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1.
Arq Gastroenterol ; 61: e23104, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38451663

RESUMO

BACKGROUND: Lactose tolerant test (LTT) is the most broadly used diagnostic test for lactose intolerance in Brazil, is an indirect, minimally invasive and a low-cost test that is widely available in primary care and useful in clinical practice. The C/T-13910 polymorphism in lactase persistence has been well characterized in Caucasian populations, but there are no studies evaluating the concordance between C/T-13910 polymorphism genotyping results and LTT results in Brazil, where the population is highly mixed. OBJECTIVE: We aimed to evaluate agreement between presence of C/T-13910 polymorphism genotyping and malabsorption in LTT results. METHODS: This is a retrospective analysis of a Brazilian population whose data were collected from a single laboratory database present in several Brazilian states. Results of individuals who underwent both genetic testing for lactose intolerance (C/T-13910 polymorphism genotyping) and an LTT from April 2016 until February 2019 were analysed to evaluate agreement between tests. Groups were classified according to age (<10-year-old (yo), 10-17 yo, ≥18 yo groups) and state of residence (São Paulo or Rio Grande do Sul). Results: Among the 404 patients evaluated, there was agreement between the genotyping and LTT results in 325 (80.4%) patients and discordance in 79 (19.6%) patients (k=0.42 -moderate agreement). Regarding the genotype, 47 patients with genotype C/C (lactase nonpersistence) had normal LTT results, and 32 with genotype C/T or T/T (indicating lactase persistence) had abnormal LTT results. Neither age nor state of residence (Rio Grande do Sul or São Paulo) affected the agreement between test results. CONCLUSION: Considering the moderate agreement between C/T-13910 polymorphism genotyping and LTT results (κ=0.42) in the Brazilian population, we hypothesize that an analysis of other polymorphisms could be a strategy to improve the agreement between genotyping and established tests and suggest that additional studies should focus on exploring this approach. BACKGROUND: • Lactose intolerance is highly prevalent and may be implicated as a cofactor, or as a differential diagnosis, in many gastrointestinal conditions. BACKGROUND: • The C/T-13910 polymorphism in lactase persistence is well characterized in Caucasian populations for lactase persistence. BACKGROUND: • Concordance between genotyping and functional tests does not occur in all patients. BACKGROUND: • Brazil has a highly mixed population and knowledge regarding presence of other polymorphisms is of importance in clarifying difficult cases.


Assuntos
Intolerância à Lactose , Humanos , Criança , Teste de Tolerância a Lactose , Brasil , Intolerância à Lactose/diagnóstico , Intolerância à Lactose/genética , Genótipo , Estudos Retrospectivos , Lactase/genética
2.
Food Funct ; 15(2): 460-480, 2024 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-38170850

RESUMO

Lactose intolerance affects about 68-70% of the world population and bovine whey protein is associated with allergic reactions, especially in children. Furthermore, many people do not consume dairy-based foods due to the presence of cholesterol and ethical, philosophical and environmental factors, lifestyle choices, and social and religious beliefs. In this context, the market for beverages based on pulses, oilseeds, cereals, pseudocereals and seeds and products that mimic dairy foods showed a significant increase over the years. However, there are still many sensory, nutritional, and technological limitations regarding producing and consuming these products. Thus, to overcome these negative aspects, relatively simple technologies such as germination and fermentation, the addition of ingredients/nutrients and emerging technologies such as ultra-high pressure, pulsed electric field, microwave and ultrasound can be used to improve the product quality. Moreover, consuming plant-based beverages is linked to health benefits, including antioxidant properties and support in the prevention and treatment of disorders and common diseases like hypertension, diabetes, anxiety, and depression. Thus, vegetable-based beverages and their derivatives are viable alternatives and low-cost for replacing dairy foods in most cases.


Assuntos
Intolerância à Lactose , Verduras , Criança , Humanos , Animais , Bovinos , Bebidas , Sementes , Grão Comestível
3.
Rev Alerg Mex ; 69(3): 105-108, 2023 Jan 16.
Artigo em Espanhol | MEDLINE | ID: mdl-36869009

RESUMO

OBJECTIVE: To determine the prevalence of cow´s milk allergy and lactose intolerance in a sample of late adolescents. METHODS: Through a population-based study, data corresponding to students with aged 15 to 18 years were analyzed. RESULTS: A total of 1992 adolescents was analized. The prevalence of cow´s milk allergy was 1.4% (95% CI: 0.2% to 0.8%) and the prevalence of lactose intolerance was 0.5% (95% CI: 0.2% to 0.8%). Adolescents with cow´s milk allergy had fewer gastrointestinal symptoms (p = 0.036), but more skin (p < 0.001) and respiratory (p = 0.028) ailments than adolescents with lactose intolerance. CONCLUSIONS: The manifestations associated with cow's milk consumption in late adolescents seem to correspond mainly to cow´s milk allergy than to lactose intolerance.


OBJECTIVO: Determinar la prevalencia de alergia a la proteína de la leche de vaca e intolerancia a la lactosa en una muestra de adolescentes tardíos. MÉTODOS: Estudio transversal con base poblacional, en el que se analizaron los datos de pacientes adolescentes de 15 a 18 años. RESULTADOS: Se registraron 1992 estudiantes. La prevalencia de alergia a la proteína de la leche de vaca fue de 1.4% (IC95%: 0.9% a 2.0%) y de intolerancia a la lactosa de 0.5% (IC95%: 0.2% a 0.8%). Los adolescentes con alergia a la proteína de la leche de vaca tuvieron menos síntomas gastrointestinales (p = 0.036), pero más molestias cutáneas (p < 0.001) y respiratorias (p = 0.028) que los adolescentes con intolerancia a la lactosa. CONCLUSIONES: Las manifestaciones asociadas con el consumo de leche de vaca en adolescentes tardíos corresponden, principalmente, a la alergia de la proteína de la leche de vaca que a la intolerancia a la lactosa.


