Lactose Intolerance Research Articles

7370 Review of the Literature, and Report of a Series of Patients with Lactose Intolerance and Levothyroxine Malabsorption in Treatment with Liquid L-T4

Abstract Disclosure: S. Ferrari: None. A. Patrizio: None. V. Mazzi: None. F. Ragusa: None. C. Botrini: None. G. Elia: None. E. Balestri: None. E. Barozzi: None. L. Rugani: None. F. Bracchitta: None. G. Stoppini: None. G. Frenzilli: None. E. Baldini: None. C. Virili: None. S. Benvenga: None. P. Fallahi: None. A. Antonelli: None. Intolerance to lactose-containing foods is frequent, with a prevalence of 7-20% in Caucasians, and of 80-95% among Native Americans. Therefore, lactose intolerance (LI) issue needs to be taken in account in the management of hypothyroid patients needing large doses of levothyroxine (L-T4) (> 1.7-2 μg/kg/day) to achieve euthyroidism. Indeed, the absorption of oral T4 may be affected in patients with LI, by following a diet containing lactose, whereas it is resulted to be improved with a lactose-free diet. Lactose is often present as a supplementary ingredient in many commercially available drugs, as L-T4 preparations. In susceptible individuals, drugs containing lactose can cause LI symptoms, and lactose in L-T4 preparations could impair thyroxine absorption. Moreover, it has been shown that patients with LI requiring an increased dosage of L-T4 benefit from a treatment with a lactose-free L-T4 formulation. The lactose-free liquid L-T4 formulation is able to circumvent LI malabsorption leading to the normalization of thyroid-stimulating hormone (TSH) in patients with subclinical hypothyroidism, and long term stable TSH levels. Further studies will be needed to evaluate the liquid L-T4 formulation in larger numbers of patients with hypothyroidism and LI. Presentation: 6/3/2024

8183 An Unusual Cause of Fluctuating Thyroid Hormone Levels

Abstract Disclosure: V. Taqi: None. W. Akhter: None. J.L. Gilden: None. Background: Thyroid disease, especially congenital hypothyroidism is a common endocrine problem with an estimated global prevalence of 4.25%. Since every organ system is affected by thyroid hormones, untreated hypothyroidism can lead to profound adverse outcomes. Many drugs, hormones, and dietary supplements have been noted to affect the efficacy of thyroid hormones, yet there was always concern about the effect of the excessive growth of intestinal flora in the small intestine on thyroid supplement absorption. Drugs, malabsorption, celiac disease and increased excretion are common causes of fluctuating thyroid hormones. In this case, we present a young male patient with congenital hypothyroidism, who required fluctuating doses of levothyroxine due to abnormal thyroid hormone levels, despite compliance with proper administration, and dramatic improvement of thyroid hormone levels after starting probiotic therapy. Case : An 18-year-old Caucasian male with congenital hypothyroidism had been treated with varying doses of thyroid hormone replacement by a Pediatric Endocrine Center. Due to his recall that TSH=4.13 mIU/L and he was “tired of taking medication”, he stopped taking 125 mcg of levothyroxine. Four months later, TSH was > 200 mIU/L (nl=0.48-4.17). Levothyroxine 137 mcg was then started. However, 11 months later, TSH=14.2 mIU/L, Free T4=1.6 ng/dL (nl=1.03-1.64). He was then referred to our Endocrine Clinic. He denied symptoms of hypo or hyperthyroidism or other medical issues. His grandfather was known to have hypothyroidism and diabetes mellitus (details unknown). On exam: Wt. was 149 Ib, Ht= 67 Inch. VS: BP 98/46, P 69, R:16,temp: 97.9F, Physical exam showed normal findings without thyromegaly, but there was a delay in tendon reflexes. Laboratory-unremarkable CBC, CMP panels with normal thyroid antibodies, and Celiac titers. TSH initially improved from 14.2 to 8.4 mIU/L after increasing the thyroxine dosage from 137 to 150 mcg for 2 weeks, then to 175 mcg after 4 weeks, but TSH increased to 12.1 mIu/L, despite being compliant with medication and ensuring proper way of administration. He continued to deny symptoms of hypo or hyperthyroidism, or any other medical issues, including lactose intolerance or malabsorption. However, probiotics were then added to his regimen, and continuation of the current dose resulted in a suppressed TSH=0.15 mIU/L. The levothyroxine was then decreased to 150 mcg with continuation of probiotics. One month later, TSH was 1.31 mIU/L with Free T4 of 1.5 ng/dL. Conclusion : Common causes for fluctuating thyroid hormone levels include intestinal malabsorption, celiac disease, nephrotic syndrome, drugs, and food interaction. This case demonstrates that despite proper administration, fluctuating thyroid hormone levels can result from some uncommon causes, such as lactose intolerance, which can be unmasked by co-administration of probiotics. Presentation: 6/2/2024

