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group_2_presentation_2_-_lactose_intolerance [2019/03/09 00:09] pateln25 [Lactose Substitutes] |
group_2_presentation_2_-_lactose_intolerance [2019/03/09 12:07] (current) pateln25 |
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| There are several ways to test for lactose intolerance including breath tests, blood tests, internal biopsies, and stool tests. When diagnosing, if the symptoms described line up with those of lactose intolerance, a lactose- free diet can be implemented. The diet can last up to 2 weeks and must not include any sources of lactose, especially from hidden sources. If the symptoms appear to be subtle, then further testing can be done using the techniques listed below. | There are several ways to test for lactose intolerance including breath tests, blood tests, internal biopsies, and stool tests. When diagnosing, if the symptoms described line up with those of lactose intolerance, a lactose- free diet can be implemented. The diet can last up to 2 weeks and must not include any sources of lactose, especially from hidden sources. If the symptoms appear to be subtle, then further testing can be done using the techniques listed below. | ||
| - | <box 40% round | > {{ :playground:7.png?450 |}} </box| Figure 4: Map of the world showing percentage of people affected by lactose intolerance. (Retrieved from: The University of Alabama, 2013)> | + | <box 40% round | > {{ :playground:7.png?450 |}} </box| Figure 4: The various tests used for diagnosing lactose intolerance.> |
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| - | ====== TREATMENTS & LIFESTYLE ====== | + | ====== TREATMENTS ====== |
| Lactose intolerance can be treated with simple dietary changes. The following are some of the strategies that can be used to reduce the amount of milk or daily products in his or her diet. | Lactose intolerance can be treated with simple dietary changes. The following are some of the strategies that can be used to reduce the amount of milk or daily products in his or her diet. | ||
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| - | ===== Lactase Supplements ===== | ||
| - | |||
| - | When dietary restriction of lactose consumption is not a suitable option, lactase supplements are available (Mattar //et al.//, 2012). Lactase enzyme produced industrially by fungi of the genus Aspergillus, are suitable supplements to the lactase produced in the small intestines of humans (Mattar //et al.//, 2012). This enzyme in the form of beta-galactosidase tablets, is available over the counter in several countries. The beta-galactosidase tablets must be taken at the time of lactose consumption in order to effectively aid in the digestion of lactose (Mattar //et al.//, 2012). In addition, most available forms of this tablet are pH sensitive and are only active in acidic environments such as that of the stomach (Mattar //et al.//, 2012). It is important to not that excessive acidity can denature the enzyme so consumption while fasting is not recommended (Mattar //et al.//, 2012). | ||
| ===== Dietary Management ===== | ===== Dietary Management ===== | ||
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| ===== Lactose Substitutes ===== | ===== Lactose Substitutes ===== | ||
| - | Individuals with primary or secondary hypolactasia can tolerate varying concentrations of lactose consumption, which is often considerably lower than lactose tolerant individuals (Mattar et al., 2012). Thus, dietary modifications for these individuals often involve the consumption of lactose-reduced or lactose-free substitutes (Mattar et al., 2012). There are many products currently on the market that are lactose-free. Many of them are also based on legumes, seeds and grains. These include almond, rice, hazelnut hemp, soy, sunflower, oat, and coconut milks (Shaukat et al., 2010). They are available in original or other flavors as sweetened and unsweetened. | + | Individuals with primary or secondary hypolactasia can tolerate varying concentrations of lactose consumption, which is often considerably lower than lactose tolerant individuals (Mattar //et al.//, 2012). Thus, dietary modifications for these individuals often involve the consumption of lactose-reduced or lactose-free substitutes (Mattar //et al.//, 2012). There are many products currently on the market that are lactose-free. Many of them are also based on legumes, seeds and grains. These include almond, rice, hazelnut hemp, soy, sunflower, oat, and coconut milks (Shaukat //et al.//, 2010). They are available in original or other flavors as sweetened and unsweetened. |
