RESUMEN
The author summarises the interrelations between lactose intolerance, calcium and vitamin D metabolism and osteoporosis. Lactose intolerance enhances the risk of forearm and hip fractures in some patients. Lactase gene genotype and fracture risk are related in some populations. Calcium and vitamin D supplementation increase bone mineral content and they are justified in children, during pregnancy and lactation, and in postmenopausal women. The intake of milk and milk products could increase the risk of ovarian carcinoma. CC genotype of the lactase gene increased the risk of colorectal carcinoma in Finns; no such effect was observed in British, Spanish and Italian patients. Even small quantities of lactose in drugs (10-750 mg) could elicit intolerance symptoms due to individual susceptibility. In spite of public knowledge and advertising, controlled studies did not prove the beneficial effect of either a lactose-free diet, enzyme supplementation or probiotics in an evidence-based manner. While accepted guidelines are lacking, a personalised therapy is mandatory. In spite of increasing public interest in lactose intolerance, many unknown factors must still be studied.
Asunto(s)
Calcio de la Dieta/metabolismo , Suplementos Dietéticos , Lactasa/uso terapéutico , Intolerancia a la Lactosa/complicaciones , Intolerancia a la Lactosa/tratamiento farmacológico , Lactosa/efectos adversos , Fracturas Osteoporóticas/metabolismo , Vitamina D/metabolismo , Animales , Densidad Ósea/efectos de los fármacos , Calcio de la Dieta/administración & dosificación , Productos Lácteos/efectos adversos , Enfermedades del Sistema Digestivo/tratamiento farmacológico , Costos de los Medicamentos , Medicina Basada en la Evidencia , Femenino , Predisposición Genética a la Enfermedad , Humanos , Hungría , Lactosa/administración & dosificación , Intolerancia a la Lactosa/economía , Intolerancia a la Lactosa/etiología , Intolerancia a la Lactosa/metabolismo , Fracturas Osteoporóticas/etiología , Fracturas Osteoporóticas/prevención & control , Neoplasias Ováricas/etiología , Medicina de Precisión , Factores de Riesgo , Sociedades , Vitamina D/administración & dosificaciónRESUMEN
OBJECTIVE: To determine attitudes, beliefs, and barriers related to adequate milk consumption in low-income women ages ≥ 60 years. METHODS: Nine focus groups were conducted with a convenience sample of 59 women at congregate meal sites in a metropolitan area. Grounded in Social Cognitive Theory, focus group questions were used to explore personal, behavioral, and environmental factors associated with milk consumption. RESULTS: Key response themes indicated a positive attitude for the taste of milk (except for low-fat), a primary belief that milk was important for bones and health, and a primary barrier of gastrointestinal side effects. CONCLUSIONS AND IMPLICATIONS: Knowledge regarding the benefits of milk and the dislike of its taste were not the primary reason for the lack of consumption. Instead, gastrointestinal side effects seemed to be the major barrier to adequate consumption. Future nutrition campaigns should test strategies for lactose intolerance management when communicating with low-income older women.