Lactose Intolerance

 

HEALTHY LIVING,HEALTHY DIET & LACTOSE INTOLERANCE

AN IMPORTANT ROLE FOR YOGHURT

  • Although dairy products are well recognised as being an essential element of a healthy daily diet, a significant proportion of populations in many countries either are, or believe themselves to be, lactose intolerant.

    How can you help ensure that they can reap the well-established benefits of daily dairy product intake?
  • A low intake of calcium is known to be a problem in westerncountries1’4 even though calcium intake is necessary for the maintenance of bone health, which has been linked to a lower risk of developing chronic diseases, such as osteoporosis.4
  • Removing milk and milk products from the diet requires careful replacement with other food sources of calcium, including fortified foods.
  • Calcium in some plant food is well absorbed, but consuming enough plant food to achieve the recommended dietary allowance (RDA) may be unrealistic for many.5
  • Additionally, there are ethnic, regional and age differences in the prevalence of lactosemalabsorption.3
  • Much of what is generally referred to as lactose intolerance is actually lactose malabsorption or maldigestion and is due to a lack of the enzyme lactase(a subtype of beta-galactosidase).3
  • Lactase deficiency is one of the most common enzyme deficiencies in adults.
  • Lactase breaks down lactose which is the major carbohydrate in milk and all dairy products.

Lactose intolerance & malabsorption.

Lactose in tolerance is a clinical3 syndrome characterised by the physiological conditions lactose malabsorption or lactase deficiency and causes one or more of the following: abdominal discomfort/pain, flatulence, nausea, diarrhoea and/or bloating after the ingestion of lactose or lactose-containing food. The amount of lactose that causes these symptoms varies from individual to individual depending on the amount of lactose consumed, the degree of lactase deficiency and the form of food containing the lactose.3

Milk and dairy products, such as yoghurt, are often well tolerated by many children with underlying inflammatory conditions of the intestines, including Crohn’s disease and ulcerative colitis.3 In these children, the prevalence of lactose intolerance does not seem to be any greater than in the general population.3

It is important to understand that not all dairy products are equally problematic for people who believe themselves to be lactose intolerant.

By choosing dairy products wisely, it is possible to improve an individual’s ability to digest lactose and, therefore, to help ensure they can benefit from the nutrients present in dairy products.

LACTOSE INTOLERANCE, LACTOSE MALABSORPTION AND THE RISKS OF A DAIRY DEFICIENT DIET

  • It is well established that a healthy, balanced diet is essential to leading a healthy life and to help prevent the development of a wide range of non-communicable diseases.
  • Dairy products are recognised as being essential to a well-balanced diet with most dietary guidelines and expert advice recommending an intake of between 2 and 5 portions of dairy products daily (e.g. recommended in the guidelines for US, UK, France, Italy, Spain and Belgium).*
  • However, a significant proportion of people fail to achieve the recommended daily dairy productintake.1,2
  • A diet lacking in dairy products can have a negative effect on the growth and development of infants, children and adolescents due to a reduced intake of protein, calcium and vitamins.3

STUDIES IN THE USA4 (FIG. 1A) AND FRANCE1 (FIG. 1B) HAVE DEMONSTRATED THAT THE RDA OF CALCIUM IS NOT BEING REACHED BY THE MAJORITY OF THESE POPULATIONS.

One reason for the failure of some people to achieve their recommended daily intake of dairy products may be due to the fact that they believe themselves to be lactose intolerant and, therefore, may tend to avoid dairy products.

* Varies according to country, population age and serving size.

