Skip to main content

Lactose Maldigestion

  • Chapter
Probiotics 2

Abstract

Lactose, the main milk sugar, is frequently partly maldigested either because of gastrointestinal diseases or because of the physiological decline of the intestinal lactase activity with age. Lactose maldigestion can lead to clinical symptoms of ‘lactose intolerance’. Improvement of lactose digestion and tolerance is one of the best established properties of probiotics, especially lactic acid bacteria. In this chapter we review the basic mechanisms of lactose digestion and tolerance, evidence for the good digestion and tolerance of fermented dairy products by lactase deficient subjects, and the mechanisms involved in this effect.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Alm, L. (1982) Effect of fermentation on lactose, glucose, and galactose content in milk and suitability of fermented milk products for lactose intolerant individuals. J. Dairy Sci., 65, 346–352.

    Article  PubMed  CAS  Google Scholar 

  • Arrigoni, E., Marteau, P., Briet, F. et al. (1994) Tolerance and absorption of lactose from milk and yogurt during short bowel syndrome in humans. Am. J. Clin. Nutr., 60, 926–929.

    PubMed  CAS  Google Scholar 

  • Besnier, M.O., Bourlioux, P., Fourniat, J. et al. (1983) Influence de l’ingestion de yogurt sur l’activité lactasique intestinale chez des souris axéniques ou holoxéniques. Ann. Microbiol., 134, 219–230.

    Google Scholar 

  • Bond, J.H. and Lewitt, M.D. (1976) Quantitative measurement of lactose absorption. Gastroenterology, 70, 1058–1062.

    PubMed  CAS  Google Scholar 

  • Boudraa, G., Touhami, M., Pochart P. et al. (1990) Effect of feeding yogurt versus milk in children with persistent diarrhea. J. Pediat. Gastroenterol. Nutr., 11, 509–512.

    Article  CAS  Google Scholar 

  • Brummer, R.J.M., Karibe, M. and Stockbrügger R.W. (1993) Lactose malabsorption: optimalization of investigational methods. Scand. J. Gastroenterol., 28Suppl. 200), 65–69.

    Article  CAS  Google Scholar 

  • Buts, J.P., de Keyser, N. and de Raedemaeker L. (1994) Saccharomyces boulardii enhances rat intestinal enzyme expression by endoluminal release of polyamines. Pediat. Res., 36, 522–527.

    Article  PubMed  CAS  Google Scholar 

  • Buts, J.P., Bernasconi, P., Van Craynest, M.P. et al. (1986) Response of human and rat small intestinal mucosa to oral administration of Saccharomyces boulardii. Pediat. Res., 20, 192–196.

    Article  PubMed  CAS  Google Scholar 

  • Collington, G.K., Parker, D.S. and Armstrong, D.G. (1990) The influence of inclusion of either an antibiotic or a probiotic in the diet on the development of digestive enzyme activity in the pig. Br. J. Nutr., 64, 59–70.

    Article  PubMed  CAS  Google Scholar 

  • Corazza, G.R., Benati, G., Sorge, M. et al. (1992) β-galactosidase from Aspergillus niger in adult lactose malabsorption: a double-blind crossover study. Aliment. Pharmacol. Therapy, 6, 61–66.

    Article  CAS  Google Scholar 

  • Debongnie, J.C., Newcomer, A.D., McGill, D.B. et al. (1979) Absorption of nutrients in lactase deficiency. Dig. Dis. Sci., 24, 225–231.

    Article  PubMed  CAS  Google Scholar 

  • Dehkordi, N., Rao, D.R., Warren, A.P. et al. (1995) Lactose malabsorption as influenced by chocolate milk, skim milk, sucrose, whole milk, and lactic cultures. J. Am. Dietetic Ass., 95, 484–486.