Assuntos
Intolerância à Lactose , Hipersensibilidade a Leite , Animais , Bovinos , Feminino , Humanos , Prevalência , Pele , Estudantes
4.
Am J Hum Biol ; 35(6): e23868, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36695417

RESUMO

Uruguay has one of the highest per capita milk intakes worldwide, even with a limited supply of lactose-free products; furthermore, the admixed nature of its population is well known, and various frequencies of lactase persistence (LP) are observed in the source populations. We aimed to contribute to the understanding of the relation between allelic variants associated with LP, milk consumption, digestive symptoms, and genetic ancestry in the Uruguayan population. Samples of saliva or peripheral blood were collected from 190 unrelated individuals from two regions of Uruguay, genotypes for polymorphic sites in a fragment within the LCT enhancer were determined and allelic frequencies calculated in all of them. Data were collected on frequency of milk and dairy consumption and self-reported symptoms in a subsample of 153 individuals. Biparental and maternal ancestry was determined by analyzing individual ancestry markers and mitochondrial DNA. Twenty-nine percentage of individuals reported symptoms attributed to the ingestion of fresh milk, with abdominal pain, bloating and flatulence being the most frequent. European LP-associated allele T-13910 showed a frequency of 33%, while other LP-associated alleles like G-13915 and T-14011 were observed in very low frequencies. Associations between self-reported symptoms, fresh milk intake, and C/T-13910 genotype were statistically significant. No evidence of association between genetic ancestry and C/T-13910 was found, although individuals carrying one T-13910 allele appeared to have more European ancestry. In conclusion, the main polymorphism capable of predicting lactose intolerance in Uruguayans is C/T-13910, although more studies are required to unravel the relation between genotype and lactase activity, especially in heterozygotes.


Assuntos
Intolerância à Lactose , Humanos , Animais , Intolerância à Lactose/epidemiologia , Intolerância à Lactose/genética , Leite , Lactase/genética , Uruguai , Genótipo , DNA Mitocondrial , Polimorfismo de Nucleotídeo Único
5.
Av. enferm ; 40(3): 432-443, 01-09-2022.
Artigo em Espanhol | LILACS, COLNAL, BDENF - Enfermagem | ID: biblio-1415427

RESUMO

Introducción: los bebés deben beneficiarse de la leche materna, incluso cuando presentan intolerancia a la lactosa. Por esto, se debe recurrir a la obtención de leche materna deslactosada. Objetivo: analizar el efecto de la enzima beta galactosidasa en la hidrólisis de la lactosa de leche materna madura para bebés clínicamente diagnosticados con intolerancia a la lactosa. Materiales y método: estudio exploratorio, descriptivo y explicativo. El contenido de lactosa se cuantificó desde el inicio hasta el final del tratamiento, controlando temperatura, tiempos y cantidad de enzima ß-galactosidasa adicionada en la leche materna. Se recolectaron 1000 ml de leche materna, obtenidos del Banco de Leche del Hospital General de Medellín (Antioquia, Colombia). Resultados: las muestras donadas se encontraban pasteurizadas y posteriormente fueron sometidas a la acción de la enzima lactasa. Se cuantificó el contenido de lactosa sin la enzima, reportando en promedio 6,34 mg/100 ml ± 0,23. El mayor aporte de lactosa obtenido posterior a la exposición a la enzima (30 minutos) fue de 6,07 mg/ml ± 0,35 (correspondiente a 95 % del contenido inicial), finalizando con un aporte de 0,35 % a una concentración de 0,4 % tras 24 horas, porcentaje que representa 95 % de la hidrólisis total en la leche materna. Conclusiones: en todas las muestras analizadas de diferentes madres se pudo obtener leche materna con bajas concentraciones de lactosa tras 24 horas de haber sido sometidas a la acción de ß-galactosidasa. Lo anterior se establece como una alternativa para los bebés intolerantes a la lactosa, que permitiría no privarlos de todos los beneficios que ofrece este alimento.


Introduction: Babies should benefit from breast milk, even when they are lactose intolerant. For this reason, parents should resort to obtaining lactose-free breast milk. Objective: To examine the effect of the enzyme ß-galactosidase on the hydrolysis of lactose in mature breast milk for babies clinically diagnosed with lactose intolerance. Materials and method: Exploratory, descriptive, and explanatory study. The lactose content was quantified from the beginning to the end of the treatment, controlling variables such as temperature, times, and the amount of ß-galactosidase enzyme added in breast milk. A total of 1000 ml of breast milk were obtained from the milk bank at Hospital General de Medellín (Antioquia, Colombia). Results: Donated samples were first pasteurized and subsequently subjected to the action of the enzyme lactase. The lactose content without the enzyme was quantified, reporting an average of 6.34 mg/100 mL±0.23. The highest contribution of lactose obtained after exposure to the enzyme was 6.07 mg/mL±0.35 (corresponding to 95% of the initial content), at 30 minutes, ending with a contribution of 0.35% at a concentration of 0.4% in 24 hours, percentage that represents 95% of total hydrolysis in breast milk. Conclusions: In all the examined samples from different mothers, it was possible to obtain breast milk with low concentrations of lactose 24 hours after these were exposed to the action of ß-galactosidase. This becomes an alternative for feeding lactose intolerant babies and not deprive them from all the benefits offered by breast milk.


Introdução: os bebês se devem beneficiar do leite materno, mesmo quando tenham intolerância à lactose, razão pela qual se deve recorrer à obtenção de leite materno sem lactose. Objetivo: analisar o efeito da enzima beta-galactosidase na hidrólise da lactose no leite materno maduro para bebês diagnosticados clinicamente com intolerância à lactose. Materiais e método: estudo exploratório, descritivo, explicativo. O teor de lactose foi quantificado do início ao fim do tratamento; temperatura, tempos e quantidade de enzima beta-galactosidase adicionada no leite materno foram controlados; foram coletados 1000ml de leite materno, obtidos no Banco de Leite do Hospital General de Medellín (Antioquia, Colômbia). VResultados: as amostras doadas foram pasteurizadas e posteriormente submetidas à ação da enzima lactase. O teor de lactose sem a enzima foi quantificado, relatando uma média de 6,34mg/100ml±0,23. A maior contribuição de lactose obtida após a exposição à enzima foi de 6,07mg/ml±0,35 (correspondendo a 95% do conteúdo inicial) em 30 minutos, finalizando com uma contribuição de 0,35% na concentração de 0,4% em 24 horas, percentual que representa 95% da hidrólise total no leite materno. Conclusões: em todas as amostras analisadas de diferentes mães, foi possível obter leite materno com baixas concentrações de lactose 24 horas após ser submetido à ação da beta galactosidase, como alternativa para bebês intolerantes à lactose e não os privar de todos os outros benefícios oferecidos por esse alimento ideal.


