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Xu, Yunli, Guowei Shu, Chunji Dai, Chun Yin, Xu Dong, Yuliang Guo, and He Chen. "Screening of lactases suitable for the preparation of low-lactose prebiotic liquid milk and optimisation of their combination." Acta Universitatis Cibiniensis. Series E: Food Technology 25, no. 2 (December 1, 2021): 275–84. http://dx.doi.org/10.2478/aucft-2021-0025.
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Abstract Lactose intolerance is an important factor restricting the consumption of dairy products. Lactase is used to hydrolyze lactose in milk while generating galactooligosaccharides (GOS), thereby reducing the incidence of lactose intolerance. We used cow milk as raw materials, and selected enzyme preparations with high lactose hydrolysis rate and strong GOS generation ability from 14 commercially available lactase enzymes. The lactose hydrolysis rate is 5.85%-81.38%, and the GOS content is 0.03 g/L- 13.10 g/L. The mixing experiment design determined the two lactase enzymes (E10 and E11) ratio and the optimal enzymatic hydrolysis process of low-lactose prebiotic milk: compound lactases (E10:E11=0.756:0.244) addition 0.11%, 55℃for 5h, lactose hydrolysis rate and GOS content were 98.02% and 19.69g/L, respectively, and the remaining lactose content was about 0.97 g/L.
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Zhao, Di, Thao T. Le, Lotte Bach Larsen, Yingqun Nian, Cong Wang, Chunbao Li, and Guanghong Zhou. "Interplay between Residual Protease Activity in Commercial Lactases and the Subsequent Digestibility of β-Casein in a Model System." Molecules 24, no. 16 (August 8, 2019): 2876. http://dx.doi.org/10.3390/molecules24162876.
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One of the conventional ways to produce lactose-hydrolyzed (LH) milk is via the addition of commercial lactases into heat-treated milk in which lactose is hydrolyzed throughout storage. This post-hydrolysis method can induce proteolysis in milk proteins due to protease impurities remaining in commercial lactase preparations. In this work, the interplay between lactose hydrolysis, proteolysis, and glycation was studied in a model system of purified β-casein (β-CN), lactose, and lactases using peptidomic methods. With a lactase presence, the proteolysis of β-CN was found to be increased during storage. The protease side-activities mainly acted on the hydrophobic C-terminus of β-CN at Ala, Pro, Ile, Phe, Leu, Lys, Gln, and Tyr positions, resulting in the formation of peptides, some of which were N-terminal glycated or potentially bitter. The proteolysis in β-CN incubated with a lactase was shown to act as a kind of “pre-digestion”, thus increasing the subsequent in vitro digestibility of β-CN and drastically changing the peptide profiles of the in vitro digests. This model study provides a better understanding of how the residual proteases in commercial lactase preparations affect the quality and nutritional aspects of β-CN itself and could be related to its behavior in LH milk.
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Szilagyi, Andrew. "Adult Lactose Digestion Status and Effects on Disease." Canadian Journal of Gastroenterology and Hepatology 29, no. 3 (2015): 149–56. http://dx.doi.org/10.1155/2015/904686.
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BACKGROUND: Adult assimilation of lactose divides humans into dominant lactase-persistent and recessive nonpersistent phenotypes.OBJECTIVES: To review three medical parameters of lactose digestion, namely: the changing concept of lactose intolerance; the possible impact on diseases of microbial adaptation in lactase-nonpersistent populations; and the possibility that the evolution of lactase has influenced some disease pattern distributions.METHODS: A PubMed, Google Scholar and manual review of articles were used to provide a narrative review of the topic.RESULTS: The concept of lactose intolerance is changing and merging with food intolerances. Microbial adaptation to regular lactose consumption in lactase-nonpersistent individuals is supported by limited evidence. There is evidence suggestive of a relationship among geographical distributions of latitude, sunhine exposure and lactase proportional distributions worldwide.DISCUSSION: The definition of lactose intolerance has shifted away from association with lactose maldigestion. Lactose sensitivity is described equally in lactose digesters and maldigesters. The important medical consequence of withholding dairy foods could have a detrimental impact on several diseases; in addition, microbial adaptation in lactase-nonpersistent populations may alter risk for some diseases. There is suggestive evidence that the emergence of lactase persistence, together with human migrations before and after the emergence of lactase persistence, have impacted modern-day diseases.CONCLUSIONS: Lactose maldigestion and lactose intolerance are not synonymous. Withholding dairy foods is a poor method to treat lactose intolerance. Further epidemiological work could shed light on the possible effects of microbial adaptation in lactose maldigesters. The evolutionary impact of lactase may be still ongoing.
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Montgomery, Robert K., Stephen D. Krasinski, Joel N. Hirschhorn, and Richard J. Grand. "Lactose and Lactase—Who Is Lactose Intolerant and Why?" Journal of Pediatric Gastroenterology and Nutrition 45, Suppl 2 (December 2007): S131—S137. http://dx.doi.org/10.1097/mpg.0b013e31812e68f6.
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Forsgård, Richard A. "Lactose digestion in humans: intestinal lactase appears to be constitutive whereas the colonic microbiome is adaptable." American Journal of Clinical Nutrition 110, no. 2 (June 8, 2019): 273–79. http://dx.doi.org/10.1093/ajcn/nqz104.
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ABSTRACTGlobally, ∼70% of adults are deficient in intestinal lactase, the enzyme required for the digestion of lactose. In these individuals, the consumption of lactose-containing milk and dairy products can lead to the development of various gastrointestinal (GI) symptoms. The primary solution to lactose intolerance is withdrawing lactose from the diet either by eliminating dairy products altogether or substituting lactose-free alternatives. However, studies have shown that certain individuals erroneously attribute their GI symptoms to lactose and thus prefer to consume lactose-free products. This has raised the question whether consuming lactose-free products reduces an individual's ability to absorb dietary lactose and if lactose-absorbers should thus avoid these products. This review summarizes the current knowledge regarding the acclimatization of lactose processing in humans. Human studies that have attempted to induce intestinal lactase expression with different lactose feeding protocols have consistently shown lack of enzyme induction. Similarly, withdrawing lactose from the diet does not reduce intestinal lactase expression. Evidence from cross-sectional studies shows that milk or dairy consumption is a poor indicator of lactase status, corroborating the results of intervention studies. However, in lactase-deficient individuals, lactose feeding supports the growth of lactose-digesting bacteria in the colon, which enhances colonic lactose processing and possibly results in the reduction of intolerance symptoms. This process is referred to as colonic adaptation. In conclusion, endogenous lactase expression does not depend on the presence of dietary lactose, but in susceptible individuals, dietary lactose might improve intolerance symptoms via colonic adaptation. For these individuals, lactose withdrawal results in the loss of colonic adaptation, which might lower the threshold for intolerance symptoms if lactose is reintroduced into the diet.
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Angima, Gloria, Yunyao Qu, Si Hong Park, and David C. Dallas. "Prebiotic Strategies to Manage Lactose Intolerance Symptoms." Nutrients 16, no. 7 (March 29, 2024): 1002. http://dx.doi.org/10.3390/nu16071002.
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Lactose intolerance, which affects about 65–75% of the world’s population, is caused by a genetic post-weaning deficiency of lactase, the enzyme required to digest the milk sugar lactose, called lactase non-persistence. Symptoms of lactose intolerance include abdominal pain, bloating and diarrhea. Genetic variations, namely lactase persistence, allow some individuals to metabolize lactose effectively post-weaning, a trait thought to be an evolutionary adaptation to dairy consumption. Although lactase non-persistence cannot be altered by diet, prebiotic strategies, including the consumption of galactooligosaccharides (GOSs) and possibly low levels of lactose itself, may shift the microbiome and mitigate symptoms of lactose consumption. This review discusses the etiology of lactose intolerance and the efficacy of prebiotic approaches like GOSs and low-dose lactose in symptom management.
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Rachwał, Krystian, Karol Wielgus, Piotr Bator, Wiktor Razik, Grzegorz Łyko, Maria Antos, Julia Furgalska, Maria Pawłowska, and Angelika Wawryszuk. "Lactase Deficiency and Lactose Intolerance: Current Understanding and Future Directions." Journal of Education, Health and Sport 69 (May 17, 2024): 49393. http://dx.doi.org/10.12775/jehs.2024.69.49393.
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Introduction and purpose: Lactose, the primary carbohydrate in milk, requires the enzyme lactase for digestion. Deficiency in lactase activity leads to lactose intolerance, causing gastrointestinal symptoms. Understanding the genetic and environmental factors influencing lactase expression and activity is crucial. Moreover, accurate diagnostic methods and effective treatments are needed to manage lactose intolerance. This review aims to explore the current knowledge on lactase deficiency, lactose intolerance, diagnostic methods, and treatment options. State of knowledge: Lactase deficiency encompasses congenital, primary, and secondary forms, each with distinct etiologies. Although often used interchangeably, lactase deficiency and lactose intolerance differ. However, the association between lactase deficiency and lactose intolerance is complex, influenced by various factors including dietary habits, gut microbiota, and gastrointestinal motility. Diagnostic methods are limited, and treatment strategies primarily involve dietary modifications, lactase supplementation, and probiotics. Conclusion: Lactose intolerance presents significant clinical challenges, often underrecognized and misdiagnosed. Despite diagnostic advancements further research is needed to refine diagnostic accuracy. Treatment focuses on dietary adjustments, enzyme supplementation, and probiotics. Balancing symptom relief with nutritional adequacy is essential. Future studies should explore the role of gut microbiome modulation in lactose intolerance management through clinical trials.
