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Subclinical malabsorption in Thailand. I. Intestinal absorption in Thai children.
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Subclinical malabsorption in Thailand. II. Intestinal absorption in American military and Peace Corps personnel.
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Lactase deficiency in Mexican-American males.
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Lactose feeding and lactase deficiency.
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Comparison of whole milk and skim milk with aqueous lactose solution in lactose tolerance testing.
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Utilization of nutrients in milk- and wheat-based diets by men with adequate and reduced abilities to absorb lactose. I. Energy and nitrogen.
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Letter: Lactose malabsorption.
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Serum lipids and proteins in lactose malabsorption.
It has been suggested that dietary lactose may reduce the intestinal absorption of fat and protein in individuals with lactase deficiency. On the other hand, it is known that a high carbohydrate diet increases serum lipids. The purpose of this study was to examine whether there are differences in the fasting serum lipid and protein concentrations between people with lactose malabsorption and people with normal lactose absorption. Therefore in the connection of a family study serum lipids and proteins were measured in 409 subjects belonging to 11 families. Of these 288 were relatives of the 11 index persons and 121 were spouses or relatives of the spouses. The weight, height, and milk consumption of each person were recorded. When the age, sex, relative weight and milk consumption effects were taken into account there was a statistical difference between the lactose malabsorption and lactose absorption groups for the concentration of serum triglycerides, but not for the other variables. Besides, serum triglyceride values of over 200 mg/100 ml were significantly fewer in people with lactose malabsorption. It was hypothesized that increased intestinal motility may disturb the absorption of fats and cause the observed difference at least in the Finnish population.
Diet therapy in adult lactose malabsorption: present practices.
Three hundred twenty-three of 473 questionnaires sent to hospital dietitians in 50 states and Puerto Rico concerning diet therapy for adult lactose malabsorption were returned and analyzed. Only 42% of the responding dietitians stated that their hospital diet manuals contained a diet for adult lactose malabsorption, with less than 1% having a diet specific for patients with peptic ulcer disease and lactose malabsorption. Physicians in almost half of these hospitals rarely considered lactose malabsorption when prescribing a diet for patients with peptic ulcer disease or rarely modified diets for suspected lactose malabsorption. The responding dietitians supplied pertinent portions of their diet manuals in 99 instances, which was 72% of those having such diets. Many of the submitted diets were too rigid, frequently restricting foods that did not contain lactose. On the basis of the survey and a review of the literature, a more reasonable approach to the therapy of adult lactose malabsorption is suggested.
Lactose malabsorption in Bangladeshi village children: relation with age, history of recent diarrhea, nutritional status, and breast feeding.
The prevalence of lactose malabsorption (LM) among Bangladeshi village children has been determined using the recent developed breath hydrogen test. Initial hospital-based comparison studies showed general agreement between the breath hydrogen test and a modified lactose tolerance test. Two hundred thirty-four children, stratified by age, nutritional status, and history of recent diarrhea then participated in the field study. LM was diagnosed in more than 80% of children over 36 months of age but in none of the children under 6 months. Rates of LM were significantly increased in children with a history of recent diarrhea and a greater proportion of children in some age groups evidenced malabsorption in association with acute undernutrition. In the weanling age group children who were still breast feeding had a lower rate of LM than fully weaned subjects.
The effect of diarrhea on incidence of lactose malabsorption among Bangladeshi children.
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Hydrogen breath test of lactose absorption in adults: the application of physiological doses and whole cow's milk sources.
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Nutritional consequences of low dose milk supplements consumed by lactose-malabsorbing children.
The nutritional consequences of supplementary milk consumption by lactose-malabsorbing children were determined by nutrient balance studies. Twelve subjects received a marginally adequate rice and vegetable base-line diet alone and with simulated milk supplements containing either glucose or lactose during three separate balance periods. The diets were equally well accepted and tolerated. The children gained significantly more weight and had improved apparent nitrogen absorption and retention on the milk supplemented diets (P less than 0.001), and there was no difference between the effects of glucose milk and lactose milk. Fecal wet weights and energy and carbohydrate excretions were modestly increased with the lactose-containing diet, but not significantly so. It is suggested that low dose milk supplements can be well utilized when consumed by lactose malabsorbers in conjunction with other foods. Milk consumption need not be discouraged for populations among whom lactose malabsorption is widely prevalent, but milk should be provided in relatively low doses and the clinical responses to its consumption should be monitored.