| - | Individuals avoiding foods containing milk may lose source essential nutrients from their diet, and therefore foods must be chosen with care to replace these lost nutrients. In some cases, cross-reactivity may when the proteins in one food are similar to the proteins in another. When that happens, the body's immune system sees them as the same. There is a high degree of cross-reactivity between cow's milk and the milk from other mammals such as goat and sheep. In studies, the risk of allergy (resulting in symptoms) to goat's milk or sheep's milk in a person with cow’s milk allergy is about 90%. The risk is much lower, about 5%, for allergy to mare's milk which is less cross-reactive with cow's milk. | + | Individuals avoiding foods containing milk may lose source essential nutrients from their diet, and therefore foods must be chosen with care to replace these lost nutrients. In some cases, cross-reactivity may occur when the proteins in one food are similar to the proteins in another. When that happens, the body's immune system sees them as the same. There is a high degree of cross-reactivity between cow's milk and the milk from other mammals such as goat and sheep. Studies show the risk of allergy to goat's milk or sheep's milk in a person with cow’s milk allergy is about 90%. The risk is much lower, about 5%, for allergy to mare's milk which is less cross-reactive with cow's milk. |
| - | === Milk Products === | + | === Milk Ingredients === |
| + | Always read the entire ingredient label to look for the names of milk. Milk ingredients may be within the list of the ingredients or could be listed in a “Contains: Milk” statement beneath the list of ingredients. Advisory statements such as “may contain milk” or “made in a facility with milk” are voluntary and not required by any labeling law. It is recommend for the individual to consult their doctors if they consume products with these labels. | ||
| - | Always read the entire ingredient label to look for the names of milk. Milk ingredients may be within the list of the ingredients. Or milk could be listed in a “Contains: Milk” statement beneath the list of ingredients. Advisory statements such as “may contain milk” or “made in a facility with milk” are voluntary. Advisory statements are not required by any labeling law. It is recommend for the individual to consult their doctors if they consume products with these labels. | + | <box 50% round | > {{ :playground:33f0310b003e9be91c52d92f7c34c3b3_3_.png?500 |}} </box|Figure 8: A list of milk ingredients. (Retrieved from: Kids with Food Allergies, 2019)> |
| + | ===== Lactase Supplements ===== | ||
| + | When dietary restriction of lactose consumption is not a suitable option, lactase supplements are available (Mattar //et al.//, 2012). Lactase enzyme produced industrially by fungi of the genus Aspergillus, are suitable supplements to the lactase produced in the small intestines of humans (Mattar //et al.//, 2012). This enzyme in the form of beta-galactosidase tablets, is available over the counter in several countries. The beta-galactosidase tablets must be taken at the time of lactose consumption in order to effectively aid in the digestion of lactose (Mattar //et al.//, 2012). In addition, most available forms of this tablet are pH sensitive and are only active in acidic environments such as that of the stomach (Mattar //et al.//, 2012). It is important to not that excessive acidity can denature the enzyme so consumption while fasting is not recommended (Mattar //et al.//, 2012). | ||
| - | <box 30% round | > {{ :playground:33f0310b003e9be91c52d92f7c34c3b3_3_.png?600 |}} </box|Figure 8: A list of milk ingredients. (Retrieved from: Vesa et al., 2000)> | ||
| + | ====== REFERENCES ====== | ||
| + | Arola, H. (1994). Diagnosis of Hypolactasia and Lactose Malabsorption. //Scandinavian Journal of Gastroenterology//, 29(sup202), 26–35. doi:10.3109/0036552940909174 | ||
