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Nutrients 2015, 7(8), 6751-6779; doi:10.3390/nu7085309

Adaptation to Lactose in Lactase Non Persistent People: Effects on Intolerance and the Relationship between Dairy Food Consumption and Evalution of Diseases

Division of Gastroenterology, Department of Medicine, Jewish General Hospital, McGill University School of Medicine; 3755, Chemin de la Cote-Ste-Catherine Rd, Rm E110, Montreal H3T 1E2, QC, Canada
Received: 29 April 2015 / Revised: 29 July 2015 / Accepted: 3 August 2015 / Published: 13 August 2015
(This article belongs to the Special Issue Lactose Intolerance: Biology, Genetics and Dietary Management)
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Abstract

Dairy foods contain complex nutrients which interact with the host. Yet, evolution of lactase persistence has divided the human species into those that can or cannot digest lactose in adulthood. Such a ubiquitous trait has differential effects on humanity. The literature is reviewed to explore how the divide affects lactose handling by lactase non persistent persons. There are two basic differences in digesters. Firstly, maldigesters consume less dairy foods, and secondly, excess lactose is digested by colonic microflora. Lactose intolerance in maldigesters may occur with random lactose ingestion. However, lactose intolerance without maldigestion tends to detract from gaining a clear understanding of the mechanisms of symptoms formation and leads to confusion with regards to dairy food consumption. The main consequence of intolerance is withholding dairy foods. However, regular dairy food consumption by lactase non persistent people could lead to colonic adaptation by the microbiome. This process may mimic a prebiotic effect and allows lactase non persistent people to consume more dairy foods enhancing a favorable microbiome. This process then could lead to alterations in outcome of diseases in response to dairy foods in lactose maldigesters. The evidence that lactose is a selective human prebiotic is reviewed and current links between dairy foods and some diseases are discussed within this context. Colonic adaptation has not been adequately studied, especially with modern microbiological techniques. View Full-Text
Keywords: lactase; lactose; digesters; maldigesters adaptation lactase; lactose; digesters; maldigesters adaptation
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Szilagyi, A. Adaptation to Lactose in Lactase Non Persistent People: Effects on Intolerance and the Relationship between Dairy Food Consumption and Evalution of Diseases. Nutrients 2015, 7, 6751-6779.

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