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Lee, Ja Hyun, Hah Young Yoo, Da Un Jung, Charnho Park, Yoon Seok Song, Chulhwan Park, and Seung Wook Kim. "Research Trend of Lactulose Production from Lactose." Korean Chemical Engineering Research 52, no. 4 (August 1, 2014): 407–12. http://dx.doi.org/10.9713/kcer.2014.52.4.407.
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Shao, Xiyue. "Brief classification and latest therapy for lactose intolerance." Theoretical and Natural Science 6, no. 1 (August 3, 2023): 299–305. http://dx.doi.org/10.54254/2753-8818/6/20230257.
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Lactose intolerance is a digestive problem with a high incidence worldwide. The disease occurs mainly due to a lack or deficiency of lactase in the body, which prevents effective digestion of lactose. Congenital lactose intolerance is caused by a genetic defect that prevents the body from producing enough lactase, and its incidence is relatively low. Secondary lactose intolerance is caused by other gastrointestinal disorders, such as celiac disease, and is relatively common. Functional lactose intolerance is the most common form of lactose intolerance, in which lactase activity is reduced or lactose absorption is impaired, but there is no apparent organic disease. This article lists several possible solutions for different types of lactose intolerance based on the latest research. In studies of lactose intolerance, scientists have found that the rate of lactose intolerance varies widely across populations, with significant differences in prevalence by race and region. In addition, several studies have shown a link between lactose intolerance and the composition of the gut microbiome. Therefore, the study of lactose intolerance has important implications for understanding how the human digestive system works and the relationship between the gut microbiome and health.
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Szilagyi, Andrew, Albert Cohen, Christina Vinokuroff, Darakhshan Ahman, Usha Nathwani, and Samara Yesovitch. "Deadaption and Readaptation with Lactose, But No Cross-Adaptation to Lactulose: A Case of Occult Colonic Bacterial Adaptation." Canadian Journal of Gastroenterology 18, no. 11 (2004): 677–80. http://dx.doi.org/10.1155/2004/763529.
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The standard 3 h breath hydrogen (3hBH2) test distinguishes lactose maldigesters from lactose digesters. However, multiple factors impact on BH2and care is needed to exclude a priori variables. When these factors are controlled, a negative BH2test implies lactase persistent status or lactase nonpersistent status with colonic adaptation. A case of a Sicilian man who tested negative (lactase persistent status confirmed) on an initial 50 g lactose challenge is described. It was observed that he consumed 28.1 g lactose/day before testing. He subsequently underwent five additional challenge tests in the course of the next 10 months. In four tests the dose intake of lactose was varied upon instruction, and in the fifth test a 30 g lactulose challenge was carried out. It was demonstrated that on radically decreasing lactose intake, a full lactase nonpersistent status was unmasked. Output of 3hBH2varied inversely with daily lactose intake. Finally, at a time when he was readapted to lactose, there was no discernible adaptation to lactulose challenge. It was concluded that 'occult' colonically adapted subjects may contribute to negative BH2tests. There is a relationship between variation in lactose intake and the results of BH2testing. Finally, there was no cross-adaptation to lactulose challenge when lactose was used as the adapting sugar.
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Marushko, Yurii, and Svitlana Yesypova. "The Problem of Lactase Deficiency: Diagnosis and Treatment Approaches in Children." Family medicine. European practices, no. 3 (September 29, 2023): 29–34. http://dx.doi.org/10.30841/2786-720x.3.2023.289337.
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The article is devoted to one of the most urgent problems of pediatrics – the malabsorption syndrome caused by lactose intolerance in children of different age periods. Lactose intolerance refers to the inability of the intestinal enzyme systems to break down lactose, which manifests itself clinically. In fact, lactose intolerance is a clinical manifestation of lactase deficiency (LD), that is, a decrease in the activity of lactase in the intestine, which can be congenital or acquired. The purpose of the study is to analyze literature data on the factors of occurrence and clinical manifestations of lactase deficiency in children and to summarize the tactics of managing children with this pathology. In the world literature it is noted that lactase deficiency can be primary and secondary and is clinically manifested both in children and adults, depending on the degree of activity of the lactase enzyme. Depending on the amount of lactose consumed and lactase activity, people with lactose malabsorption experience numerous gastrointestinal manifestations. Treatment for LD consists of reducing or eliminating lactose from the diet until symptoms resolve, supplementing the diet with enzyme substitutes or lactase supplements, and eating lactose-free alternatives (lactose-free products). Cow’s milk is one of the main sources of calcium and a number of other vitamins and minerals. Thus, the complete elimination of dairy products may contribute to the development of bone diseases such as osteopenia and osteoporosis, so the dietary approach plays a critical role in the management of patients with LD. In this regard, great attention is now being paid to the use of lactose-free milk in children and adults with LD.
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Cooper, B. T. "Lactase Deficiency and Lactose Malabsorption." Digestive Diseases 4, no. 2 (1986): 72–82. http://dx.doi.org/10.1159/000171139.
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Fassio, Filippo, Maria Facioni, and Fabio Guagnini. "Lactose Maldigestion, Malabsorption, and Intolerance: A Comprehensive Review with a Focus on Current Management and Future Perspectives." Nutrients 10, no. 11 (November 1, 2018): 1599. http://dx.doi.org/10.3390/nu10111599.
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Milk is a fundamental component of the diet of every mammal; nevertheless, not every individual can tolerate this kind of food, especially in adulthood. However, lactose intolerance has only been recognized in the last 50 years, and currently, lactose intolerance is defined as a clinical syndrome characterized by pain, abdominal distention, flatulence, and diarrhoea that occur after lactose consumption. Lactose is currently a common disaccharide in human nutrition, both in breastfed infants and in adults, but its digestion requires a specialized enzyme called lactase. The genetically programmed reduction in lactase activity during adulthood affects most of the world’s adult population and can cause troublesome digestive symptoms, which may also vary depending on the amount of residual lactase activity; the small bowel transit time; and, especially, the amount of ingested lactose. Several diagnostic tests are currently available for lactose intolerance, but the diagnosis remains challenging. The treatment for lactose intolerance mainly consists of reducing or eliminating the dietetic amount of lactose until the symptoms disappear, but this is hard to achieve, as lactose is present in dairy products and is even commonly used as a food additive. In addition to dietetic restriction of lactose-containing foods, lactase can be administered as an enzymatic food supplement, but its efficacy is still controversial. Recently, probiotics have been proposed for the management of lactose intolerance; certain probiotic strains have shown specific β-galactosidase activity, thus aiding in the digestion of lactose. The aim of this paper was to review the current knowledge about lactose intolerance and to discuss the potential for the use of specific probiotic strains such as dietary supplements in lactose-intolerant patients.
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Renner, E. "Dietary approaches to alleviation of lactose maldigestion / Efectos de la dieta sobre la digestión de la lactosa." Food Science and Technology International 3, no. 2 (April 1997): 71–79. http://dx.doi.org/10.1177/108201329700300201.
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Because dairy products are a significant source of essential nutrients, elimination of all dairy foods in the diet would be nutritionally unwise and is usually not necessary in the case of lactose maldigestion. About 250 ml milk/d can generally be taken without adverse effects. If milk is taken in combination with solid foods, lactose malabsorption may be reduced by about 50%, probably due to a slower rate of colonic fermentation which may lower gastrointestinal symptoms in lactose malabsorbers. It is well established that, in lactase-deficient subjects, yoghurt is better tolerated than milk. This is only to some extent related to the fact that the lactose content of the products is reduced during fermentation, but is mainly attributed to the fact that the culture organisms- by virtue of being rich in lactase - are able to participate in the hydrolysis of ingested lactose. Up to 20 g of lactose in yoghurt is tolerated well by lactase-deficient persons. The enhanced absorp tion of lactose in yoghurt is explained as a result of the intestinal release of lactase from the yoghurt organisms. Ripened cheese is also tolerated very well by lactose-intolerant persons since virtually all of the lactose present is decomposed to lactic acid and other metabolites.
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Romero-Velarde, Enrique, Dagoberto Delgado-Franco, Mariana García-Gutiérrez, Carmen Gurrola-Díaz, Alfredo Larrosa-Haro, Ericka Montijo-Barrios, Frits A. J. Muskiet, Belinda Vargas-Guerrero, and Jan Geurts. "The Importance of Lactose in the Human Diet: Outcomes of a Mexican Consensus Meeting." Nutrients 11, no. 11 (November 12, 2019): 2737. http://dx.doi.org/10.3390/nu11112737.
