A Narrative Review of Human Clinical Trials to Improve Lactose Digestion and Tolerance by Feeding Bifidobacteria or Galacto-Oligosacharides.

Supplementation with the probiotic Bifidobacterium and prebiotic galacto-oligosaccharides (GOS) could improve gut health and benefit lactose intolerant individuals. A narrative review was conducted to identify human clinical trials that evaluated lactose digestion and/or tolerance in response to consumption of Bifidobacterium, GOS, or both. A total of 152 studies on Bifidobacterium and GOS or both were published between 1983 and 2022. Out of the 152 studies, 20 were human clinical trials conducted in lactose intolerant subjects; 8 studies were conducted with Bifidobacterium supplementation and 3 studies involved GOS supplementation. Five studies reported favorable outcomes of Bifidobacterium supplementation in managing lactose intolerance (LI). Similarly, three studies reported favorable outcomes with GOS supplementation. The other three studies reported neutral outcomes. In conclusion, most studies reported a favorable effect of Bifidobacterium and GOS on managing the symptoms of LI. No study has examined the effects of combined supplementation with Bifidobacterium and GOS in lactose intolerant subjects. Future research could examine if co-supplementation with Bifidobacterium and GOS is a more effective strategy to reduce the dairy discomfort in LI individuals.

The use of probiotics and prebiotics can enable the ingestion of dairy products by lactose intolerant individuals.

OBJECTIVE: To investigate, through a systematic review, the efficiency of the clinical application of probiotic and prebiotic supplements in reducing the symptoms of lactose intolerance (LI). METHODS: This systematic review was conducted without limits for publication time and followed the PRISMA 2020 guidelines. The study was registered at the PROSPERO platform (CRD42022295691). The inclusion criteria were: studies addressing the issue of LI associated with the use of probiotics and prebiotics of any nature; studies performed with adults; randomized, placebo-controlled trials; and open access scientific articles, theses, or dissertations. The studies were retrieved from the following databases: SciELO, PubMed, LILACS, ScienceDirect, and gray literature, with no restrictions imposed regarding the years of publication of the investigations. To document the risk of bias, the RoB 2.0 tool was adopted, and to assess the certainty of the evidence, the GRADE tool was used. RESULTS: A total of 830 studies were found; however, after applying the inclusion and exclusion criteria, only five studies remained. Two studies used the prebiotic GOS (RP-G28) for the treatment of LI and, together, included 462 subjects. The results of these studies showed improvement of LI symptoms during treatment phase and up to 30 days after cessation of GOS use (RP-G28). Three studies used the probiotics Bifidobacterium bifidum 900791, Limosilactobacillus reuteri DSM 17938 (Lactobacillus reuteri), and Lactobacillus acidophilus DDS-1 to evaluate their effects on LI and comprised 117 subjects. The results showed that B. bifidum 900791 did not significantly improve LI symptoms, and only Limosilactobacillus reuteri DSM 17938 showed significant improvement in symptoms and in reduction of expired hydrogen, while Lactobacillus acidophilus DDS-1 showed significant improvement for LI symptoms. The risk of bias for studies on probiotics suggested concerns in all studies, whereas the risk of bias was low in investigations evaluating prebiotics, with only one study classified as concerning. The certainty of evidence was high for the studies using the GOS (RP-G28) prebiotic and low for the probiotics. Pooling for meta-analysis could not be performed due to the lack of similar probiotic strains or lack of common outcomes. CONCLUSION: In summary, the probiotics Limosilactobacillus reuteri DSM 17938 and Lactobacillus acidophilus DDS-1 showed the best results in the management of LI symptoms. The prebiotic GOS (RP-G28) appeared to be more efficient in reducing post-treatment symptoms. However, it is noteworthy that evidence regarding the use of probiotics for the management of LI is considerably scarce; as for prebiotics, data are limited. Studies adopting robust methodologies, especially regarding the complete reporting of data, are therefore warranted.

Efficacy of i3.1 Probiotic on Improvement of Lactose Intolerance Symptoms: A Randomized, Placebo-controlled Clinical Trial.