    Article  CAS  Google Scholar 

  • Dewit, O., Pochart, P. and Desjeux, J.F. (1988) Breath hydrogen concentration and plasma glucose, insulin and free fatty acid levels after lactose, milk, fresh and heated yogurt ingestion by healthy young adults with or without lactose malabsorption. Nutrition, 4, 1–5.

    Google Scholar 

  • Dewit, O., Boudraa, G., Touhami, M. et al. (1987) Breath hydrogen test and stools characteristics after ingestion of milk and yogurt in malnourished children with chronic diarrhoea and lactase deficiency. J. Trop. Pediat., 33, 177–180.

    Article  CAS  Google Scholar 

  • Flatz, G. (1995) The genetic polymorphism of intestinal lactase activity in adult humans, in The Metabolic and Molecular Basis of Inherited Disease, 7th edn (eds C.R. Scriver, A.L. Beaudet, W.S. Sly et al.), McGraw-Hill, London, pp. 4441–4450.

    Google Scholar 

  • Florent, C, Flourié, B., Leblond, A. et al. (1985) Influence of chronic lactulose ingestion on the colonic metabolism of lactulose in man (an in vivo study). J. Clin. Invest, 75, 608–613.

    Article  PubMed  CAS  Google Scholar 

  • Gallagher, C.R., Molleson, A.L. and Caldwell, J.H. (1974) Lactose intolerance and fermented dairy products. J. Am. Dietetic Ass., 65, 418–419.

    CAS  Google Scholar 

  • Gaon, D., Doweck, Y., Zavaglia, A.G. et al. (1995) Lactose digestion by milk fermented with human strains of Lactobacillus acidophilus and Lactobacillus casei Medicina, 55, 237–242.

    CAS  Google Scholar 

  • Gilliland, S.E. and Kim, H.S. (1984) Effect of viable starter culture bacteria in yogurt on lactose utilization in humans. J. Dairy Sci., 67, 1–6.

    Article  PubMed  CAS  Google Scholar 

  • Hove, H., Nordgaard-Andersen, I. and Portensen, P.B. (1994) Effect of lactic acid bacteria on the intestinal production of lactate and short-chain fatty acids, and the absorption of lactose. Am. J. Clin. Nutr., 59, 74–79.

    PubMed  CAS  Google Scholar 

  • Isolauri, E., Juntunen, M. and Rautanen, T. (1991) A human Lactobacillus strain (Lactobacillus casei sp GG) promotes recovery from acute diarrhea in children. Pediatrics, 88, 90–97.

    PubMed  CAS  Google Scholar 

  • Kim, H.S. and Gilliland, S.E. (1983) Lactobacillus acidophilus as a dietary adjunct for milk to aid lactose digestion in humans. J. Dairy Sci., 66, 959–966.

    Article  PubMed  CAS  Google Scholar 

  • Kolars, J.C., Levitt, MD., Aouji, M. et al, (1984) Yogurt: an autodigesting source of lactose. N. Engl. J. Med., 310, 1–3.

    Article  PubMed  CAS  Google Scholar 

  • Kotz, CA., Furne, J.K., Savaiano, D.A. et al. (1994) Factors affecting the ability of a high β-galactosidase yogurt to enhance lactose absorption. J. Dairy Sci., 77, 3538–3544.

    Article  PubMed  CAS  Google Scholar 

  • Lehtniemi, A. and Lindholm, R. (1995) Laktobasillivalmisteen vaikutus laktoosiintoleranssin oireisiin (in Finnish). Duodecitn, 111, 1027–1031.

    CAS  Google Scholar 

  • Lerebours, E., N’Djitoyap Ndam, C, Lavoine, A. et al. (1989) Yogurt and fermented-then-pasteurized milk: effects of short-term and long-term ingestion on lactose absorption and mucosal lactase activity in lactase-deficient subjects. Am. J. Clin. Nutr., 49, 823–827.