Assuntos
Feminino , Gravidez , Aleitamento Materno , Lactase-Florizina Hidrolase , Lactose , Intolerância à Lactose , Leite Humano
6.
Arch. argent. pediatr ; 120(1): 59-66, feb 2022. tab, ilus
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1353500

RESUMO

La lactosa es el principal carbohidrato de la leche materna. Es un disacárido conformado por glucosa y galactosa. Su producción en la glándula mamaria es independiente de la dieta materna. Además de proveer energía, es la única fuente de galactosa de la dieta, necesaria para la síntesis de macromoléculas como oligosacáridos, glicoproteínas y glicolípidos. Favorece la absorción y retención de calcio, magnesio y cinc. Su digestión por la enzima lactasa y posterior absorción tienen lugar en intestino delgado. El déficit de lactasa, que puede ser primario congénito (muy infrecuente), primario tardío o secundario por lesión intestinal, puede generar intolerancia con síntomas como dolor, distensión abdominal, flatulencia y diarrea. En el colon, bifidobacterias y lactobacilos pueden hidrolizarla. El manejo nutricional de la intolerancia deberá hacerse siempre preservando la lactancia materna. La reducción o suspensión de la lactosa deberá ser transitoria y se reemplazarán alimentos suspendidos por otros con adecuados aportes calóricos, proteicos y de minerales y vitaminas.


Lactose is the main carbohydrate present in humanmilk. It is a disaccharide made up of glucoseand galactose. It is produced in the mammaryglands, regardless of maternal diet. In addition toproviding energy, it is the only source of dietarygalactose, necessary for macromolecule synthesis,including oligosaccharides, glycoproteins, andglycolipids. It favors calcium, magnesium, andzinc absorption and retention. Its digestion bylactase and subsequent absorption occurs inthe small intestine. Lactase deficiency may beclassified into congenital primary (very rare),late-onset primary or secondary due to an injuryof the intestine; it may cause intolerance withpain, abdominal distension, abdominal gas, anddiarrhea. In the colon, it may be hydrolyzed bybifidobacteria and lactobacilli. The nutritionalmanagement of intolerance should alwayspreserve breastfeeding. Lactose reduction orelimination should be transient, and eliminatedfood should be replaced with other similar incalorie, protein, mineral, and vitamin content.


Assuntos
Humanos , Intolerância à Lactose/diagnóstico , Lactase/metabolismo , Dieta , Lactose/metabolismo , Leite Humano/metabolismo
7.
Arch Argent Pediatr ; 120(1): 59-66, 2022 02.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-35068123

RESUMO

Lactose is the main carbohydrate present in human milk. It is a disaccharide made up of glucose and galactose. It is produced in the mammary glands, regardless of maternal diet. In addition to providing energy, it is the only source of dietary galactose, necessary for macromolecule synthesis, including oligosaccharides, glycoproteins, and glycolipids. It favors calcium, magnesium, and zinc absorption and retention. Its digestion by lactase and subsequent absorption occurs in the small intestine. Lactase deficiency may be classified into congenital primary (very rare), late-onset primary or secondary due to an injury of the intestine; it may cause intolerance with pain, abdominal distension, abdominal gas, and diarrhea. In the colon, it may be hydrolyzed by bifidobacteria and lactobacilli. The nutritional management of intolerance should always preserve breastfeeding. Lactose reduction or elimination should be transient, and eliminated food should be replaced with other similar in calorie, protein, mineral, and vitamin content.


La lactosa es el principal carbohidrato de la leche materna. Es un disacárido conformado por glucosa y galactosa. Su producción en la glándula mamaria es independiente de la dieta materna. Además de proveer energía, es la única fuente de galactosa de la dieta, necesaria para la síntesis de macromoléculas como oligosacáridos, glicoproteínas y glicolípidos. Favorece la absorción y retención de calcio, magnesio y cinc. Su digestión por la enzima lactasa y posterior absorción tienen lugar en intestino delgado. El déficit de lactasa, que puede ser primario congénito (muy infrecuente), primario tardío o secundario por lesión intestinal, puede generar intolerancia con síntomas como dolor, distensión abdominal, flatulencia y diarrea. En el colon, bifidobacterias y lactobacilos pueden hidrolizarla. El manejo nutricional de la intolerancia deberá hacerse siempre preservando la lactancia materna. La reducción o suspensión de la lactosa deberá ser transitoria y se reemplazarán alimentos suspendidos por otros con adecuados aportes calóricos, proteicos y de minerales y vitaminas.


Assuntos
Intolerância à Lactose , Dieta , Humanos , Lactase/metabolismo , Lactose/metabolismo , Intolerância à Lactose/diagnóstico , Leite Humano/metabolismo
8.
Nutrients ; 13(8)2021 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-34444815

RESUMO

The presence of milk in meals and products consumed daily is common and at the same time the adoption of a milk-free diet increases due to milk allergy, lactose intolerance, vegan diets, and others. Therefore, there is an increasing demand for plant-based beverages, which present variable and, sometimes, unknown nutritional characteristics. This study sought to compare the nutritional aspects of plant-based beverages used as substitutes for cow's milk described in scientific studies. Therefore, we used a review of the scientific literature on PubMed, Google Scholar, Scopus, Web of Science, Google Patents, Embase, and ScienceDirect databases. The inclusion criteria were scientific studies referring to plant-based beverage used as an alternative to cow's milk; published in the English language; present data on the serving size, ingredients, and nutritional composition, containing at least data on energy and macronutrients of plant-based beverages. Ingredients and data on energy, macronutrients, and, if available, dietary fiber and some micronutrients of plant-based beverages were collected. Data were obtained from 122 beverages of 22 different matrices, with soy being the most used (27.87%, n = 34). The variation in the amount of nutrients found was 6-183 Kcal/100 mL for energy value; 0.00-22.29 g/100 mL for carbohydrate; 0.06-12.43 g/100 mL for protein; 0.00-19.00 g/100 mL for lipid; 0.00-4.40 g/100 mL for dietary fiber; 0.00-1252.94 mg/100 mL for calcium; 0.04-1.40 mg/100 mL for iron; 0.84-10,178.60 mg/100 mL for magnesium; 0.00-343.43 mg/100 mL for sodium. Salt was the most commonly found added ingredient in plant-based beverages. Some beverages have reached certain amounts of cow's milk nutrients. However, studies have pointed out differences in their qualities/types. Thus, attention is needed when replacing milk with these alternatives.


