Calcium Absorption from Milk and Lactose-Free Milk in Healthy Subjects and Patients with Lactose Intolerance

Abstract

By means of isotope ⁴⁷Ca, changes in the rate and intensity of calcium absorption from lactose-free milk and normal milk were investigated as well as ⁴⁷Ca losses in faeces and urine and Ca retention in the organism during a 7-day period in healthy volunteers and in patients with lactose intolerance. The shape of ⁴⁷Ca absorption curves after lactose-free milk in healthy subjects is lower than after milk with a normal lactose content. Conversely, in subjects with lactose intolerance, the shape of the absorption curves of ⁴⁷Ca was lower after ingestion of normal milk and higher after ingestion of lactose-free milk. The total amount of absorbed and retained Ca practically does not differ, regardless whether Ca was administered in milk or lactose-free milk. No significant differences were found in the utilization of Ca in subjects with lactose intolerance. In these patients, the retardation of the peaks of the absorption curves after ingestion of milk most probably suggests a compensatory delay of gastric evacuation. The slower supply of chyme into the gut improves the utilization of Ca in spite of relative lactase insufficiency. Well-tolerated lactose-free milk could be used to ensure a sufficient dietary supply of Ca in subjects with lactose intolerance.

Bone Development and Mineral Homeostasis in the Fetus and Neonate: Roles of the Calciotropic and Phosphotropic Hormones

“…Similar to the data from rodents, calcium absorption in neonates is enhanced by the lactose content of milk (317,318). Intestinal absorption and retention of calcium increase with both postnatal age and gestational age, with additional variations superimposed by the composition of the milk (45,221,256,485,604,613).…”

Effect of lactose hydrolysis on calcium absorption during duodenal milk perfusion

“…The varying observations with lactose tolerance seem to indicate that intestinal lactose lydrolysis is necessary before the enhancing effect of lactose on calcium absorption can be expressed (Debongnie et al, 1979). This new hypothesis refutes earlier ones in which lactose played a direct role (Pansu et al, 1975) (Cochet et al, 1983 ;Kocian, Skala and Bakos, 1973 Glucose and galactose were absorbed at similar rates by each subject, but these rates differed slightly between the two groups. In group 1, glucose and galactose absorption during hydrolysed milk perfusion was similar to lactose absorption during milk perfusion (36.0 % of glucose, 34.0 % of galactose and 35 % of lactose perfused).…”

“…Some reported an enhancing action of lactose in man (Fournier and Dupuis, 1960 ;Pansu and Chapuy, 1970) and in rats (Fournier, 1954 ;Pansu et al, 1975 ;Armbrecht and Wasserman, 1979 ;Vaughan and Filer, 1960) ; others failed to demonstrate any effect in man (Debongnie et al, 1979) or observed an inhibition of Ca absorption in lactose-intolerant subjects in the presence of lactose, while a positive effect was observed in lactose-tolerant subjects (Cochet et al, 1983 ;Condon et al, 1970 ;Kocian, Skala and Bakos, 1973). The varying observations with lactose tolerance seem to indicate that intestinal lactose lydrolysis is necessary before the enhancing effect of lactose on calcium absorption can be expressed (Debongnie et al, 1979).…”

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

“…Estimates of fractional calcium absorption from metabolic balance studies have shown that neonates absorb ϳ60 -70% of calcium from human milk (5,8,289,382), thereby making ϳ120 -140 mg of calcium available for the skeleton to potentially take up each day. Fractional calcium absorption is proportional to intake and facilitated by lactose in neonates and infants (479,480), and can be as low as 30 -40% when formula (which has twice the calcium content as human milk) is consumed (6).…”