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Lactose is a unique component of breast milk, many infant formulas and dairy products, and is widely used in pharmaceutical products. In spite of that, its role in human nutrition or lactose intolerance is generally not well-understood. For that reason, a 2-day-long lactose consensus meeting with health care professionals was organized in Mexico to come to a set of statements for which consensus could be gathered. Topics ranging from lactase expression to potential health benefits of lactose were introduced by experts, and that was followed by a discussion on concept statements. Interestingly, lactose does not seem to induce a neurological reward response when consumed. Although lactose digestion is optimal, it supplies galactose for liver glycogen synthesis. In infants, it cannot be ignored that lactose-derived galactose is needed for the synthesis of glycosylated macromolecules. At least beyond infancy, the low glycemic index of lactose might be metabolically beneficial. When lactase expression decreases, lactose maldigestion may lead to lactose intolerance symptoms. In infancy, the temporary replacing of lactose by other carbohydrates is only justified in case of severe intolerance symptoms. In those who show an (epi)genetic decrease or absence of lactase expression, a certain amount (for adults mostly up to 12 g per portion) of lactose can still be consumed. In these cases, lactose shows beneficial intestinal-microbiota-shaping effects. Avoiding lactose-containing products may imply a lower intake of other important nutrients, such as calcium and vitamin B12 from dairy products, as well as an increased intake of less beneficial carbohydrates.
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Seoane, Rafael G., Verónica Garcia-Recio, Manuel Garrosa, María Á. Rojo, Pilar Jiménez, Tomás Girbés, Manuel Cordoba-Diaz, and Damián Cordoba-Diaz. "Human Health Effects of Lactose Consumption as a Food and Drug Ingredient." Current Pharmaceutical Design 26, no. 16 (May 21, 2020): 1778–89. http://dx.doi.org/10.2174/1381612826666200212114843.
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: Lactose is a reducing sugar consisting of galactose and glucose, linked by a β (1→4) glycosidic bond, considered as an antioxidant due to its α-hydroxycarbonyl group. Lactose is widely ingested through the milk and other unfermented dairy products and is considered to be one of the primary foods. On the other hand, lactose is also considered as one of the most widely used excipients for the development of pharmaceutical formulations. In this sense, lactose has been related to numerous drug-excipient or drug-food pharmacokinetic interactions. : Intolerance, maldigestion and malabsorption of carbohydrates are common disorders in clinical practice, with lactose-intolerance being the most frequently diagnosed, afflicting 10% of the world’s population. Four clinical subtypes of lactose intolerance may be distinguished, namely lactase deficiency in premature infants, congenital lactase deficiency, adult-type hypolactasia and secondary lactase intolerance. An overview of the main uses of lactose in human nutrition and in the pharmaceutical industry and the problems derived from this circumstance are described in this review.
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Vionnet, Nathalie, Linda H. Münger, Carola Freiburghaus, Kathryn J. Burton, Grégory Pimentel, François P. Pralong, René Badertscher, and Guy Vergères. "Assessment of lactase activity in humans by measurement of galactitol and galactonate in serum and urine after milk intake." American Journal of Clinical Nutrition 109, no. 2 (February 1, 2019): 470–77. http://dx.doi.org/10.1093/ajcn/nqy296.
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ABSTRACT Background Lactase is an enzyme that hydrolyzes lactose into glucose and galactose in the small intestine, where they are absorbed. Hypolactasia is a common condition, primarily caused by genetic programming, that leads to lactose maldigestion and, in certain cases, lactose intolerance. Galactitol and galactonate are 2 products of hepatic galactose metabolism that are candidate markers for the intake of lactose-containing foods. Objectives The primary objective of the study was to explore the changes in serum and urine metabolomes during postprandial dairy product tests through the association between lactase persistence genotype and the postprandial dynamics of lactose-derived metabolites. Methods We characterized the 6-h postprandial serum kinetics and urinary excretion of lactose, galactose, galactitol, and galactonate in 14 healthy men who had consumed a single dose of acidified milk (800 g) which contained 38.8 g lactose. Genotyping of LCT-13910 C/T (rs4988235) was performed to assess primary lactase persistence. Results There were 2 distinct postprandial responses, classified as high and low metabolite responses, observed for galactose, and its metabolites galactitol and galactonate, in serum and urine. In all but 1 subject, there was a concordance between the high metabolite responses and genetic lactase persistence and between the low metabolite responses and genetic lactase nonpersistence (accuracy 0.92), galactitol and galactonate being more discriminative than galactose. Conclusions Postprandial galactitol and galactonate after lactose overload appear to be good proxies for genetically determined lactase activity. The development of a noninvasive lactose digestion test based on the measurement of these metabolites in urine could be clinically useful. This trial was registered at clinicaltrials.gov as NCT02230345.
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Castellano, Beatriz França, Carolina Maria Aumann Sardá, Fernanda Prehs Izar, Khadija Assis Pascholatto, Laura Ribeiro Santos, Luísa Domingos Cancela Gonçalves, Maria Augusta Karas Zella, Liya Regina Mikami Wormsbecker, Andrea Maciel De Oliveira Rossoni, and Joachim Graf. "Intolerância à lactose: diagnóstico clínico laboratorial e genético." BioSCIENCE 80, no. 2 (November 1, 2022): 12. http://dx.doi.org/10.55684/80.2.12.
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Introdução: A intolerância à lactose é síndrome decorrente da má digestão do dissacarídeo lactose por deficiência da enzima lactase, gerando sintomas principalmente gastrintestinais. Ela envolve 4 causas principais: deficiência congênita de lactase; deficiência de lactase de desenvolvimento; intolerância primária à lactose; e deficiência secundária à lactase.
Objetivo: Revisão da apresentação clínica da intolerância à lactose e os principais métodos disponíveis para seu diagnóstico clínico.
Método: Revisão narrativa da base de dados PubMed, por meio das palavras-chave “lactose intolerance” e “genetic test” utilizando o descritor boleano and. Foram incluídos somente artigos em língua inglesa e publicados entre os anos de 2017 e 2022, totalizando 8 artigos.
Resultado: O diagnóstico de intolerância à lactose relaciona-se com o seu tipo e utiliza-se dos principais métodos: teste oral de tolerância à lactose, teste genético, teste do hidrogênio expirado.
Conclusão: Quanto aos métodos de diagnóstico, o teste do hidrogênio expirado é o de escolha, por não ser invasivo, possuir execução fácil e baixo custo. Entretanto, ele não dispensa associação com outras técnicas diagnósticas. O teste genético também é muito útil e sua vantagem é que não há necessidade da realização do teste oral de tolerância.
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Chin, Elizabeth, Liping Huang, Yasmine Bouzid, Joanne Arsenault, Charles Stephensen, and Danielle Lemay. "Estimated Daily Lactose Consumption in Healthy U.S. Adults in Relation to Lactase Persistence Genotype (rs4988235)." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 1250. http://dx.doi.org/10.1093/cdn/nzaa058_008.
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Abstract Objectives Lactase persistence (LP), a heritable trait in which lactose can be digested throughout adulthood, is often used to predict dairy intake. However, it is currently unknown how LP relates to daily lactose consumption in healthy US adults. The objective of the study was to estimate lactose from foods reported in the Automated Self-Administered 24-Hour Dietary Assessment Tool (ASA24) and to compare lactose and total dairy consumption in relation to LP genotypes. Methods ASA24 dietary data were collected from healthy Caucasians and Hispanics (n = 215) genotyped for the lactase persistence SNP ID: rs4988235. ASA24 outputs servings of dairy but not the nutrient lactose. Lactose was estimated by matching ASA24-reported foods to foods in the Nutrition Coordinating Center Food and Nutrient Database, which outputs lactose. Analysis of covariance was used to identify whether genotype influenced lactose and total dairy consumption with total energy intake and weight as covariates. Pairwise testing was conducted on the adjusted means using the Tukey adjustment to correct for multiple testing. Results Median lactose consumption for subjects with the AA genotype (homozygous LP) was 12.08 g (min: 0.91 g, max: 81.85 g), 10.05 g (min: 0.46 g, max: 45.82) for subjects with the AG genotype (heterozygous LP), and 8.97 g (min: 0.47, max: 38.96 g) for subjects with the GG genotype (homozygous lactase non-persistent). AA subjects consumed more lactose than GG subjects (P = 0.024). When stratifying by sex, there were no significant differences among genotypes in women, although GG women consumed the least amount of lactose compared to AA and AG women. AA men consumed more lactose than AG (P = 0.028) and GG men (P = 0.032). Subjects with the AA genotype consumed the most, and GG subjects the least amount of dairy. However, there were no significant differences in total dairy consumption among genotypes. Conclusions The median amount of lactose consumed daily by healthy adults is 9–12 g/day, with higher consumption by those with an LP genotype. Total dairy intake was not significantly influenced by genotype, highlighting the value in specifically estimating lactose consumption. Maximal lactose intake by lactase non-persisters exceeding 15 g/day suggests alternate routes of lactose catabolism. Funding Sources The California Dairy Research Foundation and the USDA-ARS.
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Campbell, Anthony K., Jonathan P. Waud, and Stephanie B. Matthews. "The Molecular basis of Lactose Intolerance." Science Progress 88, no. 3 (August 2005): 157–202. http://dx.doi.org/10.3184/003685005783238408.
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A staggering 4000 million people cannot digest lactose, the sugar in milk, properly. All mammals, apart from white Northern Europeans and few tribes in Africa and Asia, lose most of their lactase, the enzyme that cleaves lactose into galactose and glucose, after weaning. Lactose intolerance causes gut and a range of systemic symptoms, though the threshold to lactose varies considerably between ethnic groups and individuals within a group. The molecular basis of inherited hypolactasia has yet to be identified, though two polymorphisms in the introns of a helicase upstream from the lactase gene correlate closely with hypolactasia, and thus lactose intolerance. The symptoms of lactose intolerance are caused by gases and toxins produced by anaerobic bacteria in the large intestine. Bacterial toxins may play a key role in several other diseases, such as diabetes, rheumatoid arthritis, multiple sclerosis and some cancers. The problem of lactose intolerance has been exacerbated because of the addition of products containing lactose to various foods and drinks without being on the label. Lactose intolerance fits exactly the illness that Charles Darwin suffered from for over 40 years, and yet was never diagnosed. Darwin missed something else – the key to our own evolution – the Rubicon some 300 million years ago that produced lactose and lactase in sufficient amounts to be susceptible to natural selection.
