Q&A on lactose intolerance

Why does lactose intolerance occur?

why-does-lactose-intolerance-occur

Lactose is a type of sugar, naturally found in milk and dairy products. In the intestine, lactose is transformed by lactase, an enzyme, into glucose and galactose, both simpler sugars, which are used by our body for energy and various functions. Most people have difficulty digesting lactose. It is due to the normal decline of lactase activity after weaning, called non- persistence of lactase. Symptoms of lactose intolerance generally do not occur until there is less than 50% of lactase activity.

At the genetic level, the gene coding for lactase, LCT, becomes normally less active with age. In some individuals, lactase production in the intestine is sustained and they keep the ability to digest lactose after infancy, while others lose this capacity and can experience intestinal discomfort regarding the amount of lactose they consume. Lactase activity decline is more common in people of Asian, African, South American, Southern European, and Australian Aboriginal heritage than in people of Northern European (Scandinavia, the British Islands and Germany) descent.

Lactose intolerance occurs when lactose maldigestion results into one or many symptoms of intestinal discomfort such as bloating, diarrhea, and gas.

Lactose maldigesters are encouraged to consume lactose in small amounts (up to 12 g in one intake, and up to 24 g across the day, which represents one and two bowls of milk, respectively). Yogurt, which contains live bacteria that help digesting the lactose it contains, and cheeses that contain low or no lactose (cheddar, provolone, mozzarella, Grana padano, etc.) are good alternatives for lactose maldigesters.

Sources:
Adolfsson et al. Am J Clin Nutr 2004;80:245-56.
Bailey et al. J Natl Med Assoc 2013;105:112-27.
Deng et al. Nutrients 2015;7:8020-35.
Efsa Panel on Dietetic Products N, Allergies. Scientific Opinion on lactose thresholds in lactose intolerance and galactosaemia. EFSA Journal 2010;8:n/a-n/a.
Efsa Panel on Dietetic Products N, Allergies. Scientific Opinion on the substantiation of health claims related to live yoghurt cultures and improved lactose digestion (ID 1143, 2976) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal 2010;8:n/a-n/a.
Lukito et al. Asia Pac J Clin Nutr 2015;24 Suppl 1:S1-8.
Misselwitz et al. United European Gastroenterol J 2013;1:151-9.
Suarez et al. N Engl J Med 1995;333:1-4.
Szilagyi et al. Nutrients 2015;7:6751-79.
Szilagyi et al. Can J Gastroenterol Hepatol 2015;29:149-56.

YINI-WGO-Lactose-Intolerance

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