    PubMed  CAS  Google Scholar 

  • Lin, M., Savaiano, D. and Harlander, S. (1991) Influence of nonfermented dairy products containing bacterial starter cultures on lactose maldigestion in humans. J. Dairy Sci., 4, 87–95.

    Article  Google Scholar 

  • Lynn, R.B. and Friedman, L.S. (1993) Irritable bowel syndrome. N. Engl. J. Med., 329, 1940–1945.

    Article  PubMed  CAS  Google Scholar 

  • Majamaa, H., Isolauri, E., Saxelin, M. et al (1995) Lactic acid bacteria in the treatment of acute rotavirus gastroenteritis. J. Pediat. Gastroenterol. Nutr., 20, 333–338.

    Article  CAS  Google Scholar 

  • Malagelada, J.R. (1995) Lactose intolerance. N. Engl. J. Med., 333, 53–54.

    Article  PubMed  CAS  Google Scholar 

  • Marteau, P., Flourié B., Pochart, P. et al (1990) Effect of the microbial lactase (EC 3. 2. 1. 23) activity in yoghurt on the intestinal absorption of lactose: an in vivo study in lactase-deficient humans. Br. J. Nutr., 64, 71–79.

    Article  PubMed  CAS  Google Scholar 

  • Marteau, P., Pochart, P., Mahé, S. et al. (1991) Gastric emptying but not orocecal transit time differs between milk and yoghurt in lactose digesters. Gastroenterology, 100, A353 (abstr).

    Google Scholar 

  • Marteau, P., Pochart, P., Bouhnik, Y. et al. (1993) Fate and effects of some transiting microorganisms in the human gastrointestinal tract. Wd. Rev. Nutr. Dietetics, 74, 1–21.

    CAS  Google Scholar 

  • Martini, M.C., Kukielka, D. and Savaiano, D.A. (1991a) Lactose digestion from yogurt: influence of meal and additional lactose. Am. J. Clin. Nutr., 53, 1253–1258.

    PubMed  CAS  Google Scholar 

  • Martini, M.C., Bollweg, G.L., Levitt, M.D. et al. (1987) Lactose digestion by yogurt β-galactosidase: influence of pH and microbial cell integrity. Am. J. Clin. Nutr., 45, 432–436.

    PubMed  CAS  Google Scholar 

  • Martini, M.C., Lerebours, E.C., Lin, W. et al. (1991b) Strains and species of lactic aid bacteria in fermented milks (yogurts): effect on in vivo lactose digestion. Am. J. Clin. Nutr., 54, 1041–1046.

    PubMed  CAS  Google Scholar 

  • McDonough, F.E., Hitchins, A.D., Wong, N.P. et al. (1987) Modification of sweet acidophilus milk to improve utilization by lactose-intolerant persons. Am. J. Clin. Nutr., 45, 570–574.

    PubMed  CAS  Google Scholar 

  • Newcomer, A.D. and McGill, D.B. (1984) Clinical importance of lactase deficiency. N. Engl. J. Med., 310, 42–43.

    Article  PubMed  CAS  Google Scholar 

  • Newcomer, A.D., Park, H.S., O’Brien, P.C. et al. (1983) Response of patients with irritable bowel syndrome and lactase deficiency using unfermented acido-philus milk. Am. J. Clin. Nutr., 38, 257–263.

    PubMed  CAS  Google Scholar 

  • Onwulata, C.I., Rao, D.R. and Vankineni, P. (1989) Relative efficiency of yogurt, sweet atidophilus milk, hydrolyzed-lactose milk, and a commercial lactase tablet in alleviating lactose maldigestion. Am. J. Clin. Nutr., 49, 1233–1237.

    PubMed  CAS  Google Scholar 

  • Payne, D.L., Welsh, S.D., Manion, C.V. et al. (1981) Effectiveness of milk products in dietary management of lactose malabsorption. Am. J. Clin. Nutr., 34, 2711–2715.