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Misselwitz, Benjamin, Matthias Butter, Kristin Verbeke, and Mark R. Fox. "Update on lactose malabsorption and intolerance: pathogenesis, diagnosis and clinical management." Gut 68, no. 11 (August 19, 2019): 2080–91. http://dx.doi.org/10.1136/gutjnl-2019-318404.
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Lactose is the main source of calories in milk, an essential nutriedigestion, patients with visceral hypersensitivity nt in infancy and a key part of the diet in populations that maintain the ability to digest this disaccharide in adulthood. Lactase deficiency (LD) is the failure to express the enzyme that hydrolyses lactose into galactose and glucose in the small intestine. The genetic mechanism of lactase persistence in adult Caucasians is mediated by a single C→T nucleotide polymorphism at the LCTbo −13’910 locus on chromosome-2. Lactose malabsorption (LM) refers to any cause of failure to digest and/or absorb lactose in the small intestine. This includes primary genetic and also secondary LD due to infection or other conditions that affect the mucosal integrity of the small bowel. Lactose intolerance (LI) is defined as the onset of abdominal symptoms such as abdominal pain, bloating and diarrhoea after lactose ingestion by an individual with LM. The likelihood of LI depends on the lactose dose, lactase expression and the intestinal microbiome. Independent of lactose digestion, patients with visceral hypersensitivity associated with anxiety or the Irritable Bowel Syndrome (IBS) are at increased risk of the condition. Diagnostic investigations available to diagnose LM and LI include genetic, endoscopic and physiological tests. The association between self-reported LI, objective findings and clinical outcome of dietary intervention is variable. Treatment of LI can include low-lactose diet, lactase supplementation and, potentially, colonic adaptation by prebiotics. The clinical outcome of these treatments is modest, because lactose is just one of a number of poorly absorbed carbohydrates which can cause symptoms by similar mechanisms.
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Costa, Simone Leal da, Natália Porfírio Rossi, and Rafael Resende Maldonado. "Evaluation of Lactose in Milk and Dairy Products." International Journal for Innovation Education and Research 1, no. 3 (November 30, 2013): 56–59. http://dx.doi.org/10.31686/ijier.vol1.iss3.115.
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Milk is an emulsion containing fat, protein, carbohydrate, vitamins, minerals and water. Lactose is the main carbohydrate presented in milk and dairy products. This sugar is composed by one unit of glucose and one of galactose. Metabolism of lactose depends on enzyme lactase which hydrolyzes this sugar. In some cases, lactase may be absent or an insufficient quantity in human body. Deficiency in lactase production causes numerous symptoms such as diarrhea; abdominal pain and bloating that characterize lactose intolerance. The aim of this work was to evaluate concentration of lactose in milk and dairy products to determine the effect of the processing and to calculate the quantity of each product which can be consumed without symptoms in lactose intolerant. Results obtained show lactose concentration of 4.42% w/v in Milk; 3.5% w/w in Minas cheese; 9.9%w/v in condensed milk and 4.76%w/v in yogurt. Portion innocous ranged from 60 to 170 mL depending on each product.
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Abaturov, Alexandr Ye, Yuri M. Stepanov, and Anna A. Nikulina. "TREATMENT OF LACTASE DEFICIENCY IN CHILDREN’S OBESITY WITH GENOTYPE C/C 13910 OF LACTASE GENE." Wiadomości Lekarskie 72, no. 1 (January 2019): 17–21. http://dx.doi.org/10.36740/wlek201901103.
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Introduction: Excess lactose in the diet of modern man causes the development of not only lactase deficiency, but it can be a factor that contributes to obesity. The aim: To study associations between obesity and genotype C/C 13910 of lactase gene (LCT) in children, to investigate the effectiveness of treatment using drug exogenous lactase and a low-lactose diet. Materials and methods: genotyping of lactase gene by real-time polymerase chain reaction, determining the level of lactose maldigestion by hydrogen breath test (HBT), estimating the insulin resistance with the HOMA-IR index in 70 obese children and 40 healthy children 6 - 18 years. Obese children with genotype C/C 13910 and lactose maldigestion (n=40) were randomized in two groups: children from group I (n=20) received an exogenous lactase preparation, and children from group II (n=20) - low-lactose diet. Results: in obese children, the genotype C/C 13910 is 2 times more often than in healthy children. Obese children with genotype C/C 13910 have a significantly higher value of HBT (32.8–39.8 ppm) compared to healthy children (p<0.05), and an increased value of the HOMA-IR index. After treatment, there was a significant decrease in HBT and the HOMA-IR index in the two comparison groups. Conclusions: signs of insulin resistance are observed in children with obesity, genotype C/C 13910 and lactose maldigestion. The use of exogenous lactase in the therapy or the administration of a low-lactose diet cause approximately the same decrease in the HOMA-IR index.
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Domżał-Magrowska, Danuta, Marek K. Kowalski, and Ewa Małecka-Wojciesko. "Subjective, but not documented, lactose intolerance accompanies irritable bowel syndrome." Postępy Higieny i Medycyny Doświadczalnej 76, no. 1 (January 1, 2022): 444–49. http://dx.doi.org/10.2478/ahem-2022-0027.
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Abstract Introduction Lactose intolerance, due to lactase deficiency, may overlap with the symptoms of irritable bowel syndrome (IBS) or lead to an incorrect diagnosis of IBS. Identification of lactose intolerance and lactase deficiency enables targeted treatment to be implemented. The aim of the study was to search for a frequency of a lactose intolerance symptoms in patients with IBS, depending on the results of hydrogen breath test (HBT). Materials and Methods The study involved 56 patients with IBS and 23 healthy people. Both, IBS patients and healthy controls, were asked to complete a survey about IBS symptoms and tolerance of lactose-containing products. A HBT was performed on all subjects. Results Lactase deficiency was diagnosed in 60.7% of patients with IBS and 43.5% of control group. The differences between the study groups were not statistically significant. No statistically significant differences were observed between the incidence of lactase deficiency depending on the type of IBS. In the group of patients with IBS and normal HBT results, as well as in patients with IBS and lactase deficiency, there were no statistically significant differences in the frequency of lactose intolerance symptoms. However, among people with normal HBT results, patients with IBS reported symptoms of intolerance after consuming lactose-containing foods significantly more often compared to the control group (p<0.05). Conclusions Frequency of lactase deficiency does not differ between IBS patients and healthy individuals. Patients with IBS are more likely to report symptoms of lactose intolerance, regardless of the HBT result, compared to healthy individuals.
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Shubham, Shubham Arjun Lonkar, Anju Boora Khatkar, Narender Kumar Chandla, Pranav Kumar Singh, Sanjeev Kumar, Mukul Sain, and Dr Sunil Kumar Khatkar Sunil. "Lactose Intolerance: A Review for facts and fictions." Environment Conservation Journal 23, no. 3 (October 30, 2022): 479–85. http://dx.doi.org/10.36953/ecj.7382076.
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Milk is assumed to be a complete food, due to its high nutritional status. Regular consumption of milk reduces the problems of nutrition deficiency. Milk contains sugar, mainly lactose in higher amount and lactose, with other ingredients of milk, also contributes to maintain the energy level of body. But, in some cases a problem arises due to the intake of lactose mainly owing to the deficiency of ?-galactosidase (Lactase) enzyme. Deficiency of lactase enzyme in human body, results in inefficiency of body for degrading the lactose into its smaller constituents. Un-degraded/ undigested lactose consumed by the bacteria and converts it into several acids and gases, which results in arise of several types of intestinal disorders. In this article, main focus is given on the lactose intolerance, its types, and remedies.
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Gorlova, A. I., and A. M. Ilyina. "The physiological role of lactose in native and hydrolyzed milk: a review." Proceedings of the Voronezh State University of Engineering Technologies 84, no. 2 (April 5, 2022): 57–61. http://dx.doi.org/10.20914/2310-1202-2022-2-57-61.
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Lactose is a disaccharide composed of glucose and galactose fragments. It is the most predominant carbohydrate found in milk. The physiological significance of lactose is primarily determined by its energetic properties. Consuming lactose helps maintain the balance of the gut microflora. In addition, lactose stimulates the absorption of calcium in children and helps to increase bone strength. However, not all people absorb lactose equally. In the body, lactose is hydrolyzed by the enzyme β-galactosidase (lactase). Lactase deficiency in the gastrointestinal tract causes lactose intolerance and is defined as a clinical syndrome characterized by abdominal pain, nausea, flatulence, and diarrhea that may occur after drinking milk. Two thirds of the world's population have problems digesting lactose. People with lactose intolerance often avoid dairy products. However, dairy products are an essential part of a healthy, balanced diet and are a rich source of nutrients. Limiting the consumption of dairy products can lead to deficiencies in important nutrients and contribute to the development of long-term health risks such as decreased bone density, hypertension and diabetes. Nutritional support, in this case, is one of the most effective methods of disease prevention. The need for people with lactose intolerance is shown to optimize nutritional status by including lactose-free and low-lactose dairy products in the diet. It is shown that the world market for lactose-free dairy products is the fastest growing segment in the dairy.
