Adaptation to Lactose in Lactase Non Persistent People: Effects on Intolerance and the Relationship between Dairy Food Consumption and Evalution of Diseases

Abstract

Dairy foods contain complex nutrients which interact with the host. Yet, evolution of lactase persistence has divided the human species into those that can or cannot digest lactose in adulthood. Such a ubiquitous trait has differential effects on humanity. The literature is reviewed to explore how the divide affects lactose handling by lactase non persistent persons. There are two basic differences in digesters. Firstly, maldigesters consume less dairy foods, and secondly, excess lactose is digested by colonic microflora. Lactose intolerance in maldigesters may occur with random lactose ingestion. However, lactose intolerance without maldigestion tends to detract from gaining a clear understanding of the mechanisms of symptoms formation and leads to confusion with regards to dairy food consumption. The main consequence of intolerance is withholding dairy foods. However, regular dairy food consumption by lactase non persistent people could lead to colonic adaptation by the microbiome. This process may mimic a prebiotic effect and allows lactase non persistent people to consume more dairy foods enhancing a favorable microbiome. This process then could lead to alterations in outcome of diseases in response to dairy foods in lactose maldigesters. The evidence that lactose is a selective human prebiotic is reviewed and current links between dairy foods and some diseases are discussed within this context. Colonic adaptation has not been adequately studied, especially with modern microbiological techniques.

Nutrient Estimation from 24-Hour Food Recalls Using Machine Learning and Database Mapping: A Case Study with Lactose

“…Those who are genetically lactase non-persistent (LNP) may become lactose intolerant and experience gastrointestinal discomfort following lactose consumption and therefore may consume different types of or less dairy than those who are LP. Consumption of lactose by LNP individuals may be fermented and alter the gut microbiome, which may have other impacts on health [8,9]. Since lactose is unavailable in the ASA24 output, studying the relationship between diet and LP genetics is limited to using dairy intake as a whole as a proxy for lactose consumption.…”

Effects of dietary supplementation with increasing doses of lactose on faecal bacterial populations and metabolites and apparent total tract digestibility in adult dogs

“…As each lactose-supplemented diet was fed to dogs for a relative long time (20 d), the variation in faecal water content observed throughout the study may be attributable to a sort of slow 'adaptation' displayed by the digestive enzymatic system of the dogs, which have been never fed with diets containing lactose prior the beginning of the trial. Moreover, similarly to what happens in 'lactase non persistent people' (Szilagyi 2015), also in adult dogs the regular consumption of lactose may have led to 'colonic adaptation' by the intestinal microbiome. Later, the improvement of lactose digestion may have gradually reduced its by-pass towards the hindgut, where it had firstly exerted a mild osmotic effect (with a consequent increase of the faecal water content of the dogs) during the first twosupplementation periods.…”

Lactose malabsorption in systemic sclerosis

“…Finally, the metabolic impact of lactose on the colonic microbiome has been reported, including increase in bifidobacteria and lactobacilli and decrease in the genus Bacteroides and Clostridia . Interestingly, a recent study showed that SSc patients, compared to healthy controls, had: (i) decreased levels of commensal bacteria, especially Faecalibacterium and Clostridium .…”