Lactose Intolerance in Jazan: Awareness and Impact

Background: Lactose intolerance is a frequent disorder characterized by gastrointestinal symptoms (such as nausea, bloating, and discomfort) following dairy product consumption. LI can be considerably decreased with simple understanding of symptoms and the use of milk substitutes. Aim: The goal of this study was to look into the prevalence of lactose intolerance and its relationship to nutrition and dietary habits in Jazan, Saudi Arabia. Methods: This study used a cross-sectional descriptive design with a sample of 283 participants who met the qualifying requirements. A questionnaire was used to collect the data, which was then analyzed using statistical tools for social sciences (SPSS) and Microsoft Excel. Results: Dairy/dairy products were highly consumed on daily basis (64.7%) accompanied by abdominal distention and gases (18%), yet, only 13.8% had been diagnosed with lactose intolerance. The magnitude of lactose intolerance was mainly in late childhood (11-20 years) and emerging adulthood (21-30 years) (56.4%). only 36% had good knowledge about the disorder, with females had significantly higher levels of awareness compared to males (p<0.05). Conclusion: Almost one-third of the population in Jazan had good knowledge on lactose intolerance with females having significantly higher levels.

Objectives for the use of raw materials and component composition for the production of low-lactose ice cream from goat milk

A huge number of people all over the world suffer from lactose intolerance. The second problem is an allergy to cow milk protein. People with lactose intolerance, as well as those who suffer from cow milk allergies, are forced to significantly limit their choice of ice cream or give it up completely. The article describes a solution to the problem of eating ice cream by children and adults suffering from lactose intolerance and an allergy to cow milk protein, and presents ways to overcome it.The goal of the research. Objectives for the use of raw materials and component composition for the production of low-lactose ice cream from goat milk. During the research, the quality indicators of the selected raw materials have been studied, the characteristics of the main ingredients for the production of low-lactose ice cream have been substantiated and given. Goat milk, in terms of its quality indicators, is most suitable for the production of ice cream, because it contains more protein, fat, solids, less lactose and does not cause allergies, and therefore it has been chosen as the main raw material for the production of ice cream. A theoretical and practical analysis of the chemical composition and properties of goat milk has been carried out, and compared with cow. To reduce the lactose content, a dual method of lactose hydrolysis has been chosen - the use of probiotic starter cultures and the lactase enzyme. In the process of combined hydrolysis at a temperature of 37-39⁰ C for 4-6 hours, a reduction in lactose content of less than 0.9% is achieved, while the concentration of cells of probiotic microorganisms in active form reaches 108 CFU/cm3. It is proposed to use the “Lactomix KM” stabilization system, which is usually used in the production of fermented milk products.

The intestinal microbiome, but not clinical aspects of inflammatory bowel disease, is impacted by lactose malabsorption compared to lactose digestion in children

BackgroundDietary exclusion of lactose from patients with inflammatory bowel disease (IBD) persists with speculation that deleterious effects are mediated through intestinal microbes. ObjectivesTo compare IBD characteristics and changes in the intestinal microbiome (IM) at diagnosis in children with and without lactose malabsorption (LM). MethodsA cross-sectional cohort of children (8–17 y of age) diagnosed with Crohn’s disease [n = 149 (63%)] or ulcerative colitis (n = 86) that had undergone lactose breath hydrogen testing was evaluated. The IM of mucosal luminal aspirates was profiled at the time of diagnosis using 16S ribosomal ribonucleic acid gene amplicon sequencing of the V6 hypervariable region. ResultsOf the 235 children, 61 (26%) had LM. Microbial characterization yielded differences in bacterial differential abundance between children who could and could not absorb lactose, which varied by intestinal site and between subtypes of IBD. There were no differences in the ages [13.2 ± 3.0 y (mean ± standard deviation) compared with 12.7 ± 3.4 y; P = 0.25], sex (P = 0.88), extent of disease involvement or severity of disease at presentation (P = 0.74) when comparing those that could or could not absorb lactose nor was there a difference in the need for initiation of biological agents (P = 0.43) during 2 y of follow-up. ConclusionsLM does not affect the clinical presentation or outcomes of children with IBD. However, this study establishes that a single nonabsorbed fermentable food product can alter the IM in both a regional and disease-specific manner. As we continue to learn more about the pathophysiology of IBD and the role of the IM in disease onset and progression, it would be of benefit to examine the impact of other potential fermentable nutrients and their products on IBD outcomes.