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Mukhanbetzhanov, N. A., Zh Ye Mukhanbetzhanova, S. S. Kozhakhmetov, and A. R. Kushugulova. "The role of probiotics in the modulation of intestinal microbiota in lactose intolerance." BULLETIN of the L.N. Gumilyov Eurasian National University. BIOSCIENCE Series 145, no. 4 (2023): 86–96. http://dx.doi.org/10.32523/2616-7034-2023-145-4-86-96.
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Lactose intolerance is one of the most common eating disorders. People affected by this disorder cannot digest large amounts of lactose due to the genetically low expression of the lactase enzyme. The human gut microbiota consists of the majority of diverse microbial communities that affect intestinal health, immunological balance and also metabolize lactose. One of the methods to combat this disorder is the use of probiotics. Probiotic microorganisms are contained in large quantities in live fermented milk products, which are used as functional food products all over the world because of their beneficial effects on human health. In addition, there are low lactose/lactose free fermented milk products on the world market, which, in addition to having a positive effect on the human body, contribute to the breakdown and reduction of the amount of lactose, thereby helping to tolerate lactose more easily. This review focuses on important developments that can neutralize the adverse effect of lactase on human health when consuming dairy products.
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Szilagyi, Andrew, and Norma Ishayek. "Lactose Intolerance, Dairy Avoidance, and Treatment Options." Nutrients 10, no. 12 (December 15, 2018): 1994. http://dx.doi.org/10.3390/nu10121994.
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Lactose intolerance refers to symptoms related to the consumption of lactose-containing dairy foods, which are the most common source for this disaccharide. While four causes are described, the most common is the genetically-determined adult onset lactose maldigestion due to loss of intestinal lactase governed by control of the gene by a 14,000 kb promoter region on chromosome 2. Gastrointestinal symptoms from lactose have expanded to include systemic effects and have also been confounded by other food intolerances or functional gastrointestinal disorders. Partly because lactose maldigestion is often interpreted as lactose intolerance (symptoms), focus of therapy for these symptoms starts with lactose restriction. However, withholding of dairy foods completely is not appropriate due to a more favorable impact on health. Industrial efforts to substitute with plant-based products is not completely successful at this time. This narrative article reviews the complexities of the perception of lactose intolerance, its epidemiology, and pathogenesis. Treatments are discussed, including the inappropriateness of dairy avoidance. In conjunction, effects of dairy products on 19 common diseases are reviewed. Different methods of treatment, lactose-reduced products, plant-based dairy substitutes, adaptation, prebiotics, exogenous lactase, probiotics, and some other dietary interventions are further discussed.
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Roslavtseva, Elena A., Ina Sokolov, Olga I. Simonova, Tatiana V. Bushueva, Tatiana E. Borovik, Ivan E. Smirnov, Vera P. Chernevich, and Maksim M. Lokhmatov. "Diagnostic possibilities of lactase deficiency in children with cystic fibrosis." Russian Pediatric Journal 24, no. 3 (July 16, 2021): 157–62. http://dx.doi.org/10.46563/1560-9561-2021-24-3-157-162.
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Introduction. Children with cystic fibrosis often have gastrointestinal symptoms despite properly selected primary therapy and pancreatic substitution therapy. A possible reason is lactase deficiency. Aim is to determine the frequency of lactase deficiency in children with cystic fibrosis and the need for appropriate dietary correction of their diets. Materials and methods. In 213 children with cystic fibrosis, during esophagogastroduodenoscopy in biopsies of the small intestinal mucosa 359 rapid tests, «Lactose intolerance quick test” were performed. According to the results of an express test, some patients diagnosed with hypolactasia to determine their tolerance to lactose underwent a glycemic load test with lactose and measured the level of fecal calprotectin to assess the level of faecal calprotectin the degree of chronic intestinal inflammation. Results. Normal lactase activity was observed in 129 (36%) biopsies studied, moderate hypolactasia in 91 (25%) biopsies, severe hypolactasia in 139 (39%) biopsies. In patients with moderate hypolactasia, according to the express test results, 20% confirmed intolerance to lactose as a result of the load test. In patients with severe hypolactasia, 72% were confirmed to be lactose intolerant, according to the results of an express test. There was no correlation between the level of calprotectin and the results of the glycemic load test with lactose. Conclusion. Lactase deficiency is observed in a significant proportion of patients with cystic fibrosis, which may be a consequence of primary adult hypolactasia and chronic intestinal inflammation. In children with cystic fibrosis with dyspeptic symptoms persisted despite correctly prescribed basic therapy and pancreatic enzymes, it is necessary to exclude lactose intolerance and prescribe a low-lactose diet.
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Szilagyi, Andrew. "Redefining Lactose as a Conditional Prebiotic." Canadian Journal of Gastroenterology 18, no. 3 (2004): 163–67. http://dx.doi.org/10.1155/2004/350732.
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Lactose in dairy products is maldigested by up to 70% to 75% of the world's population and many people may therefore suffer symptoms reminiscent of irritable bowel syndrome. As a result, most research to date has concentrated on ways of improving lactose tolerance to enhance dairy as a source of nutrition. However, research on other possible benefits of lactose and its maldigestion has lagged. In view of an exponential growth in the understanding of intestinal microfloral host interactions and the expanding therapeutical potential of probiotics, a reassessment of the role of lactose as a potential prebiotic in lactase nonpersistent subjects is required. Gibson and Roberfroid introduced the concept of prebiotics and outlined definitive requirements for such a compound. The present article examines scientific and clinical knowledge about the properties of lactose and argues that in lactase nonpersistent subjects, lactose qualifies as a prebiotic.
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Liburdi, Katia, and Marco Esti. "Galacto-Oligosaccharide (GOS) Synthesis during Enzymatic Lactose-Free Milk Production: State of the Art and Emerging Opportunities." Beverages 8, no. 2 (April 2, 2022): 21. http://dx.doi.org/10.3390/beverages8020021.
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Much attention has recently been paid to β-Galactosidases (β-D-galactoside galactohidrolase; EC 3.2.1.23), commonly known as lactases, due to the lactose intolerance of the human population and the importance of dairy products in the human diet. This enzyme, produced by microorganisms, is being used in the dairy industry for hydrolyzing the lactose found in milk to produce lactose-free milk (LFM). Conventionally, β-galactosidases catalyze the hydrolysis of lactose to produce glucose and galactose in LFM; however, they can also catalyze transgalactosylation reactions that produce a wide range of galactooligosaccharides (GOS), which are functional prebiotic molecules that confer health benefits to human health. In this field, different works aims to identify novel microbial sources of β-galactosidase for removing lactose from milk with the relative GOS production. Lactase extracted from thermophilic microorganisms seems to be more suitable for the transgalactosylation process at relatively high temperatures, as it inhibits microbial contamination. Different immobilization methods, such as adsorption, covalent attachment, chemical aggregation, entrapment and micro-encapsulation, have been used to synthesize lactose-derived oligosaccharides with immobilized β-galactosidases. In this mini-review, particular emphasis has been given to the immobilization techniques and bioreactor configurations developed for GOS synthesis in milk, in order to provide a more detailed overview of the biocatalytic production of milk oligosaccharides at industrial level.
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Usai-Satta, Paolo, and Mariantonia Lai. "New Perspectives on Lactose Malabsorption, Celiac Disease and Related Disorders." Nutrients 15, no. 11 (May 29, 2023): 2512. http://dx.doi.org/10.3390/nu15112512.
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scheindlin, benjamin. "Lactose Intolerance and Evolution: No Use Crying Over Undigested Milk." Gastronomica 7, no. 2 (2007): 59–63. http://dx.doi.org/10.1525/gfc.2007.7.2.59.
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Lactose intolerance is an inability to digest milk sugar, characterized by abdominal cramps, nausea, and diarrhea after ingesting milk products. It develops in adolescence or adulthood among those whose bodies naturally stop producing the lactose-digesting enzyme lactase after childhood. Although uncommon in the United States, lactose intolerance actually occurs in the majority of people around the world. The ability to continue producing lactase, and thus to digest milk products, is a relatively recent evolutionary development. After presentation of an illustrative clinical example, the biology of lactase production and lactose intolerance is reviewed. The "culture-historical" hypothesis of Simoons in the 1970's held that persistent lactase production developed in a dairy herding population in Northern Europe during a time of food scarcity, when the ability to digest milk would have provided a survival advantage. Simoons demonstrated that low prevalence of lactose intolerance was associated with pastoral practices among early populations around the world. Hirschhorn recently provided strong genetic evidence for the culture-historical hypothesis using contemporary techniques of genomics and single nucleotide polymorphisms. His research group found that European derived persistent lactase production is due to a mutation near the lactase gene that occurred only about 10 million years ago and rapidly increased in prevalence.
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Hegar, Badriul, and Hans A. Buller. "Breath Hydrogen Test in Lactose Malabsorption." Paediatrica Indonesiana 35, no. 7-8 (October 8, 2018): 161–71. http://dx.doi.org/10.14238/pi35.7-8.1995.161-71.