Assuntos
Bebidas , Substitutos do Leite , Leite , Valor Nutritivo , Animais , Bovinos , Bases de Dados Factuais , Fibras na Dieta , Humanos , Intolerância à Lactose , Micronutrientes , Hipersensibilidade a Leite , Nutrientes
9.
Arq Gastroenterol ; 58(1): 26-31, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909793

RESUMO

BACKGROUND: Worldwide, colorectal cancer (CRC) and gastric cancer (GC) are the third and the fifth most prevalent, respectively. Diarrhea is a common symptom in patients on chemotherapy or radiotherapy treatment and can reduce treatment tolerance. Surgical resections and chemotherapy change the intestinal microbiota that can lead to lactose intolerance, small intestinal bacterial overgrowth (SIBO). OBJECTIVE: The aim of the study was to evaluate the frequency of diarrhea in patients with CRC and GC on chemotherapy with SIBO or intolerance of lactose. METHODS: This is a descriptive and observational study with patients of both sexes, over 18 years old, in treatment in the Gastro-Oncology outpatient clinic of the Federal University of São Paulo. Patients with a confirmed diagnosis of CRC or GC during chemotherapy treatment were included. To detect bacterial overgrowth and lactose intolerance, breath hydrogen test with lactulose and lactose was done. Number and aspects of the evacuations and toxicity degree were collected. For the nutritional assessment, weight and height were performed to calculate the BMI. and the Patient Generated Subjective Global Assessment (PG-SGA). RESULTS: A total of 33 patients were included, 29 with CRC and 3 with GC. Most of them were male (57.57%), mean age of 60.03±10.01 years and in chemotherapy with fluoropyrimidine and oxaliplatin (54.5%). Diarrhea was present in 57.6% and 30.3% had toxicity grade 2. According to the BMI, 78.9% were eutrophics, obese or overweight, but according to PG-SGA, 84.9% had moderate or severe nutritional risk grade. Between patients, 45% had lactose intolerance and 9% SIBO. Diarrhea grade 2-3 was observed in 66.6% of patients with SIBO and 66.7% of that with lactose intolerance. No statistical difference was observed between patients with SIBO or lactose intolerance and grade of diarrhea. CONCLUSION: Diarrhea was a frequent symptom in chemotherapy patients with gastric or colorectal cancer independent of the presence of SIBO or lactose intolerance. Surgery and chemotherapy treatment impacted in the intestinal habit of patients. Diagnosis of other causes of diarrhea may contribute to a better tolerance to treatment and quality of life.


Assuntos
Neoplasias Colorretais , Intolerância à Lactose , Neoplasias Gástricas , Adolescente , Idoso , Testes Respiratórios , Neoplasias Colorretais/tratamento farmacológico , Feminino , Humanos , Hidrogênio , Intestino Delgado , Lactose , Intolerância à Lactose/diagnóstico , Masculino , Pessoa de Meia-Idade , Qualidade de Vida
11.
Arq. gastroenterol ; Arq. gastroenterol;58(1): 26-31, Jan.-Mar. 2021. tab
Artigo em Inglês | LILACS | ID: biblio-1248982

RESUMO

ABSTRACT BACKGROUND: Worldwide, colorectal cancer (CRC) and gastric cancer (GC) are the third and the fifth most prevalent, respectively. Diarrhea is a common symptom in patients on chemotherapy or radiotherapy treatment and can reduce treatment tolerance. Surgical resections and chemotherapy change the intestinal microbiota that can lead to lactose intolerance, small intestinal bacterial overgrowth (SIBO). OBJECTIVE: The aim of the study was to evaluate the frequency of diarrhea in patients with CRC and GC on chemotherapy with SIBO or intolerance of lactose. METHODS: This is a descriptive and observational study with patients of both sexes, over 18 years old, in treatment in the Gastro-Oncology outpatient clinic of the Federal University of São Paulo. Patients with a confirmed diagnosis of CRC or GC during chemotherapy treatment were included. To detect bacterial overgrowth and lactose intolerance, breath hydrogen test with lactulose and lactose was done. Number and aspects of the evacuations and toxicity degree were collected. For the nutritional assessment, weight and height were performed to calculate the BMI. and the Patient Generated Subjective Global Assessment (PG-SGA). RESULTS: A total of 33 patients were included, 29 with CRC and 3 with GC. Most of them were male (57.57%), mean age of 60.03±10.01 years and in chemotherapy with fluoropyrimidine and oxaliplatin (54.5%). Diarrhea was present in 57.6% and 30.3% had toxicity grade 2. According to the BMI, 78.9% were eutrophics, obese or overweight, but according to PG-SGA, 84.9% had moderate or severe nutritional risk grade. Between patients, 45% had lactose intolerance and 9% SIBO. Diarrhea grade 2-3 was observed in 66.6% of patients with SIBO and 66.7% of that with lactose intolerance. No statistical difference was observed between patients with SIBO or lactose intolerance and grade of diarrhea. CONCLUSION: Diarrhea was a frequent symptom in chemotherapy patients with gastric or colorectal cancer independent of the presence of SIBO or lactose intolerance. Surgery and chemotherapy treatment impacted in the intestinal habit of patients. Diagnosis of other causes of diarrhea may contribute to a better tolerance to treatment and quality of life.