HOW YOGHURT CAN HELP

For the majority of individuals with lactose malabsorption, perhaps the most important attribute of yoghurt is its proven capacity to improve lactose digestion with regular consumption.6

  • Based on fourteen human studies, the EFSA (European Food Safety Agency)stated that a cause and effect relationship exists between the consumption of live yoghurt cultures in yoghurt and improved lactose digestion in individuals with lactose maldigestion.7
  • The majority of adults and adolescents with diagnosed lactose malabsorption can tolerate up to 12g of lactose in a single dose with few or no symptoms and can tolerate even higher amounts if intake is spread throughout the day.3,8,9
  • A typical 1OOg portion of whole milk yoghurt contains less than 5g of lactose, thereby making it easier for individuals with lactose malabsorption to tolerate.10
  • Due to this tolerance, yoghurt can be seen as a way of attaining a dietary dose of calcium. Indeed, one study explicitly described that yogurt consumption helps prevent osteoporosis in lactose deficient individuals, through a correlation that was made between bone mineral density and calcium intake.11
  • It has been demonstrated that individuals fed with 20g of yoghurt-borne lactose experienced no intolerance symptoms, in contrast to those who ingested the same amount of lactose in ice cream or milk.12

Also including fermented milks

Although typical portions or ‘pots’ of commercially-available yoghurts may vary from one country to another, if we assume that most typically contain 100-125g of yoghurt, it would therefore seem that even those individuals. with diagnosed lactose malabsorption may be able to consume several pots of yoghurt daily without experiencing intolerance symptoms.

  • Active microbial beta-galactosidase(of which lactase is a subtype) in bacteria-containing yoghurts survives gastric passage and is released by bile salts into the small intestine, where it supports lactose digestion.13
  • The viscosity of yoghurt delays the passage of yoghurt through the intestine, which may prolong the effect of the beta-galactosidase digestion process, thus enhancing the hydrolysis of lactose.13

YOGHURT IS A NUTRIENT-DENSE, TASTY, HANDYAND EASILY-DIGESTED WAY TO HELP PEOPLE TO REACH THEIR RECOMMENDED DAILY DAIRY INTAKE
(e.g. Dietary guidelines for US, UK, France, Italy, Spain and Belgium)

HEALTHY LIVING,HEALTHY DIET & LACTOSE INTOLERANCE

AN IMPORTANT ROLE FOR YOGHURT

  • With regular consumption yoghurt is proven to improve lactose digestion.6,7
  • Even those individuals with diagnosed lactose malabsorption maybe able to consume several pots of yoghurt daily without experiencing intolerance symptoms.
  • Yoghurt is a nutrient-dense, tasty, handy and easily-digested way to help people to reach their recommended daily dairy intake.

References:

  1. Etude nationale nutrition santé (ENNS). 2006. Available at: http://opac.invs.sante.fr/doc_num.php?explnum_id= 3481. Accessed May 2012.
  2. Report of the Dietary Guidelines Advisory Committee on the Dietary Guidelines for Americans (DGAC). 2010.Available at: http://www.cnpp.usda.gov/dgas2ol 0-dgacreport.htm. Accessed May 2012.
  3. Heyman MB. Lactose intolerance in infants, children, and adolescents Pediatrics. 2006;118(3):1279-86.
  4. Miller GD et al. The importance of meeting caldum needs with foods. J Am CoIl Nutr. 2001:20(2 Suppl):168S-185S.
  5. Dietary Guidelines for Americans, 2010. Available at: www.dietaryguidelines.gov.
  6. Wilton JM. Yoghurt a top health food. Blackwell Scientific Publication. 2004;pp,36-44.
  7. EFSA Journal. Scientific Opinion on the substantiation of health claims related to live yoghurt cultures and improved lactosedigestion. 2010:8(10):1763-80.
  8. EFSA Journal. Scientific Opinion on lactose thresholds in lactose intolerance and gcilactosaemia. 2010;8(9):1777-805.
  9. Wilt Ti et al. Lactose intolerance and health. Evid Rep Technol Assess (Full Rep). 2010;(192):1-410.
  10. National Nutrient Database for Standard Reference. Available at: http://ndb.nal.usda.gov/ndb/foods/list. Accessed May 2012.
  11. Di Stefano M et al. Lactose malabsorption and intolerance and peak bone mass. Gastroenterology. 2O02;12(7):1793-9.
  12. Martini MC et al. Lactose digestion from flavored and frozen yogurts, ice milk, and ice cream by lactase-dijnt persons4irAm I Clin Nutr. 1987:46(4):636-40.
  13. De Vrese M et al. Probiotics-compensation for lactose insufficiency. Am] Chn Nutr. 2001 ;73(2 Suppl)429.