Prevention of allergies and infections by minimally processed milk in infants-The MARTHA feasibility and safety trial.

Consumption of raw cow's milk has repeatedly been shown to protect from asthma, allergies, and respiratory infections. As raw milk bears potential health hazards, it cannot be recommended for prevention. Therefore, we performed an intervention study with microbially safe but otherwise minimally processed cow's milk. Here we describe feasibility and safety of the trial. The MARTHA trial (DRKS00014781) was set up as a double-blind randomized intervention in a population residing in Bavaria. Infants from 6 to 36 months of age consumed minimally processed cow's milk (intervention arm) or ultra-heat-treated (UHT) semi-skimmed milk (comparator arm). At the age of 6 to 12 months, 260 infants were enrolled, with 72% having a family history of atopy. The extensive screening system for milk consumption and symptoms suggestive of adverse events was well accepted with 22,988 completed weekly surveys and an average completion of 82% surveys sent out. The children consumed the study milk on average on 457 days (61% of intervention days). The intervention proved to be safe without any case of milk allergy or milk intolerance under the intervention in both arms. All 6 cases of serious adverse events were unrelated to milk. The most common reason was unscheduled hospitalization of more than 3 days. The intervention with minimally processed milk and the study instruments proved feasible. During the age of 6 to 36 months, there was no increased risk of milk allergy in a population with a substantial proportion of family history of atopy.

Carbohydrate composition of cow's milk and plant-based milk alternatives

The prevalence of lactose intolerance is one of the factors driving consumers toward plant-based milk alternatives (PBMA). This study aimed to analyze the carbohydrate profile of cows' milk (regular and lactose-free from both pasteurized and UHT milks; n = 80) and PBMA (n = 60) by HPLC. The study revealed that there was no significant difference in the energy content and total carbohydrate content between regular milk and lactose-free milk. Although milk and PBMA are entirely different food matrices, some PBMA types, as soya and coconut, may have energy contents and total carbohydrate contents comparable to those of milk. Furthermore, the variability observed in total carbohydrate content, as well as in carbohydrate profile, both between PBMA types and within samples of the same type, arises not only from variations in raw materials but also from the number of dilutions of the vegetable extract and the addition of different types and levels of carbohydrates, such as sucrose, fructose, or sorbitol, during PBMA manufacture. Although, milk presents a regular carbohydrate composition, differing solely between presentations (regular/lactose-free), the PBMA differs significantly between types and among the same type, not being for that reason regarded as a milk substitute.

Systematic review: Diagnosis, treatment and management strategies of lactose intolerance

Systematic review: Diagnosis, treatment and management strategies of lactose intolerance

β-galactosidase producing Lactiplantibacillus spp in intestinal microbiome mouse diarrhea model and metagenomic analyses