GOAL: The aim of this study was to assess the efficacy of probiotic i3.1 in improving lactose intolerance symptoms compared with placebo after 8 weeks of treatment. BACKGROUND: Probiotics are promising strategies to prevent and improve lactose intolerance symptoms, but previous studies have provided conflicting results. MATERIALS AND METHODS: This randomized, prospective, placebo-controlled study was conducted at the Hospital Juárez de México. We recruited adult patients with lactose intolerance confirmed by a lactose hydrogen breath test (LHBT) ≥20 parts per million (ppm) and a lactose intolerance symptom score ≥6 both upon lactose challenge. We compared the change from baseline in the scores of a validated symptom questionnaire and the LHBT after 8 weeks of probiotic or placebo treatment. RESULTS: We included 48 patients: 33 receiving the probiotic and 15 receiving placebo (2:1 randomization). Demographic characteristics were homogeneous between groups. The reduction in total symptom score after a lactose challenge was significantly higher in the probiotic group versus the placebo group (-5.11 vs. -1.00; P<0.001). All the subscores significantly decreased from baseline in the probiotic group, except for vomiting, with significant differences between the probiotic and placebo groups for abdominal pain (P=0.045) and flatulence (P=0.004). The area under the curve of the LHBT was significantly reduced from baseline in the probiotic group (P=0.019), but differences between groups were not significant (P=0.621). Adverse events were mild without differences between groups, and no serious adverse event was registered. CONCLUSION: The i3.1 probiotic was safe and efficacious in reducing lactose intolerance symptoms in patients with lactose intolerance, but did not change the LHBT.

Fermented foods and probiotics: An approach to lactose intolerance.

The aim of this review was to present various topics related to lactose intolerance with special attention given to the role of fermented foods and probiotics in alleviating gastrointestinal symptoms. Lactose intolerance is a common digestive problem in which the human body is unable to digest lactose, known as milk sugar. Lactose intolerance can either be hereditary or a consequence of intestinal diseases. Recent work has demonstrated that fermented dairy products and probiotics can modify the metabolic activities of colonic microbiota and may alleviate the symptoms of lactose intolerance. We suggest that, lactose free dairy products could be recommended as alternatives for the alleviation of lactose intolerance and for the promotion of human health and wellness.

Lactose intolerance: An update on its pathogenesis, diagnosis, and treatment.

Lactose intolerance has a high prevalence worldwide, ranging between 57% and 65%. It is caused by a reduction or loss of the activity of the intestinal enzyme lactase-phlorizin hydrolase, responsible for the digestion of lactose. This alteration determines an increased osmotic load in the small intestine and the fermentation of lactose by the bacterial flora, which leads to a high production of short-chain fatty acids and gas. This is followed by the onset of abdominal pain, diarrhea, and flatulence. In addition to these problems, it was found that subjects with lactose intolerance have an increased risk of developing various extra-intestinal diseases, including cancers. The diagnosis is essential to undertake an adequate treatment and, for this purpose, different methods have been tested. These include genetic test, hydrogen breath test (HBT), quick lactase test, and lactose tolerance test. HBT is the most used method because it is non-invasive, inexpensive, and highly sensitive and specific, as well as easy to perform. In clinical practice, the other methods are mainly used as HBT integration tests. There are also many therapeutic options. An appropriate intervention concerns the dietetic style, such as the consumption of lactose-free foods, but with nutritional characteristics comparable to dairy products. Other valid choices are represented by the use of exogenous enzymes, probiotics, prebiotics, the selection of milk containing specific types of beta-caseins. This review is intended to illustrate the diagnostic methods currently available and the possible therapeutic options for lactose intolerance.

Lactose Intolerance: A Concise Review to Skim the Surface.

Lactose intolerance is a common but poorly understood cause of gastrointestinal symptoms. Contrary to popular belief, there is much more to its diagnosis beyond symptoms with exposure and management beyond milk- and dairy-product avoidance. In this article, we review definitions, genetic basis, pathogenesis, clinical signs, as well as diagnostic and management strategies.

Update on lactose malabsorption and intolerance: pathogenesis, diagnosis and clinical management.

