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Nutrients
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Dietary Management and Lactose Intolerance
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Dietary Management and Lactose Intolerance

A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Prebiotics and Probiotics".

Deadline for manuscript submissions: closed (15 December 2020) | Viewed by 36605

Special Issue Editor

Prof. Dr. Rosaura Leis

E-Mail Website
Guest Editor
Unit of Pediatric Gastroenterology, Department of Pediatrics, Hepatology and Nutrition University Clinical Hospital of Santiago, 15706 Santiago de Compostela, Spain
Interests: pediatric obesity; pediatric obesity comorbidity; pediatric obesity intervention; pediatric metabolic syndrome; microbiota; probiotics and prebiotics; lactose metabolism

Special Issue Information

Dear Colleagues,

Lactose intolerance is characterized by the presence of symptoms, mainly gastrointestinal, vomiting, diarrhea, flatulence, and abdominal pain, due to colonic fermentation of lactose not absorbed by lactase enzyme deficiency.

Lactase deficiency can be primary, congenital, which is very rare, or adult-type lactase deficiency, and secondary to other pathologies that involve a loss of enzyme activity. The prevalence of adult type lactose malabsorption varies among different ethnic groups and geographic location. In Europe, it is related to the presence of two single nucleotide polymorphisms (SNPs C/T-13910 and G/A-22018), but their lack would not justify the prevalence of this malabsorption in other populations.

The best technique for diagnosis is still being discussed, especially with what dose the provocation should be done and for how long it should be performed.

We must bear in mind that, in some occasions, lactose intolerance is at the base of some of the gastrointestinal functional disorders, so knowing their prevalence in the area can help us in the diagnosis and treatment of these, which today constitute a main cause of consultation and increased morbidity.

The clinical symptomatology in lactose intolerance is modified by the load of the lactose substrate, the activity of the lactase enzyme, the speed of intestinal transit, the rate of gastric emptying, and colonic compensation. A significant percentage of individuals with lactose intolerance have no symptoms after the intake of usual amounts of milk consumption and, mainly, of dairy products, yogurt and cheese, which allows them to be able to consume these foods of such high nutritional value. In addition, the intestinal microbiota will also modify the presence and severity of symptoms. Thus, the modification with biotics could be a possibility of treatment.

On the other hand, it should be kept in mind that lactose not absorbed in malabsorbers could be a good prebiotic for the maintenance of a healthier intestinal flora.

Lactase persistence is one of the clearest examples of niche construction and possible gene–nutrient interaction and how particular genotypes can influence food intolerances.

A better knowledge of the prevalence of lactose intolerance, its clinical implications, its diagnostic techniques, nutritional recommendations, and possible treatments will be of great help in assisting this prevalent entity.

Prof. Rosaura Leis
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Breath hydrogen test
  • Dairy products
  • Food intolerance
  • Genotype
  • Lactose intolerance
  • Microbiota
  • Nutrient deficiency
  • Prebiotics
  • Probiotics

Published Papers (3 papers)

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Research

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14 pages, 635 KiB  
Article
Clinical Utility of LCT Genotyping in Children with Suspected Functional Gastrointestinal Disorder
by María L. Couce, Paula Sánchez-Pintos, Emiliano González-Vioque and Rosaura Leis
Nutrients 2020, 12(10), 3017; https://doi.org/10.3390/nu12103017 - 1 Oct 2020
Cited by 5 | Viewed by 2700
Abstract
Genetic testing is a good predictor of lactase persistence (LP) in specific populations but its clinical utility in children is less clear. We assessed the role of lactose malabsorption in functional gastrointestinal disorders (FGID) in children and the correlation between the lactase non-persistence [...] Read more.
Genetic testing is a good predictor of lactase persistence (LP) in specific populations but its clinical utility in children is less clear. We assessed the role of lactose malabsorption in functional gastrointestinal disorders (FGID) in children and the correlation between the lactase non-persistence (LNP) genotype and phenotype, based on exhaled hydrogen and gastrointestinal symptoms, during a hydrogen breath test (HBT). We also evaluate dairy consumption in this sample. We conducted a 10-year cross-sectional study in a cohort of 493 children with suspected FGID defined by Roma IV criteria. Distribution of the C/T-13910 genotype was as follows: CC, 46.0%; TT, 14.4% (LP allele frequency, 34.1%). The phenotype frequencies of lactose malabsorption and intolerance were 36.3% and 41.5%, respectively. We observed a strong correlation between genotype and both lactose malabsorption (Cramér’s V, 0.28) and intolerance (Cramér’s V, 0.54). The frequency of the LNP genotype (p = 0.002) and of malabsorption and intolerance increased with age (p = 0.001 and 0.002, respectively). In 61% of children, evaluated dairy consumption was less than recommended. No association was observed between dairy intake and diagnosis. In conclusion, we found a significant correlation between genotype and phenotype, greater in older children, suggesting that the clinical value of genetic testing increases with age. Full article
(This article belongs to the Special Issue Dietary Management and Lactose Intolerance)
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Review