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Lactose is the most important source in mammalian milk. In normal children, Lactose is hydrolyzed by lactase, and directly absorbed into bloodstream by an active transport mechanism. The term of lactose malabsorption is reserved to patients in whom impaired intestinal lactose hydrolysis and uptake has been proven by an appropriate test. The severity of lactose malabsorption and the extent of symptoms vary widely and are the results of several factors such as the amount of ingested lactose, gastric emptying time, intestinal transit time, and colonic flora. The diagnosis of lactose malabsorption is based on clinical findings and the results of appropriate tests. The breath hydrogen test has obvious advantages for pediatric population because it is painless, non-invasive, sensitive and specific. In the absence of bacterial colonization in the small intestine, the elevation of the concentration of hydrogen in the expired air implies the arrival of lactose in the colon. The increasing respiratory excretion of hydrogen is indicative of a deficit of lactase in enterocyte brush border. This test can also be used to show the existence of bacterial growth. Dietary fiber, some drugs, preparation for colonoscopy, colonic pH, and diarrhea can influence the result of breath hydrogen test.
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Szilagyi, Andrew, Ian Shrier, Debra Heilpern, Jung Sung Je, Sunghoon Park, George Chong, Catherine Lalonde, Louis-Francois Cote, and Byong Lee. "Differential Impact of Lactose/Lactase Phenotype on Colonic Microflora." Canadian Journal of Gastroenterology 24, no. 6 (2010): 373–79. http://dx.doi.org/10.1155/2010/649312.
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BACKGROUND: The ability to digest lactose divides the world’s population into two phenotypes that may be risk variability markers for several diseases. Prebiotic effects likely favour lactose maldigesters who experience lactose spilling into their colon.OBJECTIVE: To evaluate the effects of fixed-dose lactose solutions on fecal bifidobacteria and lactobacilli in digesters and maldigesters, and to determine whether the concept of a difference in ability to digest lactose is supported.METHODS: A four-week study was performed in 23 lactose mal-digesters and 18 digesters. Following two weeks of dairy food withdrawal, subjects ingested 25 g of lactose twice a day for two weeks. Stool bifidobacteria and lactobacilli counts pre- and postintervention were measured as the primary outcome. For secondary outcomes, total anaerobes, Enterobacteriaceae, beta-galactosidase and N-acetyl-beta-D-glucosaminidase activity in stool, as well as breath hydrogen and symptoms following lactose challenge tests, were measured.RESULTS: Lactose maldigesters had a mean change difference (0.72 log10colony forming units/g stool; P=0.04) in bifidobacteria counts compared with lactose digesters. Lactobacilli counts were increased, but not significantly. Nevertheless, reduced breath hydrogen after lactose ingestion correlated with lactobacilli (r=−0.5; P<0.001). Reduced total breath hydrogen and symptom scores together, with a rise in fecal enzymes after intervention, were appropriate, but not significant.CONCLUSIONS: Despite failure to achieve full colonic adaptation, the present study provided evidence for a differential impact of lactose on microflora depending on genetic lactase status. A prebiotic effect was evident in lactose maldigesters but not in lactose digesters. This may play a role in modifying the mechanisms of certain disease risks related to dairy food consumption between the two phenotypes.
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Mendoza Torres, Evelyn, Lourdes Luz Varela Prieto, José Luis Villarreal Camacho, and Daniel Antonio Villanueva Torregroza. "Diagnosis of adult-type hypolactasia/lactase persistence: genotyping of single nucleotide polymorphism (SNP C/T-13910) is not consistent with breath test in Colombian Caribbean population." Arquivos de Gastroenterologia 49, no. 1 (March 2012): 5–8. http://dx.doi.org/10.1590/s0004-28032012000100002.
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CONTEXT: Genotyping of single nucleotide polymorphism (SNP C/T-13910) located upstream of the lactase gene is used to determine adult-type hypolactasia/lactase persistence in North-European Caucasian subjects. The applicability of this polymorphism has been studied by comparing it with the standard diagnostic methods in different populations. OBJECTIVE: To compare the lactose hydrogen breath test with the genetic test in a sample of the Colombian Caribbean population. METHODS: Lactose hydrogen breath test and genotyping of SNP C/T-13910 were applied to 128 healthy individuals (mean age 35 ± 1). A positive lactose hydrogen breath test was indicative of hypolactasia. Genotyping was done using polymerase chain reaction/restriction fragment length polymorphism. The kappa index was used to establish agreement between the two methods. RESULTS: Seventy-six subjects (59%) were lactose-maldigesters (hypolactasia) and 52 subjects (41%) were lactose-digesters (lactase persistence). The frequencies of the CC, CT and TT genotypes were 80%, 20% and 0%, respectively. Genotyping had 97% sensitivity and 46% specificity. The kappa index = 0.473 indicates moderate agreement between the genotyping of SNP C/T-13910 and the lactose hydrogen breath test. CONCLUSION: The moderate agreement indicates that the genotyping of the SNP C/T-13910 is not applicable to determine adult-type hypolactasia/lactase persistence in the population participating in this study.
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Coluccia, Enza, Patrizia Iardino, Diego Pappalardo, Anna Lisa Brigida, Vincenzo Formicola, Bruna De Felice, Claudia Guerra, et al. "Congruency of Genetic Predisposition to Lactase Persistence and Lactose Breath Test." Nutrients 11, no. 6 (June 20, 2019): 1383. http://dx.doi.org/10.3390/nu11061383.
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The physiological decline of lactase production in adulthood, in some individuals, is responsible for the so-called “Lactose Intolerance.” This clinical syndrome presents with gastrointestinal and non-gastrointestinal symptoms following the consumption of dairy containing food. Lactose intolerance can be evaluated by means of the Lactose Breath Test (phenotype) and/or genetic evaluation of lactase-gene polymorphism (genotype). A comparison of the two tests was carried out in a large number of symptomatic adult subjects, which are selected and not representative of the general population. Congruency was as high as 88.6%. Among lactase non-persistent (genotype C/C), 14 subjects showed a negative Lactose Breath Test (LBT), possibly due to young age. Among lactase-persistent (genotype C/T), four subjects showed a positive LBT, which helps to diagnose secondary lactose intolerance. Symptoms, both gastrointestinal and extra-gastrointestinal, were reported by 90% of patients during the breath test. Clinical use of both tests in the same patients could be taken into consideration as a sharp diagnostic tool. We suggest considering the use of the genetic test after LBT administration, when secondary hypolactasia is suspected, for completion of diagnostic procedures.
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Zhang, Ying, Mingjian Huang, Jianfeng Chen, Shuyuan Wang, and Jian Xu. "Relationship between Lactase Activity and Intestinal Flora Structure." Tobacco Regulatory Science 7, no. 5 (September 30, 2021): 3104–9. http://dx.doi.org/10.18001/trs.7.5.1.81.
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To analyze and explore the relationship between lactase activity and the structure of intestinal flora in infants under 1 year old. Method: Our hospital selected 60 infants and young children in the Haizhu Maternity and Child Health Hospital from August 2019 to September 2020 as the research objects. The infants in the experimental group were diagnosed as lactose intolerant infants, the control group were normal infants, and the experimental group and control group had 30 cases each. The relationship between lactase activity and intestinal flora structure. Result: The experimental group had fewer beneficial bacteria in the intestinal tract than the control group, but improved lactase activity by correcting the structure of the intestinal flora and alleviating symptoms of lactose intolerance. Conclusion: Infants and young children are prone to non-infectious diarrhea, and the causes are more complicated, but most of them are related to lactose intolerance. When infants and young children develop lactose intolerance, it is necessary to pay attention to the lack of beneficial bacteria in the intestinal tract. Targeted supplementation of probiotics (such as Lactobacillus reuteri, Clostridium butyricum, etc.) can correct the intestinal flora, improve lactase activity, and relieve symptoms of lactose intolerance.
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Buzás, György Miklós. "A laktózintoleranciáról: Múlt és jelen – I. rész." Orvosi Hetilap 156, no. 38 (September 2015): 1532–39. http://dx.doi.org/10.1556/650.2015.30261.
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Lactose intolerance is the most prevalent intestinal malabsorption disorder. After presentation of its history, the author describes the emergence of lactose intolerance during the evolution of species, and the biochemistry of lactose as well as features of human and bacterial lactase enzymes are then described. The unequal distribution of lactose intolerance in different continents and population is discussed, followed by presentation of past and present prevalence data in Hungary. Adult-type hypolactasia is caused by a polymorphism of the MCM6 gene located upstream from the lactase gene on the long arm of the chromosome 2. It can be determined with the polymerase chain reaction. The intestinal symptoms of lactose intolerance are well known, but its extra-intestinal manifestations are less recognised. Invasive diagnostic methods (determination of lactase activity from small intestinal biopsies, lactose tolerance test), are accurate, but have been replaced by the non-invasive methods; their gold standard is the H2 breath test. Genetic testing is being used more and more frequently in Hungary too, and, presumably, the methane breath test will be also available in the near future. Lactose intolerance can be accompanied by inflammatory bowel diseases, coeliac disease and irritable bowel syndrome; it could be established whether this association is causal or not in order to start a correct diet and therapy. Orv. Hetil., 2015, 156(38), 1532–1539.
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Alves, Sabrina Moreira dos Santos, Rafaela Machado Marques, Denise Gonçalves Costa Oliveira, and Tulio Cesar de Lima Lins. "Redução dos teores de lactose em leites com diferentes concentrações de gordura, fermentados por grãos de Kefir." Brazilian Journal of Food Research 11, no. 2 (January 1, 2020): 1. http://dx.doi.org/10.3895/rebrapa.v11n2.11042.