History and current status of infant formulas.
Formulas that approximate the composition of human milk are widely used as the sole source of nutrients for infants during the first months of life. Such formulas contain milk, soy, or meal proteins, or protein hydrolysates together with those forms of fat carbohydrate, vitamins, and minerals shown to be bioavailable to the infant. Legislation concerning nutrient composition and quality assurance of products labeled as infant formulas has been enacted by Congress. Governmental and industrial standards also help to assure microbiological safety and stability. Problems of nutrient composition and adverse reactions have occurred during the evolution and development of infant formulas. Problems concerning nutrient deficiency are now almost unknown, but adverse reactions of individuals to specific formula ingredients continue. Accurate information on composition and related nutritional properties of infant formulas is essential for their effective use and for the avoidance of undesirable complications.
Effect of fiber on breath hydrogen response and symptoms after oral lactose in lactose malabsorbers.
The effect of ingesting cellulose, pectin, and psyllium with orally administered lactose in water or milk was tested in six lactose malabsorbers. Breath hydrogen tests were used to evaluate lactose malabsorption and mouth-to-cecum transit times. Addition of psyllium significantly reduced the breath hydrogen response, and symptoms in each subject; whereas, less diminution of expired hydrogen was seen after cellulose or pectin was added. The effect of each fiber on gastric emptying rates of an equal volume liquid meal was evaluated in three volunteers. Pectin had no effect, while the cellulose and psyllium modestly delayed emptying at approximately 30 min.
Calcium nutrition and bone health in the elderly.
The average elderly person is in negative calcium balance and accordingly is losing bone mass. While factors such as decreased mechanical loading of the skeleton undoubtedly figure in this age-related loss, a growing body of evidence suggests that inadequate calcium intake may contribute to this loss. On any given day men and women in the US 65 yr or older ingest about 600 and 480 mg calcium, respectively. Calcium intake in the elderly is less than in the young, and reduced absorption efficiency further lowers effective intake. Additionally, other nutrients such as protein and fiber, taken in excess, effectively increase the calcium requirement. Estrogen withdrawal at menopause leads to a decrease in intestinal calcium absorption efficiency and in renal calcium conservation, both effects equivalent to an effective increase in calcium intake requirement. Thus it is not surprising that all studies of mean requirements for zero balance performed in elderly subjects have yielded values above the current RDA for the US. The available evidence thus suggests that the RDA for adults should surely not be lowered below its current level (800 mg), but that, instead, it ought to be raised. It is not possible to say with certainty to exactly what level, but available evidence is compatible with allowances of at least 1200 to 1500 mg/day. Further, the evidence indicates that the mean requirement ought to be thought of as a complex function of age, sex, absorption efficiency, intake of protein, fiber, and probably other nutrients, estrogen status, and mechanical loading. Extensive experience with calcium supplements indicates that daily intakes up to at least 2.5 g of elemental calcium are quite safe in all persons except for certain subsets of the population uncommon among the elderly (eg, those with sarcoidosis, active tuberculosis, or other absorptive hypercalciuric syndromes). At the same time it must be said that osteoporosis is a complex, multifactorial disorder, and that factors unrelated to calcium nutrition undoubtedly play important, even dominant roles in many--perhaps most--osteoporotics. The available evidence, taken together, does not indicate that raising calcium intake will abolish the problem of osteoporosis. It does indicate, however, that calcium nutrition is considerably more important in the genesis of osteoporosis than has been commonly thought for the past 35 yr. As our listing of "important issues" indicates, the full extent of that importance, in both pathogenesis and prophylaxis, remains to be elucidated.(ABSTRACT TRUNCATED AT 400 WORDS)
Lactose malabsorption in Australian Aborigines.
The aim of this study was to determine the incidence of lactose malabsorption in healthy, adult Australian Aborigines. Malabsorption of lactose was measured in 45 full-blood Aboriginal subjects and 37 non-Aboriginal, multiracial controls using the breath hydrogen method. Eighty-four percent of the Aboriginal subjects were found to be lactose malabsorbers and 64% developed abdominal pain or diarrhea. In the control subjects, 20% were found to be lactose malabsorbers and all of these developed symptoms of diarrhea. The results provide strong evidence that Australian Aborigines, in common with most human adults, are lactase deficient.