| + | Fang, L., Ahn, J. K., Wodziak, D., & Sibley, E. (2012). The human lactase persistence-associated SNP− 13910* T enables in vivo functional persistence of lactase promoter–reporter transgene expression. //Human Genetics//, 131(7), 1153-1159. doi: 10.1007/s00439-012-1140-z | ||
| - | ====== REFERENCES ====== | + | IMB Labor Berlin: Lactose Intolerance. (2019). Retrieved from https://www.imd-berlin.de/en/special-areas-of-competence/food-intolerances/lactose-intolerance.html |
| - | Arola, H. (1994). Diagnosis of Hypolactasia and Lactose Malabsorption. Scandinavian Journal of Gastroenterology, 29(sup202), 26–35. doi:10.3109/0036552940909174 | + | Itan, Y., Jones, B. L., Ingram, C. J. E., Swallow, D. M., & Thomas, M. G. (2010). A worldwide correlation of lactase persistence phenotype and genotypes.// BMC Evolutionary Biology//, 10, 36. doi: /10.1186/1471-2148-10-36 |
| - | Fang, L., Ahn, J. K., Wodziak, D., & Sibley, E. (2012). The human lactase persistence-associated SNP− 13910* T enables in vivo functional persistence of lactase promoter–reporter transgene expression. Human genetics, 131(7), 1153-1159. doi: 10.1007/s00439-012-1140-z | + | |
| - | Itan, Y., Jones, B. L., Ingram, C. J. E., Swallow, D. M., & Thomas, M. G. (2010). A worldwide correlation of lactase persistence phenotype and genotypes. BMC Evolutionary Biology, 10, 36. doi: /10.1186/1471-2148-10-36 | + | Itan, Y., Powell, A., Beaumont, M. A., Burger, J., & Thomas, M. G. (2009). The origins of lactase persistence in Europe. //PLoS Computational Biology//, 5(8), e1000491. doi: 10.1371/journal.pcbi.1000491 |
| - | Itan, Y., Powell, A., Beaumont, M. A., Burger, J., & Thomas, M. G. (2009). The origins of lactase persistence in Europe. PLoS computational biology, 5(8), e1000491. doi: 10.1371/journal.pcbi.1000491 | + | Kids with Food Allergies: Milk Allergy. (2019). Retrieved from https://www.kidswithfoodallergies.org/page/milk-allergy.aspx |
| Lactose Intolerance: Background, Pathophysiology, Etiology. (2017). Retrieved from https://emedicine.medscape.com/article/187249-overview | Lactose Intolerance: Background, Pathophysiology, Etiology. (2017). Retrieved from https://emedicine.medscape.com/article/187249-overview | ||
| - | Louvard, D., Kedinger, M., & Hauri, H. P. (1992). The differentiating intestinal epithelial cell: establishment and maintenance of functions through interactions between cellular structures. Annual review of cell biology, 8(1), 157-195. | + | Louvard, D., Kedinger, M., & Hauri, H. P. (1992). The differentiating intestinal epithelial cell: establishment and maintenance of functions through interactions between cellular structures. //Annual Review of Cell Biology//, 8(1), 157-195. |
| - | Mattar, R., de Campos Mazo, D. F., & Carrilho, F. J. (2012). Lactose intolerance: diagnosis, genetic, and clinical factors. Clinical and experimental gastroenterology, 5, 113-121. doi: 10.2147/CEG.S32368 | + | Mattar, R., de Campos Mazo, D. F., & Carrilho, F. J. (2012). Lactose intolerance: diagnosis, genetic, and clinical factors. //Clinical and Experimental Gastroenterology//, 5, 113-121. doi: 10.2147/CEG.S32368 |
| - | Misselwitz, B., Pohl, D., Frühauf, H., Fried, M., Vavricka, S. R., & Fox, M. (2013). Lactose malabsorption and intolerance: pathogenesis, diagnosis and treatment. United European gastroenterology journal, 1(3), 151-159. doi: 10.1177/205064061384463 | + | Misselwitz, B., Pohl, D., Frühauf, H., Fried, M., Vavricka, S. R., & Fox, M. (2013). Lactose malabsorption and intolerance: pathogenesis, diagnosis and treatment. //United European Gastroenterology Journal//, 1(3), 151-159. doi: 10.1177/205064061384463 |
| - | Patel, Y. T., & Minocha, A. (2000). Lactose intolerance: Diagnosis and management. Comprehensive Therapy, 26(4), 246–250. doi:10.1007/s12019-000-0025-6 | + | Patel, Y. T., & Minocha, A. (2000). Lactose intolerance: Diagnosis and management. //Comprehensive Therapy//, 26(4), 246–250. doi:10.1007/s12019-000-0025-6 |
| Prevalence of lactose intolerance. (2013). Retrieved from https://www.food-intolerance-network.com/food-intolerances/lactose-intolerance/ethnic-distribution-and-prevalence.html | Prevalence of lactose intolerance. (2013). Retrieved from https://www.food-intolerance-network.com/food-intolerances/lactose-intolerance/ethnic-distribution-and-prevalence.html | ||
