Lactose Intolerance in Infants, Children, and Adolescents

PEDIATRICS (Impact Factor: 5.47). 10/2006; 118(3):1279-86. DOI: 10.1542/peds.2006-1721
Source: PubMed


The American Academy of Pediatrics Committee on Nutrition presents an updated review of lactose intolerance in infants, children, and adolescents. Differences between primary, secondary, congenital, and developmental lactase deficiency that may result in lactose intolerance are discussed. Children with suspected lactose intolerance can be assessed clinically by dietary lactose elimination or by tests including noninvasive hydrogen breath testing or invasive intestinal biopsy determination of lactase (and other disaccharidase) concentrations. Treatment consists of use of lactase-treated dairy products or oral lactase supplementation, limitation of lactose-containing foods, or dairy elimination. The American Academy of Pediatrics supports use of dairy foods as an important source of calcium for bone mineral health and of other nutrients that facilitate growth in children and adolescents. If dairy products are eliminated, other dietary sources of calcium or calcium supplements need to be provided.

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    • "Also, the donkey milk has a low fat content and, hence, a low energetic value which suggests its potential use in the hypocaloric human diets. Many authors (Heyman 2006; Lomer and others MS 20141602 Submitted 9/24/2014, Accepted 2/22/2015. Authors are with School of Agricultural, Forestry, Food and Environmental Sciences, Univ. of Basilicata, Potenza, Viale dell'Ateneo Lucano 10-85100, Italy. "
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    ABSTRACT: The aim of this work was to investigate on the functional features of a donkey milk probiotic berevage as a novel food. Particularly, it was to study the decrease of lactose content and the antioxidant activity of standard yogurt (YC) and probiotic yogurt (YP; Lactobacillus acidophilus, Lactobacillus casei) from donkey milk during the storage up to 30 d at 4 °C. The evolution of lactose content using enzymatic-spectrophotometric kits was analyzed. Antioxidant activity of yogurt was measured using 2,2’-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid (ABTS), ferric reducing antioxidant power (FRAP), and thiol assays. Parallel consumer sensory studies were carried out as consumer test in order to gain information about the impact of these novel fermented beverages on sensory perceptions. The statistical analysis has shown significant effect of studied factors. The results showed that the lactose content gradually decreased during storage in both yogurts, reaching values of 2.36% and 2.10% in YC and YP, respectively, at 30 d (P < 0.05). During storage of both yogurt types, the antioxidant activity increased, but YP showed a higher antioxidant activity than YC. The results suggest that the antioxidant activity of yogurt samples was affected by cultures of lactic acid bacteria (LAB). We conclude that the fermented donkey milk could be configured as health and nutraceutical food, which aims to meet nutritional requirements of certain consumers groups with lactose or cow milk protein intolerance.
    Full-text · Article · Jan 2015
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    • "Although our findings suggest the benefit of zinc supplementation to lactose-induced osmotic diarrhea in rats, we acknowledge that this model may not necessarily induce the same level, mechanisms, and characteristics of the inflammatory condition seen with different pathogenic-driven-diarrhea in children. On the other hand, transient lactase deficiency secondary to brush border damage from gastrointestinal infections is a well-recognized clinical entity that prolongs diarrheal symptoms in the aftermath of acute infections [56]. Hence, amelioration of osmotic diarrhea may account, in part, for zinc's benefits in the setting of secretory and inflammatory diarrhea that damage intestinal villi. "
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    ABSTRACT: Background WHO guidelines recommend zinc supplementation as a key adjunct therapy for childhood diarrhea in developing countries, however zinc’s anti-diarrheal effects remain only partially understood. Recently, it has been recognized that low-grade inflammation may influence stunting. In this study, we examined whether oral zinc supplementation could improve weight, intestinal inflammation, and diarrhea in undernourished weanling rats. Methods Rats were undernourished using a northeastern Brazil regional diet (RBD) for two weeks, followed by oral gavage with a saturated lactose solution (30 g/kg) in the last 7 days to induce osmotic diarrhea. Animals were checked for diarrhea daily after lactose intake. Blood was drawn in order to measure serum zinc levels by atomic absorption spectroscopy. Rats were euthanized to harvest jejunal tissue for histology and cytokine profiles by ELISA. In a subset of animals, spleen samples were harvested under aseptic conditions to quantify bacterial translocation. Results Oral zinc supplementation increased serum zinc levels following lactose-induced osmotic diarrhea. In undernourished rats, zinc improved weight gain following osmotic diarrhea and significantly reduced diarrheal scores by the third day of lactose intake (p < 0.05), with improved jejunum histology (p < 0.0001). Zinc supplementation diminished bacterial translocation only in lactose-challenged undernourished rats (p = 0.03) compared with the untreated challenged controls and reduced intestinal IL-1β and TNF-α cytokines to control levels. Conclusion Altogether our findings provide novel mechanisms of zinc action in the setting of diarrhea and undernutrition and support the use of zinc to prevent the vicious cycle of malnutrition and diarrhea.
    Full-text · Article · Aug 2014 · BMC Gastroenterology
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    • "in their gastrointestinal tract (Simoons, 1978) (Figure 11.5). When lactase-deficient people consume milk, they have one or more of the following clinical symptoms: abdominal pain, watery diarrhea, bloating, and cramping, and these symptoms are generally known as lactose intolerance (Heyman, 2006). The reduction of lactase activity is a genetically programmed process which occurs after weaning when lactose is no longer an essential element in the human diet (Swallow, 2003). "
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    ABSTRACT: The supplementation into milk and dairy products of bioactive and nutritional ingredients or adaptation of certain techniques to address lactose intolerance is a complex phenomenon which is worthy of great attention. In this regard, microencapsulation and nanotechnology have evolved as two advanced technologies with huge potential. This chapter presents an overview of the recent inventions relating to the application of microencapsulation and nanotechnology to milk and dairy products. The nutraceutical ingredients that have been applied to milk are chitosan, isoflavone, mistletoe, conjugated linoleic acid, Inonotus obliquus, and peanut sprout extract. Marine fish oil and peanut sprout extracts are the two substances that have been used to develop nutraceutical yogurt. A liposome-encapsulated enzyme cocktail containing flavourzyme, neutral bacterial protease, acid fungal protease and lipase could be incorporated into cheese milk for a balanced ripening.
    Full-text · Chapter · Apr 2014
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