Lactose maldigestion and milk intolerance in healthy Greek schoolchildren

Article Abstract:

Lactase is an enzyme found in the intestines that breaks down lactose, the main sugar contained in milk, into glucose and galactose. The activity of lactase decreases with age and results in low lactose-digestion capacity (LDC), or a decreased ability to digest lactose. When the amount of lactose consumed is greater than the amount that can be digested, the undigested lactose causes: accumulation of water in the intestines; increased intestinal activity; rapid movement of food through the small bowel; production of intestinal gas; and subsequent development of abdominal distention, pain, and possibly diarrhea. These symptoms of lactose maldigestion are referred to as lactose intolerance. Studies show that the incidence of low LDC is 75 percent and of lactose intolerance, 30 percent among adult Greeks. The age at which lactase activity starts to decrease is not known. One study showed that 67 percent of Greek children aged one to 13 years had a low LDC. The daily milk consumption and prevalence of low LDC (lactose maldigestion) and lactose intolerance were assessed among 150 Greek children aged five to 12 years. The prevalence of lactose maldigestion was 29.4 percent in five-year-old children and 80.0 percent in 12-year-old children. The incidence of symptoms associated with lactose intolerance was 21.1 percent among children with high LDC and 39.7 percent among children with low LDC. However, the incidence of lactose intolerance after milk ingestion was 7.3 percent among children with high LDC and 8.6 percent among children with low LDC. These findings show that lactase activity decreases before age five, however, the incidence of true lactose maldigestion and intolerance after drinking a glass of milk is low at age five. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Greece, Pediatric diseases, Demographic aspects, Lactose intolerance in children

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Xylitol vs glucose: effect on the rate of gastric emptying and motilin, insulin, and gastric inhibitory polypeptide release

Article Abstract:

The effects of xylitol (an alcohol used as a sweetener) were compared with the effects of glucose (a sugar) with regard to the stomach. The rate at which the stomach passes food to the intestines and the rate at which food passes through the intestines were measured. Levels of motilin (increases the rate at which food passes through several sections of the digestive tract), levels of a bodily substance that inhibits the passage of food out of the stomach (gastric inhibitory polypeptide, GIP), and levels of insulin (helps convert carbohydrates to energy in the blood) were also measured. Patients were given a single dose of 200 milliliters of water containing 30 grams of glucose or 30 grams of xylitol. Compared with glucose, xylitol slowed stomach emptying but speeded passage through the intestines. After glucose ingestion, the stomach took 40 minutes to empty half its remaining contents; after xylitol, it took 77 minutes. Glucose suppressed levels of motilin but stimulated GIP production; xylitol stimulated motilin secretion but had no effect on GIP. The accelerated intestinal transit and increase in motilin after xylitol ingestion were thought to cause the diarrhea and stomachache observed.

Complications and side effects, Diarrhea, Gastrointestinal system, Xylitol, Gastrointestinal motility, Gastrointestinal hormones

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Relative efficiency of yogurt, sweet acidophilus milk, hydrolyzed-lactose milk, and a commercial lactase tablet in alleviating lactose maldigestion

Article Abstract:

Lactose is a sugar found in dairy products; deficiency of the enzyme lactase causes difficulty digesting lactose. The effectiveness of various dairy products containing lactase for alleviating indigestion due to lactase deficiency was studied in 10 black subjects with this problem. The products were ordinary plain yogurt (Y), sweet acidophilus milk (SAM, fermented with bacteria that alter the bacteria present in the digestive tract), milk containing lactose (hydrolysed-lactose milk or HLM), a lactase tablet (LT), and whole milk (WM). Breath hydrogen levels, a sign of digestion problems, were 12 parts per million for Y, 37 for SAM, 29 for LT, 18 for HLM, and 33 for WM. Average peak breath hydrogen levels correlated with symptom severity. Symptoms did not correlate with diagnoses made on the basis of patient medical history. Although Y was as effective as HLM at reducing lactose indigestion, subjects liked its taste the least. The microbe-associated lactase in yogurt is more effective than the straight lactase in the LT for alleviating indigestion.

Health aspects, Case studies, Dairy products, Yogurt, Indigestion

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