Effects of Prebiotic and Probiotic Supplementation on Lactase Deficiency and Lactose Intolerance: A Systematic Review of Controlled Trials
Abstract
:1. Introduction
2. Materials and Methods
2.1. Literature Search
2.2. Inclusion and Exclusion Criteria
2.3. Intervention Types
2.4. Primary Outcome Measures
2.5. Study Selection
2.6. Data Extraction
2.7. Assessment of Risk of Bias
3. Results
3.1. Study Characteristics
3.2. Prebiotics, Probiotics, and LI Symptoms
3.3. Prebiotics, Probiotics, and Lactose Digestion
3.4. Risk-of-Bias Assessment
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Parameter 1 | Inclusion Criteria |
---|---|
Population | Lactose-intolerant subjects |
Intervention | Controlled intake of biotics |
Comparison | Non-exposed control group |
Outcomes | Symptoms of lactose intolerance and signs of lactose malabsorption |
Settings | Controlled trials |
Reference | n | Age, y 1 | Intervention | Trial Type (Intervention Duration) | Outcome Measure | Results 2 | Conclusions |
---|---|---|---|---|---|---|---|
Montes et al. (1995) [30] | 20 (11F) | 5–16 | IG1: 1010 CFU L. acidophilus IG2: 108 CFU L. acidophilus + 1010 CFU S. thermophilus (250 mL milk) | Crossover RCT (-) | Mean 8-h symptom score for abdominal pain, bloating, borborygmi and flatus (0 = absent, 4 = severe symptoms) after ingestion of 2 g/kg of lactose | Symptom score: IG1 0.9 ± 0.43; IG2 1.62 ± 0.71; CG 4.6 ± 0.73 | Significantly lower symptom score |
Pakdaman et al. (2016) [31] | 38 | 18–75 | 109 CFU DDS-1 strain of L. acidophilus/day (capsules) | Crossover RCT (4 weeks) | Mean 6-h symptom scores (0 = no symptoms, 10 = most severe symptoms) after ingestion of 25 g of lactose | Abdominal cramping: IG 1.94 ± 2.341; CG 2.39 ± 2.188 Bowel sounds: IG 2.76 ± 2.536; CG 2.86 ± 2.497 Diarrhea: IG 1.34 ± 2.462; CG 1.69 ± 2.558 Flatulence: IG 3.16 ± 2.873; CG 3.21 ± 2.699 Vomiting: IG 0.08 ± 0.379; CG 0.36 ± 0.936 Overall symptoms: IG 9.28 ± 9.202; CG 10.51 ± 9.327 | Significantly less abdominal cramping, diarrhea, vomiting and lower overall symptom score |
Roškar et al. (2017) [32] | 44 (36F) IG 22 | IG 28 (19–54) CG 31 (18–55) | 1010 CFU L. plantarum + 1010 CFU B. animalis/day (capsules) | RCT (6 weeks) | Mean LI symptom assessment score (0 = absent, 10 = worst) | Abdominal pain: IG 2.4 (1.3–3.4); CG 2.3 (0.9–3.7) Diarrhea: IG 0.3 (−0.1;0.8); CG 0.6 (−0.3;1.5) Flatulence: IG 4.2 (2.9–5.5); CG 4.2 (2.8–5.5) Rumble: IG 3.9 (2.8–5.1); CG 3.6 (2.1–5.1) Vomiting: IG 0.2 (−0.2;0.7); CG 0.2 (−0.1;0.4) Total (Ʃ): IG 11.1 (7.9–14.3); CG: 10.8 (6.4–5.3) | No significant differences |
Ojetti et al. (2010) [33] | 40 (33F) IG 20 | IG 33 ± 11 CG 32 ± 12 | 8 × 108 CFU L. reuteri/day (capsules) | RCT (10 days) | Mean 8-h symptom scores values (0 = absent, 10 = severe symptoms) after ingestion of 25 g of lactose | Abdominal pain: IG 6.9 ± 1.07; CG 7.1 ± 0.72 Bloating: IG 9.95±0.88; CG 7.1 ± 0.72 Diarrhea: IG 2.95±2.07; CG 5.9 ± 0.85 Flatulence: IG 3.95 ± 1.35; CG: 5.15 ± 0.93 | Significant improvement in abdominal pain, bloating, diarrhea, and flatulence |
Savaiano et al. (2013) [34] | 85 (49F) IG 57 | 41 | 15 g RP-G28 (95% GOS)/day (capsules) | RCT (35 days) | Rate of disappearance of abdominal pain (%) | Abdominal pain: IG 72%; CG 28% | Significantly higher rate of disappearance of abdominal pain |
Vitellio et al. (2019) [35] | 23 (19F) | 48 ± 3.1 | 4 × 109 CFU B. longum BB536 + 109 CFU L. rhamnosus/day (packets) | Crossover RCT (4 weeks) | Mean VAS perceived symptom score (0 = absent, 100 = worst) [abdominal pain and bloating] and mean BSFS (1 = constipation, 7 = diarrhea) | Abdominal pain: IG 39 ± 6; CG 53 ± 7 Bloating: IG 60 ± 5; CG 77 ± 4 Bowel movements: IG 3 ± 0; CG 3 ± 0 | Significantly less bloating |
