Dietary approaches to alleviation of lactose maldigestion / Efectos de la dieta sobre la digestión de la lactosa

Because dairy products are a significant source of essential nutrients, elimination of all dairy foods in the diet would be nutritionally unwise and is usually not necessary in the case of lactose maldigestion. About 250 ml milk/d can generally be taken without adverse effects. If milk is taken in combination with solid foods, lactose malabsorption may be reduced by about 50%, probably due to a slower rate of colonic fermentation which may lower gastrointestinal symptoms in lactose malabsorbers. It is well established that, in lactase-deficient subjects, yoghurt is better tolerated than milk. This is only to some extent related to the fact that the lactose content of the products is reduced during fermentation, but is mainly attributed to the fact that the culture organisms- by virtue of being rich in lactase - are able to participate in the hydrolysis of ingested lactose. Up to 20 g of lactose in yoghurt is tolerated well by lactase-deficient persons. The enhanced absorp tion of lactose in yoghurt is explained as a result of the intestinal release of lactase from the yoghurt organisms. Ripened cheese is also tolerated very well by lactose-intolerant persons since virtually all of the lactose present is decomposed to lactic acid and other metabolites.