Recent advances on lactose intolerance: Tolerance thresholds and currently available answers

Abstract

The genetically programmed reduction in lactase activity during adulthood affects 70% of the world adult population and can cause severe digestive disorders, which are the sign of lactose intolerance. Lactose intolerance symptoms vary depending on the residual lactase activity, the small bowel transit time, and especially the amount of ingested lactose. To formulate dairy products suitable for the vast majority of lactose intolerants, it is essential to define lactose intolerance threshold. A recent meta-analysis permitted to show that almost all lactose intolerants tolerate 12 g of lactose in one intake and approximately 18 g of lactose spread over the day. The prevalence and severity of lactose intolerance are probably overestimated by the general public. This misconception usually leads to an unnecessary reduction of dairy foodstuff consumption. Nevertheless, dairy products are essential for health mainly due to their calcium content and the positive influence of probiotic bacteria. The formulation of dairy products suitable for most intolerant and suspicious subjects seems necessary. The use of exogenous enzyme preparations, as well as the consumption of lactose-free products or products rich in probiotic bacteria are proposed as symptom-reducing strategies.

Ciência e Tecnologia de Leite e Produtos Lácteos Sem Lactose

“…Figura 1: Tipos de deficiência de lactase. Fonte: Adaptado de Corgneau et al (2017). Kuokkanen et al (2006) relataram cinco mutações distintas na região codificadora do gene da lactase (LCT) para pacientes com DLC.…”

“…A lactose-florizina hidrolase intestinal possui dois sítios ativos: um catalisa a hidrólise da lactose, enquanto o outro catalisa a hidrólise de outros carboidratos (incluindo a florizina). A lactose-florizina hidrolase está localizada no intestino delgado e apresenta maior expressão no jejuno (CORGNEAU et al, 2017). Assim como outras enzimas envolvidas na digestão e absorção de carboidratos, a lactose-florizina hidrolase está ancorada na superfície da borda em escova (SWALLOW, 2011).…”

“…Uma ingestão inadequada de cálcio aumenta o risco de osteoporose, hipertensão e, possivelmente, de câncer de cólon (MILLER et al, 2000). O grau de má absorção de lactose varia muito entre os seres humanos, mas a maioria pode ingerir até 18 g de lactose diariamente sem apresentar nenhum sintoma (CORGNEAU et al, 2017). A gravidade dos sintomas depende muito da taxa de esvaziamento gástrico, do tempo de trânsito intestinal e da microflora intestinal.…”

“…A literatura carece de pesquisas relacionadas à produção de derivados lácteos probióticos sem lactose, mas sabe-se que o consumo de produtos ricos em bactérias probióticas é proposto como estratégia de redução dos sintomas de intolerância a lactose, pois algumas delas têm a capacidade de metabolizar o dissacarídeo, como é o caso das bifidobactérias e lactobacilos (CORGNEAU et al, 2017). Isso foi observado nos trabalhos de Corbo et al (2001) e Vesa et al (1996).…”

Advanced approaches to produce polyhydroxyalkanoate (PHA) biopolyesters in a sustainable and economic fashion

“…Although whey, because of its high content in proteins, sugars, lipids, vitamins, and minerals like calcium has a considerable nourishing value with 100 g of whey corresponding to more than 100 kJ of nutritional energy, its application in the food sector is restricted by about 75% of all adults worldwide suffering from lactose intolerance (hypolactasia) caused by insufficient activity of the enzyme β-galactosidase (lactase). Particularly, hypolactasia is frequently diagnosed in South European regions and countries of the Southern world hemisphere (64). Together with the current price drop for whey powder, this makes clear that alternative policies for whey valorization are needed.…”