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Improved Lactose Digestion and Intolerance Among African-American Adolescent Girls Fed a Dairy Rich-Diet

  • BETHANY A PRIBILA
    Affiliations
    B. A. Pribila was a graduate student, B.R. Martin is a research associate, D.A. Savaiano is a professor, and C.M. Weaver is a professor and head of the Department of Foods and Nutrition, Purdue University, West Lafayette, Ind. D.A. Savaiano is also the dean of the School of Consumer and Family Sciences at Purdue University, USA
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  • STEVE R HERTZLER
    Affiliations
    S.R. Hertzler is an associate professor in the Department of Nutrition and Dietetics at Kent State University, Kent, Ohio, USA
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  • BERDINE R MARTIN
    Affiliations
    B. A. Pribila was a graduate student, B.R. Martin is a research associate, D.A. Savaiano is a professor, and C.M. Weaver is a professor and head of the Department of Foods and Nutrition, Purdue University, West Lafayette, Ind. D.A. Savaiano is also the dean of the School of Consumer and Family Sciences at Purdue University, USA
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  • CONNIE M WEAVER
    Affiliations
    B. A. Pribila was a graduate student, B.R. Martin is a research associate, D.A. Savaiano is a professor, and C.M. Weaver is a professor and head of the Department of Foods and Nutrition, Purdue University, West Lafayette, Ind. D.A. Savaiano is also the dean of the School of Consumer and Family Sciences at Purdue University, USA
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  • DENNIS A SAVAIANO
    Correspondence
    Address correspondence to: Dennis A. Savaiano, 1260 Stone Hall, Room 110, Purdue University, West Lafayette, IN 47907.
    Affiliations
    B. A. Pribila was a graduate student, B.R. Martin is a research associate, D.A. Savaiano is a professor, and C.M. Weaver is a professor and head of the Department of Foods and Nutrition, Purdue University, West Lafayette, Ind. D.A. Savaiano is also the dean of the School of Consumer and Family Sciences at Purdue University, USA
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      Abstract

      Objective To determine whether African-American adolescent girls who were fed a dairy-rich diet for 21 days could adapt to lactose, experiencing an overall improvement in lactose tolerance as well as a decrease in hydrogen gas production.
      Design Twenty-one–day dietary intervention study.
      Subjects/setting Seventeen of 21 African-American girls (aged 11 to 15 years) enrolled in a calcium metabolism study chose to participate in the lactose tolerance study. Subjects were screened for any diseases, conditions, or medications that might alter calcium metabolism or colonic fermentation. Subjects were housed in a fraternity on the Purdue University, West Lafayette, Ind, campus, and were supervised 24 hours a day.
      Intervention Subjects consumed a dairy-based diet averaging 1,200mg calcium and 33g lactose per day for 21 days. Lactose digestion was assessed by an 8-hour breath hydrogen test on days 1 and 21, and symptoms of intolerance (abdominal pain, bloating, flatulence, and diarrhea) were evaluated hourly on a ranked scale during the breath hydrogen tests and once each evening during the 21-day feeding period.
      Main outcome measures A comparison of breath hydrogen production and gastrointestinal symptoms at the beginning and end of the study.
      Statistical analyses performed The Wilcoxon signed ranks test was used to compare the area under the curve for the 2 breath hydrogen tests. Spearman's p test for trend was used to determine whether there was a change in symptoms. All statistical analyses were 2-tailed and significance was set at P=.05.
      ResultsFourteen of the 17 subjects had lactose maldigestion. Breath hydrogen excretion decreased significantly (P<.03) from the beginning (148.3±27.0 ppm×hours) to the end (100.7±19.3 ppm×hours) of the 21-day period. Gastrointestinal symptoms were negligible during both the breath hydrogen tests as were symptoms during the 21-day period.
      Applications/conclusions The diet was well tolerated by the subjects. Furthermore, the decrease in breath hydrogen suggests colonic adaptation to the high-lactose diet. The results indicate that lactose maldigestion should not be a restricting factor in developing adequate calcium diets for this population. The existence of lactose maldigestion does not result in lactose intolerance in this population when it is fed a dairy-rich diet. J Am Diet Assoc. 2000;100:524-528.
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      References

        • Hertzler S.R.
        • BaoChau H.L.
        • Savaiano D.A.
        How much lactose is low lactose?.
        J Am Diet Assoc. 1996; 96: 243-246
      1. Committee on Nutrition. Practical significance of lactose intolerance in children: supplement. Pediatrics. 1990;86:643-644.

        • Hertzler S.R.
        • Savaiano D.A.
        • Levitt M.D.
        Fecal hydrogen production and consumption measurements response to daily lactose ingestion by lactose maldigesters.
        Dig Dis Sci. 1997; 42: 348-353
        • Suarez F.L.
        • Savaiano D.A.
        • Levitt M.D.
        A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self-reported severe lactose intolerance.
        N Engl J Med. 1995; 333: 1-4
      2. American Academy of Pediatrics. The practical significance of lactose intolerance in children. Pediatrics. 1978;62:240-245.