Lactose is the main source of calories in milk, an essential nutriedigestion, patients with visceral hypersensitivity nt in infancy and a key part of the diet in populations that maintain the ability to digest this disaccharide in adulthood. Lactase deficiency (LD) is the failure to express the enzyme that hydrolyses lactose into galactose and glucose in the small intestine. The genetic mechanism of lactase persistence in adult Caucasians is mediated by a single C→T nucleotide polymorphism at the LCTbo -13'910 locus on chromosome-2. Lactose malabsorption (LM) refers to any cause of failure to digest and/or absorb lactose in the small intestine. This includes primary genetic and also secondary LD due to infection or other conditions that affect the mucosal integrity of the small bowel. Lactose intolerance (LI) is defined as the onset of abdominal symptoms such as abdominal pain, bloating and diarrhoea after lactose ingestion by an individual with LM. The likelihood of LI depends on the lactose dose, lactase expression and the intestinal microbiome. Independent of lactose digestion, patients with visceral hypersensitivity associated with anxiety or the Irritable Bowel Syndrome (IBS) are at increased risk of the condition. Diagnostic investigations available to diagnose LM and LI include genetic, endoscopic and physiological tests. The association between self-reported LI, objective findings and clinical outcome of dietary intervention is variable. Treatment of LI can include low-lactose diet, lactase supplementation and, potentially, colonic adaptation by prebiotics. The clinical outcome of these treatments is modest, because lactose is just one of a number of poorly absorbed carbohydrates which can cause symptoms by similar mechanisms.

The effects of probiotics in lactose intolerance: A systematic review.

Over 60 percent of the human population has a reduced ability to digest lactose due to low levels of lactase enzyme activity. Probiotics are live bacteria or yeast that supplements the gastrointestinal flora. Studies have shown that probiotics exhibit various health beneficial properties such as improvement of intestinal health, enhancement of the immune responses, and reduction of serum cholesterol. Accumulating evidence has shown that probiotic bacteria in fermented and unfermented milk products can be used to alleviate the clinical symptoms of lactose intolerance (LI). In this systematic review, the effectiveness of probiotics in the treatment of LI was evaluated using 15 randomized double-blind studies. Eight probiotic strains with the greatest number of proven benefits were studied. Results showed varying degrees of efficacy but an overall positive relationship between probiotics and lactose intolerance.

Lactose Intolerance, Dairy Avoidance, and Treatment Options.

Lactose intolerance refers to symptoms related to the consumption of lactose-containing dairy foods, which are the most common source for this disaccharide. While four causes are described, the most common is the genetically-determined adult onset lactose maldigestion due to loss of intestinal lactase governed by control of the gene by a 14,000 kb promoter region on chromosome 2. Gastrointestinal symptoms from lactose have expanded to include systemic effects and have also been confounded by other food intolerances or functional gastrointestinal disorders. Partly because lactose maldigestion is often interpreted as lactose intolerance (symptoms), focus of therapy for these symptoms starts with lactose restriction. However, withholding of dairy foods completely is not appropriate due to a more favorable impact on health. Industrial efforts to substitute with plant-based products is not completely successful at this time. This narrative article reviews the complexities of the perception of lactose intolerance, its epidemiology, and pathogenesis. Treatments are discussed, including the inappropriateness of dairy avoidance. In conjunction, effects of dairy products on 19 common diseases are reviewed. Different methods of treatment, lactose-reduced products, plant-based dairy substitutes, adaptation, prebiotics, exogenous lactase, probiotics, and some other dietary interventions are further discussed.

Lactose Intolerance: Common Misunderstandings.

Lactose intolerance primarily refers to a syndrome having different symptoms upon the consumption of foods containing lactose. It is one of the most common form of food intolerance and occurs when lactase activity is reduced in the brush border of the small bowel mucosa. Individuals may be lactose intolerant to varying degrees, depending on the severity of these symptoms. When lactose is not digested, it can be fermented by gut microbiota leading to symptoms of lactose intolerance that include abdominal pain, bloating, flatulence, and diarrhea with a considerable intraindividual and interindividual variability in the severity of clinical manifestations. These gastrointestinal symptoms could be similar to cow's milk allergy and could be wrongly labeled as symptoms of "milk allergy." There are important differences between lactose intolerance and cow's milk allergy; therefore, a better knowledge of these differences could limit misunderstandings in the diagnostic approach and in the management of these conditions.