RESUMO CONTEXTO: Mundialmente, o câncer colorretal (CCR) e gástrico (CG) são a terceira e a quinta causa de câncer mais prevalente, respectivamente. A diarreia é um sintoma comum entre os pacientes em quimioterapia ou radioterapia e pode reduzir a tolerância ao tratamento. Quimioterapia e ressecções cirúrgicas causam alterações da microbiota intestinal que podem levar a intolerância à lactose e ao supercrescimento bacteriano do intestino delgado (SBID). OBJETIVO: Avaliar a presença de diarreia nos pacientes com câncer colorretal e gástrico em quimioterapia e a presença de SBID ou intolerância à lactose. MÉTODOS: Foi realizado um estudo descritivo, observacional com pacientes ambulatoriais de ambos os sexos, maiores de 18 anos, em tratamento no ambulatório de gastro-oncologia da Universidade Federal de São Paulo. Foram incluídos pacientes com diagnóstico confirmado de CCR ou CG durante tratamento quimioterápico. Para detectar supercrescimento bacteriano e intolerância à lactose, foram realizados testes respiratórios com lactulose e lactose respectivamente. Número, aspecto das evacuações e grau de toxicidade foram coletados. Para a avaliação nutricional foram aferidos peso e altura para cálculo do IMC e para avaliação do risco nutricional foi realizada a avaliação subjetiva global produzida pelo próprio paciente (ASG-PPP). RESULTADOS: Foram incluídos 33 pacientes, 29 com CCR e 3 com CG. A maioria era do sexo masculino (57,5%) com média de idade 60,03±10,01 anos e em tratamento quimioterápico com fluoropirimidina e oxaliplatina (54,5%). Diarreia foi relatada por 57,6% dos pacientes sendo em 30% grau 2. Pelo IMC, 78,9% apresentavam eutrofia, sobrepeso ou obesidade grau 1, mas pela ASG-PPP 84,9 apresentavam risco nutricional moderado ou severo. Entre os pacientes 9% apresentavam SBID e 45% intolerância à lactose. Diarreia grau 2-3 foi observada em 66,6% daqueles pacientes com SBID e 66,7% dos com intolerância à lactose. Não encontramos diferenças estatísticas entre os pacientes com SBID ou intolerância à lactose e intensidade de diarreia. CONCLUSÃO: Diarreia foi um sintoma frequente entre os pacientes com câncer gástrico ou colorretal em quimioterapia independente da presença de SBID ou intolerância à lactose. Cirurgia e quimioterapia impactaram no hábito intestinal dos pacientes. O diagnóstico de outras causas de diarreia pode contribuir para a melhor tolerância do tratamento e qualidade de vida.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Idoso , Neoplasias Gástricas , Neoplasias Colorretais/tratamento farmacológico , Intolerância à Lactose/diagnóstico , Qualidade de Vida , Testes Respiratórios , Hidrogênio , Intestino Delgado , Lactose , Pessoa de Meia-Idade
12.
J Int Soc Sports Nutr ; 18(1): 14, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-33568169

RESUMO

BACKGROUND: Chocolate milk has gained recent scientific support as a recovery drink. However, it is known that high exercise-demand triggers gastrointestinal discomfort which continues post-exercise, thereby hindering this nutritional strategy. In addition, those who are lactose intolerant cannot benefit from a milk-based beverage. Thus, the aim of this preliminary study was to develop a low-fat, lactose-free, and leucine-enriched chocolate cow milk prototype (CML) representing nutrition-related recommendations for football players, as well as assess athletes' individual subjective outcomes for gastrointestinal complaints and sensorial acceptability in a field-based setting following strenuous team-sport physical demands. METHODS: This study followed a single group and repeated-measured design with 10 football players (23 ± 2 yrs., 74 ± 14 kg, 174 ± 5 cm) who consumed CML following a 90-min football match simulation protocol (FMP). The total CML intake to achieve 0.150 g leucine·kg [BW]·h- 1 occurred in aliquots of 50, 30 and 20% at 0-, 45- and 75-min post-FMP, respectively. Athletes were evaluated by the prevalence, the type and severity (bloating, nausea, flatulence, and gastric reflux) of gastrointestinal complaints and sensorial acceptability (overall perception, appearance, consistency, and flavour) after drinking each aliquot in a 4-h recovery period. RESULTS: The CML showed higher scores for "Product Acceptability Index" (88%) and sensorial acceptability (~ 8 in 9-point hedonic scale). Kendall's W with bootstrapped resample (95%CI) revealed agreement among respondents as "moderate" (overall perception, flavour) to "strong" (appearance, consistency) and with no significant agreement differences between rater response in the timeline analysis (0.57 up to 0.87; p > 0.05). Agresti-Caffo add-4 analysis (95% confidence interval, [95%CI]) revealed no differences in each time-point analysis versus baseline for athletes classified as having severe gastrointestinal symptoms, but confirmed concern with bloating (three athletes showed a transient response at 2-h and only one continued until 3-h; p = 0.051). CONCLUSIONS: These preliminary findings suggest that CML presents good taste and high acceptability by the sampled athletes. Thus, CML may be an alternative sport drink for immediate post-workout supplementation to overcome the energy deficit, offer co-ingested leucine, maintain palatability and adherence including lactose intolerance following a team sport-specific fatigue. TRIAL REGISTRATION: RBR-2vmpz9 , 10/12/2019, retrospectively registered.


Assuntos
Chocolate , Alimentos Fortificados , Leucina , Leite/química , Futebol/fisiologia , Paladar , Animais , Bovinos , Ingestão de Energia , Flatulência/etiologia , Alimentos Fortificados/efeitos adversos , Refluxo Gastroesofágico/etiologia , Gastroenteropatias/etiologia , Humanos , Lactose , Intolerância à Lactose/complicações , Leucina/administração & dosagem , Masculino , Leite/efeitos adversos , Náusea/etiologia , Fenômenos Fisiológicos da Nutrição Esportiva , Adulto Jovem
13.
Lifestyle Genom ; 13(4): 129-133, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32659776

RESUMO

BACKGROUND/AIMS: Polymorphisms in the enhancer of the lactase gene (LCT) are strongly associated with lactase persistence, but not always predictive of the phenotype. We investigated a possible association between the regulatory rs140433552*CA>del variant of LCT and lactose intolerance (LI). METHODS: We genotyped 122 individuals for rs140433552 and rs4988235 (-13910*C>T). RESULTS: Associations of rs140433552*CA>del with LI depend on -13910*C>T. Homozygous individuals for the C-CA haplotype, as well as C-CA+/C individuals, seem more likely to manifest LI (OR 3.33 [95% CI 1.32-8.35], p = 0.011, and OR 3.93 [95% CI 1.61-9.61], p = 0.003, respectively), while homozygous individuals for the T-CA haplotype seem more likely to be lactose tolerant (OR 0.04 [95% CI 0.002-0.70], p = 8 × 10-4). CONCLUSIONS: rs140433552*CA>del is not independently associated with LI.