Probiotics have attained significant interest in recent years as a result of their gut microbiome modulation and gastrointestinal health benefits. Numerous fermented foods contain LAB with GRAS grade and probiotic bacteria. The most promising isolates with high potentiality were selected for 16S rRNA gene sequence analysis and identified as Lactiplantibacillus plantarum, L. fermentum, L. pentosus and Lactiplantibacillus sp. The present study was conducted to determine the gastrointestinal symptoms after the consumption of milk and dairy products, lactose intolerance status using mice model. Post-weaning Balb/c mice were orally administered with probiotic bacteria to assess their efficiency in reducing lactose intolerance symptoms. They exhibited significantly reduced total feces weight and slower intestinal motility and they efficiently alleviated diarrhea symptoms within 6 h of lactose challenge in lactose intolerance-induced mice. Next generation sequence analysis was performed using intestinal content of model treated with L. plantarum GV54 and GV64, the intestinal bacterial diversity was studied using Illumina NGS analysis (16S rRNA hypervariable regions [V3 and V4]). NGS report confirmed the existence of the dominant phyla of the gut microbiome in mice are Bacteroidetes, Firmicutes and Proteobacteria. Due to the influence of the probiotic bacteria in the model group (GV54 and GV64), maximum abundance of phylum Firmicutes were observed when compared to the control group, whereas control group showed more abundance of phylum Bacteriodetes. However, the relative abundance of Bacteroidetes in the model group was decreased and Firmicutes abundance was increased. This indicates the genus abundance of Lactobacillus (Lactiplantibacillus) species or Lactiplantibacillus plantarum GV54 and GV64 bacteria. After treatment with probiotic bacteria Lactobacillus (Lactiplantibacillus) species, the probiotic bacterial abundance was increased consequently genera Helicobacter, Clostridiales unclassified and Desulfovibrio were decreased in the model groups. Probiotic bacteria has a positive impact on the regulation of intestinal microbial diversity in the tested mice system and it reflects that the intestinal microbiota of mice is dynamic and has positive impact on gut health. Considering this point, it is possible to promote Lactiplantibacillus spp. as probiotics and therapeutic food development at industrial scale.

Molecular insights into the interaction between graphene oxide and β-galactosidase: From multispectral experiment, enzyme kinetics experiment to computational simulations

β-galactosidase has potential applications in various scientific disciplines, including the food industry, genetic engineering, and enzyme engineering. In this study, multi-spectral experiments combined with enzyme kinetics experiments and computational simulation were used to explore the interaction mechanism, structural and functional changes, and effects on the microenvironment of graphene oxide and β-galactosidase. Graphene oxide was synthesized using the improved Hummer method, and the characterization experiments demonstrated that the structure was flat and free of cracks, and the functional groups satisfied the required amount. Zeta potential experiments and molecular docking results jointly confirmed that graphene oxide and β-galactosidase were combined by van der Waals forces, electrostatic forces, and hydrophobic forces. Fluorescence quenching experiments showed that the quenching constant decreased from 2.90 × 1012 mLμg-1s−1 to 1.76 × 1012 mLμg−1 s−1 with the increase of temperature, indicating that the quenching mode was static quenching, accompanied by increased polarity and decreased hydrophilicity of β-galactosidase. Circular Dichroism Spectrum, Fourier Transform infrared spectroscopy, the ONPG experiment, and molecular dynamics simulation proved that the stability and activity of β-galactosidase were improved after binding with graphene oxide. These findings provide support for the potential applications of β-galactosidase in addressing lactose intolerance, optimizing gene expression efficiency, and developing innovative biosensors or bioprocessing systems.

Microbiome signature suggestive of lactose-intolerance in rhesus macaques (Macaca mulatta) with intermittent chronic diarrhea

BackgroundChronic diarrhea is a common cause of mortality and morbidity in captive rhesus macaques (Macaca mulatta). The exact etiology of chronic diarrhea in macaques remains unidentified. The occurrence of diarrhea is frequently linked to dysbiosis within the gut microbiome. Research into microbiome signatures correlated with diarrhea in macaques have predominantly been conducted with single sample collections. Our analysis was based on the metagenomic composition of longitudinally acquired fecal samples from rhesus macaques with chronic diarrhea and clinically healthy rhesus macaques that were obtained over the course of two years. We aimed to investigate potential relationships between the macaque gut microbiome, the presence of diarrhea and diet interventions with a selection of commercially available monkey diets.ResultsThe microbiome signature of macaques with intermittent chronic diarrhea showed a significant increase in lactate producing bacteria e.g. lactobacilli, and an increase in fermenters of lactate and succinate. Strikingly, two lactose free diets were associated with a lower incidence of diarrhea.ConclusionA lactose intolerance mechanism is suggested in these animals by the bloom of Lactobacillus in the presence of lactose resulting in an overproduction of intermediate fermentation products likely led to osmotically induced diarrhea. This study provides new insights into suspected microbiome-lactose intolerance relationship in rhesus macaques with intermittent chronic diarrhea. The integration of machine learning with metagenomic data analysis holds potential for developing targeted dietary interventions and therapeutic strategies and therefore ensuring a healthier and more resilient primate population.

