1) Most humans, like other mammals, gradually lose the intestinal enzyme lactase after infancy and with it the ability to digest lactose, the principle sugar in milk. At some point in prehistory, a genetic mutation occurred and lactase activity persisted in a majority of the adult population of Northern and Central Europe. 2) Persistence of intestinal lactase, the uncommon trait worldwide, is inherited as a highly penetrant autosomal-dominant characteristic. Both types of progeny are almost equally common when one parent is a lactose maldigester and the other a lactose digester. 3) The incidence of lactose maldigestion is usually determined in adults by the administration in the fasting state of a 50-g dose of lactose in water, the equivalent of that in 1 L of milk. Measurement is made of either the subsequent rise in blood glucose or the appearance of additional hydrogen in the breath. It is also sometimes identified by measuring lactase activity directly in a biopsy sample from the jejunum. For children the test dose is reduced according to weight. Depending on the severity of the lactase deficiency and other factors, the test dose may result in abdominal distention, pain, and diarrhea. 4) The frequency of lactose maldigestion varies widely among populations but is high in nearly all but those of European origin. In North American adults lactose maldigestion is found in approximately 79% of Native Americans, 75% of blacks, 51% of Hispanics, and 21% of Caucasians. In Africa, Asia, and Latin America prevalence rates range from 15-100% depending on the population studied. 5) Whenever the lactose ingested exceeds the capacity of the intestinal lactase to split it into the simple sugars glucose and galactose, which are absorbed directly, it passes undigested to the large intestine. There it is fermented by the colonic flora, with short-chain fatty acids and hydrogen gas as major products. The gas produced can cause abdominal distention and pain and diarrhea may also result from the fermentation products. 6) Among individuals with incomplete lactose digestion, there is considerable variation in awareness of lactose intolerance and in the quantity of lactose that can be ingested without symptoms. A positive standard lactose test is not a reliable predictor of the ability of an individual to consume moderate amounts of milk and milk products without symptoms. In usual situations the quantity of lactose ingested at any one time is much less than in the lactose-tolerance test.(ABSTRACT TRUNCATED AT 400 WORDS)
Sixteen young male students participated in two studies designed to determine the nitrogen balance response to beef or stone-ground, whole wheat protein over the submaintenance-to-maintenance range of protein intake. The objective of the studies was to evaluate the relative capacities of these proteins to meet the minimum protein needs in young adult males. A modified Latin-square design was used to allocate subjects to the four 15-day metabolic balance diet periods in each study. The last 10 days were used for fecal nitrogen determination and the last 5 days for evaluation of urinary nitrogen excretion. The diet periods were separated by a 4-day break period and began with 1 day on a "protein-free" diet. The levels of protien (N times 6.25) intake tested were 0.2, 0.3, 0.4, and 0.5 g/kg body weight/day in the beef study. The results have been compared with those obtained in a previous similar study with egg protein. The regression of estimated "true" nitrogen balance (Y) (mg N/kg/day) on nitrogen intake (X) (mg N/kg/day) was: Y equals 0.51(plus or minus 0.08)X minus 41.9(plus or minus 4.6) for beef and Y equals 0.27(plus or minus 0.06)X minus 33.6(plus or minus 5.0) for whole wheat protein. The amounts of beef and wheat proteins estimated to be requried to support body nitrogen balance in 97.5% of the population supplied 96 and 178 mg N/kg/day, respectively. The relative protein value of beef and wheat proteins, in comparison with egg protein, was 78 plus or minus 12 and 41 plus or minus 10, respectively. It is concluded that the variations in dietary protein quality should be taken into account in assessing the protein adequacy of diets for individuals and population groups.
For 14 days 83 healthy Caucasian male university students, 18 to 26 years of age and 58 to 104 kg body weight consumed daily either an essen tially protein-free diet (44 subjects) or one supplying 0.1 g egg protein per kilo gram body weight (39 subjects). Body cell mass (BCM) was calculated from whole body 4°K in 37 randomly chosen subjects. Urine was analyzed daily for nitrogen (N) and creatinine; fecal N was measured on pooled samples. Urinary N output reached a steady state between days 3 and 8 for all subjects; the average for days 10 to 14 was taken as the measure of obligatory urinary N loss. Mean urine and fecal N losses were not significantly different for the two diet groups and the data were combined for overall analysis. Obligatory urinary N was nor mally distributed, averaging 37.2 ±5.5 mg N/kilogram body weight, 76.8 ±12.5 mg N/kilogram BCM, 1.8 ±0.30 mg N/basal kilocalorie. Obligatory fecal N was 9 ±2 mg N/kg body weight, amounting to 20% of the total obligatory N loss. Although statistically significant correlations were found between obligatory urinary N and body weight, BCM, basal metabolic rate, and creatinine, they accounted for little of the variation in daily loss among individuals. Four subjects were restudied after a 3-year interval; obligatory urinary N loss per kilogram body weight did not differ significantly between the two periods.
To evaluate the capacity of an isolated soy protein to maintain long-term protein nutritional status in healthy young adult men, an 84-day metabolic balance experiment was conducted in eight subjects. The sole source of protein intake was provided by the isolated soy protein, given at a level of 0.8 g (N X 6.25) per kg per day. In a second and similar study, four young men received 0.8 g protein and three subjects 0.68 g protein per kg per day from beef proteins for 60 to 81 days. Body weight, nitrogen balance, blood chemistries, and body composition (whole body 40K) were monitored throughout each study. Body nitrogen balances were maintained within the range of N equilibrium in both diet groups. Body cell mass, as judged from 40K measurements, did not reveal any deterioration in protein nutritional status. These observations confirm the prediction, derived from previous short-term. N balance studies, that the nutritional quality of isolated soy protein is high and that this plant protein can serve as the sole source of essential amino acids and nitrogen for protein maintenance in adults.
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