        • Garza C.
        • Scrimshaw N.S.
        Relationship of lactose intolerance to milk intolerance in young children.
        Am J Clin Nutr. 1976; 29: 192
        • Paige D.M.
        • Bayless T.M.
        • Dellinger Jr., W.S.
        Relationship of milk consumption to blood glucose rise in lactose intolerant individuals.
        Am J Clin Nutr. 1975; 28: 677
        • Lin M.Y.
        • Dipalma J.A.
        • Martini M.C.
        • Gross C.J.
        • Harlander S.K.
        • Savaiano D.A.
        Comparative effects of exogenous lactase (β-galactosidase) preparations on in vivo lactose digestion.
        Dig Dis Sci. 1993; 38: 2022-2027
        • Martini M.C.
        • Savaiano D.A.
        Reduced intolerance symptoms from lactose consumed during a meal.
        Am J Clin Nutr. 1988; 47: 57-60
        • Savaiano D.A.
        • AbouEIAnouar A.
        • Smith D.E.
        • Levitt M.D.
        Lactose malabsorption from yogurt, pasteurized yogurt, sweet acidophilus milk, and cultured milk in lactase-deficient individuals.
        Am J Clin Nutr. 1984; 40: 1219-1223
        • Savaiano D.A.
        • Levitt M.D.
        Milk intolerance and microbe-containing dairy foods.
        J Dairy Sci. 1987; 70: 397-406
        • Hertzler S.R.
        • Savaiano D.A.
        Colonic adaptation to daily lactose feeding in lactose maldigesters reduces lactose intolerance.
        Am J Clin Nutr. 1996; 64: 232-236
        • Johnson A.O.
        • Semenya G.
        • Buchowski M.S.
        • Enwonwu C.O.
        • Scrimshaw N.S.
        Adaptation of lactose maldigesters to continued milk intakes.
        Am J Clin Nutr. 1993; 58: 879-881
      3. Life Sciences Research Office, Federation of American Societies for Experimental Biology.
        Third Report on Nutrition Monitoring in the United States. Vol 2. Third National Health and Nutrition Examination Survey, Phase I. 1988-1991. US Dept of Health and Human Services, Washington, DC1995
        • Jackman L.A.
        • Millane S.S.
        • Martin B.R.
        • Wood O.B.
        • McCabe G.P.
        • Peacock M.
        • Weaver C.M.
        Calcium retention in relation to calcium intake and postmenarcheal age in adolescent females.
        Am J Clin Nutr. 1997; 66: 327-333
        • Anderson I.H.
        • LevineS, Levitt M.D.
        Incomplete absorption of the carbohydrate in all-purpose wheat flour.
        N Engl J Med. 1981; 304: 891-892
        • Kerlin P.
        • Wong L.
        • Harris B.
        • Capra S.
        Rice flour, breath hydrogen, and malabsorption.
        Gastroenterology. 1984; 87: 578-585
        • Scrimshaw N.S.
        • Murray E.B.
        Chapter.
        Am J Clin Nutr. 1988; 48: 1099-1104
      4. Posati LP, Orr ML. Consumption of foods dairy and egg products raw processed prepared. Agriculture Handbook No. 8-1. United States Department of Agriculture. Agricultural Research Service. 1976.

        • Weaver C.M.
        • Martin B.R.
        • Plawecki K.L.
        • Peacock M.
        • Wood O.B.
        • Smith D.L.
        • Wastney M.E.
        Differences in calcium metabolism between adolescent and adult females.
        Am J Clin Nutr. 1995; 61: 577-581
        • Holum JR.
        Fundamentals of General, Organic, and Biological Chemistry. 2nd ed. John Wiley and Sons, New York, NY1982
        • Wolever T.M.
        • Jenkins D.J.A.
        • Jenkins A.L.
        • Josse R.G.
        The glycemic index.
        Am J Clin Nutr. 1991; 54: 846-854
        • Conover W.J.
        Practical nonparametric statistics. John Wiley and Sons, New York, NY1971
      5. Systat Inc. SYSTATforthe Macintosh, version 5.2. Evanston, IL:SYSTAT, Inc. 1992.

        • Suarez F.L.
        • Savaiano D.A.
        • Arbisi P.
        • Levitt M.D.
        Tolerance to the daily ingestion of two cups of milk by individuals claiming lactose intolerance.
        Am J Clin Nutr. 1997; 65: 1502-1506
        • Nusser S.M.
        • Carriquiry A.L.
        • Dodd K.W.
        • Fuller W.A.
        A semiparametric transformational approach to estimating usual daily intake distributions.
        J Am Stat Assoc. 1996; 91: 1440-1465
        • Suarez F.L.
        • Adshead J.
        • Furne J.K.
        • Levitt M.D.
        Lactose maldigestion is not an impediment to the intake of 1500mg calcium daily as dairy products.
        Am J Clin Nutr. 1998; 68: 1118-1122