| - | Ridefelt, P., & Håkansson, L. D. (2005). Lactose intolerance: Lactose tolerance test versus genotyping. Scandinavian Journal of Gastroenterology, 40(7), 822–826. doi: 10.1080/0036552051001576 | + | Ridefelt, P., & Håkansson, L. D. (2005). Lactose intolerance: Lactose tolerance test versus genotyping. //Scandinavian Journal of Gastroenterology//, 40(7), 822–826. doi: 10.1080/0036552051001576 |
| - | Rusynyk, R. A., & Still, C. D. (2001). Lactose intolerance. Journal of the American Osteopathic Association, 101(4 supplement 1), 10S. | + | Rusynyk, R. A., & Still, C. D. (2001). Lactose intolerance. //Journal of the American Osteopathic Association//, 101(4 supplement 1), 10S. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11392211 |
| - | Simoons, F. J. (1969). Primary adult lactose intolerance and the milking habit: A problem in biological and cultural interrelations. The American Journal of Digestive Diseases, 14(12), 819–836. doi: 10.1007/BF02233204 | + | Simoons, F. J. (1969). Primary adult lactose intolerance and the milking habit: A problem in biological and cultural interrelations. T//he American Journal of Digestive Diseases//, 14(12), 819–836. doi: 10.1007/BF02233204 |
| - | Simren, M., & Stotzer, P. O. (2006). Use and abuse of hydrogen breath tests. Gut, 55(3), 297-303. doi:10.1136/gut.2005.075127 | + | Simren, M., & Stotzer, P. O. (2006). Use and abuse of hydrogen breath tests.// Gut//, 55(3), 297-303. doi:10.1136/gut.2005.075127 |
| - | Shaukat, A., Levitt, M. D., Taylor, B. C., MacDonald, R., Shamliyan, T. A., Kane, R. L., & Wilt, T. J. (2010). Systematic review: effective management strategies for lactose intolerance. Annals of internal medicine, 152(12), 797-803. doi: 10.7326/0003-4819-152-12-201006150-00241 | + | Shaukat, A., Levitt, M. D., Taylor, B. C., MacDonald, R., Shamliyan, T. A., Kane, R. L., & Wilt, T. J. (2010). Systematic review: effective management strategies for lactose intolerance. //Annals of Internal Medicine//, 152(12), 797-803. doi: 10.7326/0003-4819-152-12-201006150-00241 |
| - | Solomons, N. W., García-Ibañez, R., & Viteri, F. E. (1980). Hydrogen breath test of lactose absorption in adults: the application of physiological doses and whole cow’s milk sources. The American Journal of Clinical Nutrition, 33(3), 545–554.doi:10.1093/ajcn/33.3.545 | + | Solomons, N. W., García-Ibañez, R., & Viteri, F. E. (1980). Hydrogen breath test of lactose absorption in adults: the application of physiological doses and whole cow’s milk sources. //The American Journal of Clinical Nutrition//, 33(3), 545–554.doi:10.1093/ajcn/33.3.545 |
| - | Srinivasan, R., & Minocha, A. (1998). When to suspect lactose intolerance: symptomatic, ethnic, and laboratory clues. Postgraduate medicine, 104(3), 109-123. doi: 10.3810/pgm.1998.09.577 | + | Srinivasan, R., & Minocha, A. (1998). When to suspect lactose intolerance: symptomatic, ethnic, and laboratory clues. //Postgraduate Medicine//, 104(3), 109-123. doi: 10.3810/pgm.1998.09.577 |
| - | Swagerty, D. L., Walling, A. D., & Klein, R. M. (2002). Lactose intolerance. American family physician, 65(9), 1845-1860. | + | Swagerty, D. L., Walling, A. D., & Klein, R. M. (2002). Lactose intolerance. //American Family Physician//, 65(9), 1845-1860. |
| - | Swallow, D. M. (2003). Genetics of lactase persistence and lactose intolerance. Annual review of genetics, 37(1), 197-219. | + | Swallow, D. M. (2003). Genetics of lactase persistence and lactose intolerance. //Annual Review of Genetics//, 37(1), 197-219. |
| - | Vesa, T. H., Marteau, P., & Korpela, R. (2000). Lactose intolerance. Journal of the American College of Nutrition, 19(sup2), 165S-175S. doi: 10.1080/07315724.2000.10718086 | + | Vesa, T. H., Marteau, P., & Korpela, R. (2000). Lactose intolerance. //Journal of the American College of Nutrition//, 19(sup2), 165S-175S. doi: 10.1080/07315724.2000.10718086 |
| - | Villako, K., & Maaroos, H. (1994). Clinical Picture of Hypolactasia and Lactose Intolerance. Scandinavian Journal of Gastroenterology, 29(sup202), 36–54. doi:10.3109/00365529409091743 | + | Villako, K., & Maaroos, H. (1994). Clinical Picture of Hypolactasia and Lactose Intolerance. //Scandinavian Journal of Gastroenterology//, 29(sup202), 36–54. doi:10.3109/00365529409091743 |