Assuntos
Mutação INDEL , Lactase/genética , Intolerância à Lactose/genética , Polimorfismo de Nucleotídeo Único , Adolescente , Adulto , Idoso , Alelos , Brasil/epidemiologia , Feminino , Frequência do Gene , Predisposição Genética para Doença , Testes Genéticos , Genótipo , Haplótipos , Homozigoto , Humanos , Lactose , Masculino , Pessoa de Meia-Idade , Fenótipo , Adulto Jovem
14.
Rev Gastroenterol Mex (Engl Ed) ; 85(3): 321-331, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32482516

RESUMO

Lactose intolerance is a condition with an elevated prevalence worldwide, especially in Latin American, Asian, and African countries. The aim of the present narrative review was to highlight the importance of accurately diagnosing lactose intolerance to prevent self-diagnosis that results in the unnecessary elimination of milk and dairy products from the diet and the consequent deprivation of nutrients that could be essential at certain stages of life. The pathophysiologic mechanism of deficient lactose absorption in the intestine can be primary, secondary to other enteropathies, or coexistent with other intestinal diseases with similar symptoms, such as irritable bowel syndrome, bacterial overgrowth syndrome, or celiac disease, causing confusion in relation to diagnosis and treatment. Lactose intolerance consists of a set of symptoms attributed to the consumption of milk and dairy products that are assumed to be due to deficient digestion of that disaccharide. A wide range of tests have been validated to detect deficient digestion that include blood tests, genetic mutation analyses, breath tests, and recently, a urine test, all of which are described in the present article. Nevertheless, there are few validated questionnaires for symptom evaluation and measurement, partly due to the heterogeneity of concepts and the subjectivity of each of the symptoms.


Assuntos
Intolerância à Lactose/diagnóstico , Algoritmos , Humanos , Avaliação de Sintomas
15.
Acta méd. costarric ; 62(2)jun. 2020.
Artigo em Espanhol | LILACS, SaludCR | ID: biblio-1383316
16.
Demetra (Rio J.) ; 15(1): e45766, jan.- mar.2020. tab
Artigo em Inglês, Português | LILACS | ID: biblio-1103908

RESUMO

Introdução: Devido ao fato de que muitas pessoas são intolerantes à lactose, novas propostas de preparações dietéticas com bons atributos sensoriais e isentas deste dissacarídeo são necessárias para garantir bem-estar e qualidade de vida para estes indivíduos. Objetivo: desenvolver sorvete com extrato hidrossolúvel de arroz. Método: Foram produzidos sorvetes com 50% e 100% de substituição do leite bovino por extrato hidrossolúvel de arroz em dois sabores (morango e chocolate). Os métodos para o desenvolvimento deste estudo basearam-se na análise físico-química do sorvete, bem como a análise sensorial para definir o nível de aceitação do produto e preferência por parte dos consumidores. Resultados: Os sorvetes de extrato hidrossolúvel de arroz, tanto de chocolate, como de morango obtiveram maiores teores de carboidratos e menores valores energéticos, devido ao fato de ter menor teor de proteína e lipídio, em comparação com o sorvete feito com leite bovino. Obteve-se boa aceitação, sendo que o sorvete de 50% extrato de arroz sabor morango não obteve diferença significativa do sorvete com 100% de leite de bovino, em relação à preferência. Conclusão: Conclui-se que o sorvete com extrato hidrossolúvel de arroz é um produto com boas características nutricionais e tem boa aceitação, podendo ser uma opção para pessoas intolerantes à lactose. (AU)


Introduction: As there are many people with lactose intolerance, new dietary preparations with good sensory aspects and free from this disaccharide need to be proposed, which would ensure these individuals' well-being and quality of life. Purpose: To develop an ice cream made with water-soluble rice extract. Method: Ice creams were produced replacing 50% and 100% of cow milk with water-soluble rice extract, in two flavors (strawberry and chocolate). The methods for developing this study were based on the physicochemical analysis of the ice cream and the sensory analysis, to establish the degree of acceptability of the product, as well as the preference on the part of the consumers. Results: Both the chocolate and the strawberry water-soluble rice extract ice creams had higher carbohydrate content and lower energy values, due to its lower protein and lipid content in comparison with cow milk ice cream. There was good acceptability; particularly, the 50% rice extract strawberry ice cream had no significant difference to the 100% cow milk ice cream, regarding preference. Conclusion: It is concluded that the water-soluble rice extract ice cream is a product with good nutritional characteristics and good acceptability. It can be considered an alternative for people with lactose intolerance. (AU)


Assuntos
Humanos , Masculino , Feminino , Alimentos Formulados , Sorvetes/análise , Intolerância à Lactose/dietoterapia , Leite , Alimentos , Lactose
17.
Nutrients ; 11(11)2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718111

RESUMO

Lactose is a unique component of breast milk, many infant formulas and dairy products, and is widely used in pharmaceutical products. In spite of that, its role in human nutrition or lactose intolerance is generally not well-understood. For that reason, a 2-day-long lactose consensus meeting with health care professionals was organized in Mexico to come to a set of statements for which consensus could be gathered. Topics ranging from lactase expression to potential health benefits of lactose were introduced by experts, and that was followed by a discussion on concept statements. Interestingly, lactose does not seem to induce a neurological reward response when consumed. Although lactose digestion is optimal, it supplies galactose for liver glycogen synthesis. In infants, it cannot be ignored that lactose-derived galactose is needed for the synthesis of glycosylated macromolecules. At least beyond infancy, the low glycemic index of lactose might be metabolically beneficial. When lactase expression decreases, lactose maldigestion may lead to lactose intolerance symptoms. In infancy, the temporary replacing of lactose by other carbohydrates is only justified in case of severe intolerance symptoms. In those who show an (epi)genetic decrease or absence of lactase expression, a certain amount (for adults mostly up to 12 g per portion) of lactose can still be consumed. In these cases, lactose shows beneficial intestinal-microbiota-shaping effects. Avoiding lactose-containing products may imply a lower intake of other important nutrients, such as calcium and vitamin B12 from dairy products, as well as an increased intake of less beneficial carbohydrates.