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20 pages, 1334 KiB  
Review
Genetics of Lactose Intolerance: An Updated Review and Online Interactive World Maps of Phenotype and Genotype Frequencies
by Augusto Anguita-Ruiz, Concepción M. Aguilera and Ángel Gil
Nutrients 2020, 12(9), 2689; https://doi.org/10.3390/nu12092689 - 3 Sep 2020
Cited by 42 | Viewed by 20068
Abstract
In humans the ability to digest milk lactose is conferred by a β-galactosidase enzyme called lactase-phlorizin hydrolase (LPH). While in some humans (approximately two-thirds of humankind) the levels of this enzyme decline drastically after the weaning phase (a trait known as lactase non-persistence [...] Read more.
In humans the ability to digest milk lactose is conferred by a β-galactosidase enzyme called lactase-phlorizin hydrolase (LPH). While in some humans (approximately two-thirds of humankind) the levels of this enzyme decline drastically after the weaning phase (a trait known as lactase non-persistence (LNP)), some other individuals are capable of maintaining high levels of LPH lifelong (lactase persistence (LP)), thus being able to digest milk during adulthood. Both lactase phenotypes in humans present a complex genetic basis and have been widely investigated during the last decades. The distribution of lactase phenotypes and their associated single nucleotide polymorphisms (SNPs) across human populations has also been extensively studied, though not recently reviewed. All available information has always been presented in the form of static world maps or large dimension tables, so that it would benefit from the newly available visualization tools, such as interactive world maps. Taking all this into consideration, the aims of the present review were: (1) to gather and summarize all available information on LNP and LP genetic mechanisms and evolutionary adaptation theories, and (2) to create online interactive world maps, including all LP phenotype and genotype frequency data reported to date. As a result, we have created two online interactive resources, which constitute an upgrade over previously published static world maps, and allow users a personalized data exploration, while at the same time accessing complete reports by population or ethnicity. Full article
(This article belongs to the Special Issue Dietary Management and Lactose Intolerance)
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13 pages, 498 KiB  
Review
Effects of Prebiotic and Probiotic Supplementation on Lactase Deficiency and Lactose Intolerance: A Systematic Review of Controlled Trials
by Rosaura Leis, María-José de Castro, Carmela de Lamas, Rosaura Picáns and María L. Couce
Nutrients 2020, 12(5), 1487; https://doi.org/10.3390/nu12051487 - 20 May 2020
Cited by 46 | Viewed by 13321
Abstract
Lactose intolerance (LI) is characterized by the presence of primarily gastrointestinal clinical signs resulting from colonic fermentation of lactose, the absorption of which is impaired due to a deficiency in the lactase enzyme. These clinical signs can be modified by several factors, including [...] Read more.
Lactose intolerance (LI) is characterized by the presence of primarily gastrointestinal clinical signs resulting from colonic fermentation of lactose, the absorption of which is impaired due to a deficiency in the lactase enzyme. These clinical signs can be modified by several factors, including lactose dose, residual lactase expression, concurrent ingestion of other dietary components, gut-transit time, and enteric microbiome composition. In many of individuals with lactose malabsorption, clinical signs may be absent after consumption of normal amounts of milk or, in particular, dairy products (yogurt and cheese), which contain lactose partially digested by live bacteria. The intestinal microbiota can be modulated by biotic supplementation, which may alleviate the signs and symptoms of LI. This systematic review summarizes the available evidence on the influence of prebiotics and probiotics on lactase deficiency and LI. The literature search was conducted using the MEDLINE (via PUBMED) and SCOPUS databases following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and included randomized controlled trials. For each study selected, the risk of bias was assessed following the Cochrane Collaboration methodology. Our findings showed varying degrees of efficacy but an overall positive relationship between probiotics and LI in relation to specific strains and concentrations. Limitations regarding the wide heterogeneity between the studies included in this review should be taken into account. Only one study examined the benefits of prebiotic supplementation and LI. So further clinical trials are needed in order to gather more evidence. Full article
(This article belongs to the Special Issue Dietary Management and Lactose Intolerance)
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