[Lactose intolerance]. / Intolerancia a la lactosa.

The most common problem limiting milk consumption worldwide is lactose intolerance (LI), which is defined as the experience of gastrointestinal symptoms due to the intake of lactose-containing food. When symptoms ensue the intake of milk, the condition is referred as milk intolerance, and it may or may not be due to LI. The most common cause of LI is primary lactase deficiency which occurs in 30% of Mexican adults when one glass of milk is consumed (12-18 g of lactose). LI occurs in less than 15% of adults after the intake of this dose of lactose. Another cause of lactose intolerance is due to secondary lactase deficiency, which occurs because lactase is reduced due to diseases that affect the intestinal mucosa. Lactose intolerance can be eliminated or significantly reduced by elimination or reduction of the intake of milk and milk containing products. Recent studies demonstrate that when ß-casein-A1 contained in milk is hydrolyzed it produces ß-casomorphine-7 which is an opioid associated with milk intolerance.

The effects of the DDS-1 strain of lactobacillus on symptomatic relief for lactose intolerance - a randomized, double-blind, placebo-controlled, crossover clinical trial.

BACKGROUND: Lactose intolerance is a form of lactose maldigestion where individuals experience symptoms such as diarrhea, abdominal cramping, flatulence, vomiting and bowel sounds following lactose consumption. Lactobacillus acidophilus is a species of bacteria known for its sugar fermenting properties. Preclinical studies have found that Lactobacillus acidophilus supplementation may assist in breaking down lactose; however, no human clinical trials exist evaluating its efficacy in alleviating symptoms related to lactose intolerance. OBJECTIVE: The aim of this randomized, double-blind, placebo-controlled, crossover study was to evaluate the effect of a proprietary strain of Lactobacillus acidophilus on relieving discomfort related to lactose intolerance. METHODS: The study enrolled healthy volunteers between 18 and 75 years of age who complained of lactose intolerance. Screening visits included a lactose challenge visit to confirm eligibility based on a score of 10 or higher on subjective assessment of the following symptoms after lactose challenge: diarrhea, abdominal cramping, vomiting, audible bowel sounds, flatulence, and overall symptoms. Qualified subjects participated in a 2-arm crossover design, with each arm consisting of 4 weeks of intervention of either active or placebo product, with a 2-week washout period during crossover. The study product consisted of the DDS-1 strain of Lactobacillus acidophilus (Nebraska Cultures, Walnut Creek, California). The placebo was formulated from maltodextrin. Study participants were instructed to take the product once daily for 4 weeks. Data collected included subjective symptom scores related to lactose intolerance. RESULTS: Longitudinal comparison between the DDS-1 group and placebo group demonstrated statistically significant reductions in abdominal symptom scores during the 6-h Lactose Challenge at week 4 for diarrhea (p = 0.033), abdominal cramping (p = 0.012), vomiting (p = 0.0002), and overall symptom score (p = 0.037). No adverse events were reported. CONCLUSIONS: The present study has found that this unique DDS-1 strain of Lactobacillus acidophilus, manufactured by Nebraska Cultures, is safe to consume and improves abdominal symptom scores compared to placebo with respect to diarrhea, cramping, and vomiting during an acute lactose challenge.

Aspectos atuais da intolerância à lactose / Current aspects of intolerance lactose