Improvement of lactose digestion by highland barley (Hordeum vulgare var. coeleste L.) β-glucan: Activation of lactase under simulated gastric/small intestinal digestive conditions

β-Galactosidase (lactase) plays a crucial role as a dietary supplement in managing lactose intolerance. Here, the catalytic activity of lactase was successfully activated for the first time through complexation with water-extractable β-glucans from highland barley (WHBG). Under simulated gastric/small intestinal digestive conditions, WHBG and lactase spontaneously formed complexes, resulting in a remarkable increase in catalytic activity up to 172.6 %. Structural analyses revealed that the incorporation of WHBG caused partial unfolding of lactase, thereby exposing its hydrophobic regions with active sites, and the electrostatic and hydrophobic interactions between the two played pivotal roles. Meanwhile, according to microstructure and particle size analyses, the dissociation of aggregates and the re-distribution of lactase molecules were also observed. Consequently, the enzyme-substrate contact was promoted, and the hydrolysis efficiency of complexed lactase in the digestion of lactose in milk was superior to that of native lactase. Notably, among WHBG30/50/70 obtained by continuous fractionation of WHBG with 30 %/50 %/70 % ethanol, WHBG70 exhibited the lowest molecular weights and size, and the highest negative ζ-potential, potentially contributing to its superior activation abilities on lactase. These findings challenge the traditional view of polysaccharides as enzyme inhibitors and highlight their potential for diverse applications.

Recent Research on the Human Biology of Pastoralists.

Despite encroachment by agricultural systems and globalization, pastoral nomads maintain a robust presence in terms of numbers and subsistence activity. At the same time, increasing concern about climate change has promoted awareness that increased climatic fluctuation may push pastoral population past their capacity for resilience. The response of pastoralists to climate change has important implications for our evolutionary past and our increasingly problematic future. Yet, pastoralists have received less explicit attention than foragers as populations under consistent selective constraints including limited caloric intake, high levels of habitual activity, and high disease burdens. Additional factors include exposure to cold and high temperatures, as well as high altitude. Over the last 20 or so years, the use of new techniques for measuring energetics, including actigraphs and doubly labeled water have built on existing noninvasive sample collection for hormones, immune markers and genes to provide a more detailed picture of the human biology of pastoral populations. Here I consider recent work on pastoralists from Siberia and northern Europe, Africa, Asia, and South America. I survey what is known about maternal milk composition and infant health, childhood growth, lactase persistence, and adult energy expenditure and lactase persistence to build a picture of the pastoralist biological response to environmental conditions, including heat, cold, and high altitude. Where available I include information about population history because of its importance for selection. I end by outlining the impact of milk consumption and climate over the human life cycle and make suggestions for further research.

Health benefits of fermented olives, olive pomace and their polyphenols: a focus on the role of lactic acid bacteria.

Fermented foods have regained popularity in Western diets for their health-promoting potential, mainly related to the role of lactic acid bacteria (LAB) during the fermentation process. Nowadays, there is an increasing demand for vegetable-based fermented foods, representing an environmentally sustainable options to overcome the limitations of lactose intolerance, vegetarian, or cholesterol-restricted diets. Among them, table olives and their co-products (i.e., olive pomace) represent important plant-origin matrices, whose exploitation is still limited. Olives are an important source of fiber and bioactive molecules such as phenolic compounds with recognized health-promoting effects. Based on that, this minireview offer a brief overview about the potential beneficial role of fermented table olives/olive pomace, with a particular focus on the role of LAB to obtain healthy and/or probiotic-enriched fermented foods.

Enhancing Yogurt Functionality through Enrichment with Cow and Soy Milk: Production and Quality Evaluation

