Abstract
Oral lactose and glucose/galactose loading tests were done in Bantu children convalescing from kwashiorkor and pellagra. Small bowel biopsies and disaccharidase estimations were performed in all except 2 patients. Lactose absorption was more impaired and intestinal lactase levels were lower in the pellagra than in the kwashiorkor group. The fact that diarrhoea after admission to hospital was less common in pellagra than kwashiorkor was ascribed to a lesser lactose load due to the early introduction of a mixed diet in the former group, in comparison with milk feeds only in the latter group. The absence of troublesome diarrhoea while on moderate quantities of lactose in the diet, in the presence of low intestinal lactase levels, but evidence of lactose malabsorption after loading, has a bearing on preventive and therapeutic nutrition programmes in non-Caucasian children. Lactase deficiency is not necessarily synonymous with symptomatic lactose intolerance if the threshold is not exceeded. Concern is expressed that excessive caution against the use of milk may lead to a worsening of infantile malnutrition in developing countries.
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- Alzate H., González H., Guzmán J. Lactose intolerance in South American Indians. Am J Clin Nutr. 1969 Feb;22(2):122–123. doi: 10.1093/ajcn/22.2.122. [DOI] [PubMed] [Google Scholar]
- BOWIE M. D., BRINKMAN G. L., HANSEN J. D. ACQUIRED DISACCHARIDE INTOLERANCE IN MALNUTRITION. J Pediatr. 1965 Jun;66:1083–1091. doi: 10.1016/s0022-3476(65)80095-6. [DOI] [PubMed] [Google Scholar]
- BOWIE M. D., BRINKMAN G. L., HANSEN J. D. DIARRHOEA IN PROTEIN-CALORIE MALNUTRITION. Lancet. 1963 Sep 14;2(7307):550–551. doi: 10.1016/s0140-6736(63)92645-x. [DOI] [PubMed] [Google Scholar]
- Bayless T. M., Huang S. S. Inadequate intestinal digestion of lactose. Am J Clin Nutr. 1969 Mar;22(3):250–256. doi: 10.1093/ajcn/22.3.250. [DOI] [PubMed] [Google Scholar]
- Bayless T. M., Rosensweig N. S. A racial difference in incidence of lactase deficiency. A survey of milk intolerance and lactase deficiency in healthy adult males. JAMA. 1966 Sep 19;197(12):968–972. [PubMed] [Google Scholar]
- Bolin T. D., Crane G. G., Davis A. E. Lactose intolerance in various ethnic groups in South-East Asia. Australas Ann Med. 1968 Nov;17(4):300–306. doi: 10.1111/imj.1968.17.4.300. [DOI] [PubMed] [Google Scholar]
- Bolin T. D., Davis A. E. Primary lactase deficiency: genetic or acquired? Am J Dig Dis. 1970 Jul;15(7):679–692. doi: 10.1007/BF02236031. [DOI] [PubMed] [Google Scholar]
- CUATRECASAS P., LOCKWOOD D. H., CALDWELL J. R. LACTASE DEFICIENCY IN THE ADULT. A COMMON OCCURRENCE. Lancet. 1965 Jan 2;1(7375):14–18. doi: 10.1016/s0140-6736(65)90922-0. [DOI] [PubMed] [Google Scholar]
- Chandra R. K., Pawa R. R., Ghai O. P. Sugar intolerance in malnourished infants and children. Br Med J. 1968 Dec 7;4(5631):611–613. doi: 10.1136/bmj.4.5631.611. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Chung M. H., McGill D. B. Lactase deficiency in Orientals. Gastroenterology. 1968 Feb;54(2):225–226. [PubMed] [Google Scholar]
- Cook G. C., Kajubi S. K. Tribal incidence of lactase deficiency in Uganda. Lancet. 1966 Apr 2;1(7440):725–729. doi: 10.1016/s0140-6736(66)90888-9. [DOI] [PubMed] [Google Scholar]
- Cook G. C. Lactase activity in newborn and infant Baganda. Br Med J. 1967 Mar 4;1(5539):527–530. doi: 10.1136/bmj.1.5539.527. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DAHLQVIST A. METHOD FOR ASSAY OF INTESTINAL DISACCHARIDASES. Anal Biochem. 1964 Jan;7:18–25. doi: 10.1016/0003-2697(64)90115-0. [DOI] [PubMed] [Google Scholar]
- Davis A. E., Bolin T. Lactose intolerance in asians. Nature. 1967 Dec 23;216(5121):1244–1245. doi: 10.1038/2161244a0. [DOI] [PubMed] [Google Scholar]
- Desai H. G., Gupte U. V., Pradhan A. G., Thakkar K. D., Antia F. P. Incidence of lactase deficiency in control subjects from India. Role of hereditary factors. Indian J Med Sci. 1970 Nov;24(11):729–736. [PubMed] [Google Scholar]
- Dubois R. S., Roy C. C., Fulginiti V. A., Merrill D. A., Murray R. L. Disaccharidase deficiency in children with immunologic deficits. J Pediatr. 1970 Mar;76(3):377–385. doi: 10.1016/s0022-3476(70)80476-0. [DOI] [PubMed] [Google Scholar]
- Huang S. S., Bayless T. M. Lactose intolerance in healthy children. N Engl J Med. 1967 Jun 8;276(23):1283–1287. doi: 10.1056/NEJM196706082762303. [DOI] [PubMed] [Google Scholar]
- Jersky J., Kinsley R. H. Lactose deficiency in the South African Bantu. S Afr Med J. 1967 Dec 16;41(46):1194–1196. [PubMed] [Google Scholar]
- Jussila J. Milk intolerance and lactose malabsorption in hospital patients and young servicemen in Finland. Ann Clin Res. 1969 Nov;1(3):199–207. [PubMed] [Google Scholar]
- LOWRY O. H., ROSEBROUGH N. J., FARR A. L., RANDALL R. J. Protein measurement with the Folin phenol reagent. J Biol Chem. 1951 Nov;193(1):265–275. [PubMed] [Google Scholar]
- McCracken R. D. Adult lactose tolerance. JAMA. 1970 Sep 28;213(13):2257–2260. [PubMed] [Google Scholar]
- PRADER A., AURICCHIO S. DEFECTS OF INTESTINAL DISACCHARIDE ABSORPTION. Annu Rev Med. 1965;16:345–358. doi: 10.1146/annurev.me.16.020165.002021. [DOI] [PubMed] [Google Scholar]
- Prinsloo J. G., Du Plessis J. P., Kruger H., De Lange D. J., De Villiers L. S. Protein nutrition status in childhood pellagra. Evaluation of nicotinic acid status and creatinine excretion. Am J Clin Nutr. 1968 Jan;21(1):98–106. doi: 10.1093/ajcn/21.1.98. [DOI] [PubMed] [Google Scholar]
- Prinsloo J. G., Wittmann W., Pretorius P. J., Kruger H., Fellingham S. A. Effect of different sugars on diarrhoea of acute kwashiorkor. Arch Dis Child. 1969 Oct;44(237):593–599. doi: 10.1136/adc.44.237.593. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Welsh J. D., Rohrer G. V., Walker A. Human intestinal disaccharidase activity. I. Normal individuals. Arch Intern Med. 1966 Apr;117(4):488–494. [PubMed] [Google Scholar]