A lactose é um dissacarídeo hidrolisado pela enzima lactase, que libera seus componentes monossacarídeos para absorção na corrente sanguínea. Na falta dessa enzima, a lactose é fermentada no cólon causando desconforto abdominal. O seu tratamento é evitar o consumo de produtos ricos em lactose ou ingerir a enzima lactase com os produtos lácteos ou, ainda, dar preferência a produtos que a lactose tenha sido removida pela fermentação. Porém, essa redução no consumo de leite e seus derivados podem comprometer a absorção de proteínas e cálcio. O presente estudo tem como objetivo realizar uma atualização sobre a intolerância a lactose, com ênfase na epidemiologia e principais tratamentos, em especial o tratamento nutricional que visa prevenir possíveis carências nutricionais. Foi realizada uma pesquisa bibliográfica a partir de artigos nacionais e internacionais publicados junto ao banco de dados PubMed, SciELO e Google Acadêmico, utilizando-se as seguintes palavras-chave: Deficiência de Lactase, Epidemiologia, Intolerância à Lactose e Lactose. Foram selecionadas publicações datadas do ano de 2002 a 2014, sendo os artigos agrupados por assunto e selecionados conforme a qualidade e relevância com o tema proposto. Ao término dessa pesquisa, concluiu-se que a intolerância à lactose afeta muitas pessoas mundialmente, ocasionando uma baixa ingestão de cálcio. As pessoas que possuem o distúrbio devem buscar outros tipos de alimentos fontes desse mineral, pois a sua deficiência pode acarretar em prejuízos a saúde, em especial do tecido ósseo

Lactose is a disaccharide hydrolyzed by lactase enzyme that releases its monosaccharide components for absorption into the bloodstream. In the absence of this enzyme, lactose is fermented in the colon causing abdominal discomfort. The treatment is avoiding consumption of products rich in lactose or ingesting the enzyme lactase to milk products, or even to prefer products that lactose has been removed by fermentation. However, this reduction in the consumption of milk and dairy products may compromise the absorption of protein and calcium. This study aims to perform an update on lactose intolerance, with emphasis on epidemiology and major treatments, especially nutritional treatment that aims to prevent possible nutritional deficiencies. a literature search was conducted from national and international articles published by the PubMed database, SciELO and Google Scholar, using the following keywords: Deficiency Lactase, Epidemiology, Lactose intolerance and lactose. dated publications were selected from the year 2002 to 2014, and the articles grouped by subject and selected according to the quality and relevance to the theme. At the end of this research, it was concluded that lactose intolerance affects many people worldwide, causing a low calcium intake. People with the disorder should seek other sources of zinc because its deficiency can result in damage to health, especially of bone tissue

Diagnosis and clinical observation of lactose-free milk powder on treatment of neonatal diarrhea.

Neonatal lactose intolerance syndrome is a series of digestive system symptoms caused by the lack of lactase, and could not fully digest the lactose in breast milk or cow milk. Lactose is one of the disaccharides mainly existed in mammalian milk. Lactose content in breast milk is 7.2g/100ml, cow milk is 4.7g/100ml. Dairy products are the main energy sources for the newborn, and lactose provides 20% energy for infants. During the growth of the newborn, lactose not only play a significant role in energy supply, but also involve in the development of the brain growing. This study mainly studied the lactose development features, the reasons for lactose intolerance, and the measures to treat lactose deficiency.

Milk Intolerance, Beta-Casein and Lactose.

True lactose intolerance (symptoms stemming from lactose malabsorption) is less common than is widely perceived, and should be viewed as just one potential cause of cows' milk intolerance. There is increasing evidence that A1 beta-casein, a protein produced by a major proportion of European-origin cattle but not purebred Asian or African cattle, is also associated with cows' milk intolerance. In humans, digestion of bovine A1 beta-casein, but not the alternative A2 beta-casein, releases beta-casomorphin-7, which activates µ-opioid receptors expressed throughout the gastrointestinal tract and body. Studies in rodents show that milk containing A1 beta-casein significantly increases gastrointestinal transit time, production of dipeptidyl peptidase-4 and the inflammatory marker myeloperoxidase compared with milk containing A2 beta-casein. Co-administration of the opioid receptor antagonist naloxone blocks the myeloperoxidase and gastrointestinal motility effects, indicating opioid signaling pathway involvement. In humans, a double-blind, randomized cross-over study showed that participants consuming A1 beta-casein type cows' milk experienced statistically significantly higher Bristol stool values compared with those receiving A2 beta-casein milk. Additionally, a statistically significant positive association between abdominal pain and stool consistency was observed when participants consumed the A1 but not the A2 diet. Further studies of the role of A1 beta-casein in milk intolerance are needed.

The management of lactose intolerance among primary care physicians and its correlation with management by gastroenterologists: the SEPD-SEMG national survey.