Lin et al. (1998) [36] | 20 | - | IG1: 4 × 108 CFU L. acidophilus/day IG2: 4 × 109 CFU L. acidophilus/day IG3: 4 × 108 CFU L. bulgaricus/day IG4: 4 × 109 CFU L. bulgaricus/day (400 mL milk) | Crossover RCT (-) | Mean 8-h symptom score for stomach pain, gas, and diarrhea (0 = absent, 5 = severe) after ingestion of 25 g of lactose | Symptom score: IG1 9.8; IG2 6.5; IG3 3.9; IG4 2.8; CG 12.5 | Significantly lower symptom score in IG2, IG3, and IG4 |
Reference | n | Age, y 1 | Intervention | Trial Type (Intervention Duration) | Outcome Measure | Results 2 | Conclusions |
---|---|---|---|---|---|---|---|
Kim et al. (1983) [37] | 24 IG 6 × 3 | 20–31 | IG1: 1.25 × 107 CFU L. acidophilus/kg/day IG2: 1.25 × 108 CFU L. acidophilus/kg/day IG3: 1.25 × 109 CFU L. acidophilus/kg/day (milk 10 mL/kg/day) | RCT (6 days) | Change in mean breath H concentration (ppm) 3 h after ingestion of 5 mL/kg milk | Change in mean breath H concentration: IG1-15.2; IG2-1.1; IG3-19.2; CG-0.3 | Significant change in mean breath H concentration in IG1 and IG3. |
Lin et al. (1991) [38] | 10 (4F) | 24–40 | IG1: 107 CFU L. acidophilus NCFM/day IG2: 108 CFU L. acidophilus NCFM/day IG3: 107 CFU L. acidophilus LA1/day IG4: 108 CFU L. acidophilus LA1/day IG5: 107 CFU L. acidophilus LA2/day IG6: 108 CFU L. acidophilus LA2/day IG7: 107 CFU S. thermophilus/L. bulgaricus/day IG8: 108 CFU S. thermophilus/L. bulgaricus/day (400 mL milk) | Crossover RCT (-) | Mean individual breath H concentration 8 h after ingestion of 25 g lactose | Breath H concentration: IG1 36.33; IG2 35.08; IG3 27.64; IG4 22.43; IG5 31.03; IG6 25.32; IG7 24.1; IG8 9.81; CG 30.78 | Significantly lower breath H concentration in IG4 and IG8 |
Ojetti et al. (2010) [33] | 40 (33F) IG 20 | IG 33 ± 11 CG 32 ± 12 | 8 × 108 CFU L. reuteri/day (capsules) | RCT (10 days) | HBT normalization rate (%) Mean peak H2 excretion (ppm) | HBT normalization rate: IG 35%; CG 0% Peak H2: IG 23.1 ± 7.85; CG 31.7 ± 8.3 | Significantly higher HBT normalization rate and reduced mean peak H2 excretion |
Savaiano et al. (2013) [34] | 85 (49F) IG 57 | 41 | 15 g RP-G28 (95% GOS)/day (capsules) | RCT (35 days) | Mean change in HBT values 2 h after ingestion of 25 g lactose | HBT change: IG-10.12; CG 13.95 | No significant differences |
Lin et al. (1998) [36] | 20 | - | IG1: 4 × 108 CFU L. acidophilus/day IG2: 4 × 109 CFU L. acidophilus/day IG3: 4 × 108 CFU L. bulgaricus/day IG4: 4 × 109 CFU L. bulgaricus/day (400 mL milk) | Crossover RCT (-) | Mean hourly breath H concentration 8 h after ingestion of 25 g lactose | Breath H: IG1 262; IG2 231; IG3 188; IG4 135; CG 280 | Significantly lower breath H concentration in IG3 and IG4 (L. bulgaricus) |
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Leis, R.; de Castro, M.-J.; de Lamas, C.; Picáns, R.; Couce, M.L. Effects of Prebiotic and Probiotic Supplementation on Lactase Deficiency and Lactose Intolerance: A Systematic Review of Controlled Trials. Nutrients 2020, 12, 1487. https://doi.org/10.3390/nu12051487
Leis R, de Castro M-J, de Lamas C, Picáns R, Couce ML. Effects of Prebiotic and Probiotic Supplementation on Lactase Deficiency and Lactose Intolerance: A Systematic Review of Controlled Trials. Nutrients. 2020; 12(5):1487. https://doi.org/10.3390/nu12051487
Chicago/Turabian StyleLeis, Rosaura, María-José de Castro, Carmela de Lamas, Rosaura Picáns, and María L. Couce. 2020. "Effects of Prebiotic and Probiotic Supplementation on Lactase Deficiency and Lactose Intolerance: A Systematic Review of Controlled Trials" Nutrients 12, no. 5: 1487. https://doi.org/10.3390/nu12051487