    PubMed  CAS  Google Scholar 

  • Pochart, P., Bisetti, N. Bourlioux, P. et al. (1989a) Effect of daily consumption of fresh or pasteurized yogurt on intestinal lactose utilisation in lactose malab-sorbers. Microecology and Therapy, 18,105–110.

    Google Scholar 

  • Pochart, P., Dewit, O., Desjeux, J.F. et al. (1989b) Viable starter culture, β-galac-tosidase activity and lactose in the duodenum; after yogurt ingestion in lactase-deficient humans. Am. J. Clin. Nutr., 49, 828–831.

    PubMed  CAS  Google Scholar 

  • Rambaud, J.C., Bouhnik, Y. and Marteau, P. (1994) Dairy products and intestinal flora, in Proceedings of the First World Congress of Dairy Products in Human Health and Nutrition, Madrid, 7-10 June 1993 (eds M. Serrano Rios, A. Sastre, M.A. Perez Juez et al.), Balkema, Rotterdam, pp. 389–399.

    Google Scholar 

  • Sahi, T. (1994) Genetics and epidemiology of adult-type hypolactasia. Scand. J. Gastroenterol., 29, (Suppl. 202), 7–20.

    Article  Google Scholar 

  • Savaiano, D.A., Abou El Anouar, A., Smith, D.E. et al. (1984) Lactose malabsorption from yogurt, pasteurized yogurt, sweet acidophilus milk, and cultured milk in lactase-deficient individuals. Am. J. Clin. Nutr., 40, 1219–1223.

    PubMed  CAS  Google Scholar 

  • Scrimshaw, N.S. and Murray, E.B. (1988) The acceptability of milk and milk products in populations with a high prevalence of lactose intolerence. Am. J. Clin. Nutr., 48, (Suppl.), 1083–1159.

    Google Scholar 

  • Semenza, G. and Auricchio, S. (1995) Small-intestinal disaccharidases, in The Metabolic and Molecular Basis of Inherited Disease, 7th edn (eds C.R. Scriver, A.L. Beaudet, W.S. Sly et al.), McGraw-Hill, London, pp. 4451–4479.

    Google Scholar 

  • Shah, N.P., Fedorak, R.N. and Jelen, P.J. (1992) Food consistency effects of quarg in lactose malabsorption. Int. Dairy J., 2, 257–269.

    Article  CAS  Google Scholar 

  • Suarez, F.L., Savaiano, D.A. and Levitt, M.D. (1995) A comparison of symptoms after the consumption of milk or lactose-hydrolyzed milk by people with self-reported severe lactose intolerance. N. Engl. J. Med., 333, 1–4.

    Article  PubMed  CAS  Google Scholar 

  • Varela-Moreiras, G., Antoine, J.M., Ruiz-Roso, B. et al (1992) Effects of yogurt and fermented-then-pasteurized milk on lactose absorption in an institutionalized elderly group. J. Am. Coll. Nutr., 11,168–171.

    PubMed  CAS  Google Scholar 

  • Vesa, T.H., Marteau, P., Zidi, S. et al (1996) Digestion and tolerance of lactose from yoghurt and different semi-solid fermented dairy products containing Lactobacillus acidophilus and bifidobacteria in lactose maldigesters-Is bacterial lactase so important? Eur. J. Clin. Nutr., 50, 730–733.

    PubMed  CAS  Google Scholar 

  • Wytock, D.H. and Di Palma, J.A. (1988) All yogurts are not created equal. Am. J. Clin. Nutr., 47, 454–457.

    PubMed  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1997 Springer Science+Business Media Dordrecht

About this chapter

Cite this chapter

Marteau, P., Vesa, T., Rambaud, J.C. (1997). Lactose Maldigestion. In: Fuller, R. (eds) Probiotics 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-5860-2_4

Download citation

  • DOI: https://doi.org/10.1007/978-94-011-5860-2_4

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-6476-7

  • Online ISBN: 978-94-011-5860-2

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics