Impact of molecularly defined hypolactasia, self-perceived milk intolerance and milk consumption on bone mineral density in a population sample in Northern Europe

Kull, Mart; Kallikorm, Riina; Lember, Margus

doi:10.1080/00365520802588117

Cited by 32 publications

(25 citation statements)

References 29 publications

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“…Such a self-prescribed reduction is in agreement with a study in Finnish children with the -13910C/C genotype, who naturally diminished their usage of milk [31] and also with a study in children of other ethnicities [42]. It was also shown that other age groups also tend to reduce their milk consumption because of the appearance of symptoms after milk [24,38]. …”

Section: Discussionsupporting

confidence: 87%

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Lactase non-persistent genotype influences milk consumption and gastrointestinal symptoms in Northern Russians

et al. 2011

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BackgroundMilk is an important source of nutrients. The consumption of milk, however, may cause abdominal complaints in lactose intolerant individuals. The frequency of -13910C/C genotype is known to be high among Northern Russians, exceeding the prevalence in northern Europe. In our study we tested two hypotheses: 1) subjects with lactase non-persistent genotype (-13910C/C) have more gastrointestinal (GI) symptoms associated with milk 2) subjects with lactase non-persistence avoid using milk.MethodsIn total, 518 students aged 17 to 26 years were randomly selected from different departments in the Northern State Medical University (NSMU) for genotyping the lactase activity-defining -13910C/T variant. All subjects filled in a questionnaire covering their personal data, self-reported GI symptoms and milk consumption habits.ResultsNorthern Russians consume very small amounts of milk daily. Among carriers of the lactase non-persistent (LNP) genotype there were 10 percentage units of milk-consumers fewer than among lactase-persistent (LP) subjects (p = 0.03). Complaints of GI disorders caused by milk were different between the genotypes (p = 0.02). Among all types of food analyzed only milk was associated with increased GI symptoms among subjects with the LNP genotype (OR = 1.95, CI 1.03-3.69)ConclusionsSubjects with -13910C/C have more GI symptoms from milk. Subjects with lactase non-persistent genotype avoid using milk. In the case of increasing milk consumption symptoms may increase the need for medical consultation. It is thus important either for people themselves or for health care staff to be aware of lactase persistence/non-persistence.

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Section: Discussionsupporting

confidence: 87%

“…Recent studies have shown that subjects with intolerance to lactose tend to reduce their consumption of milk, which is predictable as far as they suffer from symptoms after milk consumption [31,35-38]. In our previous study [7] subjects showed no differences between genotypes in the frequency of GI complaints during life.…”

Section: Introductionmentioning

confidence: 68%

Lactase non-persistent genotype influences milk consumption and gastrointestinal symptoms in Northern Russians

et al. 2011

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“…147 The prevalence of specific malabsorption syndromes (such as lactose, fructose intolerance) is well-established in many countries, 148 but in health surveys many more individuals claim to be lactose intolerant. 149 A similar puzzle seems to be arising with the claims of noncoeliac gluten sensitivity. 150 In a study of >300 patients with a negative hydrogen breath test following lactose challenge, nearly 10% reported abdominal symptoms during the test, and when they were deceptively given glucose before another breath test, half of them reproduced their symptoms, as did 25% of those with lactose malabsorption.…”