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O Kefir é uma bebida fermentada de leite reconhecida como um alimento probiótico funcional e popularmente conhecida como de baixo teor de lactose. Objetivou-se analisar o teor de lactose em amostras de leite com diferentes concentrações de gordura, fermentadas por grãos de Kefir. O estudo experimental utilizou amostras de leites do tipo: Integral pasteurizado tipo C, integral tipo UHT, semidesnatado UHT e desnatado UHT, e seus respectivos Kefir fermentados por 24 horas. Para determinação de açúcares redutores em lactose foi utilizada titulometria pelo método Lane-Eynon e espectrofotometria enzimática para determinação de glicose. Adição de enzima Lactase pós-fermentação foi realizada para identificar a presença de lactose pelo incremento de glicose em função do tempo. A redução de lactose ocorreu no Kefir de leite integral pasteurizado tipo C em 39%, seguido pelo leite integral UHT em 17%, 16% para semidesnatado e 15% para desnatado. Após a adição de lactase, houve aumento da concentração de glicose, evidenciando lactose remanescente após a fermentação de 24h, obtendo menor concentração no leite integral, seguido do semidesnatado e desnatado. A redução de lactose no Kefir ocorreu conforme maior concentração de gorduras, porém foi mais acentuada no leite pasteurizado integral. Pela observação de considerável teor de lactose remanescente após a fermentação, não é possível afirmar que o Kefir é isento ou com baixo teor de lactose. Dessa forma, seu consumo e indicação para as pessoas com intolerância a lactose poderá ser feita preferencialmente mediante acompanhamento de seus efeitos fisiológicos no organismo.
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Catanzaro, Roberto, Morena Sciuto, and Francesco Marotta. "Lactose Intolerance—Old and New Knowledge on Pathophysiological Mechanisms, Diagnosis, and Treatment." SN Comprehensive Clinical Medicine 3, no. 2 (February 2021): 499–509. http://dx.doi.org/10.1007/s42399-021-00792-9.
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AbstractLactose intolerance is a pathology frequently encountered today. It occurs when the activity of lactase in the intestine is reduced or absent, with consequent failure to digest lactose. The global prevalence of this clinical condition is estimated of about 57% with instrumental methods, while the real prevalence exceeds 65%. The absence of lactase determines both the excessive osmotic load in the small intestine and the fermentation of lactose by the bacterial flora with consequent production of short-chain fatty acids and gas. This latter process is responsible for the onset of symptoms associated with lactose intolerance (abdominal pain, bloating, flatulence, etc.) which arise after the intake of lactose. Several studies have shown an increased risk of developing various pathologies for lactose-intolerant subjects (some types of cancer, osteoporosis, etc.). Therefore, it is essential to diagnose and properly treat this pathology. Various options exist for diagnosing lactose intolerance: Hydrogen Breath Test, genetic test, Quick Lactose Intolerant Test, Lactose Tolerance Test, Gaxilose Test. Like diagnostic methods, there are several options for treating intolerance. In addition to a food restriction, the use of exogenous enzymes and/or probiotic and the selection of milk containing specific types of beta-caseins less correlated to the appearance of gastrointestinal symptoms are very useful. The aim of this review is to illustrate the main and most modern diagnostic and therapeutic choices for lactose intolerance currently available.
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Russette, Helen K., and Taeho Oh. "In Search of Lactose." Journal of Pharmacy Technology 12, no. 1 (January 1996): 16–20. http://dx.doi.org/10.1177/875512259601200106.
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Objective: To describe lactose in medications, answer commonly asked questions about lactose intolerance, and to provide useful information to pharmacists on how to identify lactose content in medications. Design: Descriptive. Summary: Within the population of lactose-intolerant individuals, a wide variation exists concerning the degree to which the lactase enzyme is deficient. When asked whether lactose-intolerant individuals can take their lactose-containing product without complications, the surveyed drug manufacturers offered a number of suggestions, including the following: avoid the product; determine the patient's level of lactose intolerance and, depending on the severity of the condition, decide with the physician whether the medication should be taken or whether it can be substituted with a suitable formulation that does not contain lactose; and supplement each dosage with an exogenous lactase enzyme. Because drug manufacturers themselves acknowledge that even minute amounts of lactose in medications may be a problem for those who are severely intolerant of lactose, this agent may not be the ideal filler, as it is described in standard pharmacologic references. Although the original intent was to develop a comprehensive list of lactose-containing and lactose-free drugs, that proved to be an unmanageable task. Instead, from a literature search and primary investigation, information and discussion are provided in a question/answer format that is designed to help clinicians serve their lactose-intolerant patients. Conclusions: Primary healthcare professionals should be aware of the potential effects of lactose, not only in foods, but also in medications. If patients experience diarrhea, cramping, or bloating, or if babies become colicky for no medically apparent reason, a search for lactose content in medications or in infant formulas may reveal the cause. However, medical evaluation is always appropriate, as a small percentage of such patients may in fact have an underlying intestinal disease to which lactose intolerance is secondary. Because drug manufacturers acknowledge that even minute amounts of lactose in medications may be a problem for those who are severely intolerant of lactose, this agent may not be the ideal filler. A worthy subject for research in this area would be the discovery or development of a new filler for pharmaceuticals without the contraindications possible with lactose.
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Pimentel, Grégory, Kathryn J. Burton, Marta Rosikiewicz, Carola Freiburghaus, Ueli von Ah, Linda H. Münger, François P. Pralong, et al. "Blood lactose after dairy product intake in healthy men." British Journal of Nutrition 118, no. 12 (December 4, 2017): 1070–77. http://dx.doi.org/10.1017/s0007114517003245.
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AbstractThe absence of a dedicated transport for disaccharides in the intestine implicates that the metabolic use of dietary lactose relies on its prior hydrolysis at the intestinal brush border. Consequently, lactose in blood or urine has mostly been associated with specific cases in which the gastrointestinal barrier is damaged. On the other hand, lactose appears in the blood of lactating women and has been detected in the blood and urine of healthy men, indicating that the presence of lactose in the circulation of healthy subjects is not incompatible with normal physiology. In this cross-over study we have characterised the postprandial kinetics of lactose, and its major constituent, galactose, in the serum of fourteen healthy men who consumed a unique dose of 800 g milk or yogurt. Genetic testing for lactase persistence and microbiota profiling of the subjects were also performed. Data revealed that lactose does appear in serum after dairy intake, although with delayed kinetics compared with galactose. Median serum concentrations of approximately 0·02 mmol/l lactose and approximately 0·2 mmol/l galactose were observed after the ingestion of milk and yogurt respectively. The serum concentrations of lactose were inversely correlated with the concentrations of galactose, and the variability observed between the subjects’ responses could not be explained by the presence of the lactase persistence allele. Finally, lactose levels have been associated with the abundance of theVeillonellagenus in faecal microbiota. The measurement of systemic lactose following dietary intake could provide information about lactose metabolism and nutrient transport processes under normal or pathological conditions.
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Albuquerque, Alessandra Cristina Moraes, Michelline Lins Silvério, Vilma Sobral Bezerra, and Juliana Mendes Correia. "Produção e caracterização de queijo tipo ricota tratado com lactase." Research, Society and Development 11, no. 8 (June 27, 2022): e50511830300. http://dx.doi.org/10.33448/rsd-v11i8.30300.
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O consumo excessivo de leite de origem animal pode levar ao surgimento da intolerância à lactose, decorrente da redução ou interrupção na produção da enzima lactase. Para atender a esse grupo de consumidores, a indústria alimentícia tem comercializado alguns laticínios sem lactose, entretanto além de serem insuficientes, possuem sabores pouco atrativos. Desta forma, o presente estudo se propôs a elaborar um laticínio sem lactose, mantendo os aspectos nutricionais, organolépticos, físico-químicos e microbiológicos atraentes ao consumidor portador de intolerância à lactose. Para realização do estudo foram elaborados dois queijos tipo ricota (A1 – com lactose e A2 – sem lactose, tratado com lactase). Os aspectos físicos e químicos foram obtidos de acordo com a metodologia proposta pela Instrução Normativa 68 (IN 68/2006), Instrução Normativa 62 (IN 62/2003) e Portaria n° 146, de 07/03/1996, do Ministério da Agricultura, Pecuária e Abastecimento (MAPA). A análise de glicídios redutores em lactose foi realizada segundo o método titulométrico de Lane-Eynon. A análise microbiológica, aspecto, consistência, cor, odor, sabor, cloreto de sódio, gordura total, matéria gorda no extrato seco e umidade se apresentaram conforme a Instrução Normativa 68 (IN 68/2006), a Instrução Normativa 62 (IN 62/2003) e a Portaria nº 146, de 07/03/1996. Em conclusão, o queijo ricota tratado com lactase e produzido de forma artesanal não apresenta diferenças em relação às ricotas comercializadas quanto ao aspecto, entretanto são mais saborosas e quando preparadas seguindo as boas práticas na manipulação não apresentam risco à saúde, tornando-se uma opção para a população que possui intolerância à lactose.
