A Comparison of Symptoms after the Consumption of Milk or Lactose-Hydrolyzed Milk by People with Self-Reported Severe Lactose Intolerance

Suarez, Fabrizis L.; Savaiano, Dennis A.; Levitt, Michael D.

doi:10.1056/nejm199507063330101

Cited by 460 publications

(178 citation statements)

References 21 publications

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“…Although consumers may find justification for a dietary strategy in an apparent reduction in symptoms, confidence may be misplaced (20) . Non-specific gastrointestinal symptoms often attributed to intolerance have been found to be susceptible to the placebo effect associated with dietary manipulations (21)(22)(23)(24) . In short, the potential for misattribution of an underlying symptomatic state is clearly considerable.…”

Section: Discussionmentioning

confidence: 99%

Food avoidance in an Australian adult population sample: the case of dairy products

Yantcheva

Golley

Topping

et al. 2015

Public Health Nutr.

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Objective: To assess the prevalence of and explanations for the avoidance of dairy foods, including symptoms attributed to their consumption, diagnoses and psychological predictors of avoidance. Also considered were comparisons with symptom-related avoidance of wheat in the same sample. Design: Cross-sectional population survey. Setting: The study was conducted in Australia using a national postal omnibus survey. Subjects: Adults aged 18 years and over (n 1184; 52·9 % female) selected at random from the Australian Electoral Roll.Results: Despite few claims of formally diagnosed allergy or intolerance, 11·8 % of the sample reported avoiding dairy products because of adverse physiological effects, which commonly included gastrointestinal symptoms. Unlike wheat (3·5 %) or wheat-and-dairy (3·6 %) avoidance, dairy avoidance (8·2 %) was predicted by age (negatively) and worry about illness (positively). Conclusions: The findings are further evidence of a widespread tendency for consumers to exercise control over their health by eliminating dietary factors considered suspect without medical evidence or oversight. Unanswered questions include the decision processes underlying dairy avoidance, whether symptoms are attributed correctly, the agents and physiological mechanism(s) involved, the relative contributions of symptom severity and vigilance to the association with illness worry, and the nutritional adequacy of dairy avoiders' diets. Irrespective of the accuracy of self-diagnoses, if the elimination of suspect foods is an end in itself the paradoxical possibility for nutritional imbalances may have significant public health implications.

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Section: Discussionmentioning

confidence: 99%

Food avoidance in an Australian adult population sample: the case of dairy products

Yantcheva

Golley

Topping

et al. 2015

Public Health Nutr.

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“…T he colonic micro biota is variable [28] and the individual sensitivity to feel distension of the colon and to sense discomfort varies [29] . Accordingly, the recognition of the possible link between milk consumption and abdominal symptoms is not always easy [30] . The meal content has an effect on emptying of the stomach and thereby affects the lactose load in the Table 2 The frequency of gastrointestinal symptoms according to the three genotype groups of lactase persistence/nonpersistence during previous three months intestine [31,32] .…”

Section: Discussionmentioning

confidence: 99%

Molecularly defined adult-type hypolactasia among working age people with reference to milk consumption and gastrointestinal symptoms

Anthoni¹

2007

WJG

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“…Although some patients adjust their dietary habits in an attempt to alleviate symptoms 178,180 , many patients do not [180][181][182][183] , despite identifying certain foods as symptom triggers. With the exception of dietary fat 146,185,189 , studies that applied blind challenge tests produced inconsistent outcomes 190,191 , and causal links between specific foods and the induction of symptoms remain to be established. This is a highly challenging under taking, given that functional dyspepsia is a multifactorial disorder with multiple dietary factors implicated and potential additional effects from cognitive factors 146,192 .…”

Section: Box 4 | the Role Of Intestinal Gasmentioning

confidence: 99%

Functional dyspepsia

Enck¹,

Azpiroz

Boeckxstaens

et al. 2017

Nat Rev Dis Primers

254

247

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| Functional dyspepsia is one of the most prevalent functional gastrointestinal disorders. Functional dyspepsia comprises three subtypes with presumed different pathophysiology and aetiology: postprandial distress syndrome (PDS), epigastric pain syndrome (EPS) and a subtype with overlapping PDS and EPS features. Functional dyspepsia symptoms can be caused by disturbed gastric motility (for example, inadequate fundic accommodation or delayed gastric emptying), gastric sensation (for example, sensations associated with hypersensitivity to gas and bloating) or gastric and duodenal inflammation. A genetic predisposition is probable but less evident than in other functional gastrointestinal disorders, such as irritable bowel syndrome (IBS). Psychiatric comorbidity and psychopathological state and trait characteristics could also play a part, although they are not specific to functional dyspepsia and are less pronounced than in IBS. Possible differential diagnoses include Helicobacter pylori infection and peptic ulceration. Pharmacological therapy is mostly based on the subtype of functional dyspepsia, such as prokinetic and fundus-relaxing drugs for PDS and acid-suppressive drugs for EPS, whereas centrally active neuromodulators and herbal drugs play a minor part. Psychotherapy is effective only in a small subset of patients, whereas quality of life can be severely affected in nearly all patients. Future therapies might include novel compounds that attempt to treat the underlying gastric and duodenal inflammation. NATURE REVIEWS | DISEASE PRIMERS VOLUME 3 | ARTICLE NUMBER 17081 | 1 PRIMER © 2 0 1 7 M a c m i l l a n P u b l i s h e r s L i m i t e d , p a r t o f S p r i n g e r N a t u r e . A l l r i g h t s r e s e r v e d .standard therapy for gastro -oesophageal reflux disease. Paediatric dyspeptic symptoms are being addressed in a separate classification effort 10 . This Primer covers functional dyspepsia in adults only, although we sporadically refer to paediatric functional dyspepsia when similarities exist. EpidemiologyThe population prevalence of functional dyspepsia is quite variable across the globe, with overall high numbers (10-40%) in Western countries and low numbers (5-30%) in Asia, independent of the respective functional dyspepsia definitions 11 . A large-scale health and nutrition survey from France 12 (which involved >35,000 people) identified that 15% of individuals had suspected functional dyspepsia, 28% had irritable bowel syndrome (IBS) and 6% had both. The population of patients who are affected by both IBS and functional dyspepsia has been reported to range between 10% and 27% in previous studies 13 and to approach 30% in popu lation samples; it could be even higher in specific populations 14,15 . This observation has given rise to the term 'overlap syndrome' (REF. 13), which calls into question the sensitivity and specificity of the Rome criteria, at least for IBS and functional dyspepsia. This argument is also supported by the observation that patients with functional dyspepsia m...

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A Comparison of Symptoms after the Consumption of Milk or Lactose-Hydrolyzed Milk by People with Self-Reported Severe Lactose Intolerance

Cited by 460 publications

References 21 publications

Food avoidance in an Australian adult population sample: the case of dairy products

Food avoidance in an Australian adult population sample: the case of dairy products

Molecularly defined adult-type hypolactasia among working age people with reference to milk consumption and gastrointestinal symptoms

Functional dyspepsia

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