INTRODUCTION AND AIMS: The understanding of lactose intolerance (LI) is limited in some professional settings. Sociedad Española de Patología Digestiva (SEPD) and Sociedad Española de Medicina General (SEMG) have developed a survey in order to: a) Analyze primary care physicians (PCPs) knowledge and clinical management; and b) to compare results with those of a previous survey of Spanish gastroenterologists (GEs). MATERIAL AND METHODS: An online questionnaire was sent to SEMG members with 27 items on various issues: Demographics, occupational characteristics, outlook on LI, diagnostic tests, treatment, and follow-up. Results were compared to those from a survey of GEs. RESULTS: A total of 456 PCPs responded, versus 477 GEs. PCPs had an older mean age and longer professional experience. Level of understanding of LI was similar, albeit a higher proportion of PCPs lacked epidemiological awareness (p < 0.01). GEs tended to consider LI a "minor" condition (71.3 vs. 40.1%; p > 0.001), and LI symptoms as overlapping those of irritable bowel syndrome (93.5 vs. 88.2%; p = 0.005), although symptoms perceived as suspicious of LI were similar in both groups. Dietary recommendations were recognized as the primary therapeutic approach. CONCLUSION: This study reveals the outlook of PCPs on LI, and allows comparison with that of GEs, as a basis for the development of strategies aimed at improving LI understanding, approach and management in our setting.

Adult lactose digestion status and effects on disease.

BACKGROUND: Adult assimilation of lactose divides humans into dominant lactase-persistent and recessive nonpersistent phenotypes. OBJECTIVES: To review three medical parameters of lactose digestion, namely: the changing concept of lactose intolerance; the possible impact on diseases of microbial adaptation in lactase-nonpersistent populations; and the possibility that the evolution of lactase has influenced some disease pattern distributions. METHODS: A PubMed, Google Scholar and manual review of articles were used to provide a narrative review of the topic. RESULTS: The concept of lactose intolerance is changing and merging with food intolerances. Microbial adaptation to regular lactose consumption in lactase-nonpersistent individuals is supported by limited evidence. There is evidence suggestive of a relationship among geographical distributions of latitude, sunhine exposure and lactase proportional distributions worldwide. DISCUSSION: The definition of lactose intolerance has shifted away from association with lactose maldigestion. Lactose sensitivity is described equally in lactose digesters and maldigesters. The important medical consequence of withholding dairy foods could have a detrimental impact on several diseases; in addition, microbial adaptation in lactase-nonpersistent populations may alter risk for some diseases. There is suggestive evidence that the emergence of lactase persistence, together with human migrations before and after the emergence of lactase persistence, have impacted modern-day diseases. CONCLUSIONS: Lactose maldigestion and lactose intolerance are not synonymous. Withholding dairy foods is a poor method to treat lactose intolerance. Further epidemiological work could shed light on the possible effects of microbial adaptation in lactose maldigesters. The evolutionary impact of lactase may be still ongoing.

A combination of acid lactase from Aspergillus oryzae and yogurt bacteria improves lactose digestion in lactose maldigesters synergistically: A randomized, controlled, double-blind cross-over trial.

BACKGROUND & AIMS: Lactose digestion can be improved in subjects with impaired or completely absent intestinal lactase activity by administration of lactase preparations and particularly of acid lactase, which is active in the stomach, or by yogurt containing live lactic acid bacteria. It is the question, if lactose digestion can be further enhanced by combining these two approaches. METHODS: We investigated in a randomised, placebo-controlled, double-blind, 5-arm crossover study on 24 lactose malabsorbers with variable degrees of lactase deficiency if different lactase preparations and freeze-dried yogurt culture affect gastrointestinal lactose digestion after consuming moderate amounts of lactose (12.5 g) by assessing hydrogen exhalation over 6 h. Furthermore, symptoms of lactose intolerance (excess gas production, abdominal pain, diarrhoea or nausea) were assessed using validated questionnaires. RESULTS: All preparations increased lactose digestion and reduced peak hydrogen exhalation by -27% (yogurt), -29/-33% (3300/9000 FCC(1) ((1) One FCC hydrolyses about 5 or 1.7-2.5 mg lactose in aquous solution or in (artificial) chyme, respectively, according to the FCC-III method of the Committee on Codex Specifications, Food and Nutrition Board, National Research Council. Food Chemicals Codex, 3rd edition. Washington, DC, National Academy Press, 1981 It cannot precisely be defined how much lactose can be hydrolysed in vivo by the consumption of a certain number of FCC units.) units acid lactase from Aspergillus oryzae) or -46%, respectively (3300 FCC units lactase plus yogurt culture combined), as compared with placebo (p < 0.001, Friedman test). The combination preparation had not only the strongest effect, but also showed the lowest variance in H(2)-exhalation values (less malabsorbers with no reduction of H(2)-exhalation) Apart from this, both the higher dose lactase and the combination preparation significantly reduced the symptoms most closely associated with H(2)-exhalation, namely flatulences and abdominal pain, respectively. CONCLUSIONS: The combined administration of freeze-dried yogurt cultures and acid lactase increases lactose digestion more than either freeze-dried yogurt cultures or acid lactase alone, and more lactose malabsorbers benefited from this effect.