Assuntos
Dieta , Intolerância à Lactose , Lactose , Adulto , Criança , Consenso , Microbioma Gastrointestinal , Humanos , Lactente , Lactase , México , Ciências da Nutrição/organização & administração
18.
Arq Gastroenterol ; 56(3): 304-311, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31633730

RESUMO

BACKGROUND: Irritable bowel syndrome is a clinical condition presenting pain, distension and abdominal fullness, diarrhea, constipation, and other symptoms. It generates significant impacts on the quality of life of those affected. The pathophysiology is uncertain, but the role of various food types has been established in bowel sensitivity and its clinical manifestations. Carbohydrate intolerance, particularly to lactose, generates similar and sometimes indistinguishable symptoms from irritable bowel syndrome, and in clinical practice is both a frequent and underdiagnosed condition. Carbohydrate intolerance is related to enzymatic deficiencies, alterations of intestinal microbiota and even genetic change. The principal test for a diagnosis of lactose intolerance is the breath test, which measures hydrogen emission (produced only by bacteria), after ingestion of the corresponding substrate. OBJECTIVE: The present work aims to verify the prevalence of lactose intolerance in university students, presenting gastrointestinal symptoms suggestive of irritable bowel syndrome. METHODS: In a transversal study, to screen for those with suggestive symptoms, 124 medicine students participated by responding to a form. Those with abdominal pain were referred for anti-parasite treatment in order to exclude intestinal parasites as a secondary cause. Subsequently, using the hydrogen breath test, bacterial overgrowth was investigated, and if negative, lactose intolerance testing would be performed. Patients presenting high hydrogen concentrations of ≥20 ppm above the basal level were considered lactose intolerant. RESULTS: Of the total of students researched (n=124), 7 were excluded because they did not completing all study phases. From those 117 individuals effectively included in the survey; 8 (6.8%) were diagnosed with lactose intolerance and 2 (1.7%) with bacterial overgrowth. Intolerance was more frequent in; female individuals (75%), age range 18 to 25 years (62.5%), being colored (50%), and in their 5th semester of studies (37.5%). The presence of at least one gastrointestinal symptom among those presenting intolerance (100%), and those not presenting intolerance (42.2%) was found (P=0.002). In addition to abdominal pain (100%) (P<0.001), the most recurrent gastrointestinal symptom in the lactose intolerant students was the distension/flatulence (62.5%) (P=0.026). In relation to life habits and food patterns, there was no statistical difference between lactose tolerant and intolerant individuals, or for symptom frequencies. The more advanced students, completing more periods towards graduation, demonstrated more occurrences of gastrointestinal symptoms, yet without presenting significant statistical discrepancies. CONCLUSION: In view of the test sample quantity (n=21), a high prevalence of lactose intolerance (6.8%) in the academic environment, with epidemiological characteristics compatible to those found the literature is demonstrated, generating knowledge with understanding to prevent, diagnose, alleviate and treat lactose intolerant university students, and generate positive impacts towards well-being, improving the quality of life of these individuals.


Assuntos
Síndrome do Intestino Irritável/complicações , Intolerância à Lactose/epidemiologia , Adolescente , Adulto , Testes Respiratórios , Feminino , Humanos , Intolerância à Lactose/etiologia , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Estudantes , Adulto Jovem
19.
Arq. gastroenterol ; Arq. gastroenterol;56(3): 304-311, July-Sept. 2019. tab
Artigo em Inglês | LILACS | ID: biblio-1038709

RESUMO

ABSTRACT BACKGROUND: Irritable bowel syndrome is a clinical condition presenting pain, distension and abdominal fullness, diarrhea, constipation, and other symptoms. It generates significant impacts on the quality of life of those affected. The pathophysiology is uncertain, but the role of various food types has been established in bowel sensitivity and its clinical manifestations. Carbohydrate intolerance, particularly to lactose, generates similar and sometimes indistinguishable symptoms from irritable bowel syndrome, and in clinical practice is both a frequent and underdiagnosed condition. Carbohydrate intolerance is related to enzymatic deficiencies, alterations of intestinal microbiota and even genetic change. The principal test for a diagnosis of lactose intolerance is the breath test, which measures hydrogen emission (produced only by bacteria), after ingestion of the corresponding substrate. OBJECTIVE: The present work aims to verify the prevalence of lactose intolerance in university students, presenting gastrointestinal symptoms suggestive of irritable bowel syndrome. METHODS: In a transversal study, to screen for those with suggestive symptoms, 124 medicine students participated by responding to a form. Those with abdominal pain were referred for anti-parasite treatment in order to exclude intestinal parasites as a secondary cause. Subsequently, using the hydrogen breath test, bacterial overgrowth was investigated, and if negative, lactose intolerance testing would be performed. Patients presenting high hydrogen concentrations of ≥20 ppm above the basal level were considered lactose intolerant. RESULTS: Of the total of students researched (n=124), 7 were excluded because they did not completing all study phases. From those 117 individuals effectively included in the survey; 8 (6.8%) were diagnosed with lactose intolerance and 2 (1.7%) with bacterial overgrowth. Intolerance was more frequent in; female individuals (75%), age range 18 to 25 years (62.5%), being colored (50%), and in their 5th semester of studies (37.5%). The presence of at least one gastrointestinal symptom among those presenting intolerance (100%), and those not presenting intolerance (42.2%) was found (P=0.002). In addition to abdominal pain (100%) (P<0.001), the most recurrent gastrointestinal symptom in the lactose intolerant students was the distension/flatulence (62.5%) (P=0.026). In relation to life habits and food patterns, there was no statistical difference between lactose tolerant and intolerant individuals, or for symptom frequencies. The more advanced students, completing more periods towards graduation, demonstrated more occurrences of gastrointestinal symptoms, yet without presenting significant statistical discrepancies. CONCLUSION: In view of the test sample quantity (n=21), a high prevalence of lactose intolerance (6.8%) in the academic environment, with epidemiological characteristics compatible to those found the literature is demonstrated, generating knowledge with understanding to prevent, diagnose, alleviate and treat lactose intolerant university students, and generate positive impacts towards well-being, improving the quality of life of these individuals.