Yoghurt is a fermented dairy product produced from cow’s milk. Soybeans are abundant, reasonably priced, and high in protein, so there has been some work done to use them to make more pleasant and acceptable food products. Although many people eat cow's milk yoghurt, others who are lactose intolerant or follow a plant-based diet could find it incompatible. However, in comparison to regular yoghurt, soy milk yoghurt does not always live up to customer expectations regarding flavor and texture, even though it is nutritionally sound. The difficult part of making yoghurt is creating a recipe that combines the health advantages of soy milk with the desired sensory attributes of cow milk yoghurt. In the current investigation, soy milk was added to the milk of cows. The final soybean yoghurt was assessed about post-acidification modifications. The primary aim of this research is to improve the nutritional value and functioning of yoghurt by the addition of a blend of soy and cow's milk. In keeping in mind yogurt is made out of cow milk and soy milk. Cow milk is rich in protein, calcium, vitamin D, and Potassium. Soy milk is rich in vitamins A, B, and proteins. The yogurt made out of this may have various health benefits. The study blended cow and soy milk in various proportions to create different yogurt formulations. The treatments were as follows: T1: Soy milk (200 ml) without cow milk, T2: Cow milk (200 ml) without soy milk, T3: [Cow milk (100 ml) + Soy milk (100 ml)], T4: [Cow milk (120 ml) + Soy milk (80 ml)], T5: [Cow milk (80 ml) + Soy milk (120 ml)], T6: [Cow milk (160 ml) + Soy milk (40 ml)], and T7: [Cow milk (40 ml) + Soy milk (160 ml)]. These formulations were tested to achieve a high-quality blended yogurt that is both nutritious and flavorful. Combining soy and cow's milk to enhance yoghurt is a viable way to satisfy the nutritional requirements of a wider range of customers, including those who have lactose intolerances or who choose plant-based diets. According to the study's findings, soy milk-enriched yoghurt is a competitive and enticing product on the market since it maintains the good aspects of regular yoghurt while also offering increased nutritional value. Optimising the ratio of cow to soy milk and gauging long-term customer acceptability are two potential areas for future study.

Self-Perceived Lactose Intolerance Versus Confirmed Lactose Intolerance in Irritable Bowel Syndrome: A Systematic Review.

Disorders of gut-brain interaction (DGBI) are prevalent, affecting 20-40% of the population, with irritable bowel syndrome (IBS) being the most common and impactful. While congenital lactose intolerance is rare, lactase deficiency in adults is widespread, causing gastrointestinal symptoms like bloating and diarrhea. Self-perceived lactose intolerance often overestimates symptoms, impacting dietary choices and quality of life, necessitating better understanding and management for improved patient outcomes. This article evaluates the diagnostic accuracy of self-reported lactose intolerance in patients with lactose intolerance and IBS through a systematic review. A systematic literature search was conducted using PubMed, EMBASE, and SCOPUS, including terms related to IBS, lactose intolerance, and self-reported symptoms, without applying filters to ensure comprehensive coverage. Inclusion criteria focused on observational studies with adult participants diagnosed with lactose intolerance, addressing symptoms and lactose malabsorption, while excluding non-English articles, reviews, editorials, and studies involving pediatric subjects. The systematic review analyzed six studies with 845 participants, revealing significant variability and moderate accuracy in self-reported lactose intolerance for diagnosing actual lactose intolerance in IBS patients. Hydrogen breath tests (HBTs) showed that self-reported symptoms often led to false positives, underscoring the need for objective diagnostic tools and standardized criteria. The findings highlight the complexity of diagnosing lactose intolerance in IBS patients and suggest that lactose-free diets and routine HBT should not be recommended without clear indications. The rigorous selection process ensured the inclusion of high-quality, relevant studies, thereby enhancing the reliability and validity of the review's findings. These studies revealed that a lactose-free diet should not be routinely recommended for IBS patients, nor should the routine use of HBT to identify lactose malabsorption in this group. Future research should focus on better understanding the factors influencing lactose perception and tolerance, which is crucial for more effective management of lactose intolerance in IBS patients.

Bone Mineral Density and the Risk of Type-2 Diabetes in Postmenopausal Women: rs4988235 Polymorphism Associated with Lactose Intolerance Effects.

The study was conducted among 607 female patients in the postmenopausal period in whom bone densitometry and vitamin-D3 levels were assayed and genotyping of the rs4988235 polymorphism of MCM6 gene was performed. The obtained results were analysed for the presence of T2DM, obesity surrogates, medical data, and past medical history. The distribution of genotype frequencies was consistent with the Hardy-Weinberg equilibrium (p > 0.050). Postmenopausal women with the GG homozygote of rs4988235 polymorphism consumed significantly less calcium (dairy), which was probably related to the observed lactose intolerance. The GG homozygote of women with rs4988235 polymorphism was significantly more likely to have T2DM relative to the A allele carriers (p = 0.023). GG homozygotes had significantly lower femoral-vertebral mineral density despite the significantly more frequent supplementation with calcium preparations (p = 0.010), vitamin D (p = 0.01), and anti-osteoporotic drugs (p = 0.040). The obtained results indicate a stronger loss of femoral-neck mineral density with age in the GG homozygotes relative to the A allele carriers (p = 0.038). In the population of women after menopause, the carriage of the G allele of rs4988235 polymorphism of the MCM6 gene, i.e., among the patients with lactose intolerance, significantly increased the risk of developing T2DM and the loss of BMD.