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Forget, P., J. Lombet, C. Grandfils, G. Dandrifosse, and F. Geubelle. "Lactase Insufficiency Revisited." Journal of Pediatric Gastroenterology and Nutrition 4, no. 6 (December 1985): 868–72. http://dx.doi.org/10.1002/j.1536-4801.1985.tb08979.x.
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The definition of “insufficient” small bowel lactase activity varies greatly among authors. The present study is aimed at redefining lactase insufficiency by comparing intestinal lactase activity and results of the lactose breath hydrogen test. Primary “insufficient” lactase activity was considered to be present when a child with a normal small bowel histology showed lactose malabsorption as measured by the lactose breath hydrogen test. The lactase activity of 22 “normal” children ranged from 0.77 to 4.57 U/g wet weight, while five children showed primary lactase insufficiency as defined above. Small bowel lactase activity in the latter patients was <0.74 U/g wet weight. Sucrase and maltase activities were similar in both groups of patients. We conclude that children with a normal small bowel histology should be considered to have primary lactase insufficiency when small bowel lactase activity is below 0.75 U/g wet weight.
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Szilagyi, Andrew, Alick Torchinsky, and Antoinnette Colacone. "Possible Therapeutic Use of Loperamide for Symptoms of Lactose Intolerance." Canadian Journal of Gastroenterology 14, no. 7 (2000): 581–87. http://dx.doi.org/10.1155/2000/794232.
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OBJECTIVES: To examine a potential practical therapeutic use of loperamide (Lo) to decrease the symptoms of lactose intolerance.SUBJECTS AND METHODS: Nineteen (eight men, 11 women) healthy lactose maldigesters (18 of 19 with symptoms) underwent a 25 g lactose challenge on five separate days. Breath hydrogen was measured, areas under the curve (AUC) were calculated for 4 h, and 4 and 12 h symptom scores were recorded. After establishing baseline measurements, test doses of 4 mg, 8 mg and 12 mg Lo were randomly administered without placebo in a double-blind manner. As well, each subject received seven lactase tablets, in a random, unblinded manner.RESULTS: The median AUC and mean oral cecal transit time followed dose response expectations; however, only lactase treatment achieved significance. Nevertheless, 8 mg Lo significantly improved symptom scores, which were statistically indistinguishable from those of lactase. Four subjects complained of delayed constipation and cramps with various doses of Lo.CONCLUSIONS: Lo monotherapy for lactose intolerance is not economical and may have some side effects. However, Lo may be studied further as an adjunctive treatment of lactose intolerance in an effort to reduce the need for complete lactose digestion. Such a manoeuvre may allow rapid colonic adaptation, which in turn may be beneficial for prophylaxis for a number of colonic diseases.
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Hodges, Joanna, Sisi Cao, Dennis Cladis, and Connie Weaver. "Lactose Intolerance and Bone Health: The Challenge of Ensuring Adequate Calcium Intake." Nutrients 11, no. 4 (March 28, 2019): 718. http://dx.doi.org/10.3390/nu11040718.
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Calcium is an important nutrient with impact upon many biological systems, most notably bone. Ensuring adequate calcium intake throughout the lifespan is essential to building and maintaining bone. Lactose intolerance may predispose individuals to low calcium intake as the number of lactose-free, calcium-rich food sources is limited. In this review, we summarize data from human and animal studies on the influence of lactose and lactase deficiency on calcium absorption and bone health. Based on the available evidence, neither dietary lactose nor lactase deficiency have a significant impact on calcium absorption in adult humans. However, lactose intolerance may lead to reduced bone density and fragility fractures when accompanied by decreased intake or avoidance of dairy. Recently published human trials and meta-analyses suggest a weak but significant association between dairy consumption and bone health, particularly in children. Given the availability of simple dietary approaches to building lactose tolerance and the nutritional deficiencies associated with dairy avoidance, multiple public health organizations recommend that all individuals—including those that are lactose intolerant—consume three servings of dairy per day to ensure adequate nutrient intakes and optimal bone health.
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Kable, Mary, Elizabeth Chin, Liping Huang, Charles Stephensen, and Danielle Lemay. "Association of Estimated Daily Lactose Consumption, Lactase Persistence Genotype (rs4988235), and Gut Microbiota in Healthy U.S. Adults." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 1566. http://dx.doi.org/10.1093/cdn/nzaa062_023.
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Abstract Objectives Lactase persistence (LP) is a heritable trait in which lactose can be digested into adulthood. Lactase non-persisters (LNP) who consume lactose may experience microbial adaptations in response to the undigested lactose. The objective of this study was to determine the interaction between lactose consumption, LP genotype and gut microbiota in an observational cross-sectional study of healthy U.S. adults. Methods ASA24 dietary data and stool samples were collected from healthy U.S. adults genotyped for the lactase persistence SNP ID: rs4988235 (n = 280). Lactose was estimated by matching ASA24-reported foods to foods in the Nutrition Coordinating Center Food and Nutrient Database. The 16S rRNA V4/V5 region, amplified from bacterial DNA extracted from each frozen stool sample, was sequenced using Illumina MiSeq (300bp PE) and analyzed using Qiime 2 (v 2019.10). Bacterial sequence counts present at greater than 0.1% of the total data set were analyzed using DESeq2 and LEfSe. Taxa that were differentially abundant by both analyses at the family or genus level are reported here. Results On average 246 ng/uL (3.9 – 646.5ng/uL) DNA was obtained from each sample, yielding 21,470 sequences (10,122 – 56,837). LP genotypes were unevenly distributed by ethnicity and Clostridium (family Lachnospiraceae) was significantly enriched in Asian ethnicities. Therefore, only Caucasian and Hispanic participants were grouped as LP (AA or AG genotype) or LNP (GG genotype) for further analysis. The abundance of Roseburia and family Lachnospriaceae was higher in the upper (>12.4g), relative to lower (< 5.78g), tertile of lactose consumption in LNP adults, but not in LP. Conclusions Increased abundance of Roseburia, a microbe capable of utilizing lactose, in LNP individuals consuming >12.4 g lactose/day suggests that this genus may metabolize lactose in LNP adults. Funding Sources The California Dairy Research Foundation and the United States Department of Agriculture, Agricultural Research Service.
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Marteau, Philippe, Bernard Flourie, Philippe Pochart, Claude Chastang, Jehan-François Desjeux, and Jean-Claude Rambaud. "Effect of the microbial lactase (EC 3.2.1.23) activity in yoghurt on the intestinal absorption of lactose: An in vivo study in lactase-deficient humans." British Journal of Nutrition 64, no. 1 (July 1990): 71–79. http://dx.doi.org/10.1079/bjn19900010.
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Breath hydrogen excretion was measured in eight lactase (EC 3.2.1. 108)-deficient volunteers ingesting 18 g lactose in the form of milk, yoghurt and heated yoghurt. Total excess hydrogen excretion (area under curve) was significantly lower after yoghurt and heated yoghurt, than after milk: 103 (SE 29), 191 (SE 32), and 439 (SE 69) respectively (P < 0.001). The oro-caecal transit time of fermentable components from yoghurt and heated yoghurt (mainly lactose) was longer than that from milk: 165 (SE 17), 206 (SE 19), v. 103 (SE 19) min (P < 0.01). An intestinal perfusion technique was used in the same subjects after ingestion on two consecutive days of 18 g lactose in yoghurt and heated yoghurt. Significantly less lactose was recovered from the terminal ileum after yoghurt than after heated yoghurt meals: 1740 (SE 260) v. 2825 (SE 461) mg (P < 0.05), and approximately one-fifth of the lactase activity contained in yoghurt reached the terminal ileum. These findings indicate that more than 90% of the lactose in yoghurt is digested in the small intestine of lactase-deficient subjects and suggest that both the lactase activity contained in the viable starter culture and a slow oro–caecal transit time are responsible for this excellent absorption.
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Limnaios, Athanasios, Maria Tsevdou, Eirini Zafeiri, Evangelos Topakas, and Petros Taoukis. "Cheese and Yogurt By-Products as Valuable Ingredients for the Production of Prebiotic Oligosaccharides." Dairy 5, no. 1 (January 12, 2024): 78–92. http://dx.doi.org/10.3390/dairy5010007.
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The growing global market of dairy products has led to the need for alternative approaches regarding whey valorization, which is the primary by-product of cheese and strained yogurt production. In this context, prebiotic galactooligosaccharides can be produced enzymatically from whey using commercially available β-galactosidases. A comparative study was conducted to assess the production of galactooligosaccharides from sweet and acid whey, thereby employing two commercial β-galactosidases from Aspergillus oryzae and Kluyveromyces lactis. The study considered the initial lactose content and enzyme load as variables. The maximum yields of galactooligosaccharides in concentrated sweet whey (15% w/v initial lactose) and raw acid whey (3.1% w/v initial lactose) reached 34.4 and 14.7% with lactase from Kluyveromyces lactis (0.13 U/mL), respectively. The corresponding galactooligosaccharide yields for lactase from Aspergillus oryzae were equal to 27.4 and 24.8% in the most concentrated sweet and acid whey, respectively, using enzyme loads of 2 U/mL in sweet whey and 1 U/mL in acid whey. Concerning the profile of the produced galactooligosaccharides, the Kluyveromyces lactis lactase hydrolyzed lactose more rapidly and resulted in higher levels of allolactose and lower levels of 6-galactosyl-lactose, compared to the lactase from Aspergillus oryzae, and achieved in both cases a polymerization degree of up to six.