lactose tolerance has been investigated among the!Kung in the north-western Kalahari. The opportunity was taken also to examine their acetylator status, as this affects their ability to detoxicate drugs given for the treatment of tuberculosis and other diseases.The preliminary studies reported here suggest that not more than 10% of the!Kung are tolerant to lactose, but only one person out of 30 was a slow acetylator.

Acetylation↗
PubMed1994

Diagnosis of hypolactasia and lactose malabsorption.

The article briefly describes the various methods that are available for diagnosing hypolactasia. Special attention is drawn to the fact that different methods are useful at different levels of the health care organization. When the test result indicates lactose malabsorption, general malabsorption should be excluded by a glucose-galactose tolerance test, for example. If the glucose-galactose tolerance test produces a normal result, it can be assumed that the patient has primary adult-type selective lactose malabsorption. The possibility of secondary lactose malabsorption must be excluded according to the principles described by Villako & Maaroos (104).

Diagnosis, Differential↗