Disaccharidase deficiencies and gastrointestinal symptoms in patients referred to gastroscopic examination: a single center study from Norway

Objective Gastrointestinal illnesses have been reported in relation to low disaccharidase activity, yet both the prevalence of disaccharidase deficiency and its association with gastrointestinal symptoms and irritable bowel syndrome (IBS) are largely unknown. We aimed to determine the association between low activity of disaccharidase enzymes on gastrointestinal symptoms and presence of IBS. Methods Patients referred for gastroscopic examination due to gastrointestinal complaints were consecutively included. A pinch biopsy was taken from the distal part of duodenum, and disaccharidase activity was measured using the Dahlqvist method. Gastrointestinal symptom severity was measured using IBS-Symptom Severity Score (IBS-SSS). Results A total of 40 patients were included. Disaccharidase deficiency was detected in 24 patients (60%). Half of the patients (n = 21) had IBS according to Rome IV criteria. A majority (75%) of all patients reported moderate to severe gastrointestinal symptoms. Moderate to severe gastrointestinal symptoms were reported by 16 patients (67%) with disaccharidase deficiency and in 14 patients (88%) with normal disaccharidase activity. Lactase deficiency was detected in 22 patients (55%), maltase deficiency in 11 patients (28%), sucrase deficiency in 9 patients (23%), isomaltase deficiency in 13 patients (33%) and glucoamylase deficiency in 12 patients (30%). The activity of all enzymes was reduced in 8 patients (20%). Degree of disaccharidase deficiency was not associated with either the severity of gastrointestinal symptoms or the diagnosis of IBS. Enzymes levels were not associated with gastrointestinal symptom scores. Conclusion Our findings did not reveal any association between biochemically measured disaccharidase deficiency and gastrointestinal symptoms or the presence of IBS.

Plant-based probiotic foods: current state and future trends.

Plant-based probiotic foods (PBPFs) have recently become a notable choice for many consumers. While less recognized than dairy products, these foods offer efficient alternatives for individuals with lactose intolerance, vegans, or those aiming for more sustainable dietary practices. Traditional fermented PBPFs, such as kimchi, sauerkraut, and kombucha, are part of cultures from different countries and have gained more significant popularity in recent years globally due to their peculiar flavors and health benefits. However, new plant-based probiotic products have also been studied and made available to consumers of the growing demand in this sector. Therefore, this review discusses trends in plant-based probiotic production, known benefits, and characteristics. Challenges currently faced in manufacturing, distribution, marketing, consumer acceptance, and legislation are also discussed.

Correlations between in vitro gastrointestinal digestion of β-galactosidase/carboxymethylchitosan-silica dosage powder and its physicochemical properties

Oral administration of β-galactosidase, which alleviate lactose intolerance symptoms, is challenging due to its instability throughout the gastrointestinal tract. The objective of this work was to make correlations between the in-vitro digestion and chemical characteristics of a β-galactosidase/carboxymethylchitosan-silica biocatalyst powder. This was obtained by a one-pot silica gel route assisted by carboxymethyl chitosan, using maltose as lyoprotectant. The chemical characterization allowed to understand as was modulated the calcium incorporation, through electrostatic interactions and as maltose protects the enzyme from agglomeration, by vitrification and formation of hydrogen bonds. The formulated biocatalyst could be a complement of silicon and calcium, in turn, it preserves 96 % and 63 % of the enzymatic activity compared with the biocatalyst control (without simulated digestion), in the gastric and intestinal phases, respectively. This activity was even greater than that observed in the commercial products evaluated in these phases. Likewise, the biocatalyst obtained retained its activity after 12 months of storage at 25 °C and it did not present cytotoxicity in cells derived from human colon epithelial mucosa (NCM460) under the conditions and concentrations evaluated. These results make this biocatalyst in an excellent candidate for release of this enzyme. Therefore, it could be useful for lactose-intolerant people.