Comparing Response of Sheep and Cow Milk on Acute Digestive Comfort and Lactose Malabsorption: A Randomized Controlled Trial in Female Dairy Avoiders

Abstract

Background: Sheep milk (SM) is a possible alternate dairy source for those who experience digestive symptoms with cow milk (CM). While both the milks contain lactose, one of the causes for self-reported intolerance to CM, the composition of SM and CM also differs across proteins and fats, which have been shown to impact digestive processes.Objective: To compare the acute digestive comfort and lactose malabsorption of SM to CM in female dairy avoiders.Method: In a double-blinded, randomized cross over trial, 30 dairy-avoiding females (aged 20–30 years) drank 650 mL of SM or CM (each reconstituted from spray dried powder) following an overnight fast, on two separate occasions at least 1 week apart. Blood samples were collected for glucose and insulin assessment, and single nucleotide polymorphisms of the lactase (LCT) gene (C/T13910 and G/A22018). Breath H2 and visual analog scale (VAS) digestive symptom scores were recorded at fasting and regular intervals over 4 h after ingestion.Results: Eighty percentage of study participants were lactase non-persistent (LNP; CC13910 and GG22018 genotype). Digestive symptoms, including abdominal cramps, distension, rumbling, bloating, belching, diarrhea, flatulence, vomiting, and nausea, were similar in response to SM and CM ingestion (milk × time, P > 0.05). Breath H2 was greater after CM than SM (72 ± 10 vs. 43 ± 6 ppm at 240 min, P < 0.001), which may be due to greater lactose content in CM (33 vs. 25 g). Accordingly, when corrected for the lactose content breath H2 did not differ between the two milks. The response remained similar when analyzed in the LNP subset alone (n = 20).Conclusions: Despite a higher energy and nutrient content, SM did not increase adverse digestive symptoms after ingestion, relative to CM, although there was a reduced breath H2 response, which could be attributed to the lower lactose content in SM. The tolerability of SM should be explored in populations without lactose intolerance for whom underlying trigger for intolerance is unknown.

Postprandial lipemic response in dairy-avoiding females following an equal volume of sheep milk relative to cow milk: A randomized controlled trial

“…However, there are differences between the two milk types: for example SM proteins are more digestible than CM proteins, and provides a greater quantity of branched-chain amino acids (BCAAs) with a corresponding elevation of the postprandial circulating BCAA response ( 15 ). Despite a higher energy and nutrient content in SM, SM did not increase adverse digestive symptoms relative to CM, and reduced the breath H 2 response in dairy-avoiding females, as reported previously ( 16 ). Compared to CM, SM has higher proportions (14.5–27.6 vs. 10.7–16.8%) of short- and medium-chain fatty acids (SCFA; MCFA) ( 17 – 19 ).…”

“…The primary outcome of the study has been reported by Milan et al ( 15 ). Secondary outcomes of lactose malabsorption and digestive comfort have also been reported by Shrestha et al ( 16 ). The additional secondary outcome of lipid responses was assessed and is reported here.…”

Lactose Content and Selected Quality Parameters of Sheep Milk Fermented Beverages during Storage

“…It is additionally rich in magnesium and zinc, as well as in B vitamins and vitamins A, E, and C [ 5 ]. Shrestha et al [ 6 ] showed that sheep’s milk, despite its higher energy and nutrient content, does not lead to significant undesirable digestive symptoms to the same extent as cow’s milk. Due to its favorable physical, chemical, and nutritional properties, it can serve as a valuable raw material for the production of fermented beverages, which are the basis of the functional food market [ 7 , 8 , 9 ].…”

Block freeze concentration by centrifugation and vacuum increases the content of lactose‐free milk macronutrients

“…The presence of the disaccharide lactose in milk is commonly assigned to these dairy restrictions due to a health status known as lactose malabsorption (Shrestha et al, 2021). There are some reasons for the manifestation of lactose malabsorption (such as celiac disease, microbial infections, or malnutrition that damages the intestinal villi), but the main one is the lactase nonpersistence (LNP) (OMIM#223100), a phenotypic enzyme deficiency that affects different cultures (EFSA, 2010).…”

“…In turn, full dairy avoidance from the diet may enhance the risk of nutrient insufficiency and thus contribute to metabolic bone disease, low bone mineral density, or metabolic syndromes (Appleby et al., 2007; Pearlman & Akpotaire, 2019). The presence of the disaccharide lactose in milk is commonly assigned to these dairy restrictions due to a health status known as lactose malabsorption (Shrestha et al., 2021). There are some reasons for the manifestation of lactose malabsorption (such as celiac disease, microbial infections, or malnutrition that damages the intestinal villi), but the main one is the lactase nonpersistence (LNP) (OMIM#223100), a phenotypic enzyme deficiency that affects different cultures (EFSA, 2010).…”