RESUMO CONTEXTO: A síndrome do intestino irritável é uma condição clínica que cursa com dor, distensão e plenitude abdominal, diarreia, constipação, entre outros sintomas. Gera impacto significativo na qualidade de vida das pessoas acometidas. Sua fisiopatologia é incerta, mas o papel de vários tipos de alimentos está estabelecido na sensibilização intestinal e nas manifestações clínicas. A intolerância aos carboidratos, particularmente a lactose, gera sintomas similares e por vezes indistinguíveis da síndrome do intestino irritável e é uma condição frequente e subdiagnosticada na prática clínica. Está relacionada a deficiências enzimáticas, alterações da microbiota intestinal e mesmo alterações genéticas. O principal exame para o diagnóstico da intolerância à lactose é o teste respiratório, que mede a emissão de hidrogênio produzido apenas por bactérias, após a ingestão do substrato correspondente. OBJETIVO: O presente trabalho tem como objetivo verificar a prevalência de intolerância à lactose em universitários que apresentem sintomas gastrointestinais sugestivos da síndrome do intestino irritável. MÉTODOS: O estudo, caracterizado como do tipo transversal, teve a participação de 124 discentes de medicina que responderam um formulário, a fim de realizar a triagem daqueles com sintomatologia sugestiva. Aqueles com dor abdominal foram encaminhados para o tratamento antiparasitário, a fim de excluir parasitose intestinal como causa secundária. Posteriormente, através do teste respiratório com hidrogênio expirado, foi feito primeiro a pesquisa de supercrescimento bacteriano e caso fosse negativo seria realizado o da intolerância à lactose. Foram considerados com intolerância aqueles que obtiveram uma elevação na concentração de hidrogênio ≥20 ppm acima do nível basal. RESULTADOS: Do total de alunos pesquisados (n=124), 7 foram excluídos por não cumprirem todas as etapas do estudo. A partir dos 117 indivíduos efetivamente incluídos na pesquisa, verificou-se que 8 (6,8%) foram diagnosticados com intolerância a lactose e 2 (1,7%) com supercrescimento bacteriano. A intolerância foi mais frequente nos indivíduos do sexo feminino (75%), faixa etária de 18 a 25 anos (62,5%), cor parda (50%) e do 5º semestre (37,5%). Verificou-se que a presença de pelo menos um sintoma gastrointestinal entre aqueles que possuem intolerância (100%) e os que não possuem (42,2%) foi estatisticamente significativa (P=0,002). Além da própria dor abdominal (100%) (P<0,001), o sintoma gastrointestinal mais recorrente nos discentes intolerantes foi a distensão/flatulência (62,5%) (P=0,026). Em relação aos hábitos de vida e padrão alimentar, não houve diferença estatística entre os indivíduos intolerantes e tolerantes, bem como na frequência de sintomas. Os discentes dos períodos mais avançados da graduação se destacaram por manifestarem com maior constância os sintomas gastrointestinais, porém sem apresentar discrepâncias estatísticas significativas. CONCLUSÃO: Tendo em vista a quantidade da amostra que realizou o teste (n=21), pode-se provar a alta prevalência da intolerância à lactose (6,8%) no meio acadêmico, com as características epidemiológicas compatíveis com a literatura. Assim, foi possível gerar conhecimento para entender, prevenir, diagnosticar, aliviar e tratar os universitários intolerantes, gerando impactos positivos para o bem-estar, melhorando a qualidade de vida desses indivíduos.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Síndrome do Intestino Irritável/complicações , Intolerância à Lactose/epidemiologia , Qualidade de Vida , Estudantes , Testes Respiratórios , Intolerância à Lactose/etiologia , Pessoa de Meia-Idade
20.
Lifestyle Genom ; 12(1-6): 1-9, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31352438

RESUMO

BACKGROUND/AIMS: Metabolic syndrome (MetS) comprises a cluster of physiological and anthropometric abnormalities. MetS has been linked to lactose intolerance (LI). The aim of this study was to compare the sensitivity and specificity to detect LI using 2 different tests: (1) a genetic test and (2) an oral lactose tolerance test (OLTT). METHODS: Two hundred and fifty-four MetS patients, ≥20 years of age, of both genders, were recruited for this comparative study. Nine single nucleotide polymorphisms (SNPs) were selected for genetic investigation: rs182549and rs4988235(both considered "gold standard"); rs56064699; rs148142676; rs562211644; rs59533246; rs3754689; rs2278544,and rs10552864(as potential novel SNPs). Sensitivity and specificity, as well as positive and negative predictive values, were calculated for each genotype using WINPEPI version 11.65. Differences between positive and negative OLTT groups were considered statistically significant when p ≤ 0.05. RESULTS: Among the selected SNPs, only rs182549(p < 0.001) and rs4988235(p < 0.001) gave similar results compared to an OLTT. The sensitivity of both SNPs to detect LI was 87 and 86%, and specificity was 83 and 82.5%, respectively. CONCLUSION: Genetic tests using rs182549and rs4988235SNPs showed high agreement with OLTT. These genetic tests may be a good option to replace OLTT in MetS patients.


Assuntos
Intolerância à Lactose/diagnóstico , Intolerância à Lactose/genética , Síndrome Metabólica/genética , Polimorfismo de Nucleotídeo Único , Adulto , Idoso , População Negra/etnologia , População Negra/genética , Brasil/epidemiologia , Etnicidade/genética , Etnicidade/estatística & dados numéricos , Feminino , Frequência do Gene , Predisposição Genética para Doença/etnologia , Testes Genéticos/métodos , Genótipo , Humanos , Intolerância à Lactose/complicações , Intolerância à Lactose/etnologia , Teste de Tolerância a Lactose , Masculino , Síndrome Metabólica/complicações , Síndrome Metabólica/etnologia , Pessoa de Meia-Idade , Prevalência , Sensibilidade e Especificidade , População Branca/etnologia , População Branca/genética
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