Section: Food Intolerancesmentioning

confidence: 93%

Placebo effects and their determinants in gastrointestinal disorders

Elsenbruch

Enck²

2015

Nat Rev Gastroenterol Hepatol

145

112

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Placebo effects in clinical trials have sparked an interest in the placebo phenomenon, both in randomized controlled trials (RCTs) and in experimental gastroenterology. RCTs have demonstrated similar short-term and long-term placebo response rates in gastrointestinal compared to other medical diagnoses. Most mediators and moderators of placebo effects in gastrointestinal diseases are also of similar type and size to other medical diagnoses and not specific for gastrointestinal diagnoses. Other characteristics such as an increase in the placebo response over time and the placebo-enhancing effects of unbalanced randomization were not seen, at least in IBS. Experimental placebo and nocebo studies underscore the 'power' of expectancies and conditioning processes in shaping gastrointestinal symptoms not only at the level of self-reports, but also within the brain and along the brain-gut axis. Brain imaging studies have redressed earlier criticism that placebo effects might merely reflect a response bias. These findings raise hope that sophisticated trials and experiments designed to boost positive expectations and minimize negative expectations could pave the way for a practical and ethically sound use of placebo knowledge in daily practice. Rather than focusing on a 'personalized' choice of drugs based on biomarkers or genes, it might be the doctor-patient communication that needs to be tailored.

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“…Additionally, we found a relatively high percentage of patients with genetic determination for lactose intolerance (37%) as compared with the Central European average (20%-40%) [27]. Patients' tending to avoid intolerance symptoms by reducing calcium-rich dairy products might have had a greater impact than the intolerance [5,18,20,25]. Low calcium intake would correlate with an increase in serum parathyroid hormone and increased bone turnover [35].…”

Section: Discussionmentioning

confidence: 99%

Osteoporosis in Children and Young Adults: A Late Effect After Chemotherapy for Bone Sarcoma

Pirker-Frühauf

Friesenbichler

Urban

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Premature bone loss after childhood chemotherapy may be underestimated in patients with bone sarcoma. Methotrexate (MTX), a standard agent in osteosarcoma protocols, reportedly reduces bone mineral density (BMD). The literature, however, has reported cases of BMD reduction in patients with Ewing's sarcoma treated without MTX. Thus, it is unclear whether osteoporosis after chemotherapy relates to MTX or to other factors. Questions/purposes We therefore asked whether (1) young patients with a bone sarcoma had BMD reduction, (2) patients treated with MTX had lower BMD, and (3) other factors (eg, lactose intolerance or vitamin D deficiency) posed additional risks for low BMD. Methods We retrospectively reviewed 43 patients with malignancies who had dual-energy x-ray absorptiometry (DEXA) (lumbar, femoral); 18 with Ewing's sarcoma (mean age, 26 ± 8 years), and 25 with an osteosarcoma (mean age, 27 ± 10 years). The mean time since diagnosis was 8 ± 4 years in the group with Ewing's sarcoma and 7 ± 5 years in the group with osteosarcoma. At last followup we determined BMD (computing z-scores), fracture rate, and lifestyle, and performed serum analysis. Results BMD reduction was present in 58% of patients (37% had a z-score between À1 and À2 SD, 21% had a z-score less than À2 SD) in at least one measured site. Seven of the 43 patients (16%) had nontrauma or tumor-associated fractures after chemotherapy. Findings were similar in the Ewing and osteosarcoma subgroups. We found vitamin D deficiency in 38 patients (88%) and borderline elevated bone metabolism; lactose intolerance was present in 16 patients (37%). Conclusion Doctors should be aware of the possibility of major bone loss after chemotherapy with a risk of pathologic fracture. Vitamin D deficiency, calcium malnutrition, and lactose intolerance may potentiate the negative effects of chemotherapy, and should be considered in long-term patient management. Level of Evidence Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

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Impact of molecularly defined hypolactasia, self-perceived milk intolerance and milk consumption on bone mineral density in a population sample in Northern Europe

Abstract: Self-perceived milk-intolerance rather than HL influences milk consumption and has deleterious effects on bone metabolism.

Cited by 32 publications

References 29 publications

Lactase non-persistent genotype influences milk consumption and gastrointestinal symptoms in Northern Russians

Lactase non-persistent genotype influences milk consumption and gastrointestinal symptoms in Northern Russians

Placebo effects and their determinants in gastrointestinal disorders

Osteoporosis in Children and Young Adults: A Late Effect After Chemotherapy for Bone Sarcoma

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