Alergia ao leite de vaca em lactente acompanhada em um hospital da rede pública do DF: um estudo do perfil nutricional / Allergy to cow's milk in a nursling attended in a public health hospital of Distrito Federal: a study of nutricional profile

INTRODUÇÃO: A alergia ao leite de vaca é caracterizada por reações imunológicas adversas, imediatas ou não, decorrentes do contato com a proteína do leite de vaca. OBJETIVO: Avaliar o estado nutricional e o consumo calórico-proteico de portadora de Alergia à Leite de Vaca. Metodologia: Estudo de caso realizado com escolar de 3 anos com alergia. Foi avaliado a antropometria, o consumo alimentar de calorias e proteínas pelo registro de 3 dias , antes e após a remissão dos sintomas e o uso de fórmulas para fins especiais. As informações foram comparadas com padrões de referência para consumo alimentar e protocolos de tratamento para alergia. RESULTADOS E DISCUSSÃO: Paciente com histórico de baixo peso ao nascimento. Ao longo do crescimento e desenvolvimento apresentou períodos de estagnação, baixo peso e risco nutricional devido à intercorrências como alergia, crises respiratórias e vômitos. Foi necessária intervenção clínica e nutricional com fórmulas especializadas e dieta especial. Aos 2 anos e 9 meses adquiriu espontaneamente a tolerância à proteína do leite e passou a consumir leite e derivados sem a presença de sintomas, no entanto, manteve a baixa estatura e peso para idade, mesmo ingerindo todos os grupos alimentares o que mostra a importância do acompanhamento nutricional , mesmo após cessado o agravo. CONCLUSÃO: A forma de tratamento da alergia ao leite de vaca é por meio da alimentação, com uma dieta substitutiva adequada e acompanhamento nutricional. É fundamental o acompanhamento da antropometria, o consumo calórico e proteico durante o tratamento, assim como a história do nascimento, para se evitar o comprometimento do crescimento e desenvolvimento.

INTRODUCTION: Allergy to cow's milk is characterized by harsh, immediate or otherwise, arising from contact with immune reactions to cow's milk protein. OBJECTIVE: To assess the nutritional status and calorie-protein intake carrier Allergy to Cow's Milk. METHODOLOGY: Case study done with three year-old child with allergy. Anthropometry, dietary intake of calories and protein for registering 3 days before and after remission of symptoms and the use of formulas for special purposes was evaluated. The results were compared with reference standards for food consumption and for allergy treatment protocols. RESULTS AND DISCUSSION: Patient with a history of low birth weight. Throughout the growth and development showed periods of stagnation, low weight and nutritional risk due to complications such as allergies, respiratory crises and vomiting. Was necessary clinical and nutritional intervention with specialized formulas and special diet. Since her two years and nine months, she spontaneously acquired tolerance to milk protein and proceeded to consume dairy products without the presence of symptoms, however, remained low height for age and weight, even eating all the food groups which shows the importance nutritional monitoring, ceased even after the grievance. CONCLUSION: The treatment of allergy to cow's milk is through food, with adequate replacement diet and nutritional counseling. It is critical monitoring of anthropometry, caloric and protein intake during treatment, as well as the story of the birth, to avoid compromising growth and development.